Streamlining Adult Autism Diagnosis: High-yield DSM-5-TR Predictors and Sex-Based Considerations.

Area of Science:

• Neurodevelopmental disorders
• Psychiatry
• Clinical psychology

Background:

• Autism Spectrum Disorder (ASD) diagnosis in adults presents unique challenges.
• DSM-5-TR criteria are the standard for diagnosis, but their predictive power in adults requires further investigation.
• Understanding sex-based differences in diagnostic prediction is crucial for equitable healthcare.

Purpose of the Study:

• To identify which DSM-5-TR criteria most accurately predict autism diagnosis in adults.
• To determine if predictive patterns for autism diagnosis vary by sex assigned at birth.
• To enhance the efficiency and accuracy of adult autism evaluations.

Main Methods:

• A study involving 234 adults seeking telehealth autism evaluations was conducted.
• Neurodivergent researchers and autistic community members contributed to the study design.
• Licensed psychologists used structured interviews and standardized measures to rate DSM-5-TR domains.

Main Results:

• Social-emotional reciprocity (OR=5.21) and nonverbal communication (OR=4.82) were the strongest predictors of an autism diagnosis.
• Need for routines (OR=2.57) and repetitive behaviors (OR=2.20) also showed predictive utility.
• Intense interests and sensory processing differences had limited predictive value; sex assigned at birth had minimal impact on prediction.

Conclusions:

• Clinicians should prioritize assessing social-emotional reciprocity and nonverbal communication in adult autism evaluations.
• Focusing on these core domains can improve diagnostic efficiency and accuracy.
• These findings support a more targeted approach to adult autism assessment.