title: A multisite study of the clinical diagnosis of different autism spectrum disorders.
abstract: BACKGROUND
  Best-estimate clinical diagnoses of specific autism spectrum disorders (autistic disorder, pervasive developmental disorder-not otherwise specified, and Asperger syndrome) have been used as the diagnostic gold standard, even when information from standardized instruments is available.
  
  
  OBJECTIVE
  To determine whether the relationships between behavioral phenotypes and clinical diagnoses of different autism spectrum disorders vary across 12 university-based sites.
  
  
  METHODS
  Multisite observational study collecting clinical phenotype data (diagnostic, developmental, and demographic) for genetic research. Classification trees were used to identify characteristics that predicted diagnosis across and within sites.
  
  
  METHODS
  Participants were recruited through 12 university-based autism service providers into a genetic study of autism.
  
  
  METHODS
  A total of 2102 probands (1814 male probands) between 4 and 18 years of age (mean [SD] age, 8.93 [3.5] years) who met autism spectrum criteria on the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule and who had a clinical diagnosis of an autism spectrum disorder.
  
  
  METHODS
  Best-estimate clinical diagnoses predicted by standardized scores from diagnostic, cognitive, and behavioral measures.
  
  
  RESULTS
  Although distributions of scores on standardized measures were similar across sites, significant site differences emerged in best-estimate clinical diagnoses of specific autism spectrum disorders. Relationships between clinical diagnoses and standardized scores, particularly verbal IQ, language level, and core diagnostic features, varied across sites in weighting of information and cutoffs.
  
  
  CONCLUSIONS
  Clinical distinctions among categorical diagnostic subtypes of autism spectrum disorders were not reliable even across sites with well-documented fidelity using standardized diagnostic instruments. Results support the move from existing subgroupings of autism spectrum disorders to dimensional descriptions of core features of social affect and fixated, repetitive behaviors, together with characteristics such as language level and cognitive function.
authors: Institute for Brain Development, Weill Cornell Medical College, White Plains, NY 10605-1504, USA. cal2028@med.cornell.edu
authors: Catherine
authors: C
authors: Lord
authors: Eva
authors: E
authors: Petkova
authors: Vanessa
authors: V
authors: Hus
authors: Weijin
authors: W
authors: Gan
authors: Feihan
authors: F
authors: Lu
authors: Donna M
authors: DM
authors: Martin
authors: Opal
authors: O
authors: Ousley
authors: Lisa
authors: L
authors: Guy
authors: Raphael
authors: R
authors: Bernier
authors: Jennifer
authors: J
authors: Gerdts
authors: Molly
authors: M
authors: Algermissen
authors: Agnes
authors: A
authors: Whitaker
authors: James S
authors: JS
authors: Sutcliffe
authors: Zachary
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authors: Warren
authors: Ami
authors: A
authors: Klin
authors: Celine
authors: C
authors: Saulnier
authors: Ellen
authors: E
authors: Hanson
authors: Rachel
authors: R
authors: Hundley
authors: Judith
authors: J
authors: Piggot
authors: Eric
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authors: Fombonne
authors: Mandy
authors: M
authors: Steiman
authors: Judith
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authors: Miles
authors: Stephen M
authors: SM
authors: Kanne
authors: Robin P
authors: RP
authors: Goin-Kochel
authors: Sarika U
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authors: Peters
authors: Edwin H
authors: EH
authors: Cook
authors: Stephen
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authors: Guter
authors: Jennifer
authors: J
authors: Tjernagel
authors: Lee Anne
authors: LA
authors: Green-Snyder
authors: Somer
authors: S
authors: Bishop
authors: Amy
authors: A
authors: Esler
authors: Katherine
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authors: Gotham
authors: Rhiannon
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authors: Luyster
authors: Fiona
authors: F
authors: Miller
authors: Jennifer
authors: J
authors: Olson
authors: Jennifer
authors: J
authors: Richler
authors: Susan
authors: S
authors: Risi
mesh_terms: D000293:Adolescent; D020817:Asperger Syndrome / Q000175:diagnosis / Q000523:psychology; D001321:Autistic Disorder / Q000175:diagnosis / Q000523:psychology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests