Study finds wide variation in best-estimate clinical diagnosis of autism spectrum disorders

November 7, 2011, JAMA and Archives Journals

In a study conducted at 12 university-based research sites, there was wide variation in how best-estimate clinical diagnoses within the autism spectrum were assigned to individual children, according to a study being published Online First by the Archives of General Psychiatry.

In the field of (ASDs), diagnostic instruments have been helpful in defining populations, merging samples, and comparing results across studies, according to background information in the article. Nevertheless, best-estimate clinical (BEC) diagnoses of specific autism spectrum disorders have long been the gold standard. These specific ASDs include autistic disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger syndrome.

Catherine Lord, Ph.D., of Weill Cornell Medical College, White Plains, New York, and colleagues conducted an observational study to determine whether the relationships between behavioral appearance and clinical diagnoses of different ASDs vary across 12 university-based sites. The study included 2,102 participants (1,814 male) between 4 and 18 years of age who met autism spectrum criteria on two diagnostic assessments and who had a of an . The study authors collected demographic, diagnostic, and developmental data for .

The authors report that clinical distinctions among categorical diagnostic ASD subtypes were not reliable, even across sites with well-documented fidelity using standardized diagnostic instruments.

"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," the authors write.

"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," they continue.

The authors suggest that differences in diagnoses could reflect regional variations. "For example, in some regions, children with diagnoses of autistic disorder receive different services than do children with other ASD diagnoses; elsewhere, autistic disorder diagnoses may be avoided as more stigmatizing than diagnoses of PDD-NOS or Asperger syndrome," they write.

The authors point out that their study results have implications for revisions of current diagnostic frameworks. "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," they conclude.

Explore further: New findings validate the accuracy of autism diagnosis in children with Down syndrome

More information: Arch Gen Psychiatry. Published online November 7, 2011. doi:10.1001/archgenpsychiatry.2011.148

Related Stories

New findings validate the accuracy of autism diagnosis in children with Down syndrome

October 4, 2011
New findings from a 16-year study confirm that the Diagnostic and Statistic Manual of Mental Disorders (DSM), the gold-standard for the classification of mental health conditions, can be used to accurately identify autism ...

Approach to autism may increase autism spectrum disorder prevalence estimates in children worldwide

May 10, 2011
Autism may be more common worldwide than previously thought, according to researchers from the George Washington University (GW) and Yale University. The researchers conducted an autism prevalence study for the first time ...

Study estimates rate of autism spectrum disorder in adults in England

May 2, 2011
In England, the prevalence of adults with autism spectrum disorder (ASD) was estimated to be 9.8 per 1,000 population, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Recommended for you

Researchers find increased risk of birth defects in babies after first-trimester exposure to lithium

June 18, 2018
Researchers from the Icahn School of Medicine at Mount Sinai found an elevated risk of major congenital malformations in fetuses after first-trimester exposure to lithium, in the largest study ever to examine the risk of ...

Changing room playlist could give World Cup teams the edge

June 18, 2018
Blasting out Rihanna or Kanye West could give World Cup squads that crucial psychological edge over rival teams, suggests research from Brunel University London.

Helicopter parenting may negatively affect children's emotional well-being, behavior

June 18, 2018
It's natural for parents to do whatever they can to keep their children safe and healthy, but children need space to learn and grow on their own, without Mom or Dad hovering over them, according to new research published ...

Nature programmes could put a spring in your step

June 18, 2018
New research shows that watching TV programmes such as the BBC's Springwatch and Countryfile might actually be good for you.

iReadMore app improves reading ability of stroke patients

June 18, 2018
A new smart app designed to improve the reading ability of people who have suffered a stroke provides 'significant' improvements, a UCL study has found.

Childhood sibling dynamics may predict differences in college education

June 18, 2018
The effects of sibling relationships may go beyond childhood bickering and bonding, according to Penn State researchers who found that these relationships may predict similarities and differences in siblings' education later ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.