Child and Young Person assessment

The gold standard for diagnosis of Autism

– Journal of Clinical Child and Adolescent Psychology

The 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 Autism. By observing and coding these behaviours, the test user can obtain information that informs diagnosis, treatment planning, and educational placement.

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The ADOS-2 includes five modules, each requiring around 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. 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

The ADI-R has proven effectiveness in differentiating autism from other developmental disorders, assessing syndrome boundaries, identifying new sub-groups and quantifying autistic symptomatology.

Composed of 93 items, the ADI-R focuses on three functional domains:

• Language and Communication

• Reciprocal Social Interactions

• Restricted, Repetitive and Stereotyped Behaviours and Interests

Interview questions cover eight content areas:

• The subject's background including family, education, previous diagnoses and medications

• Overview of the subject's behaviour

• Early development and development milestones

• Language acquisition and loss of language or other skills

• Current functioning in regard to language and communication

• Social development and play

• Interests and behaviours

• Clinically relevant behaviours such as aggression, self injury and possible epileptic features.

To administer ADI-R, an experienced clinical interviewer questions a parent or caregiver who is familiar with the developmental history and current behaviour of the individual being evaluated.

Administration of the ADI-R requires use of the ADI-R Interview Protocol booklet which contains the 93 items. Following a standardised procedure, the interviewer records and codes the informant's responses in the Interview Protocol booklet.

Results are scored and interpreted using a Diagnostic Algorithm or a Current Behaviour Algorithm or both depending on the purpose of the evaluation.

Our initial questionnaire covers information relating to reason for referral, current concerns, early development and family history, education, and when concerns were first noted.