What Is the ADI-R and Why Is It Used in Autism Assessments?

This guide explains what the ADI-R is, what it covers, why it matters, and what happens if no one can remember early childhood.

ADI-R stands for Autism Diagnostic Interview -- Revised. It's a structured interview used by trained clinicians as part of an autism assessment, and is widely used in the UK and internationally.

Autism is a lifelong, developmental condition, so signs are usually present from early childhood, even if they weren't noticed at the time. The ADI-R helps clinicians build a detailed picture of how a person developed, and how things are now.

Because it's an interview rather than an activity, it works well by video as well as in person.

For children: the interview is with the child's parent or carer. The child doesn't need to be there. The session will be conducted by phone.

For adults: the interview is with an informant. This is someone who knew you well when you were young, such as a parent, older sibling or other relative. You'll usually be asked to suggest someone, and they'll need to agree to take part. You don't need to be there for their interview. The session will be conducted by phone.

The clinician asks about:

• early development: for example, when first words, walking and other milestones happened
• language and communication: how the person used speech, gestures, eye contact and conversation
• social interaction: play, friendships, sharing interests and responding to others
• repetitive behaviours and interests: routines, strong interests, repeated movements and sensory differences
• how things are now, compared with early childhood

Many questions focus on what the person was like at around 4 to 5 years old, as this is often when differences are clearest.

The ADI-R usually takes around 1.5 to 2 hours. You can take breaks whenever you need to.

No. The clinician isn't looking for particular answers. They want an honest description of what you remember.

It's completely normal not to remember everything, or to be unsure about exact ages. Saying "I'm not sure" is always fine. Examples and stories are often more helpful than precise dates.

This is common, especially for adults. Parents may have passed away, live far away, or not remember clearly. Some people are estranged from their family, or grew up in care.

An assessment can still go ahead. The clinician may:

• speak to a different informant, such as an older sibling, aunt, uncle, grandparent or long-standing family friend
• look at old school reports, health records or baby books
• use photos or videos from childhood
• ask about your own memories of growing up
• use a different, more flexible developmental history interview

NICE guidelines recognise that this information isn't always available. Clinicians use their professional judgement to build the clearest picture possible from the information there is.

The ADI-R is scored using a standard system that shows how closely the history matches patterns commonly seen in autism. But it never diagnoses autism on its own.

The clinician brings it together with:

• an observation, such as an ADOS-informed session
• questionnaires from you, your family or your child's school
• information about daily life, health and any other conditions

In line with NICE guidelines, the final decision uses DSM-5 or ICD-11 criteria and looks at the whole picture.

• Look back at old records. School reports, red books, photos and videos can jog your memory.
• Talk to family members. Others may remember things you don't.
• Jot down examples. Write down anything you remember about early play, speech, friendships or routines.
• Find a quiet space. If the interview is by video, choose somewhere you won't be interrupted.
• Take breaks. It's a long conversation, so have a drink nearby and pause when you need to.

Raiys works nationwide, offering online autism assessments carried out by an experienced, specialist team. Our assessments follow NICE guidelines, and you'll receive a clear, detailed report designed to be shared with your GP, school or employer.

If you're in crisis right now, call 999, go to A&E, or call Samaritans free on 116 123, any time of day or night.

Ready to take the next step? Find out more about our autism assessments.

The ADI-R can feel like a lot of questions, but there's no wrong way to answer. Every memory you share helps build a clearer picture, and a better understanding of you or your child.