- Semi-structured, standardized assessment to help diagnose ASD
- Assess communication, social interaction, and play/imaginative use of materials, and repetitive behaviors
- Creates contexts to observe ASD behaviors and uses standardized coding to document those behaviors
- takes about 45 min to 1 hour
The Autism Diagnostic Observation Schedule-Second Edition ADOS-2
- difficulty socially using verbal and noonverbal comunication
- deficits in communicating for social purposes
- unable to change communication to match the context
- difficulty following rules of conversation
- difficulty understanding nonliteral and ambiguous language
- Intended to be diagnosed in individuals beyond preschool year
Social Communication Disorder
Changes from DSM-IV to DSM-V (2)
- Autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and PDD-NOS all become autism spectrum disorder (ASD)
- Three domains to to domains: social/communication and repetitive behavior/restricted interest
- social and communication are difficult to separate
- language delays are not unique to ASD, and not all children with ASD have a language delay
True or False
On the ADOS, higher scores mean more symptoms
true
general screeners (2)
- infant toddler checklist
- ages and stages questionnaire social-emotional
About what percentage of persons with ASD have IQs within the average range?
46% remainder is above or below
What is the age range for the Autism Diagnostic Observation Schedule-2 (ADOS-2)
used with all ages
By what age would we expect a child to use words?
16 months
By what age would we expect to see back-and-forth sharing of sounds, smiles, or facial expressions?
9 months
Developmental Symptoms of ASD (2)
- social communication
- stereotyped or repetitive behavior
- 56 items answered by a professional after behavioral observations. Items are in six sub-scales
- restricted and repetitive behaviors
- social interaction
- social communication
- emotional responses
- cognitive style
- maladaptive speech
- can provide a measure f severity
- for individuals from 3-22 years of aged
- aligned with DSM-V
Gilliam Autism Rating Scale third edition (GARS 3)
person to toy or toy to person
gaze shift
repetitive movements or spech (3)
- body movements
- behaviors with objects
- speech (echolalia)
By what age would we expect symbolic play?
18 months
What is the age for the Childhood Autism Rating Scale- 2 (CARS 2)
2 years and up
How is ASD a qualitative disorder?
while one child may demonstrate only a few autistic-like symptoms, another child may demonstrate many significant autistic symptoms
ASD is found in combinatioin with what other conditions? (3)
- intellectual disabilities
- seizure disorders
- tuberous sclerosis
- different communications profiles than chidlren with other language disorders
- difficulty initiating social interaction
- difficulty sharing social affect
- lack of coordinatioin of nonverbal communication
- difficulty with peer relationships
social communication differences
- hypersensitive to sensory stimulation
- narrow, rigid interests
repetitive behaviors and restircted interests
- No big smiles or other warm, joyful expressions by six months
- no back-and-forth sharing of sounds, smiles, or facial expressions by 9 months
- no babbling by 12 months
- not responding to name by 12 months
- does not point to share interest by 14 months
- no words by 16 months
- repetitive movements with body or objects
- no symbolic play by 18 months
- no meaningful, two-word phrases (non-imitative) by 24 months
- any loss of speech, babbling, or social skills
Red Flags for ASD
true negatives
specificity
by what age would you expect a child to point to share interest?
14 months
Steps of the diagnostic process (7)
- referral
- screening
- parent interview
- behavioral/observational testing
- other testing
- diagnosis
- reevaluation
Impairment in social communication (3)
- impairment in social-emotional reciprocity
- impairment in the social use of nonverbal behavior joint attention: orienting to people; sharing attention; monitoring partners
- Difficulty developing relationships
