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J Autism Dev Disord (2008) 38:764770 DOI 10.1007/s10803-007-0448-3
ORIGINAL PAPER
Reliability of the ADI-R: Multiple Examiners Evaluate a Single Case
Domenic V. Cicchetti Catherine Lord Kathy Koenig Ami Klin Fred R. Volkmar
Published online: 5 December 2007 Springer Science+Business Media, LLC 2007
Abstract The authors assessed the reliability of the Autism Diagnostic Interview (ADI-R). Seven Clinical Examiners evaluated a three and one half year old female toddler suspected of being on the Autism Spectrum. Examiners showed agreement levels of 9496% across all items, with weighted kappa (Kw) between .80 and .88. They were in 100% agreement on 74% of the items; in excellent agreement on 6% of the items (9396%, with Kw between .78 and .85); in good agreement on 7% (89 90%, with Kw between .62 and 0.68); and in fair agreement on 3% (82 84%, with Kw between .40 and .47). For the remaining 10% of ADI-R items, examiners showed poor agreement (5081% with Kw between -.67 and .37).
Keywords ADI-R Reliability Single Case
Introduction
The purpose of this research is to assess the reliability of the revised Autism Diagnostic Interview (ADI-R) (Rutter
et al. 2003) when multiple clinical examiners evaluate a single case.
In the administration of the ADI-R, the interviewer uses prompts to elicit the required information for each of the 111 items comprising this clinical instrument. The rst 10 items involve medical and psychological issues that may have aroused parental concerns, as well as ages at which key developmental milestones did or did not occur. The remaining 101 items are classied under the following rubrics: Communication (Items 1141e.g., Use of others body to communicate); Social development and play (Items 4269e.g., Sharing others pleasure and excitement); Interests and behaviors (Items 7085e.g., Unusual sensory interests); and General behaviors (Items 86111e.g., Self injury). Nearly all of the ADI-R items are to be scored in terms of whether the behavior is displayed Currently (C) or has Ever occurred (E). Finally, and as appropriate, several of the items are also scored as they have occurred at their Most Abnormal level (M). Excluding the 10 aforementioned items, this results in a total of 202 items (Fig. 1).
Method
Subjects/Research Design
Seven Clinical Examiners, from two sites, were trained in the administration of the ADI-R. Each examiner...