The Autism Diagnostic Observation Schedule (ADOS) generates accurate assessments of autism and development disorders across all ages, language skills, cultural backgrounds and developmental levels. The ADOS is a standardized diagnostic assessment of social, imagination and communication skills of individuals who may have autism spectrum disorders (ASD).
The ADOS assessment uses planned social situations to trigger target responses and interpersonal interactions. These communication opportunities are designed to elicit a wide range of verbal, physical, social and imaginative interchanges.
The ADOS is divided into four unique modules that each requiring 30 to 40 minutes to administer. The individual being tested is given just one module depending on their age, functioning and language level. Module One is used for children who have limited speech. Module Two is for those who are can speak, but are not verbally fluent. Module Three is used with verbally fluent children and Module Four is used with verbally fluent adolescents and adults. The ADOS does not contain modules that address non-verbal adolescents and adults. The ADOS uses standardized terms, materials, activities, activity introductions and hierarchical sequences of social activities.
Modules One and Two require the test administrator and the child to move around the room. Modules Three and Four involve more conversation, so they can be administered at a table. The first Module for preverbal and non-verbal children includes scenarios involving snacking, free play, routines with objects, birthday parties and functional imitation. The second Module includes scenarios involving conversations, task demonstrations, picture descriptions, make-believe play, task construction and book reading. This Module is designed for individuals with phrase speech abilities. The third Module uses some of the second Module activities, but also includes cartoons, conversation reporting, emotional analysis, social challenges and story creation. Module Three is for children and adolescents who are verbally fluent. The fourth Module is for verbally fluent adolescents and adults. It includes discussions of stories, work, school, books, friendship, loneliness, relationships and future plans.
More than one Module may be administered if the behavioral specialist or educational psychologist determines that a more or less advanced module is appropriate. There are guidelines for selecting the most appropriate module and instructions for the administrating, scoring and interpreting of the results. The ADOS classifications are based on categorized and coded behaviors that use a diagnostic algorithm based on the DSM-IV diagnostic criteria. These total score is the sum of the combined communication and reciprocal social interaction scores. ADOS play activities and stereotyped behaviors are coded, but they are not included in the scoring algorithm because it is difficult to assess general characteristics in a limited period of time. The individuals’ behaviors are coded using a zero to three point ranking system. A zero indicates normal behavior, a one indicates occasional abnormalities, a two indicates a definite difference and a three indicates abnormal functioning.
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Various studies and research have explored and examined the effectiveness of the ADOS for clinical practice. Most studies show a 70 to 80 percent agreement between ADOS classifications and DSM-IV diagnostic criteria. The Autism Diagnostic Observation Schedule is being used by schools to identify and manage children who have behavioral disorders and developmental challenges.