EF/ff

Cc:

Clinic: 16 November 2021

Typed: 19 November 2021

Dear Dr Fifield

Re: Chester WESTON - dob 17.2.2016 NHI: WHG6603

25A Jeffares Place, Taradale, Napier Ph. 02102 864575
Email: fennawilson@hotmail.com

AUTISM DIAGNOSTIC OBSERVATION SCHEDULE ASSESSMENT

ADOS-2 - Module 3

Child’s Name: Chester Weston

Date of Birth: 17/02/2016
Chronological Age: 5 years 8 months
Gender: Male
Date of Evaluation: 16/11/2021
Examiner: Dr Eve Fifield

Chester presented to Shape My Health for an ADOS assessment. The ADOS is a semi-structured, standardised assessment of
communication, social interaction, and play or imaginative use of materials for individuals who have been referred because
of possible Autism or other Pervasive Developmental Disorders, referred to here as Autism Spectrum Disorders or ASDs.
The ADOS consists of standard activities that allow the examiner to observe behaviours that have been identified as
important to the diagnosis of Autism Spectrum Disorders at different developmental levels and chronological ages. The
ADOS incorporates the use of planned social occasions in which a behaviour of a particular type is likely to appear.
Structured activities and materials provide standard context in which social interactions, communication and other
behaviours relative to Autism Spectrum Disorders are observed.

Chester was accompanied by his parents. I completed the assessment with Chester on his own. Chester was compliant with
the assessment. He separated from his parents easily. He did a lot of facial grimacing at the start of the assessment.
Chester’s rapport with me improved as the assessment went on. The standardised scoring booklets will be scanned to the
system with details of pertinent factors noted below.

ADOS-2 – Module 3

SOCIAL AFFECT (SA)

Communication
Chester used sentences in a largely correct fashion. His speech was unusual at times. He spoke in a high-pitched voice but
his voice changed in pitch often. He put unusual stress on words at times. Chester did not display any echolalia. He did not
have any highly repetitive phrases during the assessment. Chester occasionally offered information spontaneously about his
own experiences, eg. talking about his holiday to Australia. Chester responded appropriately to my comments but did not
spontaneously ask about them. Chester asked a question about my experiences on one occasion when I said “I took my kids
skiing once” and he asked “to America?”. This was during the picture description task. Chester reported a specific non-
routine event – a holiday to Australia. The conversation with Chester flowed. He was able to respond appropriately to what
I asked in sentences and give more information. Chester had minimal use of conventional or descriptive gestures during the
assessment. During the demonstration task he made a gesture of brushing his teeth with his finger.

Reciprocal Social Interaction

Chester’s eye contact improved as the assessment went on and he became more comfortable. He made appropriate eye
contact with me a number of times throughout the assessment. Chester directed a range of appropriate facial expressions to
me in order to communicate his affective state, e.g. smiling during the make-believe play and grimacing when he saw me
writing notes. Chester showed definite pleasure during his interactions during the assessment, in more than one task. He
smiled at me during the make-believe play and during the telling a story from a book task. Chester communicated some
understanding of an emotion in others. He described the cat as “mad” during the cartoon task. Chester showed some insight
into one typical social relationship (marriage). When asked why someone might want to get married or live with a partner he
answered “because they like the people, they just want to marry”. Chester made some attempts at getting my attention
(making eye contact) but did not direct my attention. His attempts were reduced in frequency. Chester showed
responsiveness to most of the social contexts but these were somewhat limited. Chester engaged in reciprocal
communication, but this was reduced in frequency. The overall quality of rapport was sometimes comfortable. Chester
showed some imagination/creativity but this was limited, e.g. using a piece of cloth as a carpet during the creative story task
and saying “she is my fake mum” during the make-believe play task.

Stereotyped Behaviours and Restricted Interests:

Chester did not show any initial sensory interests or sensory seeking behaviours during the assessment. He did not have any
unusual mannerisms noted. Chester made frequent reference to ‘Among us’ during the assessment (eight times). He also
mentioned the character ‘Sirenhead’ on a number of occasions. He drew a picture of an Among us character during the
break task. Chester did not show any compulsions or rituals during the assessment. Chester was occasionally fidgety during
the assessment. He did not show any disruptive behaviour or anxiety.

SOCIAL AFFECT (SA)

Communication
Reporting of Events………………………………………………………….……............................(A-7)…………........0
Conversation………………………………………………………………….……...............................(A-8)….……........ 0
Descriptive, Conventional, Instrumental, or Informational Gestures………............(A-9)….………......2

Reciprocal Social Interaction

Unusual Eye Contact..................................................................................(B-1)................ 0
Facial Expressions Directed to Examiner ......................................................(B-2)................ 0
Shared Enjoyment in Interaction.................................................................(B-4)................ 0
Quality of Social Overtures.........................................................................(B-7)................ 1
Quality of Social Response..........................................................................(B-9)................ 1
Amount of Reciprocal Social Communication................................................ (B-10).............. 1
Overall Quality of Rapport..........................................................................(B-11).............. 0
SA TOTAL.............. 5
RESTRICTED AND REPETITIVE BEHAVIOUR (RRB)
Restricted and Repetitive Behaviours
Stereotyped / Idiosyncratic Use of Words or Phrases..................................... (A-4)................ 0
Unusual Sensory Interest in Play Material / Person........................................(D-1)................ 0
Hand and Finger and Other Complex Mannerisms......................................... (D-2)................ 1
Excessive Interest in Unusual or Highly Specific Topics/Objects
or Repetitive Behaviours..........................................................................(D-4)................ 1
RRB TOTAL............ 2

OVERALL TOTAL (SA + RRB).............. 7

This score is within the Autism Spectrum range.

I am making a follow up appointment to discuss these results with Chester’s parents.

Yours sincerely

Dr Eve Fifield
Consultant Paediatrician