The Autism Diagnostic Interview-Revised ( ADI-R ) is a structured interview conducted with the parents of individuals who have been referred for evaluation of possible autism or autism spectrum disorders. Interviews, used by researchers and doctors for decades, can be used for diagnostic purposes for anyone with a mental age of at least 18 months and measure behavior in the areas of reciprocal social interaction, communication and language, and behavior patterns.
Video Autism Diagnostic Interview
Structure
Useful for diagnosing autism, planning treatment, and distinguishing autism from other developmental disorders. Interviews include the full development history of the referred individual, usually performed in an office, home or other quiet place by a psychologist, and usually takes one to two hours. Caregivers are asked 93 questions, including three major behavior areas, about the current behavior or individual behavior at a given point in time. Interviews are divided into five sections: open questions, communication questions, social development and play questions, repetitive and restricted behavior questions, and questions about common behavioral issues. Because ADI-R is an investigator-based interview, the question is very open and investigators â € <â €
The first part of the interview is used to assess the quality of social interaction and includes questions about sharing emotions, offering and seeking comfort, social smiles, and responding to other children. Part of communication and language behavior investigates stereotyped speech, reversal of pronoun, and use of social language. Speech stereotyping is some word or sound that is used and often repeated by the individual. Restricted and recurrent behavior sections include questions about unusual preoccupations, hand and finger behavior, and unusual sense interests. Finally, the assessment contains questions about behaviors such as self-injury, aggression, and excessive activity that will help in developing a treatment plan.
Maps Autism Diagnostic Interview
Scoring
After the interview is over, the interviewer determines the ranking value for each question based on their evaluation of the caregiver's response.
Value scale
- 0: "The behavior type specified in the encoding does not exist"
- 1: "Specified behavior types are present in abnormal form, but not severe enough or often to meet the criteria for 2"
- 2: "The exact abnormal behavior"
- 3: "Extreme severity of the specified behavior"
- 7: "Certain defects in the common area of ​​encoding, but not of the specified type"
- 8: "Not applicable"
- 9: "Unknown or asked"
Algorithm
The total score is then calculated for each area of ​​the interview content. When applying the algorithm, score 3 drops to 2 and score 7, 8, or 9 drops to 0 because this score does not indicate autistic behavior and, therefore, should not be included in the total amount. To create algorithms for diagnosis, the authors chose questions from interviews most closely related to the criteria for the diagnosis of Autism Spectrum Disorder in DSM-IV and ICD-10. The diagnosis of autism is indicated when the scores in all three areas of behavior meet or exceed the specified minimum cutoff score. The cutoff score is determined using extensive years of research results.
The cutoff score
- Social interaction: 10
- Communications and languages: 8 (if verbal) or 7 (if non-verbal)
- Restricted and repeatable behavior: 3
Training
Extensive training and knowledge on autism spectrum disorders and ADI-R are required for conducting and printing interviews. Training usually takes 2 months or more to complete depending on the clinical experience and skills of one's interview. There are separate training procedures based on whether ADI-R will be performed for clinical or research purposes. To use instruments as doctors, there are training videos and workshops for administration and assessment. The ADI-R DVD Training Package offered by WPS provides clinical training in the use of ADI-R. Researchers are required to attend special research training and establish their reliability in using ADI-R to use it for research purposes. The standard practice is to attend ADI-R research training workshops directly and build research reliability with their authors or colleagues. Information about ADI-R research training workshops, including current dates and locations, can be found Autism and Brain Development Center (CADB): http://cornellpsychiatry.org/education/autism.html
History
ADI-R was written by Michael Rutter, MD FRS, Ann LeCouteur, MBBS and Catherine Lord, PhD. and published by Western Psychological Services in 2003. The original version of the Autism Diagnostic Interview, written in 1989, is used primarily for research purposes. ADI was developed in response to four major developments in the area of ​​autism diagnosis that led to the need for updated diagnostic tools. These developments include improvements in diagnostic criteria, the need to distinguish between autism and other developmental disorders that appear similar early in life, and desire, in psychology, to standard diagnostic instruments. Original ADI can be used in individuals with a chronological age of at least five years and a mental age of at least two years, but autism spectrum disorders are usually diagnosed much earlier than this age. These findings caused Rutter, LeCouteur, and Lord to revise ADI in 1994 so that it could be used to determine the diagnosis in individuals with a mental age of at least 18 months. This will allow doctors to use interviews to differentiate autism from other disorders that can appear in early childhood.
The author's primary purpose in revising ADI is to make interviews more efficient, shorter, and more appropriate for younger children. The majority of the revisions involved involved interviewing organizations. Questions are divided into five distinct sections and initial behavior and are currently consolidated in each section. Research leads to some modifications of specific interview questions. Mods include making some questions more focused on specific aspects of autism behavior and making other questions more general to improve efficiency. Also, some additional questions are added to the interview, including more specific questions about age when abnormal behavior begins. Other irrelevant items have been removed to improve interviewing ability to diagnose autism at a younger age. The revision of this question also leads the author to revise the assessment algorithm and cut-off scores as more questions are added to some sections.
Reliability
Questions from the original version of ADI found, through research, unreliable or inapplicable were removed when the interview was revised. ADI-R has also been thoroughly tested for reliability and validity using inter-rater reliability, re-test reliability and internal validity testing. The results of this study have led to ADI acceptance among both researchers and doctors for decades. ADI-R is often used in conjunction with other related instruments to determine the diagnosis of autism.
The authors have published psychometric results that demonstrate the reliability and validity of ADI-R. Good inter-rater reliability and good internal consistency across all areas of behavior investigated in the interview. The interview was also found to have adequate reliability over time. The study comparing ADI-R results from autistic children and children with other developmental disorders suggests that individual questions in interviews are slightly more valid when differentiating autism from mental retardation rather than the overall algorithm. However, further research has led to the overall acceptance of the ADI-R algorithm.
Related instruments
The social communication questionnaire (SCQ) is a short, 40-item, correct/false questionnaire filled by parents about their child's behavior. This is parallel to ADI-R in content and is used for short screening to determine the need to conduct a full ADI-R interview.
The autism diagnostic observation schedule (ADOS), is a companion instrument by the same core authors. This is a series of semi-structured observations and performed in the office as a series of activities involving the referred individual and a trained or licensed psychologist or examiner.
See also
- Autism diagnostic schedule
- Autism
- The autism spectrum
- The American Autism Society
- Autism Speaks
- Epidemiology of autism
- Michael Rutter
References
-
Lord C, Rutter M, Le Couteur A (1994). "Autism Diagnostic Interview-Revised: revised version of the diagnostic interview for individual caregivers with possible pervasive developmental disorders". A Autism Dev Disord . 24 (5): 659-85. doi: 10.1007/BF02172145. PMID 7814313. Ã,
External links
- Autism Resources - Glossary of Terms
- Western Psychology Service - ADI-R Materials
- ADI-R in other languages ​​
Source of the article : Wikipedia
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