Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation / Rebecca W LIEB in Autism, 29-11 (November 2025)  

Public ISBD [article]  inAutism > 29-11 (November 2025) . - p.2846-2857 Titre : Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation Type de document : texte imprimé Auteurs : Rebecca W LIEB, Auteur ; Luther G KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N LUDWIG, Auteur ; Christina E LOVE, Auteur ; Rowena NG, Auteur ; Danielle WEXLER, Auteur ; Allison E GORNIK, Auteur ; Calliope HOLINGUE, Auteur ; Ji Su HONG, Auteur Article en page(s) : p.2846-2857 Langues : Anglais (eng) Mots-clés : ADOS-2  assessment  autism  autism spectrum disorder  clinician ratings  E codes  emotional and behavioral problems Index. décimale : PER Périodiques Résumé : While the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is considered a “reference standard” measure to observe symptoms of autism spectrum disorder (ASD), little is known about the utility of its Other Abnormal Behaviors or “E codes.” This study investigated the unique influence of each E code (overactivity, disruptive behavior, anxiety) on ADOS-2 scoring. Data from ADOS-2 administrations (Modules 1, 2, 3) were collected from 3364 children (mean age = 6.73 years) at an outpatient ASD clinic. For those with ASD, ADOS-2 Calibrated Severity Scores (CSS) were descriptively higher for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without ASD, no patterns emerged when comparing means. After controlling for age, sex, and language level, multivariable linear models indicated the presence of overactivity was significantly associated with increased CSS for children with ASD compared to those without. No significant interaction was present for disruptive behavior. The presence of anxiety was significantly associated with increased Social Affect CSS only for those without ASD. All effect sizes were small. This is one of the first studies to evaluate the effect of each individual E code on ADOS-2 CSS. Unique differences emerged across diagnostic groups, suggesting implications for ADOS-2 interpretation.Lay Summary The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is a common assessment tool used during an autism evaluation. As part of the ADOS-2, the examiner rates “E codes,” which are levels of hyperactivity, disruptive behavior, and anxiety during testing. These codes are not part of the final ADOS-2 score. While there is a lot of research on the ADOS-2, less is known about these E codes. This study looked at how the E codes might affect the final ADOS-2 scoring. Information came from 3364 in-person autism assessments (average age = 6.73 years) who were evaluated at an autism specialty clinic. For autistic children, ADOS-2 scores were higher (i.e. more autism-related behaviors) for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without autism, there was no pattern. After accounting for the child’s age, sex, and language level, there were unique results for each E code, depending on whether the child received an autism diagnosis. This study is important as it is one of the first to evaluate the effects of each E code on ADOS-2 scores and could impact how scores are interpreted when considering an autism diagnosis. En ligne : https://dx.doi.org/10.1177/13623613251355231 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation [texte imprimé] / Rebecca W LIEB, Auteur ; Luther G KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N LUDWIG, Auteur ; Christina E LOVE, Auteur ; Rowena NG, Auteur ; Danielle WEXLER, Auteur ; Allison E GORNIK, Auteur ; Calliope HOLINGUE, Auteur ; Ji Su HONG, Auteur . - p.2846-2857. Langues : Anglais (eng) in Autism > 29-11 (November 2025) . - p.2846-2857 Mots-clés : ADOS-2  assessment  autism  autism spectrum disorder  clinician ratings  E codes  emotional and behavioral problems Index. décimale : PER Périodiques Résumé : While the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is considered a “reference standard” measure to observe symptoms of autism spectrum disorder (ASD), little is known about the utility of its Other Abnormal Behaviors or “E codes.” This study investigated the unique influence of each E code (overactivity, disruptive behavior, anxiety) on ADOS-2 scoring. Data from ADOS-2 administrations (Modules 1, 2, 3) were collected from 3364 children (mean age = 6.73 years) at an outpatient ASD clinic. For those with ASD, ADOS-2 Calibrated Severity Scores (CSS) were descriptively higher for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without ASD, no patterns emerged when comparing means. After controlling for age, sex, and language level, multivariable linear models indicated the presence of overactivity was significantly associated with increased CSS for children with ASD compared to those without. No significant interaction was present for disruptive behavior. The presence of anxiety was significantly associated with increased Social Affect CSS only for those without ASD. All effect sizes were small. This is one of the first studies to evaluate the effect of each individual E code on ADOS-2 CSS. Unique differences emerged across diagnostic groups, suggesting implications for ADOS-2 interpretation.Lay Summary The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is a common assessment tool used during an autism evaluation. As part of the ADOS-2, the examiner rates “E codes,” which are levels of hyperactivity, disruptive behavior, and anxiety during testing. These codes are not part of the final ADOS-2 score. While there is a lot of research on the ADOS-2, less is known about these E codes. This study looked at how the E codes might affect the final ADOS-2 scoring. Information came from 3364 in-person autism assessments (average age = 6.73 years) who were evaluated at an autism specialty clinic. For autistic children, ADOS-2 scores were higher (i.e. more autism-related behaviors) for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without autism, there was no pattern. After accounting for the child’s age, sex, and language level, there were unique results for each E code, depending on whether the child received an autism diagnosis. This study is important as it is one of the first to evaluate the effects of each E code on ADOS-2 scores and could impact how scores are interpreted when considering an autism diagnosis. En ligne : https://dx.doi.org/10.1177/13623613251355231 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

