Reliability and validity of the Swedish versions of the ADOS and the ADI-R


The Autism Diagnostic Observation Schedule (ADOS; Lord et al., 1999; 2012) and the Autism Diagnostic Interview-Revised (ADI-R, Rutter et al., 2003) are gold standard diagnostic instruments widely used in Sweden and internationally, both in research and in clinical practice for assessments of ASD. Studies from US research settings have reported excellent interrater reliability and validity of the ADOS and the ADI-R but for clinical and Swedish settings, information of the psychometric properties of these instruments is still incomplete (Zander et al., 2014).


In this project, the interrater reliability and the validity of the ADOS and the ADI-R in Sweden will be examined among ordinary, clinically trained users of the ADOS and the ADI-R across multiple sites in everyday clinical routine.


Interrater reliability and validity will be studied separately for each instrument.


Interrater reliability will be assessed for items, overall algorithm totals and for diagnostic classification. For the ADOS, n = 40 (26 months to 18 years) were included, n = 10 per module, and for the ADI-R, 10 children were included. Each recorded observation/interview was assessed by five independent raters (psychologists or psychiatrists with variable experience from different sites across Sweden), of whom at least four were blind for the clinical diagnosis. The data collection started in 2010 and was completed in 2014.


Sensitivity and specificity of the ADOS-2 and the ADI-R will be examined compared to clinical diagnosis in a large clinical sample from multiple sites in Sweden. Participants in all ages will be included. Convergent and divergent validity as well as the association of other factors and measures such as age, IQ, adaptive functioning and language ability on the ADOS-2 and ADI-R overall totals will also be examined, and specifically the concordance between the ADOS-2 and the ADI-R. Data collection will start during 2015.



Charlotte Willfors

Postdoctoral Studies
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Eric Zander

Affiliated to Research
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