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


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

Name Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2)
References Lord C, Rutter M, DiLavore PC, Risi S, Gotham, K, & Bishop S. (2012). Autism Diagnostic Observation Schedule, Second Edition. Torrence, CA: Western Psychological Services.

Lord C, Luyster RJ, Gotham K, Guthrie W. (2012). Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Manual (Part II): Toddler Module. Torrance, CA: Western Psychological Services.

Summary The ADOS-2 is currently considered the "gold standard" of ASD observation measures. It was developed by researchers in ASD and continues to be studied and refined, and is now in its second edition. It has been widely adopted in ASD research and clinical practice. Five modules are available depending on the individual's age and level of language (ranging from toddlers and 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-2. The ADOS-2 can be misinterpreted by general clinicians who may not have a high level of ASD expertise or specific ADOS-2 training. Research on ADOS-2 use among general clinicians is lacking. The ADOS-2 is often used along with the Autism Diagnostic Interview – Revised (ADI-R).
Age Range Ambulatory children with a developmental age of at least 12 months through adults
Format 40-60 minute direct testing
Who Can Administer and Interpret The ADOS-2 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-2 under close supervision of an ASD expert while mastering the skill of diagnosing ASD.
Results Yielded The 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 Uses The ADOS-2 is a systematic method for obtaining direct observation of the individual's social and communication behaviors, as part of a comprehensive evaluation.
Author Cautions The ADOS-2 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 Research Items and activities were generated and tested in preliminary versions of the ADOS-2, with rigorous methods for identifying items that can be coded reliably and which distinguish children on the autism spectrum and those who are not. The ADOS-2 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-2 among more general clinicians, without such rigorous reliability methods, has not been well studied.
The Center for Autism Research and The Children's Hospital of Philadelphia do not endorse or recommend any specific person or organization or form of treatment. The information included within the CAR Autism Roadmap™ and CAR Resource Directory™ should not be considered medical advice and should serve only as a guide to resources publicly and privately available. Choosing a treatment, course of action, and/or a resource is a personal decision, which should take into account each individual's and family's particular circumstances.