Modification and Validation of an Autism Observational Assessment Including ADOS-2^® for Use with Children with Visual...

Area of Science:

• Developmental Psychology
• Clinical Psychology
• Pediatric Medicine

Background:

• Children with visual impairment (VI) face an increased risk of autism spectrum disorder (ASD).
• Standard diagnostic tools for ASD, like the Autism Diagnostic Observation Schedule (ADOS-2), are not validated for children with VI.
• Accurate diagnosis is crucial for timely intervention and support for children with VI and potential ASD.

Purpose of the Study:

• To validate a modified version of the ADOS-2, Module 3, specifically for assessing ASD in children with VI.
• To establish the reliability, construct validity, and criterion validity of the modified ADOS-2 for this population.
• To determine the frequency and distribution of ASD ratings in children with VI.

Main Methods:

• A cross-sectional observational study involving 100 children (mean age 5.5 years) with moderate to profound VI.
• 83 verbally fluent children were assessed using the modified ADOS-2 (Module 3).
• Scores were compared against expert clinical formulation and parent-rated questionnaires (SRS-2, CCC-2) to assess validity.

Main Results:

• The modified ADOS-2 (Module 3) demonstrated strong internal coherence, construct validity, and inter-rater reliability.
• A new diagnostic algorithm for VI populations showed high sensitivity and specificity compared to clinician assessments.
• The tool exhibited strong concurrent criterion validity with parent-rated social responsiveness scales.

Conclusions:

• The modified ADOS-2 (Module 3) is a reliable and valid instrument for identifying children with VI at high risk for ASD.
• This validated tool addresses a critical gap in diagnostic assessments for this vulnerable group.
• The study confirmed elevated rates of ASD in the visually impaired population, aligning with prior research.