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Molecular Autism
Published in: Molecular Autism 1/2022

Open Access 01-12-2022 | Autism Spectrum Disorder | Research

Diagnostic validity of Autism Diagnostic Observation Schedule, second edition (K-ADOS-2) in the Korean population

Authors: So Yoon Kim, Miae Oh, Guiyoung Bong, Da-Yea Song, Nan-He Yoon, Joo Hyun Kim, Hee Jeong Yoo

Published in: Molecular Autism | Issue 1/2022

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Abstract

Background

Although the Korean version of the Autism Diagnostic Observation Schedule-2 (K-ADOS‐2) is widely being used to diagnose autism spectrum disorder (ASD) in South Korea, no previous study has examined the validity and reliability of all modules of K-ADOS-2 across a wide age range, particularly older children, adolescents, and adults.

Method

Data from 2,158 participants were included (mean age = 79.7 months; 73.6% male): 1473 participants with ASD and 685 participants without ASD (Toddler Module, n = 289; Module 1, n = 642; Module 2 n = 574; Module 3 n = 411; Module 4, n = 242). Participants completed a battery of tests, including the K-ADOS or K-ADOS-2 and other existing diagnostic instruments. Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, positive predictive value (PPV), negative predictive value (NPV), Cohen’s kappa (k), and agreement with existing diagnostic instruments were computed. Cronbach’s α values were also calculated.

Results

All developmental cells of the K-ADOS-2 showed sufficient ranges of sensitivity 85.4–100.0%; specificity, 80.4–96.8%; area under the ROC curve, .90-.97; PPV, 77.8–99.3%; NPV, 80.6–100.0%; and k values, .83–.92. The kappa agreements of developmental cells with existing diagnostic instruments ranged from .20 to .90. Cronbach’s α values ranged from .82 to .91 across all developmental cells.

Limitation

The best-estimate clinical diagnoses made in this study were not independent of the K-ADOS-2 scores. Some modules did not include balanced numbers of participants in terms of gender and diagnostic status.

Conclusion

The K-ADOS-2 is a valid and reliable instrument in diagnosing ASD in South Korea. Future studies exploring the effectiveness of the K-ADOS-2 in capturing restricted, repetitive behaviors and differentiating ASD from other developmental disabilities are needed.
Appendix
Available only for authorised users
Footnotes
1
We included the data from participants who were younger than 30 months when they received Module 1 (n = 10) if these data were collected prior to the publication of the Toddler Module in Korean.
 
2
We conducted a set of independent t-tests comparing the available subscores of the Child Behavior Checklist (CBCL) scores of participants with OD and participants without ASD and not categorized as OD (i.e., typically developing; TD) to provide information on potential comorbid conditions of the OD group. These analyses included 71 participants with OD (57% of all participants with OD), and 229 TD participants (40.0% of TD participants). Participants with OD scored significantly higher on all Syndrome Subscales except for in Social Problem Subscales when compared to the TD participants (all ps < .05).
 
3
We conducted a set of sensitivity tests excluding the participants categorized as OD, and the changes in values of sensitivity, specificity, AUC, PPV, NPV, k values, and α were minimal (i.e., all changes of sensitivity, specificity, PPV, and NPV were in the tenth digits, and all changes of AUC, k, and α were in hundredths).
 
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Metadata
Title
Diagnostic validity of Autism Diagnostic Observation Schedule, second edition (K-ADOS-2) in the Korean population
Authors
So Yoon Kim
Miae Oh
Guiyoung Bong
Da-Yea Song
Nan-He Yoon
Joo Hyun Kim
Hee Jeong Yoo
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Molecular Autism / Issue 1/2022
Electronic ISSN: 2040-2392
DOI
https://doi.org/10.1186/s13229-022-00506-5

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