The stability of the Autism Diagnostic Observation Schedule-2 in children aged 14-36 months with elevated likelihood for autism.

Researchers followed 304 children who have siblings with autism (putting them at higher risk) and tested them with the ADOS-2 autism assessment tool at 14, 24, and 36 months old. They found that some children's results stayed the same over time, but many children's results changed. The test became more reliable as children got older. The study shows that no single test should be used alone to diagnose autism - multiple assessments and ongoing monitoring are important for accurate early identification.

This longitudinal study examined the consistency of ADOS-2 autism classifications in 304 siblings at elevated likelihood for autism, assessed at 14, 24, and 36 months. Results showed that while some children maintained stable ADOS-2 classifications throughout the study period, a significant proportion demonstrated inconsistent classifications over time. The stability of autism spectrum classifications improved from 14 to 36 months, and agreement with clinical best estimate diagnoses was moderate, increasing with child age. The findings emphasize that ADOS-2 assessments should complement rather than replace comprehensive clinical evaluations, particularly in early identification efforts for high-risk populations.

ADOS-2 should be used as part of comprehensive evaluations rather than standalone diagnostic tools. Multiple assessments over time are recommended for elevated likelihood children. Continued follow-up beyond 14 months is essential for accurate early autism identification in high-risk populations.

Limited to siblings at elevated likelihood for autism, which may not generalize to the broader population. Sample size not specified in abstract. Study type unclear. Specific statistical measures of stability and agreement not provided in abstract.

This study investigated the stability of Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) classifications in a cohort of 304 siblings at elevated likelihood for autism (EL-siblings). ADOS-2 assessments were conducted at 14, 24 and 36 months, with Clinical Best Estimate (CBE) autism diagnoses determined at 36 months. Our findings indicate that while some children have stable ADOS-2 classifications from early on, a significant proportion of the children show inconsistent classifications over time. The overall stability of ADOS-2 autism spectrum classifications increased from 14 to 36 months and agreement with CBE autism clinical diagnosis was moderate and increased with age.

Caution is warranted when interpreting individual ADOS-2 results, as they should always complement, and can never replace, a comprehensive clinical evaluation. These findings highlight the importance of continued follow-up beyond 14 months in young EL-children, a group for whom early assessment may be both feasible and beneficial and emphasises the need to integrate multiple assessment measures and multiple informants for accurate early autism identification.