The Autism Diagnostic Interview – Revised (ADI-R) is used to help diagnose autism in individuals of all ages. It also can be used to assess related disorders known as Autism Spectrum Disorders (ASDs). It takes the form of an extended interview that produces a range of information.
The individual being assessed may be of any age as long as their mental abilities exceed two years and they may be from any setting. Administering and scoring the ADI-R takes between 1 Ã½ and 2 Ã½ hours. The 85-page ADI-R Interview Protocol booklet has ninety-three items and is used by the interviewer to record responses.
The ADI-R must be administered by an experienced interviewer who should be accompanied by a caregiver who knows the developmental history and the daily behavior of the patient. The individual being assessed is not present during the interview.
It must be used appropriately by a trained individual. The training for ADI-R administration includes three components.
Familiarity with ASDs
Interviewers must be familiar with the concepts of ASD and the ways in which certain behaviors manifest themselves as a reflection of the ASD. Clinical training in clinical psychology, pediatrics, or child psychiatry does not match the expertise that comes with extensive first-hand experience.
People who have no clinical training whatsoever can still be trained successfully in the use of the ADI-R because of their direct contact with patients and the knowledge they have of the phenomena of ASD. However, if the interviewer has never seen the types of behavior exhibited by individuals with ASDs, skilled interviewing will not be possible.
Reading is essential, but observation is key. Clinical training does not always provide adequate experience. If experience is limited, it should be supplemented.
Training in interview skills is pertinent as well. There are particular ways in which behavior descriptions should be obtained. Not only are there generic interview skills involved, but it is important to know how to ask questions about specific behaviors.
This component requires an in-depth understanding of the underlying concepts of each item. These are described in the Interview Protocol.
Understanding the Behaviors
The interviewer also needs to have a concrete understanding of the behaviors covered in each item. This component comes from both reading and observation. The interviewer needs to have a comprehensive understanding of the behaviors and how they manifest themselves in patients with ASD.
Training for Clinical and Research Usage
Everyday use of the interview in clinical practice requires an individual to have education and experience related to working with individuals who have ASDs. They need to have received prior training in clinical interviewing and be familiar with the Interview Protocol.
If clinical users do not have an extensive background in clinical interviewing or working with individuals with ASDs, they need to acquire further training specific to the ADI-R by attending a workshop.
A high level of coding accuracy, as well as the requirements listed above, is necessary for research applications of the ADI-R. Researchers must attend an approved training program and pass with competence in use of the ADI-R.
This training includes a detailed discussion of interview coding. Successful completion requires meeting standards in both interviewing informants using the ADI-R and achieving an acceptable level of agreement with consensus codings.
All trainees must submit videos of one or two interviews that they have done after the course and send in codings for one or more other teaching tapes.