PDDBI™

Test structure

• The standard set of items is appropriate if the primary concerns are specifically related to autism (e.g., whether treatment is specifically affecting targeted behaviors).
• The extended set of items—available on both parent and teacher rating forms—is appropriate when you want to assess aspects of the child’s behaviors beyond those specifically associated with autism (e.g., fear and aggression); these may be relevant in the determination of placement and treatment recommendations.

Structure of the PDDBI Standard and Extended Forms

Interpretation Steps

More information can be found in the PDDBI Professional Manual Supplement: Advanced Score, Multirater, and Progress Monitoring Interpretation.

Technical information

• The original standardization sample consisted of 369 parents and 277 teachers of children ages 1:6 to 12:5 years with well-defined autism from a range of racial/ethnic backgrounds and geographic regions. The Adolescent Normative Data manual supplement extended the norms to age 18:5 years, using ratings from an additional 147 parents and 101 teachers.
• Concurrent validity was assessed through comparison with the Childhood Autism Rating Scale, the Nisonger Child Behavior Scales, the Vineland Adaptive Behavior Scales, and the Griffiths Mental Development Scales.
• Clinical validity was assessed through comparison with the ADI™-R, the ADOS™-G, and the Vineland Adaptive Behavior Scales.
• In the original manual, test–retest stability for the teacher ratings ranged from .65 to .99 over an average 2-week interval. For the parent sample, test–retest stability coefficients ranged from .38 to .91 over a 12-month interval.
• The new Advanced Score, Multirater, and Progress Monitoring Interpretation manual supplement includes ratings from parent–teacher pairs of 225 children with autism, with interrater reliability coefficients ranging from .31 to .88. This manual supplement also includes test–retest ratings from 233 parents over an average 6-month interval (retest coefficient range = .69–.84), and test–retest ratings from 37 teachers over an average 14-month interval (range = .57–.93). Reliable change indices are provided in the manual and the new Multirater and Progress Monitoring Reports to detect significant differences (a) between raters and (b) over time.

This supplement to the PDDBI manual is unique. It explains in detail how to select informants, how to use PARiConnect to administer the PDDBI, how to interpret raw, cluster, and T- scores, how to properly score non-verbal children, how to interpret and examine the statistical significance of differences in T-scores across parent and professional informants, how to use the ASD-Decision Tree (ASD-DT) to assist with diagnostic and referral decisions, and how to examine and interpret the statistical significance of differences in T-scores over time from the same informant for a given child. One of our independent reviewers said, 'I usually do not enjoy reading manuals, but this one was very engaging.' I hope you too find this addendum to the PDDBI engaging and helpful.

- Ira L. Cohen, PhD

• See the extent to which a child’s scores conform to what would be expected for ASD and are not too high or too low.
• See the extent to which parent and teacher/other professional informant scores agree with one another.
• Quantify a child’s assets and deficits.
• Monitor change over time for the better or for the worse.

Yes. The PDDBI is approved by TRICARE for use by ABA therapists. According to the ACD, TRICARE requires the following age-based outcome measures for beneficiaries at initial assessment and every six months:

• PDDBI (2 years–18.5 years, but can accept as early as 1.5 years)

PAR publishes two other tests that evaluate parent stress and are part of the ACD program.

• PSI-4-SF (0 years–12 years and 11 months)
• SIPA (11 years–19 years and 11 months)

PAR distributes the SRS-2 which is also part of the Autism Care Demonstration program.

Please visit the TRICARE website for more information about autism tests.

Leo: An Abbreviated Case Study of Using the PDDBI Multirater Report to Diagnose ASD

Background

Leo was evaluated at 6 years, 11 months of age for diagnostic confirmation of autism. Leo's PDDBI parent report was consistent with the diagnosis of ASD, with an atypical ASD profile characterized by relatively mild- to- moderate behavior problems and relatively weak social communication skills. His teacher's ratings resulted in a classification of Minimally Verbal ASD characterized by more severe problem behaviors.

Test Results

The T-Score Profile in the new PDDBI Multirater Report illustrates the cross-informant agreement (i.e., non-significant differences) on several domains under Approach/Withdrawal Problems (AWP) and on all the Receptive/Expressive Social Communication Abilities (REXSCA) domains. However, there were significant discrepancies (marked below the profile with "!!" icons) between parent and teacher reports in three of the AWP domains (SENSORY, FEARS, and AGG) and both associated composites (REPRIT/C and AWP/C). The profile indicates that the parent reported fewer problems at home (T scores in the average range for autism) than the teacher did at school (T scores in the range of severe problems).

Outcome

Examination of each informant's cluster scores later in the report indicated marked discrepancies in several areas, including auditory and social withdrawal behaviors, problems with caregiver return, and aggressiveness toward others. Supplemental information from Leo's parents and teacher indicated that noise levels at school and Leo's intolerance for change likely played a role in these differences between settings. Understanding the differences between settings helped his school team develop a specific plan to help his teacher manage his behaviors and mitigate his distress.

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Donna: An Abbreviated Case Study of Using the PDDBI Progress Monitoring Report to Evaluate Autism Treatment Over Time

Background

Donna was first referred around age 2 years because of delayed milestones and irritable behaviors. Over the next few years repeat assessment indicated little progress with intervention, and she was eventually diagnosed with and treated for inflammatory bowel disease. She was re-assessed a third time just before she turned 5 years old; she was diagnosed with autism, and her PDDBI at that time showed ongoing concerns with expression language and social skills.

Test Results

Donna was evaluated for a fourth time with the PDDBI one year later, when she was almost six years old, to assess for treatment gains and to help update her therapy needs. Compared to her evaluation one year prior, Donna’s PDDBI T scores showed significant improvements (denoted by “!” and “!!” icons in the score table, with the “4” icon consistently indicating that time 4 scores were significantly better) in problem behaviors in three AWP domains and the accompanying composite. In each case, the magnitude of change was seen in only small percentages of the progress monitoring sample (less than 7%), indicating that this magnitude of change is unexpected in the absence of intervention. In the REXSCA dimension, the EXPRESS and LMRL domains showed significant improvements in abilities, as did both composites. A significant decrease in the overall AUTISM composite reflected these improvements.

Outcome

These gains were directly related to her ongoing treatment without the interference of medical symptoms, as her bowel condition had been successfully treated, and they had been targeting social prag¬matics and sensory tolerances with behavioral desensitization over the previous year. Her evaluating clinician recommended maintaining several of her treatment goals and setting additional goals for expressive language and social overtures.