Bret S. Stetka, MD; David Grodberg, MD

Disclosures

June 10, 2013

Editor's Note: Following the 2013 Annual Meeting of the American Psychiatric Association (APA), Medscape spoke with David Grodberg, MD, Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, about the Autism Mental Status Exam (an assessment tool he helped develop), his ongoing research using the tool,[1] and the unified autism spectrum disorder (ASD) diagnosis as appears in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Medscape: What is the Autism Mental Status Exam?

Dr. Grodberg: The AMSE is an 8-item observational assessment tool that structures the way physicians observe and document signs and symptoms of ASD. It does not add any clinical burden to one's routine exam and it provides a score: Each of the 8 items is scored 0-2 and total scores thus range from 0-16. Preliminary validation data presented at the APA meeting reported on sensitivity and specificity of the AMSE in predicting DSM-5 diagnosis of ASD in verbal adults suspected of having ASD. Although the AMSE cannot diagnose ASD by itself, it can guide an expert's clinical judgment when considering a diagnosis of ASD. It is the first mental status exam that operationalizes the direct observation of patients' social, communicative, and behavioral functioning. The AMSE's scoring instructions and a training curriculum are available online (http://autismmentalstatusexam.com/).

Medscape: Can you give us some background on how and why the AMSE was developed?

Dr. Grodberg: The AMSE was developed over the past 3 years at the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai in New York City. The AMSE is intended to provide brief and streamlined observational assessment for ASD in underresourced and underserved clinical settings where the gold-standard diagnostic assessment is not feasible. Initial validation data[2] published in the Journal of Autism and Developmental Disorders last year included an unstratified sample of persons from age 18 months through 38 years. Current multisite validation studies are looking at different subgroups. Standardized and validated observational assessment of ASD in the adult population can promote accurate diagnosis and appropriate referral to evidence-based treatments and psychosocial services.

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