Selected material from the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS

-2) manual.
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Copyright © 2018 by Western Psychological Services (WPS®). Provided by WPS for the sole purpose of introductory reference by
qualified professionals. Not to be reprinted, excerpted, or distributed in whole or in part without the prior written authorization
of WPS (rights@wpspublish.com). Full materials available for purchase at www.wpspublish.com.

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Introduction

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The Monteiro Interview Guidelines for Diagnosing the Autism Spectrum,
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Second Edition (MIGDAS™-2): A Sensory-Based Approach is a group of
products that provides evaluators with an efficient method of systemati­
cally gathering and organizing the information needed to diagnose autism
spectrum disorder (ASD) in children, adolescents, and adults. The MIGDAS-2
improves upon the original version (MIGDAS; Monteiro, 2008) by broadening
its focus to the full autism spectrum and to the range of ages and language
abilities encountered by evaluators when diagnosing ASD. The MIGDAS-2
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products include this Manual and five evaluation protocols:

··Parent/Caregiver Questionnaire

··Teacher Questionnaire
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··Diagnostic Interview for Individuals With Limited to No Verbal Fluency

··Diagnostic Interview for Children and Adolescents With Verbal Fluency

··Diagnostic Interview for Adults With Verbal Fluency

The MIGDAS-2 was developed as an outgrowth of extensive diagnostic work

with individuals on the autism spectrum, as well as their families and teach­
ers, and considerable collaboration with autism evaluation teams in public
and private schools. The MIGDAS-2 process provides an organized, systematic
way to elicit and document an individualized behavioral profile descriptive
of the singular presentation of ASD in order to better inform autism diagno­
sis and treatment planning.
The MIGDAS-2 can be used by independent evaluators and by evaluation
teams and is ideally suited for a variety of settings, including private practice,
schools, and hospitals. (The term evaluator is used throughout this Manual
and on the evaluation protocols to refer both to individual evaluators and,
where applicable, evaluation teams.) Because the MIGDAS-2 process inte­
grates the multiple sources of information that must be considered when

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 diagnosing ASD, it helps those involved in the evaluation process better
understand the way in which autism spectrum differences specifically affect
the individual being evaluated. The sensory-based diagnostic interview
allows for an authentic assessment experience for the child, adolescent, or
adult being evaluated. The qualitative behavioral profile obtained through
use of the MIGDAS-2 also assists evaluators when considering comorbidity
and making differential diagnoses, writing narrative evaluation reports, and
providing diagnostic feedback to participants in the evaluation process.

Key Features of the MIGDAS-2 Assessment Process

Interactive interview techniques The MIGDAS-2 impressions and effective, individualized treatment
provides detailed, concrete guidelines for conduct­ recommendations.
ing interactive diagnostic interviews with children,
Comprehensive qualitative information The
adolescents, and adults suspected of having ASD.
MIGDAS-2 is a unique evaluation tool that guides the
These guidelines show evaluators how to use con­

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evaluator to make a diagnosis based on direct inter­
versational techniques to draw out each individual’s
actions with the individual being evaluated, parents/
unique pattern of developmental differences. Sen­
caregivers, and teachers, in addition to a review of
sory materials (i.e., materials with distinctive visual,
PL quantitative scores. Numerous rating scales are avail­
tactile, or auditory properties) and topics of parti­
able to quantitatively rate behaviors associated with
cular interest to the individual are used to engage
ASD. A high score on a rating scale does not in itself
him or her in a dynamic and interactive exchange.
lead to a diagnosis, but rather indicates that a full
Individuals with ASD enjoy the opportunity to
diagnostic assessment is warranted. While infor­
interact with evaluators who structure the MIGDAS-2
mation obtained through rating scales is useful, it
interview to fit each individual’s unique worldview.
should serve as supplemental supportive data rather
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The individual’s active engagement in the evaluation
than as the primary source of diagnostic informa­
process provides a detailed and nuanced sample
tion. For example, although valuable diagnostic
of his or her communication, social, and sensory
information is obtained through use of the semi­
behavioral profile, which can be effectively con­
structured Autism Diagnostic Observation Schedule,
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trasted with the patterns of behaviors typically seen

