ADOS
What does the measure assess? (can think about why it was developed
- Provide current behavioral
information - Assess communication, social
interaction, and play in individuals
with ASD - Identify specific social or
communicative deficits for those
not meeting ASD criteria
ADOS
Target population (age, special populations, etc.)
Who administers?
Target Pop: All ages greater than 12 months
- credentialed professionals - extensive training and experience with ASD
ADOS
What scales are included?
Two broad domains of behaviour
1. Social Affect
2. Restricted, Repetitive Behaviours
Each module scores behaviour on 5 subscales
1. Language and communication
2. Reciprocal social interaction
3. Play and imagination
4. Stereotyped behaviours and restricted interests
5. Other abnormal behaviours
ADOS
What is involved in the assessment (e.g. materials,
administration details, general scoring guidelines)
- 5 modules that each represent a different level of verbal ability - choose module either PLAY or INTERVIEW
- Toddler module 12-30m
- Module 1 - preverbal 31 m+
- Module 2 - phrase speech 4yr level
- Module 3 - up to 16yrs - verbally fluent
- Module 4 - higher functioning and verbal
Score scales from 0-2 or 0-3
- 0= no sign of abnormality
- 1=mildly abnormal
- 2=definitely abnormal
- 3=unobservable or disrupting
Two thresholds:
- Lower = Autism specturum
- Higher = qualifying for Autism
ADOS
Is it reliable / valid? Limitations/benefits of
standardization?
Limitations of standardization - homogenous sample, hard to generalize-= predominantly male and Caucasian
High content, construct, and predictive validity
Psychometric data disorganized - limited data for module 4
ADOS
Under what situation might you choose to administer the assessment? Consider the benefits & limitations?
Naturalistic observation to supplement ADI - provide information to diagnose ASD
Limitation: No module for higher support needs (‘lower functioning’ adolescents and adults
ADOS
what are some benefits & limitations of the assessment?
Benefits:
1. Expansive and detailed
2. More applicable
3. Naturalistic
4. Improved scoring =diagnostic clarity
Limitations:
1. Generalizability - homogenous sample
2. Limited use
3. No module for higher support needs (lower functioning) adolescents and adults
4. Psychometric data disorganized - limited data for module 4
ADOS
How is the assessment similar / different from others discussed in the course?
- ADOS higher validity than ADI - due to naturalistic highly applicable nature
- ADI can assess history while ADOS can’t
- ADOS performs as well as ADOS +ADI in adolescents and older adults bc mod 3 4 integrate interview questions
ADOS
What are the central / defining features of the assessment?
ADOS-2 is a semi-structured observational tool for assessing ASD symptoms, focusing on social interaction, communication, play, and repetitive behaviors.
ADOS-2 comprises 5 modules tailored to different language abilities, each with various activities to observe developmentally typical behaviour
module 1 activities
- Free play
- Response to name
- Response to joint attention
- Bubble play
- Anticipation of a routine with objects
- Responsive smile
- Anticipation of social routine
- Functional and symbolic imitation
- Birthday party
- Snack
Language and Communication
- Overall level of non-echoed spoken language
- Frequency of Spontaneous Vocalization Directed
at Others - Intonation of Vocalizations
- Stereotyped / Idiosyncratic use of words
- Immediate Echolalia
- Use of Anothers Body
- Pointing
- Gestures
Reciprocal Social Interaction
- Unusual eye contact
- Facial expressions directed to others
- Responsive social smile
- Integration of behaviours during social overtures
- Shared enjoyment
- Response to name
- Spontaneous initiation of joint attention
- Quality of social overtures
- Response to joint attention
- Overall quality of rapport
- Level of engagement
Stereotyped behaviours / restricted interests
- Unusual sensory interest in play material / person
- Hand, finger, or other complex mannerisms
- Self injurious behaviours
- Unusually repetitive interests or stereotyped behaviours
Play
Play
Functional play with objects
* Imagination creativity
Free Play
- spontaneous engagement with caregiver,
- explore materials,
- direct affect,
- how engage with activities
- Response to Name
Hierarchy of Presses
- call name up to 4 time
- Parent call name 2 times
- Ask caregiver to say other words or make a familiar noise or sound -2x
- do whatever necessary including touching to get to look
Response to Joint Attention
- Response to Joint Attention
Hierarchy of presses
1. orient childs body towards face
- up to 5x attempts to attract attention to face
- If child not obtained still proceed
2. Say childs name look and exaggerate gaze - 2x
3. Say childs name look AT THAT - 2x
4. Activate the toy
- Bubble Play
Affect
joint attention
shared enjoyment
requesting
motor behaviour
- Response to Social Smile
Response to:
- smiling
- caregiver smiling
- parent caregiver making familiar noise or phrase
- being touched
discrete task
- Functional and Symbolic Imitation
Does child use mini objects to imitate familiar actions?
Hierarchy of presses
1. Real object car or frog up to 3x
2. Imitation trial - real object up to 3x per object
3. Imitation trials 2 - placeholder representing object just demonstrated in phase 1 - up to 3x
4. Placeholder representing object not previously demonstrated
successfully complete if you can do all
Bi
- Birthday Party
- interest and ability to join in the script of a dolls bday party
- does child treat doll as representation of animate being
- spontaneous contribution
- pay attention to shared enjoyment, and reciprocity
Snack
- SnACK
- does child indicate a preference and request food - if so how
- use gaze gesture, reaching, facial expression, and vocalization to communicate requests to you and make social overttures
- does the child shocw aregiverw his or her snack to the parent and share?
- Anticipation of a social routine
peekaboo, tickle, swing in air
Child’s affect and attempts to initiate repetition of routine
Attention to social directedness of child’s behavior and integration of gaze, facial expression, vocalization and gesture in actions directed to clinician/ caregiver & shared enjoyment.
- Anticipation of a routine with objects
- affect
- initiation of joint attention
- shared enjoyment
- requesting
- motor responses
blowing up balloon and letting it go
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1 - Assessment12
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Clinical Interviews30
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Intelligence Testing45
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Development35
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Report Writing22
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ASD32
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ADHD27
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Specific Learning Disorders29
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Visual-motor Integration16
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Neuropsychological Assessment20
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ADI8
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ADOS24
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CBCL9
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Hopkins Verbal Learning Test-Revised HVLT-R8
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DOMINIC9
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DANVA8
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ADHD LAB20
