The Accuracy of the ADOS-2 in Identifying Autism among Adults with Complex Psychiatric Conditions.
Brenna B Maddox, Edward S Brodkin, Monica E Calkins and 5 others
PMID 28589494WHAT IT FOUND
ADOS-2 flagged all six adults with autism, but 21 of 69 adults without autism also scored in the autism range.
All those adults had psychosis, so social communication scores alone should not drive adult autism diagnosis.
Key findings
01The ADOS-2 placed all six adults with study-confirmed autism in the autism or ASD range, but 21 of 69 adults without autism also scored in that range on the revised algorithm.
02All 24 adults flagged without autism on either ADOS-2 algorithm had a lifetime history of psychosis.
03False positives had social communication scores similar to true autism cases, but lower restricted and repetitive behavior scores: mean 2.0 versus 4.7.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only six adults with autism were found, so the study could not make statistical comparisons between groups and cannot show how often false positives occur in all adults with psychiatric conditions. Developmental history was often missing from charts, and family interviews were completed for only 15 of 75 participants, so some diagnoses relied heavily on self-report. The evaluation did not include structured assessment of cognitive functioning or psychiatric disorders other than autism and psychosis, so other explanations for social communication scores were not fully examined. The sample came from community mental health services, and many participants had psychosis, so the results may not apply to less complex outpatient settings.
The easy way to misread this
Do not use a high ADOS-2 social communication score as proof of autism in adults with psychiatric conditions. In this sample, 21 of 69 adults without autism scored in the autism range, and all adults flagged without autism had lifetime psychosis.