Abstract
Five years after the publication of DSM-5 in 2013, three widely-used diagnostic instruments have published algorithms designed to represent its (sub)criteria for Autism Spectrum Disorder (ASD) in children and adolescents. This study aimed to: (1) establish the content validity of these three DSM-5-adapted algorithms, and (2) identify problems with the operationalization of DSM-5 diagnostic criteria in measurable and observable behaviors. Algorithm items of the Autism Diagnostic Observation Schedule - Second Edition (ADOS-2), Developmental, Dimensional and Diagnostic Interview (3di) and Diagnostic Interview for Social and Communication Disorders - 11th edition (DISCO-11) were mapped onto DSM-5 sub-criteria. The development and decision-making rules integrated in their algorithms were then compared with DSM-5. Results demonstrated significant variability in the number and nature of sub-criteria covered by the ADOS-2, 3di and DISCO-11. In addition to differences in the development of algorithms and cut-off scores, instruments also differed in the extent to which they follow DSM-5 decision-making rules for diagnostic classification. We conclude that such differences in interpretation of DSM-5 criteria provide a challenge for symptom operationalization which will be most effectively overcome by consensus, testing and reformulation.
Original language | English |
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Pages (from-to) | 75–87 |
Number of pages | 13 |
Journal | European Child and Adolescent Psychiatry |
Volume | 30 |
Early online date | 19 Feb 2020 |
DOIs | |
Publication status | Published - Jan 2021 |
Bibliographical note
© Springer Nature B.V. 2020. The final publication is available at Springer via http://dx.doi.org/10.1007/s00787-020-01481-zKeywords
- Autism spectrum disorder
- Classification
- Content validity
- Diagnostic outcome