Autism Diagnostic Observation Schedule (ADOS)

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The Autism Diagnostic Observation Schedule (ADOS) is a highly recognized evaluative measure for diagnosing Autism Spectrum Disorder (ASD). It is used in individuals 12 months old and older (including adults). It is a systematic observation tool, which requires extensive training to perform and interpret. It is one part of a comprehensive evaluation and should be used along with additional assessments and parent/caregiver interviews when testing for ASD. It is most frequently used in research and specialty clinics.

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NameAutism Diagnostic Observation Schedule (ADOS)
ReferenceLord C, Rutter M, DeLavore PC, Risi, S (1999, 2001, 2002, 2008). Autism Diagnostic Observation Schedule. Los Angeles: Western Psychological Services.
SummaryThe ADOS is currently considered the “gold standard” of ASD observation measures. It was developed by researchers in ASD and continues to be studied and refined. It has been widely adopted in ASD research and clinical practice. Four modules are available depending on the individual’s age and level of language (ranging from nonverbal young children through verbally fluent adults). Specific activities and materials are used to create structured and unstructured social occasions or “presses.” The examiner rates both the spontaneous and prompted social relating, communication, and behaviors that occur during the ADOS. The ADOS can be over-interpreted or under-interpreted by general clinicians who may not have a high level of ASD expertise or specific ADOS training. Research on ADOS use among general clinicians is lacking. The ADOS is frequently used along with the Autism Diagnostic Interview – Revised (ADI-R).
Age RangeAmbulatory children with a mental age of at least 12 months through adults
Format40-60 minute direct testing
Who Can Administer and InterpretThe ADOS is commercially available. However, training in administration and scoring is available and highly recommended. Training can be as brief as attending a 2 day workshop or as extensive as establishing reliability with the authors (an extensive process of establishing that your administration and scoring is consistent with the authors’ administration and scoring). In specialty training clinics and research settings, trainees often administer the ADOS under close supervision of an ASD expert while mastering the skill of diagnosing ASD.
Results YieldedThe total score combines the Social and Communication domain items. Scores related to stereotyped or repetitive behaviors or interests do not contribute to the total score. A cutoff for “Autism” and a lower cutoff for “Autism Spectrum” are provided. Scores above the cutoffs suggest the presence of the disorder.
Author’s Suggested UsesThe ADOS is a systematic method for obtaining direct observation of the individual’s social and communication behaviors, as part of a comprehensive evaluation.
Author CautionsThe ADOS should not be used alone to make a diagnosis, as it does not account for the presence or absence of stereotyped behaviors and interests, and does not include information about the developmental history.
Development and Ongoing ResearchItems and activities were generated and tested in preliminary versions of the ADOS, with rigorous methods for identifying items that can be coded reliably and which distinguish children with ASD from children without ASD. The ADOS has been heavily researched since its development and continues to be refined. It is used in autism research around the world. Research on its use is generally conducted by groups with rigorous methods for establishing and maintaining reliability among examiners. Use of the ADOS among more general clinicians, without such rigorous reliability methods, has not been well studied.

Last Updated: December 16, 2013

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