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The purpose of this paper is to assess the validity of the Autism Diagnostic Interview-Revised (ADI-R) in an Iranian population to determine its efficacy in identifying children with autism spectrum disorder (ASD) who parents have Persian-speaking parents.

A case–control study was performed in March until July 2020 in Hamadan city, Iran. The case group was children were examined by the clinicians used a coding scheme based on the DSM-IV criteria for ASD. The control group was all children in the family, including healthy siblings, were asked to participate in the study. The reliability, content and face validity were performed to assess the psychometric properties of the tool. Confirmatory factor analysis (CFA) was performed to evaluate the four-dimensional structure of the tool (Scores A, B, C and D). Statistical analysis was performed using AMOS for SPSS 21, and the statistical significant level was less than 0.05.

The quantitative content validity analysis revealed that the mean of content validity ratio (CVR) and content validity index (CVI) for all domains was 0.94 and 0.91, respectively. For CFA, four domains A, B, C and D were used and demonstrated a good fit (CFI = 0.92 and RMSEA = 0.06). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in domains A, B (verbal), C and D were 100%. For domain B (non-verbal), the sensitivity, specificity, PPV and NPV were 86.7%, 100%, 100% and 88.2%, respectively.

This study showed that ADI-R has sufficient ability to discriminate between children with ASD and those with no psychiatric diagnosis, and it is a reliable tool in Iran. The sensitivity and specificity for correctly diagnosing ASD was high, regardless of the age and cognitive level of the examiner.

To the best of the authors’ knowledge, this is the first paper on psychometric properties of ADI-R in children with ASD.