Table of ContentsView AllTable of ContentsAbout the ADI-RScreening TestsDiagnostic TestsDiagnostic ProcessSetting Up an Evaluation
Table of ContentsView All
View All
Table of Contents
About the ADI-R
Screening Tests
Diagnostic Tests
Diagnostic Process
Setting Up an Evaluation
The Autism Diagnostic Interview-Revised, better known as the ADI-R, is among the tests used to screen for and diagnose children withautism. Because there is no medical test for autism, evaluators rely on checklists, interactive tests, observations, and interviews of parents of young children with suspected traits of autism spectrum disorder (ASD).
Some of the most commonly used tests include the Checklist of Autism in Toddlers (CHAT), the modified Checklist for Autism in Toddlers (M-CHAT), the Screening Tool for Autism in Two-Year-Olds (STAT), and the Social Communication Questionnaire (SCQ).
This article will discuss the ADI-R for autism, other screening or diagnostic tests, and how to set up an evaluation for a child in your care.
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The ADI-R is a parent interview, which contains 93 items and focuses on behaviors in three content areas or domains:
The measure includes other items relevant to treatment planning, such as self-injury and over-activity.
The ADI-R test asks both general and specific questions. For example, parents are asked about their child’s communication abilities with special reference to topics such aspointing, head nodding, etc.
Both verbal and nonverbal communication andsocial skillsare scored concerning the child’s chronological age. Scores are generated in the areas of communication and language, social interaction, and intensely focused or repetitive behaviors.
Screening Tests for Autism
Autism has become an increasingly common diagnosis, with one in 36 children now diagnosed with it.At the same time, traits of autism overlap with the symptoms of many developmental and physical disorders. For example:
To determine whether an infant, toddler, or young child has a developmental delay—and the extent and quality of any delay—pediatricians conduct “well-child screenings.“These are relatively quick, simple evaluations that provide enough information to determine whether there is a need for further assessments.
But pediatricians also began screening for “high level” forms of autism, now described as autism with low support needs, and related disorders which include no apparent speech delay. These tests screen for social and behavioral impairments, delays, and differences rather than for speech or motor delays.
If your pediatrician performs one or more of these screening tests and is concerned about possible autism traits, they may recommend more extensive evaluations.
If the pediatrician does not perform routine autism screenings and you have concerns, request the screenings. If your healthcare provider is not familiar with autism screening tools, consider going to a developmental pediatrician or another specialist.
Diagnostic Tests for Autism
Screening tests don’t necessarily identify an autistic child, though they can provide clues as to whether a child has delays or differences that warrant further investigation. A complete evaluation involves tests that can actually lead to a formal diagnosis of autism spectrum disorder.
Some of the most commonly used tests include the Autism Diagnostic Observation Schedule (ADOS-G) and the Childhood Autism Rating Scale (CARS). ADOS-G tests for social communication skills and behaviors.
Two other tests are often implemented for very young children: The Screening Tool for Autism in Toddlers and Young Children (STAT) and the Communication and Symbolic Behavior Scales (CSBS). The Autism Diagnosis Interview-Revised (ADI-R), a parent interview tool, is almost always included in the diagnostic process.
About the Diagnostic Process
Of course, the ADI-R should not be the only evaluation tool used for an ASD diagnosis.Ideally, an autism diagnosis should involve not a single individual but a team.
Members of the team should include a pediatrician (preferably an individual with a specialty in developmental disorders), apsychologist, aspeech and language pathologist, and anoccupational therapist.
These specialists can conduct a range of assessments that look for specific types of challenges and behaviors that would indicate autism (as opposed to orin addition to other, related disorderssuch as:
What’s the Difference Between the ADOS and the ADR-I?
How to Set Up an Evaluation for Your Child
In most cases, there are a few options for evaluation. You may choose to start with your pediatrician, who may be able to recommend an autism clinic or center where your child can be evaluated. You may also choose to work through your school district.
The district must pay for certain evaluations and can provide non-medical experts, such as a speech-language pathologist and occupational therapist, to assess your child. Bear in mind, however, that independent assessments may be helpful as you begin to work with the school to develop an educational and therapeutic plan.
How to Prepare for the ADI-R
Summary
The ADI-R is a test where caregivers of the child are asked an array of questions about the child to screen for and diagnose autism. It focuses on social interaction, communication and language skills, and any hyperfixation of specific interests or sensory input. Higher scores are more indicative of an autism diagnosis. Healthcare providers such as psychologists, neuropsychiatrists, and occupational or speech therapists may be part of the diagnostic team.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Autism Spectrum Disorder.Sophy Kim SH, Bal VH, Lord C.Autism diagnostic interview-revised. In: Volkmar FR, ed. Encyclopedia of Autism Spectrum Disorders.Springer International Publishing.2021:470-475.Zander E, Willfors C, Berggren S, et al.The interrater reliability of the autism diagnostic interview-revised (ADI-R) in clinical settings.Psychopathology. 2017;50(3):219-227. doi:10.1159/000474949Centers for Disease Control and Prevention.Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2Frigaux A, Evrard R, Lighezzolo-Alnot J.ADI-R and ADOS and the differential diagnosis of autism spectrum disorders: Interests, limits and openings.Encephale. 2019;45(5):441-448. doi:10.1016/j.encep.2019.07.002
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Autism Spectrum Disorder.Sophy Kim SH, Bal VH, Lord C.Autism diagnostic interview-revised. In: Volkmar FR, ed. Encyclopedia of Autism Spectrum Disorders.Springer International Publishing.2021:470-475.Zander E, Willfors C, Berggren S, et al.The interrater reliability of the autism diagnostic interview-revised (ADI-R) in clinical settings.Psychopathology. 2017;50(3):219-227. doi:10.1159/000474949Centers for Disease Control and Prevention.Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2Frigaux A, Evrard R, Lighezzolo-Alnot J.ADI-R and ADOS and the differential diagnosis of autism spectrum disorders: Interests, limits and openings.Encephale. 2019;45(5):441-448. doi:10.1016/j.encep.2019.07.002
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Mental Health.Autism Spectrum Disorder.Sophy Kim SH, Bal VH, Lord C.Autism diagnostic interview-revised. In: Volkmar FR, ed. Encyclopedia of Autism Spectrum Disorders.Springer International Publishing.2021:470-475.Zander E, Willfors C, Berggren S, et al.The interrater reliability of the autism diagnostic interview-revised (ADI-R) in clinical settings.Psychopathology. 2017;50(3):219-227. doi:10.1159/000474949Centers for Disease Control and Prevention.Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2Frigaux A, Evrard R, Lighezzolo-Alnot J.ADI-R and ADOS and the differential diagnosis of autism spectrum disorders: Interests, limits and openings.Encephale. 2019;45(5):441-448. doi:10.1016/j.encep.2019.07.002
National Institute of Mental Health.Autism Spectrum Disorder.
Sophy Kim SH, Bal VH, Lord C.Autism diagnostic interview-revised. In: Volkmar FR, ed. Encyclopedia of Autism Spectrum Disorders.Springer International Publishing.2021:470-475.
Zander E, Willfors C, Berggren S, et al.The interrater reliability of the autism diagnostic interview-revised (ADI-R) in clinical settings.Psychopathology. 2017;50(3):219-227. doi:10.1159/000474949
Centers for Disease Control and Prevention.Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020.
Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2
Frigaux A, Evrard R, Lighezzolo-Alnot J.ADI-R and ADOS and the differential diagnosis of autism spectrum disorders: Interests, limits and openings.Encephale. 2019;45(5):441-448. doi:10.1016/j.encep.2019.07.002
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