Racial-Ethnic Comparisons of ADOS-2 Algorithms for Young Verbal Children | JoVE Visualize

Area of Science:

Developmental Psychology
Clinical Psychology
Psychometrics

Background:

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is a key tool for diagnosing Autism Spectrum Disorder (ASD).
Ensuring the ADOS-2 functions equitably across diverse demographic groups, particularly young children from various racial and ethnic backgrounds, is crucial for accurate diagnosis.
Previous research has explored Differential Item Functioning (DIF) in older populations, but less is known about its impact in preschool-aged children.

Purpose of the Study:

To conduct a comparative analysis of ADOS-2 Module 1 and Module 2 algorithmic items between Black, Hispanic, and White children aged 3-5.
To investigate the presence and impact of Differential Item Functioning (DIF) and Differential Test Functioning (DTF) on ADOS-2 subscales for preschool-aged children.
To determine if observed DIF patterns align with findings from studies on older populations.

Main Methods:

Utilized data from the Study to Explore Early Development (SEED) involving 918 children for Module 1 and 881 for Module 2.
Performed comparative analyses of ADOS-2 Module 1 (Some Words) and Module 2 (Phrase Speech) items across racial and ethnic groups (Black, Hispanic, White).
Assessed for Significant Differential Item Functioning (DIF) on Social Affect and Restrictive Repetitive Behavior (RRB) items and Differential Test Functioning (DTF) for each subscale.

Main Results:

Significant DIF was identified on ADOS-2 Social Affect and Restrictive Repetitive Behavior (RRB) items in both modules.
Differential Test Functioning (DTF) was minimal, with values close to zero for each subscale (range: -0.07 to 0.08).
No clear patterns emerged when comparing these results with studies on older populations, suggesting unique sample variance may influence item-level differences.

Conclusions:

While item-level scoring differences (DIF) exist on the ADOS-2 for preschool-aged children of different racial and ethnic backgrounds, these are unlikely to affect overall scale interpretations.
The minimal DTF suggests that the ADOS-2 subscales maintain measurement consistency across these groups at the test level.
Findings indicate that clinicians can generally rely on ADOS-2 scale-level interpretations for preschool-aged children regardless of their racial or ethnic background.