Clinical correlates of diagnostic certainty in children and youths with Autistic Disorder

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Rødgaard, E. M., Rodríguez-Herreros, B., Zeribi, A., Jensen, K., Courchesne, V., Douard, E., Gagnon, D., Huguet, G., Jacquemont, S., & Mottron, L. (2024). Clinical correlates of diagnostic certainty in children and youths with Autistic Disorder. Molecular Autism, 15(1), 15-15. https://doi.org/10.1186/s13229-024-00592-7

Publication date: 3 Apr 2024 Added to AutiHub: 15 Sep 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
10
Publication authors identified as autistic
1 / 10 (10.0%)
  1. Eya-Mist Rødgaard *
  2. Borja Rodríguez-Herreros
  3. Abderrahim Zeribi
  4. Kristian Jensen
  5. Valérie Courchesne
  1. Elise Douard
  2. David Gagnon
  3. Guillaume Huguet
  4. Sebastien Jacquemont
  5. Laurent Mottron

Abstract

Abstract Background Clinicians diagnosing autism rely on diagnostic criteria and instruments in combination with an implicit knowledge based on clinical expertise of the specific signs and presentations associated with the condition. This implicit knowledge influences how diagnostic criteria are interpreted, but it cannot be directly observed. Instead, insight into clinicians’ understanding of autism can be gained by investigating their diagnostic certainty. Modest correlations between the certainty of an autism diagnosis and symptom load have been previously reported. Here, we investigated the associations of diagnostic certainty with specific items of the ADOS as well as other clinical features including head circumference. Methods Phenotypic data from the Simons Simplex Collection was used to investigate clinical correlates of diagnostic certainty in individuals diagnosed with Autistic Disorder (n = 1511, age 4 to 18 years). Participants were stratified by the ADOS module used to evaluate them. We investigated how diagnostic certainty was associated with total ADOS scores, age, and ADOS module. We calculated the odds-ratios of being diagnosed with the highest possible certainty given the presence or absence of different signs during the ADOS evaluation. Associations between diagnostic certainty and other cognitive and clinical variables were also assessed. Results In each ADOS module, some items showed a larger association with diagnostic certainty than others. Head circumference was significantly higher for individuals with the highest certainty rating across all three ADOS modules. In turn, head circumference was positively correlated with some of the ADOS items that were associated with diagnostic certainty, and was negatively correlated with verbal/nonverbal IQ ratio among those assessed with ADOS module 2. Limitations The investigated cohort was heterogeneous, e.g. in terms of age, IQ, language level, and total ADOS score, which could impede the identification of associations that only exist in a subgroup of the population. The variability of the certainty ratings in the sample was low, limiting the power to identify potential associations with other variables. Additionally, the scoring of diagnostic certainty may vary between clinicians. Conclusion Some ADOS items may better capture the signs that are most associated with clinicians’ implicit knowledge of Autistic Disorder. If replicated in future studies, new diagnostic instruments with differentiated weighting of signs may be needed to better reflect this, possibly resulting in better specificity in standardized assessments.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 15 Sep 2026 07:45.

Cited references
39
With a DOI
33
Without a DOI, from raw bibliography text
4
2 / 39 (5.1%) cited references include at least one author identified as autistic.
References with data to complete
3 / 39 (7.7%)
References with detected author names
37 / 39 (94.9%)
Without detected author names
2
Without a structured title
3
Without a stable identifier
4
References with raw author names still to review
2
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
188
From DOI or external metadata
188
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
2
61 / 188 (32.4%) names are linked to an author already present in AutiHub. 127 / 188 (67.6%) names are not yet linked.
Names linked to a person identified as autistic
2 / 188 (1.1%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 2 / 61 (3.3%). Distinct people identified as autistic: 2 / 161 (1.2%).
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