Upgrading

Note on version numbers

Successive versions of the 3di5_uk application are distinguished by adding to the name of the application the date of release in yymmdd (year‑month‑day) order. For example, the application called 3di5_uk_230122 would be a version of the 3di5_uk released on yymmdd so 22/01/2023.

Successive minor changes to an application release are shown by the addition of a final letter.

Successive versions of the 3di5 User Guide, and of the resource and reference documents provided in the PreEntry and Reference folders of your 3di5 application, are likewise indicated by adding to their names the yymmdd of their release. The most recent versions of documents will typically pre-date your 3di5 application. A distant date doesn’t mean a document is out of date – lots of things don’t need to change!

Using backends from an earlier version

In brief, the simplest solution is to copy each backend folder in the Backends folder in your previous 3di installation to the Backends folder in your new installation. If the new and old 3di installations are not on the same machine you can copy the required backends folders via a USB key. Copying rather than moving backend folders means that you will have the original backends as backups. You will not be able to copy a backend if you have already created a new backend with the same name.

If some reports for children in your imported backends don’t run, just open each interview from the new installation and immediately close it – that way each child will be endowed with unanswered copies of any questions which are new in your new installation.

If your new installation has dropped some questions that were active in your old installation they will not appear on the interview forms and will not be reflected in reports from the new installation.

The 2023 version and DSM-5 brief assessment

Here are some notes for users upgrading from pre-2023 to 2023-and-later versions of the 3di.

1. The new software uses the 2-domain approach to ASD – so uniting Social Reciprocity and Communication domains, and extending considerably several aspects of the Restricted Behaviours group of symptoms.

2. The 3di is now DSM-5 and ICD-11. By design the two sets of criteria are so similar that ASD outcomes (and many others) can be reported as DSM-5 or as ICD-11. The 3di always references DSM-5 because the APA got there about 7 years before the WHO; you can substitute one term for the other in your reports or perhaps reference neither.

3. In the Case Manager the buttons Report (with ASD_extended) and Report ASD_brief now generate DSM-5 output and use corresponding new interview routes.

4. The ICD-10/DSM-4 ASD routes are still included in the Route Explorer, but only the ASD_brief route is reported, and only as an optional extra in the brief and extended reports for DSM-5. Click Edit report preferences in the Case Manager and select the last option.

5. The ASD routes are renamed in all the Choose route dropdowns so that you can choose the DSM-5 routes or the original ICD-10 routes. There’s a list of all the ASD routes below.

6. The two-domain DSM-5 ASD reports are very different from the 3-domain reports of DSM-4/ICD-10: the 3-domain outcomes were reported as a single number for each domain despite the huge differences in symptomatic presentation across ASD children. Under DSM-5 there are independent scores for each of the many aspects of symptomatology; merging measures of these aspects into a single number loses a great deal of information about a child’s difficulties and strengths.

7. Both the brief and the extended assessments for DSM-5 ASD compute a measure of the child’s strengths and difficulties for each element of the diagnostic criteria. There are 16 elements across Criteria A.1 to A.3 and 11 elements across Criteria B.1 to B.4. The brief assessment gives a tally for each of the 27 elements and computes whether the child meets criteria for the diagnosis on the basis of the parental report. The extended assessment instead gives percentage scores for each element of the criteria – and DSM-5 outlines how the clinician should use these as a basis for making a clinical judgement about the outcome. The formal requirement is for a minimum of 1 number over threshold in each of Criteria A.1 to A.3 and for a minimum of 1 number over threshold in at least two of Criterion B.1 to B.4. Whether these values constitute a diagnosis when supplemented by numbers derived from the child is in the end a clinical judgement – though often the values will be clear.

8. The scope of the DSM-5 ASD symptomatic criteria is wider than it had been under DSM-4 and ICD-10 (especially in relation to sensory interest, hyper/hypo sensory sensitivity, and speech analogues of repetitive/stereotyped behaviour), so we had to replace some items in order to achieve a manageably short assessment. Items were chosen that were already reasonably represented by other items. However, if you miss certain questions you can add these to a variant of the provided Route – they won’t change the computed scores, but they will add to your clinical understanding of the child.

9. Tab_6_3 in the training manual gives details of the tallied and the percentage scoring systems.

10. Tab_6_2 in the training manual corresponds to the Report (with ASD_extended) when the option to include ICD-10 outcomes is selected in Edit report preferences. If you wanted only ICD-10 ASD outcomes and no other elements of the report you could make the preference selection and use the Report ASD_brief button. Any preference changes you make persist until you change them.

11. The extended report prior to DSM-5 attempted to cover everything you might have completed in the entire 3di – and you would select just what you needed. Under DSM-5 the extended report does the same thing and so includes all the possible variants of the DSM-5 ASD tables. Probably you would use only one or two of those in a given case. Note that the column headings of the many ASD tables make it clear whether you are looking at a tallied or a percentage set of results.

12. However, whereas the ASD_extended route is too long for most CAMHS and similar settings, the percentage scoring system means that you can probe a particular aspect of symptomatology by completing ASD_brief and then selecting ASD_extended and answering just questions around that aspect. Your additional material will be reported in the extended report to add to your clinical picture (and, of course, can be played back to you in the route report for ASD_extended).

13. The DSM-5 brief assessment does not give a diagnosis as with the prior ICD-10 assessments. The emphasis is instead on clinician interpretation. In each scoring table row, a higher score indicates a higher level of symptomatology. but there isn’t a strict cut off or benchmark for what would be considered ‘clinically significant’. This matter is covered in depth during the training course.

Route name	Description
ASD_brief (DSM-5 Crit A+B)	use routinely for a brief DSM-5
ASD_brief (DSM-5 Criterion A)	just in case you wanted to see or report Crit A uncluttered
ASD_brief (DSM-5 Criterion B)	just in case you wanted to see or report Crit B uncluttered
ASD_brief (ICD-10)	under ICD-10/DSM-4 this was the original ASD_brief
ASD_extended (DSM-5 Crit A+B)	use routinely for an extended DSM-5 when ample time is available
ASD_extended (DSM-5 Criterion A)	just in case you wanted to see Crit A uncluttered
ASD_extended (DSM-5 Criterion B)	just in case you wanted to see Crit B uncluttered
ASD_extended (ICD-10)	under ICD-10/DSM-4 this was the original ASD_brief; however it is no longer reported (except via Route Reports)

Changelog

Changes introduced in 230122

1. DSM-5 (ICD-11) scoring is promoted, while scoring according to ICD-10 (DSM-4) criteria is available but described as superseded. If you do require ICD-10 scores you can select their inclusion from the Edit report preferences button in the Case Manager. The related interview Routes are available in the Choose route dropdowns.

2. The new DSM-5_brief route and report elements have been added.

Note that as of 2024, this version is not yet generally released.

Changes introduced in 210110

1. SPSS export functionality is completely removed.

2. Support added for 64-bit Office. Compatibility with 32-bit Office retained.

3. No longer includes a bundled Microsoft Access Runtime. This means users are required to have Access preinstalled, or else download the Access Runtime themselves.

4. DSM-5_brief subscales (T and U) and routes are present but seemingly undocumented.

5. The Route Explorer now contains 'jump to question' functionality.

Changes introduced in 190109

Compared to a baseline of version 170107.

1. Bug fix: in certain cases, for example when entering the child's date of birth, dates beyond 2020 had been rejected. Now any date can be entered.

2. Bug fix: in Word reports, a pair of 'Qs to do' cells had been incorrectly swapped in the ASD Outcomes: Developmental normality table. This has been rectified.

3. Bug fix: in Word reports, Chinese characters no longer appear in patient ages in the 3di English edition.

4. Bug fix: previously only the most recently created user route could be selected. Now, any user route can be selected.

5. Bug fix: in Word reports, scores in DSM-5 SCD Criterion B: S1a Functional impairment were incorrectly calculated in certain cases. This has been rectified.