This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.Īutism spectrum disorder (ASD) is a neurodevelopmental disorder defined by a profile of persistent challenges in social communication and interaction and the presence of restrictive, repetitive patterns of behavior, interests, or activities that are present early in childhood and cause clinically significant functional impairments ( APA, 2013). Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. 80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2).
Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification.