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Open Access 01-11-2009 | Original Contribution

Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age

Authors: Emma van Daalen, Chantal Kemner, Claudine Dietz, Sophie H. N. Swinkels, Jan K. Buitelaar, Herman van Engeland

Published in: European Child & Adolescent Psychiatry | Issue 11/2009

Abstract

To examine the inter-rater reliability and stability of autism spectrum disorder (ASD) diagnoses made at a very early age in children identified through a screening procedure around 14 months of age. In a prospective design, preschoolers were recruited from a screening study for ASD. The inter-rater reliability of the diagnosis of ASD was measured through an independent assessment of a randomly selected subsample of 38 patients by two other psychiatrists. The diagnoses at 23 months and 42 months of 131 patients, based on the clinical assessment and the diagnostic classifications of standardised instruments, were compared to evaluate stability of the diagnosis of ASD. Inter-rater reliability on a diagnosis of ASD versus non-ASD at 23 months was 87% with a weighted κ of 0.74 (SE 0.11). The stability of the different diagnoses in the autism spectrum was 63% for autistic disorder, 54% for pervasive developmental disorder, not otherwise specified (PDD-NOS), and 91% for the whole category of ASD. Most diagnostic changes at 42 months were within the autism spectrum from autistic disorder to PDD-NOS and were mainly due to diminished symptom severity. Children who moved outside the ASD category at 42 months made significantly larger gains in cognitive and language skills than children with a stable ASD diagnosis. In conclusion, the inter-rater reliability and stability of the diagnoses of ASD established at 23 months in this population-based sample of very young children are good.

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Title: Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age
Authors: Emma van Daalen
Chantal Kemner
Claudine Dietz
Sophie H. N. Swinkels
Jan K. Buitelaar
Herman van Engeland
Publication date: 01-11-2009
Publisher: D. Steinkopff-Verlag
Published in: European Child & Adolescent Psychiatry / Issue 11/2009
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-009-0025-8

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Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age

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