Autism Diagnostic Observation Schedule (ADOS)
by Catherine Lord, Ph.D., Michael Rutter, M.D., FRS, Pamela C. DiLavore, Ph.D., and Susan Risi, Ph.D.
This semi-structured assessment can be used to evaluate almost anyone suspected of having autism--from toddlers to adults, from children with no speech to adults who are verbally fluent.
The ADOS consists of various activities that allow you to observe social and communication behaviors related to the diagnosis of pervasive developmental disorders. These activities provide interesting, standard contexts in which interaction can occur.
The ADOS includes four modules, each requiring just 35 to 40 minutes to administer. The individual being evaluated is given just one module, depending on his or her expressive language level and chronological age. Following guidance provided in the manual, you select the appropriate module for each person. Module 1 is used with children who do not consistently use phrase speech, Module 2 with those who use phrase speech but are not verbally fluent, Module 3 with fluent children, and Module 4 with fluent adolescents and adults. The one group within the autism spectrum that the ADOS does not address is nonverbal adolescents and adults.
Modules 1 and 2 require you and the child to move around the room. Modules 3 and 4, both of which involve more conversation, can be administered at a table. Activities included in Modules 1 and 3 are listed below:
Response to Name
Response to Joint Attention
Anticipation of a Routine With Objects
Responsive Social Smile
Anticipation of Social Routine
Functional and Symbolic Imitation
Joint Interactive Play
Description of a Picture
Telling a Story from a Book
Reporting a Non-Routine Event/Conversation
Creating a Story
These activities provide a 30- to 45-minute observation period full of opportunities for the examinee to exhibit behaviors relevant to a diagnosis of autism or PDD. As you administer the ADOS, you record your observations, then code them later and formulate a diagnosis. Cut-off scores are provided for both the broader diagnosis of PDD/atypical autism/autism spectrum, as well as the traditional, narrower conceptualization of autism.
Offering standardized materials and ratings, the ADOS gives you a measure of autism spectrum disorder that is unaffected by language. Because it can be used with a wide range of children and adults, it is a cost-effective addition to any hospital, clinic, or school that serves individuals with developmental disorders.
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