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The Relative Utility of Concurrent Sources of Information for Diagnosis of Autism Spectrum Disorder in Early
Sara Arastoo1,2, Maryam M Abdullah2,3, Julie Youssef2,4
1David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
Insights
Parental concerns about Autism Spectrum Disorder (ASD) showed moderate agreement with physician diagnoses. The Autism Diagnostic Observation Schedule (ADOS) strongly correlated with physician diagnoses, supporting its use in tiered screening for early ASD identification.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Public Health
Background:
- Effective early childhood screening for Autism Spectrum Disorder (ASD) is a global public health priority.
- Understanding the alignment between parental concerns and formal ASD diagnostic methods is crucial for timely intervention.
- Limited research exists on the concurrence of parental ASD suspicion, ADOS classification, and physician diagnosis.
Purpose of the Study:
- To investigate the relationships between parental ASD concern, Autism Diagnostic Observation Schedule (ADOS) classification, and physician specialist diagnosis.
- To assess the concordance of these measures in toddlers evaluated for ASD.
- To inform screening strategies, particularly in resource-limited settings.
Main Methods:
- Evaluated 134 toddlers (mean age 31.8 months) at a specialized university center.
- Collected data on parental ASD concern, ADOS classification, and physician diagnosis.
- Analyzed the correspondence between parental suspicion and physician diagnosis (61%), parental suspicion and ADOS (57%), and ADOS and physician diagnosis (88%).
Main Results:
- A 61% correspondence was found between parental ASD suspicion and physician diagnosis (p=0.028).
- The correspondence between parental ASD suspicion and ADOS classification was 57% (p=0.483).
- High concordance (88%, p=0.001) was observed between ADOS classification and physician diagnosis.
Conclusions:
- The strong agreement between ADOS classification and physician diagnosis supports using trained ADOS evaluators in tiered screening processes.
- This approach can identify children needing specialist evaluation, especially in areas with limited access to physicians.
- Empowering parents with developmental monitoring and encouraging communication with providers can facilitate earlier ASD identification and intervention, improving long-term outcomes.
Abstract:
The development of effective screening methods for Autism Spectrum Disorder (ASD) in early childhood remains a public health priority for communities around the world. Little is known regarding the concurrence between parent concerns about ASD and formal ASD diagnostic methods. This study aimed to examine the relationships among a priori parental ASD concern, ADOS classification, and a physician specialist's diagnosis. One hundred and thirty-four toddlers (74% male; mean age = 31.8 months, SD 4.4) received an evaluation at a university center specializing in ASD and neurodevelopmental disorders. Correspondence between a priori parental ASD suspicion and physician diagnosis of ASD was 61% (p = 0.028). Correspondence between a priori parental suspicion of ASD and ADOS ASD classification was 57% (p = 0.483). Correspondence between ADOS classification and physician diagnosis of ASD was 88% (p = 0.001). Our results have implications for evaluations in low resource regions of the world where access to physician specialists may be limited; the high correspondence between ADOS classification and a physician specialist's diagnosis supports the use of trained ADOS evaluators, such as field health workers or early childhood educators, in a tiered screening process designed to identify those most in need of a specialist's evaluation. Our results also have implications for public health efforts to provide parent education to enable parents to monitor their child's development and share concerns with their providers. Parent awareness and expression of concern coupled with timely responses from providers may lead toward earlier identification of ASD, and other neurodevelopmental disorders, and hence, generate opportunities for earlier and more personalized intervention approaches, which in turn may help improve long-term outcomes. Empowering parents and community members to screen for ASD may be especially important in regions of the world where access to formal diagnosis is limited.
