Measurement Issues: Screening and diagnostic instruments for autism spectrum disorders – lessons from research and practise
Version of Record online: 4 APR 2012
© 2012 The Authors. Child and Adolescent Mental Health © 2012 Association for Child and Adolescent Mental Health
Child and Adolescent Mental Health
Volume 18, Issue 1, pages 52–63, February 2013
How to Cite
Charman, T. and Gotham, K. (2013), Measurement Issues: Screening and diagnostic instruments for autism spectrum disorders – lessons from research and practise. Child and Adolescent Mental Health, 18: 52–63. doi: 10.1111/j.1475-3588.2012.00664.x
- Issue online: 23 JAN 2013
- Version of Record online: 4 APR 2012
- Manuscript Accepted: 9 JAN 2012
- COST Action BM1004
- Clothworkers' Foundation and Pears Foundation
- United States National Institute of Health. Grant Numbers: R01HD065277, R01 MH066469
- autism spectrum disorder (ASD);
- predictive value
Background and Scope
Significant progress has been made over the past two decades in the development of screening and diagnostic instruments for autism spectrum disorders (ASDs). This article reviews this progress, including recent innovations, focussing on those instruments for which the strongest research data on validity exists, and then addresses issues arising from their use in clinical settings.
Research studies have evaluated the ability of screens to prospectively identify cases of ASD in population-based and clinically referred samples, as well as the accuracy of diagnostic instruments to map onto ‘gold standard’ clinical best estimate diagnosis. However, extension of the findings to clinical services must be done with caution, with a full understanding that instrument properties are sample-specific. Furthermore, we are limited by the lack of a true test for ASD which remains a behaviourally defined disorder. In addition, screening and diagnostic instruments help clinicians least in the cases where they are most in want of direction, as their accuracy will always be lower for marginal cases.
Instruments help clinicians to collect detailed, structured information and increase accuracy and reliability of referral for in-depth assessment and recommendations for support, but further research is needed to refine their effective use in clinical settings.