title: Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD Without ID: A Multi-site Study.
abstract: Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verbal IQ below 85 or above 115, and ages 16 and older. Best practice diagnostic procedures should include the Module 4 in conjunction with other assessment tools. Balancing needs for sensitivity and specificity depending on the purpose of assessment (e.g., clinical vs. research) and demographic characteristics mentioned above will enhance its utility.
authors.affiliation: Center for Autism Spectrum Disorders & Children's National Research Institute, Children's National Health System, Washington, DC, USA. CPuglies@ChildrensNational.org.
authors.forename: Cara E
authors.initials: CE
authors.lastname: Pugliese
authors.affiliation: Center for Autism Spectrum Disorders & Children's National Research Institute, Children's National Health System, Washington, DC, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Kenworthy
authors.affiliation: Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA, USA.
authors.forename: Vanessa Hus
authors.initials: VH
authors.lastname: Bal
authors.affiliation: Department of Speech and Hearing Sciences, George Washington University, Washington, DC, USA.|Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Wallace
authors.affiliation: Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Psychiatry, Perelman School of Medicine - University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Yerys
authors.affiliation: Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Psychology, Virginia Tech, Blacksburg, VA, USA.
authors.forename: Brenna B
authors.initials: BB
authors.lastname: Maddox
authors.affiliation: Department of Psychology, Virginia Tech, Blacksburg, VA, USA.
authors.forename: Susan W
authors.initials: SW
authors.lastname: White
authors.affiliation: Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Haroon
authors.initials: H
authors.lastname: Popal
authors.affiliation: Center for Autism Spectrum Disorders & Children's National Research Institute, Children's National Health System, Washington, DC, USA.
authors.forename: Anna Chelsea
authors.initials: AC
authors.lastname: Armour
authors.affiliation: Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Psychiatry, Perelman School of Medicine - University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Miller
authors.affiliation: Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Psychiatry, Perelman School of Medicine - University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Herrington
authors.affiliation: Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Schultz
authors.affiliation: Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Martin
authors.affiliation: Center for Autism Spectrum Disorders & Children's National Research Institute, Children's National Health System, Washington, DC, USA.
authors.forename: Laura Gutermuth
authors.initials: LG
authors.lastname: Anthony
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001321:Autistic Disorder / Q000175:diagnosis*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008875:Middle Aged
keywords: Adolescents; Adults; Autism diagnostic observation schedule; Autism spectrum disorder; Diagnosis; Sensitivity; Specificity