6/28/2021 ASD diagnosis tools - UpToDate

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Select tools for the diagnosis of autism spectrum disorder

Diagnostic
Age Description Comments
instrument

Autism Diagnostic Mental age ≥18 Two- to three-hour Not practical for
Interview–Revised months clinical interview that clinical settings
probes for ASD Usually used in
symptoms research settings,
often combined with
the ADOS-2

Autism Diagnostic Age 12 months Semistructured Reference standard

Observation through adulthood assessment by trained for diagnosis of ASD
Schedule–Second clinician of: in research studies
edition Social interaction and in many clinical
Play/imaginative settings
use of materials
Communication
Atypical behaviors
Five modules based on
child's expressive
language abilities
(including one for
toddlers)
Takes 40 to 60 minutes
to administer

Childhood Autism Children ≥2 years of 15 items directly 15 items are

Rating Scale–Second age observed by a trained correlated with DSM-
edition (standard clinician IV
version) Can be completed by
clinicians, parents, or
teachers
Takes 20 to 30 minutes
to administer

Developmental, ≥3 years of age Computerized parental Predominantly used

Dimensional, and interview outside the United
Diagnostic Interview 266 questions related to States
ASD
291 questions related to
comorbid mental health
conditions
Measures intensity of
ASD symptoms and
comorbidities
Takes two hours to
administer
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Diagnostic Interview Any age Detailed semistructured Predominantly used

for Social and interview with outside the United
Communication informant who knows States
Disorder patient well, ideally
from infancy
Collects information on
core symptoms of ASD
and symptoms in other
domains (eg, sensory,
emotional, maladaptive
behaviors)
Takes three hours to
administer

Gilliam Autism Rating Age 2 to 22 years Checklist of 56 items  

Scale–Third edition based on DSM-5 criteria
with subscales for:
Restrictive/repetitive
behaviors
Social interaction
Social
communication
Emotional
responses
Cognitive style
Maladaptive speech
Completed by parents
Takes 5 to 10 minutes
to administer

Instrument for higher-functioning children

Asperger Syndrome Age 5 to 18 years 50 yes/no items in the  

Diagnostic Scale following areas:
Cognitive
Maladaptive
Language
Social
Sensorimotor
Completed by parents,
teachers, therapists, or
other professionals
Takes 10 to 15 minutes
to administer

Childhood Autism Children ≥2 years of 15 items directly 15 items are

Rating Scale–Second age observed by a trained correlated with DSM-
edition (high- clinician IV
functioning version) Can be completed by
clinicians, parents, or
teachers
Takes 20 to 30 minutes
to administer

These tools are recommended in national guidelines; they should be used in conjunction with clinical
judgment. Their diagnostic accuracy has not been widely studied.

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6/28/2021 ASD diagnosis tools - UpToDate

ASD: autism spectrum disorder; ADOS-2: Autism Diagnostic Observation Schedule–Second edition; DSM-IV: Diagnostic
and Statistical Manual of Mental Disorders–Fourth edition; DSM-5: Diagnostic and Statistical Manual of Mental
Disorders–Fifth edition.

Data from:
1. Randall M, Egberts KJ, Samtani A, et al. Diagnostic tests for autism spectrum disorder (ASD) in preschool children.
Cochrane Database Syst Rev 2018; 7:CD009044.
2. Skuse D. Developmental, Dimensional and Diagnostic Interview. Institute of Child Health, London 2013.
3. Leekam S. Diagnostic Interview for Social and Communication Disorders. Springer-Verlag Heidelberg, 2012.

Graphic 119224 Version 1.0

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