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Area of Science:

  • Developmental Psychology
  • Clinical Psychology
  • Neurodevelopmental Disorders

Background:

  • The Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) is a standardized assessment for autism spectrum disorder (ASD).
  • Existing ADOS-2 modules have revised algorithms and severity scores, except for Module 4, used with verbally fluent adults.

Purpose of the Study:

  • To revise the ADOS-2 Module 4 algorithm for adults.
  • To calibrate raw scores into metrics of ASD symptom severity.
  • To enhance diagnostic comparability across ADOS-2 modules.

Main Methods:

  • Revision of the ADOS-2 Module 4 diagnostic algorithm.
  • Calibration of overall and domain raw score totals.
  • Assessment of sensitivity and specificity of the revised algorithm.

Main Results:

  • The revised Module 4 algorithm demonstrated sensitivity and specificity exceeding 80% in the study sample.
  • Calibrated severity scores provide quantitative, participant-independent estimates of ASD symptom severity.
  • The revised algorithm and scores improve score comparability across ADOS-2 modules.

Conclusions:

  • The revised ADOS-2 Module 4 algorithm and calibrated severity scores offer a more robust assessment for verbally fluent adults.
  • These enhancements facilitate more consistent ASD diagnosis and the study of symptom trajectories across the lifespan.
  • Improved comparability across ADOS-2 modules aids research and clinical practice.