Diagnostic utility of the autism diagnostic observation schedule in a clinical sample of adolescents and adults

•In patients with suspicion of highfunctioning autism, differentiation to other diagnoses, especially personality disorders, is a challenge.•ADOS Module 4 has good sensitivity and specificity, with slightly better results for the revised algorithm.•For females, sensitivity is lower than for males.•The ADOS Module 4 has good diagnostic utility when it is used in combination with other sources of diagnostic information and operated by experienced examiners.