in individuals who do not have the social communi­
cation and sensory differences indicative of ASD.
Parent/caregiver and teacher participation
The MIGDAS-2 also provides structured guidelines
for obtaining key information from parents/caregiv­
ers and teachers about the individual’s behavior in
the home and school settings. The Parent/Caregiver
and Teacher Questionnaires can be used to conduct
in-person interviews or completed independently
by parents/caregivers and teachers, who appreciate
the questionnaire’s informal but structured format
and typically form a positive bond with the evalu­
ator as they participate in the evaluation process.
Evaluators who use the MIGDAS-2 are well prepared
to discuss the diagnostic outcome with parents/
caregivers and teachers, and to write meaningful
narrative evaluation reports that include the descrip­
tive information they provide, along with diagnostic
Second Edition (ADOS®-2; Lord et al., 2012), supple­
menting this standardized assessment with the
MIGDAS-2 provides additional detailed, individual­
ized information obtained through a conversation
that elicits the individual’s sensory-based language
and use of materials. The sensory-based MIGDAS-2
is designed to draw out the presence of restricted
interests and repetitive behaviors, in addition to the
social communication differences indicative of ASD.
Sensory-based approach Emphasizing the use of
sensory materials and encouraging discussion of
areas of high interest to the individual, the MIGDAS-2
process provides a system for evaluators to gather
distinctive examples of behavior patterns often
seen in individuals with ASD. This process includes
not only the evaluation protocols but also a visual
framework and associated descriptive language—
the Descriptive Triangle (see Chapter 2)—which guide

