{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:04:48Z","timestamp":1780074288980,"version":"3.54.0"},"reference-count":67,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P50 HD103538"],"award-info":[{"award-number":["P50 HD103538"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The current study investigated 1144 toddlers and preschoolers (ASD\u2009+\u2009GDD\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009592; ASD only\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009249; GDD only\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200989; no ASD or GDD\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009214) with the toddler module (38.6%), Module 1 (57.5%), and Module 2 (3.9%) as well as Mullen Scales of Early Learning. The calibrated severity score (CSS) was used to compare severity across modules. The study sample was stratified by GDD (Visual Reception Developmental Quotient\u2009&lt;\u200975), and each stratum was investigated with descriptive statistics, ROC curves, and test statistics to identify the optimal cut\u2010off CSS to differentiate ASD and non\u2010ASD. ROC analysis indicated that the CSS scores showed excellent discrimination for ASD status for both the GDD (AUC\u2009=\u20090.86) and no GDD (AUC\u2009=\u20090.95) strata. In the no\u2010GDD stratum, an ADOS\u20102 CSS of 5 was determined to be the optimal cut\u2010off. In the GDD stratum, an ADOS\u20102 CSS of 6 was determined to be the optimal cutoff. While non\u2010spectrum\/little\u2010to\u2010no concern and autism\/moderate\u2010to\u2010severe concern showed very high predictive accuracy for diagnostic outcomes, the autism spectrum\/mild\u2010to\u2010moderate concern lacked clear diagnostic directionality, regardless of GDD status. This is the first study with a large sample of toddlers and preschoolers exploring optimal ADOS\u20102 CSS cut\u2010off when stratified by GDD.\n                  <\/jats:p>","DOI":"10.1002\/aur.70233","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T10:24:53Z","timestamp":1774347893000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing Accuracy of Autism Diagnostic Observation Schedule\u20102 in Very Young Children With Modifying the Effect of Global Developmental Delay"],"prefix":"10.1002","volume":"19","author":[{"given":"Jacqueline","family":"Liu","sequence":"first","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Lu","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vini","family":"Singh","sequence":"additional","affiliation":[{"name":"Kennedy Krieger Institute  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Choi","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Cross","sequence":"additional","affiliation":[{"name":"Kennedy Krieger Institute  Baltimore Maryland USA"},{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3866-1635","authenticated-orcid":false,"given":"Ji Su","family":"Hong","sequence":"additional","affiliation":[{"name":"Kennedy Krieger Institute  Baltimore Maryland USA"},{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/09297040500473714"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.31661\/gmj.vi.3906"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0031\u20103955(16)38234\u20107"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1352\/1944-7558-116.5.331"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13802"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdev.13683"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/21622965.2012.682852"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20107610.2009.02101.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2014.09.015"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rasd.2023.102184"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.01916"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787\u2010019\u201001411\u20108"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023\u2010062511"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-009-0749-9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396941518764764"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2842"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010024\u201006712\u20109"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/073428290001800409"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010015\u20102432\u20107"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2015.04.005"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/09297049.2015.1020775"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-008-0674-3"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/CHI.0b013e31816bffb7"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-006-0280-1"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010007\u20100432\u2010y"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803\u2010020\u201004432\u20104"},{"issue":"4","key":"e_1_2_9_29_1","first-page":"862","article-title":"Age 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