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Disclaimer
This presentation is not a WPS sponsored
training. It is not intended to a substitute
for a WPS training.
This training will provide an overview of
the ADOS-2 by practitioners having
extensive experience and training in
ADOS administration.
Autism Diagnostic Observation
Schedule, Second Edition
(ADOS-2)
Lord, C., Rutter, M., DiLavore, P.C., Risi, S.,
Gotham, K., & Bishop, S.L. (2012). Autism
Diagnostic Schedule, Second Edition
(ADOS-2) Manual (Part 1): Modules 1-4.
Torrance, CA: Western Psychological
Services
ADOS-2
“The ADOS -2 is a semi-structured
standardized assessment of
communication, social interaction, play/
imaginative use of materials, and
restricted and repetitive behaviors for
individuals who have been referred
because of possible autism spectrum
disorders”
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ADOS-2
• Revision of (ADOS: Lord, Rutter,
DiLavore, & Risi,1999)
• Used as a clinical and research tool to aid
in the diagnosis of ASD
• Considered the “Gold Standard”
observational assessment for ASD
ADOS-2
• Assessment of symptoms of ASD across
– Age
– Developmental Level
– Language Skills
• Ages 12 months through adulthood
• Administration time 40 – 60 minutes
Who can administer the ADOS-2
• Examiners should have knowledge of typical
and atypical behavior of individuals within the
age range that they are assessing
• Knowledge, training, experience in ASDs and
other developmental disorders
• Extensive training- read WPS materials, training
videos, manuals
• Invest in extensive practice and reliability
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ADOS -2
• Toddler Module
• Module 1
• Module 2
• Module 3
• Module 4
ADOS-2 Format
Standardized:
Observation
Coding
Algorithm
ADOS-2 =Observation of Interactive
Social Behavior
• One examiner - administers, observes
takes notes and codes the assessment
• One examinee
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Administration
• Read the Manual
• Recognize Behaviors
• Learn the Prompt Hierarchy
• Learn the Codes
Administration
• Familiarity with materials, activities, prompts and
codes
• Record and code behaviors that occurred only
during the ADOS
• Note-taking by examiner – use shorthand
• Code immediately after administration
Selecting A Module
• Take a verbatim language sample
• Decision based primarily on expressive
language level
• No-Speech to Simple Phrases (Toddler and Module 1)
• Phrase Speech to Fluent Speech (Module 2)
• Fluent Speech (Module 3 and Module 4)
• Consider chronological age and relevance of
questions/tasks
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Coding Behaviors
• Coding or rating items that are distinct
aspects of behavior and targets of the
ADOS
• Read each coding item and section title
carefully
• Learn the Coding Conventions
ADOS-2 Interpretation
Toddler Module – provides ranges of
concern for symptoms of ASDs
Modules 1-4 – provide cutoff scores for
autism and autism spectrum classifications
Modules 1-3 – yield a Comparison
Score of autism-related symptoms
compared to other children with ASD
Interpretation
• Individual codes useful for programming
and identifying areas of strength and
concern
• Modules yield levels of concern for ASD,
cut-off scores and Comparison Scores
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Interpretation
ADOS-2 is one piece of diagnostic
assessment information and should never
be used in isolation to make a diagnosis.
History:
• Medical
• Behavioral
• Developmental
School Reports
• Cognitive/Developmental Testing
• IEP/ School records
Guidelines for Selecting
Module 1
Collect Verbatim language sample
Expressive Language Level = No speech
up to and including simple phrases
Chronological Age = 31 months and older
Module 1
• Free Play
• Response to Name
• Response to Joint Attention
• Bubble Play
• Anticipation of Routine with Objects
• Responsive Social Smile
• Anticipation of Social Routine
• Functional and Symbolic Imitation
• Birthday Party
• Snack
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Module 1
• Set up environment – child and parent
seating
• Prepare materials and activities
• Give parents instructions
• Warm-up period
Free Play
Free Play
• Create a relaxed environment and provide
a “warm-up” period
• Observation of the child’s behaviors, use
of toys and interaction with parent or
examiner
• Engage parent in discussion about toys
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Free Play
• Free play lasts approx 10 minutes
• Toys on table/floor
• Engage parent/Ignore child for 3 minutes
• Parent may play for up to 5 minutes
• Model pretend play if no spontaneous
pretend play
• Record behavior and language sample
Response to Name
• Complete when child is engaged in play
• Person calling name should be 3-5 feet
away
• Call child’s name and wait for response.
• Eye contact is required
• Follow prompt sequence for examiner and
Parent if needed.
Response to Joint Attention
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Joint Attention
• Observe child’s response to use of gaze
coordinated with facial orientation,
vocalization and pointing to direct attention
to an object placed in the distance.
Joint Attention
• Target should be 4-5 feet from the child
• Place blanket over target
• Make a triangle
• Get the child’s attention-up to 5 attempts
• Proceed with prompt hierarchy
Bubble Play
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Bubble Play
• Observation for eye contact and
vocalization from the child
• Observation for initiation of joint attention,
requesting, facial expressions, shared
enjoyment
• Observation for unusual sensory interests
or behaviors
Bubble Play
• Begin blowing bubbles when child is
engaged in something else
• Model positive affect or match child’s
positive affect to create fun interaction
• Provide opportunity for child to request
bubbles
Anticipation of Routine with
Objects
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Anticipation of Routine with
Objects
• Observe child’s anticipation of an action
routine, initiation, requesting, shared
enjoyment, repetitive body movements
• May use cause-and –effect toy or foam
darts in place of balloon
• Wait for child to bring balloon to you
Responsive Social Smile
• Observation of the child’s smiling in
response to a purely social overture from
an adult
• Follow prompt sequence
• Involve parent if necessary
Anticipation of Social Routine
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Anticipation of Social Routine
• Observe child’s anticipation, request and
enjoyment during a social routine
– Peek-a-Boo
– Tickle Bug
– Swing in the Air
• Involve parent if necessary
Functional and Symbolic
Imitation
Functional and Symbolic
Imitation
• Observation of the child’s ability to imitate
actions with objects; and with non-
meaningful placeholders for the same
objects
• Teaching trials plus 3 phases of imitation
• Learn prompt sequences
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Birthday Party
Birthday Party
Observation of symbolic and functional play,
shared enjoyment, imitation, social
overtures, ability to follow script, use of doll
Snack
• Observation of requesting in a familiar
situation
• Inquire about food allergies
• Give small amounts of snack
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Module 2- Phrased Speech
• Children of any age who use phrased
speech but are not yet verbally fluent
• “Phrased Speech defined as regular
production of non-echoed phrases made
up of three independent units, which
sometimes include an active verb.”
Module 2
• Construction Task
• Response to name
• Make-Believe Play
• Joint-Interactive Play
• Conversation
• Description of a Picture
• Telling a Story from a Book
• Free Play
• Birthday Party
• Snack
• Anticipation of a Routine with Objects
• Bubble Play
Module 2
• Prepare the assessment area/activities/seating
arrangement
• Encourage and show positive affect without
directly prompting behavior
• Provide attempts for child to initiate and sustain
interactions…..shhhh!
• Parent present but has a less active role
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Construction Task
• Observation of -
Make Believe Play
• Observation of
Joint-Interactive Play
• Observation of -
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Conversation
• Observation of -
Demonstration Task
• Observation of -
Description of Picture
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Telling a Story from a Book
Free Play
Notes
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