Understanding the ADOS-2
The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) is an activity-based assessment administered by trained clinicians to evaluate communication skills, social interaction, and imaginative use of materials in individuals who are suspected to have autism spectrum disorder (ASD). The ADOS-2 was developed by Dr. Catherine Lord and her colleagues to provide an opportunity to observe symptoms and behaviors associated with ASD in a consistent manner across different clients, clinicians, and locations. The ADOS-2 is currently considered the “gold standard” in the assessment of ASD.
Appropriate Candidates for the ADOS-2
The ADOS-2 is designed for individuals as young as 12-months of age all the way through adulthood. For individuals to adequately participate in the assessment, the ADOS-2 requires a minimum developmental level of 12-months and no significant sensory or motor impairments (e.g., blindness, deafness, confined to wheelchair).
The ADOS-2 can accommodate people across the lifespan because it comprises several modules. Clinicians select the appropriate module for an individual based upon the person’s language ability (ranging from no speech to verbally fluent) and age.
What to Expect During an Evaluation at CRG
At CRG, the ADOS-2 is used as just one part of a comprehensive evaluation. Other components include an interview with the individual suspected of having Autism Spectrum Disorder and a parent or significant other with an experienced clinician to gather information about the person’s birth, medical and developmental history, and current symptoms and concerns, as well as standardized measures that are completed by parents, teachers, and other key informants. Depending on client preference and the clinician’s judgement, a comprehensive evaluation may be completed in a single appointment. In other situations, the evaluation may be completed over the course of two appointments.
In terms of what to expect with the ADOS-2, the assessment takes between 30-60 minutes for a clinician to administer. Clients are typically scheduled with a clinician with whom they have little to no familiarity to obtain a sample of the client’s behavior that is not influenced by previous interactions. When toddlers or children are being assessed, the parent may be asked to be present in the room for the entire administration. A parent’s primary role is to simply observe, although the clinician may ask the parent to interact with the child in specific ways at certain points during the ADOS-2. For adolescents and adults, the ADOS-2 is typically administered with only the client and clinician in the room
The results of the assessment are reviewed with families shortly following the completion of the comprehensive evaluation. In some cases, this is during the same appointment as the assessment. In other cases, a separate follow-up appointment may be scheduled to go over the results and discuss recommendations. In addition to spending time with a clinician to review the results of the evaluation and address any questions, families are also provided a written report with detailed recommendations. This is typically available 1-2 weeks following the assessment.
One Final Note
Although the ADOS-2 is considered the “gold standard” for ASD assessment, it is important to know that it is just one source of information and is not on its own sufficient for making a diagnosis of ASD. The ADOS-2 should always be part of a comprehensive evaluation that considers a person’s developmental history, information provided by parents and other key informants, behavioral observations both during and outside of the ADOS-2 administration, and the judgement of experienced clinicians.
Lord, C., Risi, S., Lambrecht, L., Cook, E.H., Jr., Leventhal, B.L., DiLavore, P.C., Pickles, A., &
Rutter, M. (2000). Autism Diagnostic Observation Schedule – Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism & Developmental Disorders, 30(3), 205-223.
Lord, C., Rutter, M., DiLavore, P.C., Risi, S., Gotham, K., & Biship, S.L. (2012). Autism
Diagnostic Observation Schedule, Second Edition; Part I: Modules 1-4. Los Angeles, CA: Western Psychological Services.
Lord, C., Luyster, R.J., Gotham, K., & Guthrie, W. (2012). Autism Diagnostic Observation
Schedule, Second Edition; Part II: Toddler Module. Los Angeles, CA: Western Psychological Services.