Screening inventories and diagnostic assessment: relationship between caregiver report accuracy and final ASD diagnosis

Introduction: Multidisciplinary assessment for the diagnostic investigation of neurodevelopmental disorders involves the use of caregiver report instruments and performance-based assessment protocols in fields such as speech-language pathology, medicine, and neuropsychology. This approach aims to correlate findings and contribute to diagnostic clarification. Objective: To compare caregiver responses in report inventories with the final diagnosis in cases of suspected Autism Spectrum Disorder (ASD). Method: As part of the ASD Assessment Protocol, caregiver reports were collected using the Autism Behavior Checklist (ABC) through an online screening, with inclusion criteria based on the risk score proposed by the test. For objective, quantitative, and qualitative assessment, the following tests were used: Wechsler Abbreviated Scale of Intelligence (WASI) or SON-R 2 ½ - 7 [a] - Nonverbal Intelligence Test, Childhood Autism Rating Scale - Second Edition (CARS-2), Vineland Adaptive Behavior Scales, Pragmatic Skills Assessment Protocol for children with Autism Spectrum Disorder (PAHPEA), ABFW Vocabulary Test, Strange Stories, TiPiTi Language Examination, clinical observation through free play, and psychiatric evaluation. Results: Eighteen families were selected according to the inclusion criteria of the protocol. Three caregivers reported a low probability of ASD on the ABC; among them, one child was diagnosed with ASD level 1. Three parents indicated a moderate probability of ASD on the ABC, and among them, one child was diagnosed with ASD level 3. Twelve families reported a high probability of ASD on the ABC; however, only three children received an ASD diagnosis—two with level 2 support and one with level 3. Two types of inconsistencies were observed: false negatives (2) and false positives (9). Conclusion: Caregiver reports may be influenced by various factors, such as education level, digital literacy, and prior knowledge of the subject, which affect the accuracy of responses in report inventories, leading to discrepancies with the confirmed diagnosis. Keywords: ASD; screening tests; assessment; diagnosis. Reference: Marteleto MR, Pedromônico MR. Validity of Autism Behavior Checklist (ABC) Braz J Psychiatry, 2005.