Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2)

Overview

The ADOS provides an accurate assessment and diagnosis of autism and pervasive development disorder across all ages, developmental levels and language skills.

We provide a variety of training courses in ADOS-2 - visit this page to view upcoming courses.

Suitable for

12 months to adulthood

Language Versions

English

Product Description

The gold standard for diagnosis of ASD

– Journal of Clinical Child and Adolescent Psychology

Like its predecessor, the ADOS, ADOS-2 is a semi-structured, standardised assessment of communication, social interaction, play, and restricted and repetitive behaviours. It presents various activities that elicit behaviours directly related to a diagnosis of ASD. By observing and coding these behaviours, the test user can obtain information that informs diagnosis, treatment planning, and educational placement.

5 Modules

The ADOS-2 includes five modules, each requiring just 40 to 60 minutes to administer. The individual being evaluated is given only one module, selected on the basis of his or her expressive language level and chronological age. Following guidance provided in the manual, the test user chooses the module appropriate for the individual under evaluation.

• Toddler Module – for children between 12 and 30 months of age who do not consistently use phrase speech.
• Module 1 – for children 31 months and older who do not consistently use phrase speech.
• Module 2 – for children of any age who use phrase speech but are not verbally fluent.
• Module 3 – for verbally fluent children and young adolescents.
• Module 4 – for verbally fluent older adolescents and adults.

Each module engages the individual in a series of activities involving interactive stimulus materials (all included in the ADOS-2 Kit). As an example, activities in Module 3 are listed below:

1. Construction Task
2. Make-Believe Play
3. Joint Interactive Play
4. Demonstration Task
5. Description of a Picture
6. Telling a Story From a Book
7. Cartoons
8. Conversation and Reporting
9. Emotions
10. Social Difficulties and Annoyance
11. Break
12. Friends, Relationships, and Marriage
13. Loneliness
14. Creating a Story

Standardised administration, coding and scoring

Each ADOS-2 module has its own protocol booklet, which structures the administration and guides the user through the processes of coding and scoring. As test activities are administered, the test user observes the individual under examination and takes notes. Immediately afterwards, the test user codes the behaviours observed and then uses the Algorithm Form for scoring.

In Modules 1 to 4, algorithm scores are compared with cut-off scores to provide one of three classifications: autism, autism spectrum, and non-spectrum. The difference between autism and autism spectrum classifications is one of severity, with the former indicating more pronounced symptoms. In the Toddler Module, algorithms provide ‘ranges of concern’ rather than classification scores.

Improved protocol booklets, revised algorithms and a new comparison score

Administration and coding procedures for the ADOS-2 are functionally identical to those for the ADOS. Modules 1 to 4 retain the same basic activities and codes, though some codes have been expanded and several new codes have been added. Protocol booklets for these modules have been significantly improved and provide clear and explicit administration and coding instructions.

In the ADOS-2, algorithms for Modules 1 to 3 have been revised to achieve more accurate and targeted results. These updated algorithms provide a more uniform basis for comparing results across the three modules that are used with children and young adolescents.

A new comparison score for Modules 1 to 3 allows the test user to compare a child's overall level of autism spectrum-related symptoms to that of children diagnosed with ASD who are the same age and have similar language skills. This score also makes it easier to monitor an individual's symptoms over time. The comparison score is a continuous metric, ranging from 1 to 10. However, to facilitate clinical interpretation it can also be expressed as one of four descriptive categories – from ‘no evidence of autism spectrum-related symptoms’ to ‘a high level of autism spectrum-related symptoms’.

The new ADOS-2 scoring program helps the test user to choose the correct algorithm, converts item codes to algorithm scores, adds up the algorithm, calculates the comparison score and quickly arrives at an ADOS-2 classification or ‘range of concern’.

The Toddler Module

The Toddler Module is designed specifically for children between 12 and 30 months of age who do not consistently use phrase speech. Existing ADOS-2 components have been revised, and new components added, to more accurately identify toddlers at risk for ASD.

The Toddler Module engages the child with loosely structured activities involving highly motivating materials. The goal is to see if the child demonstrates behaviours associated with ASD. As in Modules 1 to 4, observations are coded immediately following administration, and the codes are converted to algorithm scores. However, Toddler Module algorithms provide ‘ranges of concern’ rather than cut-off scores. These ranges help the test user to form clinical impressions, but avoid formal classification – which may not be appropriate at such a young age. The Toddler Module quantifies risk for ASD and signals the need for continued monitoring.

The most accurate picture of current ASD symptoms

With improved algorithms, the ADOS-2 demonstrates strong predictive validity. It provides a highly accurate picture of current ASD-related symptoms, based on real-time observations. Clinical psychologists, educational psychologists, speech and language therapists, psychotherapists, amongst others, use ADOS-2 results to inform diagnosis, intervention, educational placement and treatment planning. ADOS-2 can be used with a wide range of children and adults in any hospital, clinic or school that serves individuals with developmental disorders.

Qualification level required:
Level 3. Please see our Test User Qualifications page for guidance.

Duration

40 to 60 minutes

Release Note

2012