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J Autism Dev Disord (2017) 47:460471 DOI 10.1007/s10803-016-2973-4
http://crossmark.crossref.org/dialog/?doi=10.1007/s10803-016-2973-4&domain=pdf
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Identifying High Ability Children withDSM-5 Autism Spectrum orSocial Communication Disorder: Performance onAutism Diagnostic Instruments
MeganFoley-Nicpon1,2 StaciL.Fosenburg1 KristinG.Wurster1 SusanG.Assouline1,2
Published online: 24 November 2016 Springer Science+Business Media New York 2016
Abstract This study was a replication of Mazefsky etal.s (Journal of Autism and Developmental Disabilities 43:12361242, 2013) investigation among a sample of 45 high ability children and adolescents diagnosed with ASD under DSM-IV-TR. Items from the ADOS and ADI-R were mapped onto DSM-5 diagnostic criteria for ASD and SCD to determine whether participants would meet either diagnosis under DSM-5. If the ADOS were administered alone, 62% of individuals diagnosed with ASD would no longer meet criteria under DSM-5; however, when the ADI-R and ADOS scores were combined, 100% of individuals would continue to meet ASD diagnosis. The ADOS was determined to be an insufficient measure for SCD due to the small number of algorithm items measuring SCD diagnostic criteria, suggesting the development of SCD measures is required.
Keywords ASD Autism High ability SCD DSM-5
Introduction
The Autism Diagnostic Interview, Revised (ADI-R; Rutter etal. 2003) and the Autism Diagnostic Observation Schedule (ADOS; Lord etal. 2002), which was recently revised (ADOS-2; Lord etal. 2012), are considered the gold standards in autism research and clinical identication. These
* Megan Foley-Nicpon [email protected]
1 The University ofIowa, N361 Lindquist Center, IowaCity, IA52242, USA
2 The University ofIowa, 600 Blank Honors Center, IowaCity, IA52242, USA
instruments have generally good sensitivity (true positive rate), specicity (true negative rate), and clinical utility (Lord etal. 2000). Less is known about their utility among high functioning populations, and no studies have specically examined diagnostic eectiveness among high ability children (i.e., children with ability scores of 120 [92nd percentile] or above) with autism spectrum disorder (ASD). Furthermore, with the advent of the new diagnostic category, Social Communication Disorder (SCD; American Psychiatric Association [APA] 2013), it is unclear whether existing ASD diagnostic instruments suffice in identifying children who may no longer meet criteria for ASD under the DSM-5 diagnostic guidelines. This is an important question because of similarities between SCD and ASD (APA 2013), the lack of diagnostic instruments specically for SCD (van Steensel etal. 2015), and the opinion that...