Development and validation of DSM-5 based diagnostic tool for children with Autism Spectrum Disorder.

Area of Science:

• Child and Adolescent Psychiatry
• Neurodevelopmental Disorders
• Diagnostic Tools

Background:

• The previous INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD) was based on DSM-IV-TR criteria.
• The transition to DSM-5 necessitated an updated diagnostic instrument for Autism Spectrum Disorder (ASD).
• Existing tools required modification to reflect the latest diagnostic criteria for ASD.

Purpose of the Study:

• To develop and validate a revised diagnostic tool for Autism Spectrum Disorder (ASD) based on DSM-5 criteria.
• To create the All India Institute of Medical Sciences (AIIMS)-Modified-INDT-ASD tool.
• To ensure the new tool is suitable for use in low- and middle-income countries (LMICs).

Main Methods:

• The AIIMS-Modified-INDT-ASD tool was developed using the Delphi method, incorporating rearranged and new questions (including sensory symptoms).
• Validation was performed against the DSM-5 diagnostic criteria for ASD.
• Receiver operating characteristic (ROC) curves were employed to determine the optimal score cutoff for ASD severity, comparing with the Childhood Autism Rating Scale (CARS).

Main Results:

• The study enrolled 225 children (159 boys, median age 47 months).
• The AIIMS-Modified-INDT-ASD tool demonstrated high diagnostic accuracy with 98.4% sensitivity and 91.7% specificity for ASD.
• A cutoff score of ≥14 indicated severe ASD (CARS > 36.5) with 80% sensitivity and 80.7% specificity (AUC = 0.89).

Conclusions:

• The AIIMS-Modified-INDT-ASD tool is a simple, structured instrument aligned with DSM-5 criteria.
• The tool facilitates the diagnosis of Autism Spectrum Disorder (ASD) with acceptable accuracy.
• This revised tool is valuable for diagnosing ASD, especially in resource-limited settings.