Dysregulation in Children and Adolescents Presenting to a Multidisciplinary Autism Clinic / Roma A. VASA in Journal of Autism and Developmental Disorders, 52-4 (April 2022)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 52-4 (April 2022) . - p.1762-1770 Titre : Dysregulation in Children and Adolescents Presenting to a Multidisciplinary Autism Clinic Type de document : texte imprimé Auteurs : Roma A. VASA, Auteur ; Vini SINGH, Auteur ; Rachel G. MCDONALD, Auteur ; Carla MAZEFSKY, Auteur ; Ji Su HONG, Auteur ; Amy KEEFER, Auteur Article en page(s) : p.1762-1770 Langues : Anglais (eng) Mots-clés : Adolescent  Ambulatory Care Facilities  Autism Spectrum Disorder/diagnosis/epidemiology/psychology  Autistic Disorder/diagnosis/epidemiology  Child  Humans  Prevalence  Autism center  Children  Dysregulation  Screening Index. décimale : PER Périodiques Résumé : Research indicates that children with autism spectrum disorder (ASD) frequently exhibit dysregulation, which refers to poorly coordinated affective, behavioral, and cognitive responses to a given situation. We examined the characteristics of dysregulation in children presenting to a multidisciplinary ASD clinic for an ASD diagnostic evaluation. Sixty percent of children presenting for an ASD evaluation exhibited dysregulation. Dysregulation prevalence was higher in children without ASD versus with ASD (69% versus 56%). Severe dysregulation was higher in children without ASD (29% versus 16%). Both groups with severe dysregulation were equally likely to be taking psychiatric medications, however, children with ASD were less likely to be receiving therapy. These findings highlight the importance of implementing dysregulation screening and treatment protocols in ASD centers. En ligne : http://dx.doi.org/10.1007/s10803-021-05056-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=476 [article] Dysregulation in Children and Adolescents Presenting to a Multidisciplinary Autism Clinic [texte imprimé] / Roma A. VASA, Auteur ; Vini SINGH, Auteur ; Rachel G. MCDONALD, Auteur ; Carla MAZEFSKY, Auteur ; Ji Su HONG, Auteur ; Amy KEEFER, Auteur . - p.1762-1770. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 52-4 (April 2022) . - p.1762-1770 Mots-clés : Adolescent  Ambulatory Care Facilities  Autism Spectrum Disorder/diagnosis/epidemiology/psychology  Autistic Disorder/diagnosis/epidemiology  Child  Humans  Prevalence  Autism center  Children  Dysregulation  Screening Index. décimale : PER Périodiques Résumé : Research indicates that children with autism spectrum disorder (ASD) frequently exhibit dysregulation, which refers to poorly coordinated affective, behavioral, and cognitive responses to a given situation. We examined the characteristics of dysregulation in children presenting to a multidisciplinary ASD clinic for an ASD diagnostic evaluation. Sixty percent of children presenting for an ASD evaluation exhibited dysregulation. Dysregulation prevalence was higher in children without ASD versus with ASD (69% versus 56%). Severe dysregulation was higher in children without ASD (29% versus 16%). Both groups with severe dysregulation were equally likely to be taking psychiatric medications, however, children with ASD were less likely to be receiving therapy. These findings highlight the importance of implementing dysregulation screening and treatment protocols in ASD centers. En ligne : http://dx.doi.org/10.1007/s10803-021-05056-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=476

Prevalence of gastrointestinal symptoms among autistic individuals, with and without co-occurring intellectual disability / Calliope HOLINGUE in Autism Research, 16-8 (August 2023)  

