December 14, 2023

ADOS-2 (The Autism Diagnostic Observation Schedule – Second Edition)

You’ve probably heard of autism before, but did you know that there are several types of autism spectrum disorders (ASDs)? The ASDs, which are diagnosed and assessed using various tools and assessments, such as the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2), include high functioning autism (HFA), Asperger syndrome, and pervasive developmental disorder – not otherwise specified (PDD-NOS).

Autism spectrum disorders (ASDs) are neurodevelopmental conditions characterized by deficits in social communication, repetitive behaviors, restricted interests, and sensory processing. They affect approximately 1 in 68 children in the United States. There is no cure for these conditions, but early intervention helps improve outcomes with the help of Autism Evaluation.

It’s important to recognize the signs of ASD in young children because they can often go unnoticed until later stages of development. This is why it’s crucial to identify the symptoms early on. One way to do this is through screening tools such as the Autism Diagnostic Observation Scale (ADOS).

What Is ASD? Understanding Autism through ADOS-2

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that manifests as deficits in reciprocal social interaction and communication, coupled with repetitive behaviors and restricted interests. Individuals with ASD frequently face challenges in interpreting nonverbal cues and comprehending complex concepts. Moreover, they often exhibit stereotyped patterns of behavior, such as hand flapping or rocking back and forth.


Symptoms vary among people with ASD. However, some general indicators of ASD include difficulties with social interaction, language, and communication; unusual sensory responses; and repetitive behaviors. These symptoms appear early in childhood and persist throughout adulthood.

1. Intellectual Disability

Intellectual disability refers to significant limitations both in conceptual thinking and learning abilities. People who have intellectual disabilities need help to understand their environment and learn appropriate ways to interact with others.

2. Social Interaction

People with ASD often struggle with social interaction. They may not know what to say or do in certain situations, and they may lack awareness of others’ feelings and perspectives. They may show little interest in developing friendships or romantic relationships, and they may find it difficult to initiate conversations or respond appropriately to questions.

3. Communication Skills

Individuals with ASD may have problems expressing themselves verbally. They may use gestures instead of words, and they may repeat phrases or ask questions over and over again. They may have trouble communicating effectively with peers and adults.

4. Interests and Activities

People with ASD may have strong preferences for particular objects, activities, or environments. They may become fascinated with specific topics or spend long hours playing with small toys or gadgets.

Manual for Autism Diagnostic Observation Scale-Second Edition (ADOS-2)

This manual offers information about diagnosing autism spectrum disorder (ASD) using the Autism Diagnostic Observation Scale-Second Edition (ADOS-2). Researchers developed ADOS-2 to evaluate children’s behaviors and determine if they have ASD. The scale comprises five modules that assess various aspects such as communication, play, social interaction, imaginative use of materials, and repetitive behavior.

2. Developmental History

Parents or caregivers, who have the best knowledge of the child, provide a developmental history. They share information such as the child’s birth date, sex, medical problems, family history, language skills, motor skills, cognitive abilities, and adaptive behaviors. Additionally, parents may communicate any concerns they have regarding their child’s development.

3. Current Functioning

The current functioning section contains questions about the child’s daily activities. Caregivers describe what the child does at home, school, and outside the home. Furthermore, the questions focus on the child’s strengths and difficulties in relation to his or her age peers. Additionally, teachers may also be asked to comment on the child’s academic performance and participation in class.

4. Adaptive Behavior Assessment System-II (ABAS-II)

The ABAS-II is a standardized test that measures functional limitations in eight domains of adaptive behavior. These domains include conceptual understanding, social skills, practical reasoning, personal autonomy, behavioral self-control, community use, home management, and safety awareness. Additionally, the ABAS-II yields two scores: one indicating the degree of impairment in each domain, and the second reflecting the extent to which the individual’s impairments interfere with everyday function. To obtain the ABAS-II scores, the examiner asks the caregiver to rate the child’s functioning in each area on a scale ranging from 1 (no problem) to 4 (severe problem). A total score is then calculated by adding together the ratings across the eight domains. Higher scores on the ABAS-II indicate greater levels of impairment.

5. Social Communication Questionnaire (Social Communication Questionnaire)

The SCQ is a screening tool designed for clinicians, teachers, and others familiar with young people with autism spectrum disorders (ASDs) to identify individuals with ASDs. The questionnaire focuses on four areas of interest in ASD: communication, reciprocal social interactions, restricted interests, repetitive behaviors, and sensory issues. The first three subscales were originally developed by Rutter et al., while the last subscale was added later. The original version of the questionnaire consisted of 40 items, while the revised version consists of 60 items. Both versions provide a total score and three subscale scores. The total score reflects the number of autistic traits present, while subscale scores indicate the frequency of particular behaviors observed.

6. Clinical Global Impression – Severity (CGI-S)

The CGI-S is a clinician-rated global assessment of symptom severity. Rated on a 7-point Likert scale ranging from 1 (normal, not ill at all) to 7 (amongst the most extremely ill patients), the CGI-S is useful when making decisions regarding treatment options, monitoring changes in patient status over time, and determining prognosis.

Testing Accommodations for ADOS-2

Creating the right environment for an ADOS-2 assessment is vital. Testing accommodations can make a significant difference in ensuring a fair and accurate evaluation process. To explore how accommodations can positively impact the ADOS-2 experience, check out our dedicated blog post on Testing Accommodations Evaluations.

Understanding the options available and how to request accommodations is crucial. Our linked blog post provides insights and practical tips to help individuals and caregivers navigate this aspect of the evaluation process effectively.

Are you worried about your child being diagnosed with autism?

The Autism Diagnostic Observation Scale (ADOS) serves as an autism evaluation tool specifically designed to assess social communication skills in children aged 2–8 years old. This test aids in determining whether your child has autism or another developmental disorder, such as Asperger syndrome.

Autism spectrum disorders affect approximately 1% of school-aged children worldwide. In some cases, symptoms appear early in life, whereas in other cases they emerge later in childhood.

“The ADOS-2 is a standardized assessment tool developed by researchers at the University of California Los Angeles,” says Dr. Michael Rutter, director of the UCLA Center for Autism Research. “It measures the severity of autistic behaviors across four domains: reciprocal social interaction, play, language, and stereotyped behavior.”

Source: ADOS 2 - NeuroPsych Doctor NY


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