10/29/14

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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