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Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by persistent deficits in social communication and interaction alongside restrictive and repetitive behaviors or interests. ASD is sometimes accompanied by intellectual impairment.
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Modeling, a key technique in therapy, uses observational learning to help clients acquire and practice new skills by watching therapists demonstrate desired behaviors. This approach, rooted in Albert Bandura's concept of vicarious learning, plays a significant role in therapeutic interventions for various psychological conditions, including social anxiety, ADHD, and depression.
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An Examination of Racial Bias in Scoring the Autism Diagnostic Observation Schedule (ADOS) Module 3: An Item Response

Yuen Yvonne Yu1,2, Austin Wyman3, Calliana J Faulk2

  • 1Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.

Autism Research : Official Journal of the International Society for Autism Research
|December 24, 2025
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Summary

This study found small racial bias in some Autism Diagnostic Observation Schedule (ADOS) items, affecting minority children more. However, this bias is statistically, not clinically, significant for autism diagnosis.

Keywords:
ADOSautismdifferential item functioningitem response theoryracial bias

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Area of Science:

  • Neurodevelopmental disorders
  • Psychometrics
  • Clinical assessment

Background:

  • Autism prevalence is rising, particularly among racial minority children in the U.S.
  • Persistent disparities exist in autism service utilization among minority groups.
  • The Autism Diagnostic Observation Schedule (ADOS) is a key diagnostic tool with potential for bias.

Purpose of the Study:

  • To investigate potential racial bias in specific items of the ADOS Module 3.
  • To analyze differential item functioning (DIF) across racial groups.
  • To determine the clinical significance of observed bias in autism diagnosis.

Main Methods:

  • Utilized unidimensional item response theory graded response models.
  • Analyzed data from a sample of 735 children.
  • Examined differential item functioning (DIF) for items within ADOS Module 3.

Main Results:

  • Three ADOS Module 3 items (A1, A5, D5) exhibited significant racial bias.
  • Black/African American and Asian children were more likely rated as exhibiting autistic behaviors than White children at similar autism levels.
  • The impact of bias on overall ADOS scores was minimal (0.23 for Black/African American, 0.16 for Asian children) and did not affect classification.

Conclusions:

  • A small, statistically detectable racial bias exists in specific ADOS items.
  • The identified bias is not clinically significant and does not impact autism diagnosis.
  • This study is the first to analyze Asian children and examine all items in the most common ADOS module.