Identifying High Ability Children with DSM-5 Autism Spectrum or Social Communication Disorder: Performance on Autism...

Area of Science:

• Neurodevelopmental Disorders
• Psychiatric Diagnostics

Background:

• The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) revised diagnostic criteria for Autism Spectrum Disorder (ASD).
• Previous research (Mazefsky et al., 2013) investigated diagnostic criteria in high-ability individuals with ASD.

Purpose of the Study:

• To replicate Mazefsky et al.'s study using DSM-5 criteria.
• To evaluate the diagnostic utility of the Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview-Revised (ADI-R) for ASD and Social Communication Disorder (SCD) under DSM-5.

Main Methods:

• Replication study involving 45 high-ability children and adolescents diagnosed with ASD under DSM-IV-TR.
• Mapping items from the ADOS and ADI-R to DSM-5 criteria for ASD and SCD.
• Analyzing diagnostic outcomes when ADOS is used alone versus combined with ADI-R.

Main Results:

• If ADOS were administered alone, 62% of participants diagnosed with ASD would not meet DSM-5 criteria.
• When ADOS and ADI-R scores were combined, 100% of participants continued to meet ASD diagnosis under DSM-5.
• The ADOS was found to be insufficient for diagnosing SCD due to limited algorithm items.

Conclusions:

• The ADI-R is crucial for maintaining ASD diagnosis in high-ability individuals when transitioning to DSM-5 criteria.
• The ADOS requires enhancement or new measures are needed for accurate SCD diagnosis.
• Diagnostic tools must align with evolving criteria for reliable ASD and SCD assessment.