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 evaluators to build a rich, detailed portrayal of the
individual’s characteristic style of relating to the
world. This results in a singular presentation of the
global condition: a description of the individual’s
distinctive pattern of autism spectrum differences
rather than a simple list of how the individual
does or does not meet various global criteria. The
MIGDAS-2 approach also emphasizes observing
areas of strength and competency in addition to
areas of developmental differences, facilitating the
Components of the MIGDAS-2
Manual
The Manual provides detailed guidelines on how to
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use the evaluation protocols to gather comprehen­
sive information from parents/caregivers, teachers,
and the individual being evaluated. In addition,
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the Manual provides guidance for evaluators in the
areas of forming diagnostic impressions; sharing the
diagnosis with parents/caregivers, teachers, and the
individual being evaluated; linking the diagnosis to
specific intervention recommendations; and writ­
ing a narrative evaluation report. The Manual also
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outlines useful resources, including suggestions
for building a sensory-based materials kit for use
during the diagnostic interview. Case examples,
including completed protocols and excerpts from
sample reports, are also included (see Chapter 4).
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Evaluation Protocols
Questionnaires
The questionnaires provide detailed sets of questions
designed to gather a comprehensive narrative about
the individual being evaluated from the point of
view of his or her parents/caregivers and/or teachers.
Information obtained through use of the question­
naires helps the evaluator shape the diagnostic
interview and write the evaluation report.
Parent/Caregiver Questionnaire
The evaluator may use the Parent/Caregiver Ques­
tionnaire to conduct a personalized interview
conversation or have the parent/caregiver write their
Components of the MIGDAS-2
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creation of a positive narrative that describes rather
than merely labels the individual being evaluated.
Understanding each individual’s distinctive pattern
allows the evaluator to produce more meaningful
narrative evaluation reports, and to provide not
only diagnostic feedback but also comprehensive
behavioral descriptions that help inform treatment
planning to improve functioning at home, at school,
and in the workplace.
narrative directly on the questionnaire and return it.
The questions guide the evaluator through the inter­
view process and are organized to enable the parent/
caregiver to share stories about the individual being
evaluated, culminating in a descriptive narrative
of the individual’s behavioral profile. This format
maximizes the establishment of trust between the
evaluator and the parent/caregiver and also provides
key information regarding the individual’s areas
of interest, sensory preferences and aversions, and
social and emotional behavior patterns. The contents
of this interview can later be included in a narrative
evaluation report, individualizing the background
information in a way that is not possible when sum­
marizing responses from rating scales. The Parent/
Caregiver Questionnaire usually takes 60 to 90 min­
utes to complete. Standardized autism rating scales
can be given to parents/caregivers in conjunction
with the MIGDAS-2 questionnaire process.
Teacher Questionnaire
The Teacher Questionnaire provides a set of
detailed questions that prompt teachers to observe
and describe the student’s behavior in a range of
academic and social situations. It is designed for
teachers to complete independently but can also
be used by the evaluator to facilitate an in-person
interview. When the questionnaire is completed
independently by the teacher, it is useful for the
evaluator to schedule a follow-up conversation to
clarify any details that may benefit from further
elaboration. The Teacher Questionnaire should be
given to teachers who work directly with the student.
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 It usually takes 30 to 60 minutes to complete.
Standardized autism rating scales can be given to
teachers in conjunction with the MIGDAS-2 ques­
tionnaire process.
Diagnostic Interview Protocols
The Diagnostic Interview protocols are the corner­
stone of the MIGDAS-2 assessment process. These
protocols guide evaluators through the process of
collecting and documenting samples of the individ­
ual’s behavior in the three key areas of development
that are affected in ASD: Sensory Use and Interests,
Language and Communication, and Social Relation­
ships and Emotional Responses. The evaluator uses
the protocols to conduct an interactive and dynamic
interview that focuses on the individual’s areas of
interest and uses sensory-based toys and materials.
The Diagnostic Interview protocols include sections
that guide the evaluator to summarize the individual’s
behavioral profile using the Descriptive Triangle
visual framework and to outline treatment recom­
mendations. The evaluator should allow 45 to
60 minutes to conduct each interview (and up to
90 minutes when interviewing an adult and his or
her family members with the Diagnostic Interview
for Adults With Verbal Fluency), plus additional
time (up to an hour) to review and document all
observations in the protocol, including team discus­
sion when applicable. This process is critical, as the
systematic completion of the Observations section
leads to effective formulation of diagnostic impres­
sions and recommendations.
Diagnostic Interview for Individuals With Limited
to No Verbal Fluency

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The Diagnostic Interviews are organized accord­
The Diagnostic Interview for Individuals With
ing to level of verbal fluency, with three distinctive
Limited to No Verbal Fluency is suitable for young
protocols: Individuals With Limited to No Verbal Flu­
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ency, Children and Adolescents With Verbal Fluency,
who are able to engage in sensory-based play) with
and Adults With Verbal Fluency. These protocols
limited to no verbal language use, as well as for
can be used with children, adolescents, and adults
older children and adolescents who display possible
of all ages and with varying levels of verbal fluency,
autism spectrum differences and language delays.
as the evaluator adjusts the materials to match the
The interview could also be used with adults who
age and developmental level of the individual being
have not yet obtained verbal fluency. The Diagnostic
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evaluated. Individuals with emerging verbal fluency
Interview for Individuals With Limited to No Verbal
could be evaluated using either the Limited to No
Fluency focuses on the use of sensory-based play
Verbal Fluency or one of the Verbal Fluency proto­
and interaction paired with limited verbal input and
cols, depending on whether their emergent language
demands. The protocol directs evaluators to limit
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skills are limited or close to becoming fully fluent.

