Validation of the Mandarin Chinese version of the Autism Diagnostic Observation Schedule-2 for autism spectrum disorder

Background: The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) is a benchmark in the assessment and diagnosis of autism spectrum disorder (ASD) and has been validated in different language settings, including German, Greek, and Korean. However, the diagnostic validity of the Taiwanese Mandarin Chinese version of the ADOS-2 is unknown. Methods: The validity of the ADOS-2 was assessed in this study. We enrolled 218 patients, including toddlers, children, adolescents, and adults, with ASD diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The study also enrolled 93 nonASD controls. The diagnostic sensitivity and specificity of five modules were calculated. Results: Based on the total scores of social affect and restricted and repetitive behaviors for the toddler module (MT) and Modules (M) 1-3 and the total score of communication and reciprocal social interaction for M4, we performed a receiver operating characteristic curve analyses, which revealed that the diagnostic specificity of the ADOS-2 ranged between 0.71 for M3 and 1.00 for MT, M1 with few to no words, and M2 with & GE; 5 years; the diagnostic sensitivity of the ADOS-2 ranged between 0.83 for MT with some words and 0.96 for M1 with few to no words. Discussion: This study clinically established the diagnostic validity of the Taiwanese Mandarin Chinese version of the ADOS-2. The ADOS-2 may be used for the assessment and diagnosis of ASD in clinical settings in Taiwan.