Evaluating the Role of the Autism Diagnostic Observation Schedule in ASD Diagnoses by Developmental-Behavioral Pediatricians

April 21, 2020

The Developmental and Behavioral Pediatrics Research Network (DBPNet) is conducting an MCHB-funded, multicenter study to evaluate the role of the Autism Diagnostic Observation Schedule (ADOS-2) in the diagnosis of Autism Spectrum Disorder (ASD) among children ages 18 months to 6 years. The ADOS-2 is widely viewed as essential to the diagnosis of ASD in children, despite the fact that the ADOS-2 was developed to be used as one component of a diagnostic assessment for ASD. Administration of the ADOS-2 requires specific training and adds time and cost to the diagnostic assessment, potentially limiting access to timely ASD diagnosis. The extent to which the ADOS-2 is utilized in academic Developmental-Behavioral Pediatric (DBP) Programs varies widely, and there is inadequate research on the circumstances in which the ADOS-2 is necessary for accurate ASD diagnosis by Developmental-Behavioral Pediatricians (DBPs). Nevertheless, in some parts of the US, results from an ADOS are required in order for children to access ASD-specific services and intervention.

The DBPNet ADOS study has successfully enrolled nearly 350 subjects across 7 DBPNet sites in the US. In addition, colleagues in Linz, Austria have independently collected data on nearly 40 additional subjects, employing the same approach as the US sites.

Data analysis is underway to determine the frequency with which the results of an ADOS-2 alter the diagnostic conclusion of a Developmental-Behavioral pediatrician who is evaluating a child aged 18 months-5 years, 11 months for possible ASD. We will also evaluate child and clinician characteristics that impact the extent to which results from the ADOS-2 contribute to final diagnostic conclusions. Ultimately, we hope that these findings will improve the evidence-base for accurate, efficient ASD diagnostic assessments that may, in turn, improve access to diagnostic services for children with ASD.