their talking at the start of the session, minimizing
Each protocol provides descriptive language that the stress inherent in language demands for indi­
contrasts behaviors that are likely to be seen in viduals with limited to no verbal abilities.
individuals with ASD with behaviors that are rep­
Evaluators are prompted to provide age-appropriate
resentative of their neurotypical counterparts. Most
sensory materials containing visual, auditory, and
individuals with ASD display some neurotypical
tactile properties, and are given suggestions for ways
behaviors, making it challenging at times for evalu­
to engage in sensory-based interactions with the
ators to make the diagnosis of ASD. The MIGDAS-2
individual throughout the interview session. The
Diagnostic Interview protocols assist the evaluator
use of sensory materials is intended to elicit patterns
in recognizing when an individual presents with a
of behavior that are different in individuals with
pattern of behaviors consistent with ASD despite
autism spectrum differences relative to their typi­
the appearance of a few neurotypical behaviors.
cally developing peers, or to individuals with limited
Individuals who do not present with the profile of
language who do not display the full behavioral
behaviors consistent with an ASD diagnosis will
profile consistent with ASD. The Observations sec­
show only a few ASD behaviors on the MIGDAS-2,
tion for each of the targeted behavior areas includes
with the majority of their behaviors recognizable in
descriptive language contrasting behaviors likely
the MIGDAS-2 descriptors of neurotypical behaviors.

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 to be seen in individuals with ASD with behaviors Diagnostic Interview for Adults With Verbal Fluency
expected of neurotypical individuals. It also pro­
The Diagnostic Interview for Adults With Verbal
vides space to document specific examples of the
Fluency is suitable for adults who have acquired
individual’s behaviors, vocalizations, and use of
language skills and use language in a fluent capacity.
materials during the interview session.
This may range from individuals for whom verbal
conversation is challenging to those who are highly
Diagnostic Interview for Children and Adolescents verbal. It is also appropriate for use with verbally
With Verbal Fluency fluent adolescents transitioning to adulthood. The
protocol guides evaluators through a structured
The Diagnostic Interview for Children and Adoles­
conversational interview that begins by introduc­
cents With Verbal Fluency is suitable for children
ing topics of high interest to the individual, thereby
and adolescents of all ages who use language in a
minimizing the stress inherent in social language
fluent capacity or who have acquired language but
demands for individuals with autism spectrum dif­
whose fluency is still emerging. The protocol guides
ferences. Questions about and discussion of social
evaluators to start the session by introducing topics
and emotional topics relevant to adults follow the
of high interest to the child, minimizing the stress
discussion of preferred topics. Age-appropriate
inherent in social language demands for individuals
sensory-based materials containing visual, auditory,
with autism spectrum differences. Visual prompts
and tactile properties are made available throughout

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are suggested for use with questions and discussion
the interview. The adult being interviewed is free to
about social and emotional topics later in the inter­
manipulate the materials as a self-regulation mea­
view session.
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Throughout the session, evaluators are prompted she desires.
to provide age-appropriate sensory materials
The interview protocol for verbally fluent adults is
containing visual, auditory, and tactile properties,
structured so that the evaluator has the option of
and are given suggestions for ways to engage in
including the individual’s adult partner, parent(s), or
sensory-based interactions with the child. The use
caregiver(s) in the session. Prompts for encouraging
of sensory materials is intended to elicit patterns
family members to add information during the
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of behavior that are different in individuals with
diagnostic interview process are included. This
autism spectrum differences relative to their typi­
structure allows the evaluator to gather more
cally developing peers. The Observations section for
extensive information for adults who have some
each of the targeted behavior areas includes descrip­
verbal fluency but for whom verbal skills are limited.
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tive language contrasting behaviors likely to be seen

The Observations section for each of the targeted
in individuals with ASD with behaviors expected of
behavior areas includes descriptive language
neurotypical individuals. It also provides space to
contrasting behaviors likely to be seen in individuals
document specific examples of the child’s behaviors,
with ASD with behaviors expected of neurotypical
conversational differences, and use of materials dur­
individuals. It also provides space to document
ing the interview session.
specific examples of the individual’s behaviors,
conversational differences, and use of materials
during the interview session.