Public ISBD [article]  inAutism Research > 16-8 (August 2023) . - p.1609-1618 Titre : Prevalence of gastrointestinal symptoms among autistic individuals, with and without co-occurring intellectual disability Type de document : texte imprimé Auteurs : Calliope HOLINGUE, Auteur ; Danika PFEIFFER, Auteur ; Natasha N. LUDWIG, Auteur ; Rachel REETZKE, Auteur ; Ji Su HONG, Auteur ; Luther G. KALB, Auteur ; Rebecca LANDA, Auteur Article en page(s) : p.1609-1618 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Gastrointestinal symptoms (GI) are very common among individuals on the autism spectrum. Prior research reports mixed findings regarding whether individuals with autism and co-occurring intellectual disability (ID) have elevated risk of gastrointestinal symptoms relative to individuals with autism alone. GI symptoms can be challenging to assess in individuals with autism spectrum disorder (ASD) and/or ID given challenges with language, communication, and interoception. Prior research has tended to only include individuals with documented presence or absence of GI symptoms or conditions, that is, to exclude observations in which there is uncertainty regarding presence of GI symptoms. Therefore, none of the prior autism studies reported the association between ID and the certainty regarding presence or absence of GI symptoms. The objective of this study was to examine differences in parental certainty and odds of reporting gastrointestinal signs and symptoms among children on the autism spectrum, with and without intellectual disability. Participants were 308 children (36% ID) with a clinical diagnosis of autism spectrum disorder (6-17 years). Parents endorsed whether their child had experienced or displayed a range of signs or symptoms related to GI problems in the past 3 months. Parents of autistic children with ID were less certain about the presence of more subjective symptoms, including abdominal pain, nausea, and bloating. Conversely, certainty regarding more objective signs (e.g., constipation, diarrhea, spitting up, etc.) was not significantly different. More accurate measures for GI signs/symptoms are needed for this population. En ligne : https://doi.org/10.1002/aur.2972 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510 [article] Prevalence of gastrointestinal symptoms among autistic individuals, with and without co-occurring intellectual disability [texte imprimé] / Calliope HOLINGUE, Auteur ; Danika PFEIFFER, Auteur ; Natasha N. LUDWIG, Auteur ; Rachel REETZKE, Auteur ; Ji Su HONG, Auteur ; Luther G. KALB, Auteur ; Rebecca LANDA, Auteur . - p.1609-1618. Langues : Anglais (eng) in Autism Research > 16-8 (August 2023) . - p.1609-1618 Index. décimale : PER Périodiques Résumé : Abstract Gastrointestinal symptoms (GI) are very common among individuals on the autism spectrum. Prior research reports mixed findings regarding whether individuals with autism and co-occurring intellectual disability (ID) have elevated risk of gastrointestinal symptoms relative to individuals with autism alone. GI symptoms can be challenging to assess in individuals with autism spectrum disorder (ASD) and/or ID given challenges with language, communication, and interoception. Prior research has tended to only include individuals with documented presence or absence of GI symptoms or conditions, that is, to exclude observations in which there is uncertainty regarding presence of GI symptoms. Therefore, none of the prior autism studies reported the association between ID and the certainty regarding presence or absence of GI symptoms. The objective of this study was to examine differences in parental certainty and odds of reporting gastrointestinal signs and symptoms among children on the autism spectrum, with and without intellectual disability. Participants were 308 children (36% ID) with a clinical diagnosis of autism spectrum disorder (6-17 years). Parents endorsed whether their child had experienced or displayed a range of signs or symptoms related to GI problems in the past 3 months. Parents of autistic children with ID were less certain about the presence of more subjective symptoms, including abdominal pain, nausea, and bloating. Conversely, certainty regarding more objective signs (e.g., constipation, diarrhea, spitting up, etc.) was not significantly different. More accurate measures for GI signs/symptoms are needed for this population. En ligne : https://doi.org/10.1002/aur.2972 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510

