Autism Diagnostic Observation Schedule (ADOS)

Video Transcript

The Autism Diagnostic Observation Schedule, commonly referred to as the ADOS, is a semi-structured standardized observational assessment tool designed to assess autism spectrum disorders in children, adolescents and adults. In this webcast Dr. Ruth Aspy and Dr. Barry Grossman will briefly discuss the modules within the ADOS and the format for administering the assessment tool.

Hello, I'm Dr. Ruth Aspy and I'm Dr. Barry Grossman. We're both psychologists and members of the Ziggurat Group. Today we are going to introduce you to the ADOS. We're often asked what's the best tool to use for assessing autism spectrum disorders. Our response is that accurate evaluation depends more on the clinician than the tool. The best instruments are meaningless when those interpreting them do not have the training and experience to make accurate judgments. A skilled evaluation team and quality instruments are the ideal combination. We are going to briefly discuss one of the most well researched tools in the field, the ADOS. The ADOS is a semi-structured standardized observational assessment tool designed to assess autism spectrum disorders in children, adolescents and adults. It may be used in children as young as two years old. The ADOS should be incorporated into a comprehensive autism evaluation. The ADOS consists of four modules that cover a broad age and developmental range. The format is interactive and play-based. For example, there are tasks such as bubbles, make-believe play and conversations about friends and emotions. The first two modules target students with absent or limited verbal skills. Modules three and four are designed for children, adolescents and adults with fluent speech. Each module consists of a variety of activities that provide the examiners with the opportunity to observe social and communication skills associated with autism spectrum disorders. When administering modules one and two, a child and evaluator move about the room. Modules three and four involve more conversation. Examiners select a module based on the individual's expressive language skills and chronological age of the student. Each module takes approximately 30 to 45 minutes to administer. Observations are recorded and scored by the examiners. There are four subscales on the ADOS: communication, reciprocal social interaction, imagination, creativity or play, and stereotyped behaviors and restrictive interests. The ADOS provides cut-off scores to aid in interpretation. While the ADOS provides cut-off scores, these are not definitive. The final decision regarding diagnosis and eligibility should be based on the complete evaluation. Remember that no test score can replace experience and expertise of the interdisciplinary team. Those who participate on interdisciplinary evaluation teams will see advantages to using the ADOS. It is highly regarded and can be administered in a short period of time. The ADOS may be used across age ranges for students in public school. Some find administration of the ADOS to be somewhat rigid. Only one examiner administers the items and interacts with the student. It's often helpful to augment the interactions following the ADOS administration. Scoring the ADOS requires practice and it may be time consuming. We find the discussion between team members to be very valuable. Formal training workshops are offered through the publisher Western Psychological Services.

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