TY - JOUR

T1 - Utility of the Autism Diagnostic Observation Schedule and the Brief Observation of Social and Communication Change for Measuring Outcomes for a Parent-Mediated Early Autism Intervention

AU - Carruthers, Sophie

AU - Charman, Tony

AU - El Hawi, Nicole

AU - Kim, Young Ah

AU - Randle, Rachel

AU - Lord, Catherine

AU - Pickles, Andrew

AU - Green, Jonathan

AU - Aldred, Catherine

AU - Barrett, Barbara

AU - Barron, Sam

AU - Beggs, Karen

AU - Blazey, Laura

AU - Bourne, Katy

AU - Byford, Sarah

AU - Collino, Julia

AU - Cutress, Anna

AU - Harrop, Clare

AU - Houghton, Tori

AU - Howlin, Pat

AU - Hudry, Kristelle

AU - Le Couteur, Ann

AU - Leach, Sue

AU - Leadbitter, Kathy

AU - MacDonald, Wendy

AU - McConachie, Helen

AU - Randles, Sarah

AU - Slonims, Vicky

AU - Taylor, Carol

AU - Temple, Kathryn

AU - White, Lydia

AU - the PACT Consortium

N1 - Publisher Copyright: © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals LLC.

PY - 2021

Y1 - 2021

N2 - Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item-level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS-2) algorithm, and ADOS-2 Calibrated Severity Scores (CSS) with autistic children aged 2–5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS-BOSCC). Among the 117 children using single or no words (Module 1), the ADOS-BOSCC, ADOS algorithm, and ADOS CSS each detected small non-significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with “few to no words” at baseline, while children with “some words” showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item-level intervention effects reached significance, with largest changes observed for Gesture (ADOS-BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item-level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS-BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item-level intervention effect plots have the potential to indicate intervention “signatures of change,” a concept that may be useful in future trials and systematic reviews. Lay Summary: This study compares two outcome measures in a parent-mediated therapy. Neither was clearly better or worse than the other; however, the Autism Diagnostic Observation Schedule produced somewhat clearer evidence than the Brief Observation of Social Communication Change of improvement among children who had use of “few to no” words at the start. We explore which particular behaviors are associated with greater improvement. These findings can inform researchers when they consider how best to explore the impact of their intervention.

AB - Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item-level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS-2) algorithm, and ADOS-2 Calibrated Severity Scores (CSS) with autistic children aged 2–5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS-BOSCC). Among the 117 children using single or no words (Module 1), the ADOS-BOSCC, ADOS algorithm, and ADOS CSS each detected small non-significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with “few to no words” at baseline, while children with “some words” showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item-level intervention effects reached significance, with largest changes observed for Gesture (ADOS-BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item-level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS-BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item-level intervention effect plots have the potential to indicate intervention “signatures of change,” a concept that may be useful in future trials and systematic reviews. Lay Summary: This study compares two outcome measures in a parent-mediated therapy. Neither was clearly better or worse than the other; however, the Autism Diagnostic Observation Schedule produced somewhat clearer evidence than the Brief Observation of Social Communication Change of improvement among children who had use of “few to no” words at the start. We explore which particular behaviors are associated with greater improvement. These findings can inform researchers when they consider how best to explore the impact of their intervention.

KW - Autism Diagnostic Observation Schedule

KW - autism spectrum disorder

KW - Brief Observation of Social Communication Change

KW - intervention

KW - outcome measures

KW - trials

U2 - 10.1002/aur.2449

DO - 10.1002/aur.2449

M3 - Journal article

C2 - 33274842

AN - SCOPUS:85097005569

VL - 14

SP - 411

EP - 425

JO - Autism Research

JF - Autism Research

SN - 1939-3792

IS - 2

ER -