Psychometric Evaluation of the Autism Spectrum Rating Scales (6-18 Years Parent Report) in a Clinical Sample / Ji Su HONG in Journal of Autism and Developmental Disorders, 54-3 (March 2024)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 54-3 (March 2024) . - p.1024-1035 Titre : Psychometric Evaluation of the Autism Spectrum Rating Scales (6-18 Years Parent Report) in a Clinical Sample Type de document : texte imprimé Auteurs : Ji Su HONG, Auteur ; Jeremy PERRIN, Auteur ; Vini SINGH, Auteur ; Luke KALB, Auteur ; Elizabeth A. CROSS, Auteur ; Ericka WODKA, Auteur ; Chana RICHTER, Auteur ; Rebecca LANDA, Auteur Article en page(s) : p.1024-1035 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : ASD is a neurodevelopmental disorder impacting 1 in 44 children and early identification of children with ASD is critical for the intervention. Several screening measures have been developed for early identification, including the Autism Spectrum Rating Scales, 6-18 years Parent Report (ASRS). The ASRS has been understudied, and the current study assessed the validity of the ASRS in a clinical sample of 490 children at a tertiary ASD-specialty clinic. Results indicated that the ASRS demonstrated favorable sensitivity, but poor specificity. True positive screening results were more likely to occur for children with a multiracial background, while they were less likely to occur for children with a high social capital. Overall, though the ASRS has clinical utility as a screening measure, it did not perform effectively to differentiate ASD from Non-ASD clinical disorders. En ligne : https://doi.org/10.1007/s10803-022-05871-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=524 [article] Psychometric Evaluation of the Autism Spectrum Rating Scales (6-18 Years Parent Report) in a Clinical Sample [texte imprimé] / Ji Su HONG, Auteur ; Jeremy PERRIN, Auteur ; Vini SINGH, Auteur ; Luke KALB, Auteur ; Elizabeth A. CROSS, Auteur ; Ericka WODKA, Auteur ; Chana RICHTER, Auteur ; Rebecca LANDA, Auteur . - p.1024-1035. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 54-3 (March 2024) . - p.1024-1035 Index. décimale : PER Périodiques Résumé : ASD is a neurodevelopmental disorder impacting 1 in 44 children and early identification of children with ASD is critical for the intervention. Several screening measures have been developed for early identification, including the Autism Spectrum Rating Scales, 6-18 years Parent Report (ASRS). The ASRS has been understudied, and the current study assessed the validity of the ASRS in a clinical sample of 490 children at a tertiary ASD-specialty clinic. Results indicated that the ASRS demonstrated favorable sensitivity, but poor specificity. True positive screening results were more likely to occur for children with a multiracial background, while they were less likely to occur for children with a high social capital. Overall, though the ASRS has clinical utility as a screening measure, it did not perform effectively to differentiate ASD from Non-ASD clinical disorders. En ligne : https://doi.org/10.1007/s10803-022-05871-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=524

Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder / Ji Su HONG in Autism Research, 15-11 (November 2022)  

Public ISBD [article]  inAutism Research > 15-11 (November 2022) . - p.2181-2191 Titre : Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder Type de document : texte imprimé Auteurs : Ji Su HONG, Auteur ; Vini SINGH, Auteur ; Luke G. KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N. LUDWIG, Auteur ; Danika PFEIFFER, Auteur ; Calliope HOLINGUE, Auteur ; Deepa MENON, Auteur ; Qing LU, Auteur ; Ahlam ASHKAR, Auteur ; Rebecca LANDA, Auteur Article en page(s) : p.2181-2191 Langues : Anglais (eng) Mots-clés : Child  Humans  Male  Female  Autism Spectrum Disorder/diagnosis  Sensitivity and Specificity  Predictive Value of Tests  Algorithms  Autistic Disorder  autism spectrum disorder  classification  cut-off score  diagnosis Index. décimale : PER Périodiques Résumé : The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians. En ligne : http://dx.doi.org/10.1002/aur.2801 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488 [article] Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder [texte imprimé] / Ji Su HONG, Auteur ; Vini SINGH, Auteur ; Luke G. KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N. LUDWIG, Auteur ; Danika PFEIFFER, Auteur ; Calliope HOLINGUE, Auteur ; Deepa MENON, Auteur ; Qing LU, Auteur ; Ahlam ASHKAR, Auteur ; Rebecca LANDA, Auteur . - p.2181-2191. Langues : Anglais (eng) in Autism Research > 15-11 (November 2022) . - p.2181-2191 Mots-clés : Child  Humans  Male  Female  Autism Spectrum Disorder/diagnosis  Sensitivity and Specificity  Predictive Value of Tests  Algorithms  Autistic Disorder  autism spectrum disorder  classification  cut-off score  diagnosis Index. décimale : PER Périodiques Résumé : The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians. En ligne : http://dx.doi.org/10.1002/aur.2801 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488

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