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J Psychopathol Behav Assess. 2018 Sep 1;40(3):367-375. doi: 10.1007/s10862-018-9642-1. Epub 2018 Jan 20.

Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder.

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Department of Pediatrics, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY 10065, USA.
Division of Pediatric Neurology, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY, USA.
Department of Neurology & Neuroscience, Weill Cornell Medical College, New York, NY, USA.
Clinical and Translational Science Center, Weill Cornell Medical College, New York, NY, USA.


To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II). Detailed developmental and medical history was obtained from all participants. Diagnosis was based on clinical consensus of at least two expert clinicians, using test results, clinical observations, and parent report. 23% of participants with a reported community diagnosis of ASD were classified as non-spectrum based on our consensus diagnosis. ASD and non-spectrum participants did not differ on age at evaluation and age of first community diagnosis. Non-verbal IQ scores and Adaptive Behavior Composite scores were significantly higher in the non-spectrum group compared to the ASD group (104.5 ± 21.7 vs. 80.1 ± 21.6, p < .01; 71.1 ± 15 versus 79.5 ± 17.6, p < .05, respectively). Participants enrolled with community diagnosis of PDD-NOS were significantly more likely to be classified as non-spectrum on the study consensus diagnosis than Participants with Autism or Asperger (36% versus 9.5%, Odds Ratio = 5.4, p < .05). This study shows suboptimal agreement between community diagnoses of ASD and consensus diagnosis using standardized instruments. These findings are based on limited data, and should be further studied, taking into consideration the influence of DSM 5 diagnostic criteria on ASD prevalence.


Autism; Autism diagnostic observation schedule (ADOS); Autism spectrum disorder (ASD); Pervasive developmental delay not otherwise specified (PDD-NOS)

Conflict of interest statement

Conflict of Interest: Moran Hausman-Kedeml, Barry E. Kosofsky, Gail Ross, Kaleb Yohay, Emily Forrest, Margaret H. Dennin, Reena Patel, Kristen Bennett, James P. Holahan and Mary J. Ward declare that there is no conflict of interest.

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