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 Principles of Use
Who may administer the MIGDAS-2 Standards of
practice that determine which professionals may
engage in assessment vary greatly within and among
countries, states, and localities. The assessment pub­
lisher authorizes individuals to purchase assessment
materials based on the purchaser’s stated education
and experience, or the stated education and experi­
ence of the purchaser’s direct supervisor. In the case
of institutional purchasers (e.g., a school district pur­
chasing on behalf of its professional employees), it is
expected that the purchase is for use by individuals
with the relevant education and experience.
In addition to possessing the authorization required
to purchase an assessment, each potential assess­
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ment user must also ensure that he or she is working
within the scope of his or her practice in a compe­
tent, legal, and ethical manner. It is the responsibility
of each assessment user to determine his or her own
competence by evaluating an assessment’s principles
of use in light of his or her training and experience,
the intended scope of use (e.g., in a research or
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applied setting; for diagnostic or treatment planning
purposes), and the guidelines set forth by relevant
professional organizations and licensing boards.
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The MIGDAS-2 process is designed for evaluation
professionals who have prior education, training,
and supervised experience in the area of ASD. It is
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expected that evaluation professionals will have a
thorough understanding of the diagnostic criteria for
ASD as defined in current editions of the Diagnostic
and Statistical Manual of Mental Disorders (DSM)
and the International Classification of Diseases
(ICD),1 as well as familiarity with current research
and theorizing about ASD. Coursework in child and
adolescent development, developmental psychopa­
thology, and related areas will be helpful as well.
A job title is not a strong indicator of who is appro­
priately qualified, as titles vary from state to state
and country to country. Evaluation professionals
should possess, or be directly supervised by those
who possess, suitable credentials in the state or
country in which they practice to allow them to draw
1 Current editions at time of publication are the DSM-5 (American Psychiatric Association, 2013) and the ICD-10 (World Health
Organization, 1992).
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diagnostic conclusions and/or develop treatment
plans appropriate to the settings in which they work.
In addition to these general qualifications, evalu­
ation professionals should familiarize themselves
with the MIGDAS-2 by thoroughly reviewing this
Manual and the evaluation protocols and by practic­
ing using the materials on cases that are not part of
formal evaluations. In order to gain a thorough foun­
dation on which to base clinical judgments, it would
be helpful for evaluation professionals to practice
using the MIGDAS-2 with children, adolescents, and
adults who do, and those who do not, have autism
spectrum differences.
Using the MIGDAS-2 as part of a team-based
autism assessment The MIGDAS-2 is designed
for use by independent evaluators as well as by
multidisciplinary evaluation teams based in school
or clinical settings. Whether the MIGDAS-2 is used
by a single evaluator or by an evaluation team, the
input provided by parents/caregivers and teachers
is combined with the interactive behavior sample
of the individual being evaluated, resulting in a
compelling, detailed description of the individual’s
distinctive autism spectrum behavioral profile. In
addition, when used by a multidisciplinary evalu­
ation team, the MIGDAS-2 allows expertise from
multiple perspectives (e.g., psychology, speech–
language pathology, occupational therapy) to be
incorporated into descriptions of the individual’s
behavioral profile and development. It also provides
the team of evaluators with a common framework
and descriptive language for recognizing and
describing autism spectrum differences.
A typical evaluation team might consist of a licensed
psychologist or credentialed school psychologist,
a licensed speech and language pathologist, and a
licensed educational diagnostician. Licensed occu­
pational therapists, when available, are also valuable
team members. As already noted, job titles vary, and
other professionals with appropriate qualifications
who possess experience with ASD and clinical inter­
viewing may be team members as well. Psychiatrists,
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 developmental pediatricians, and other medical
professionals may participate on evaluation teams in
medically based team evaluation settings. In addi­
tion, graduate students under supervision may serve
on an evaluation team.
Although all team members should have knowledge
of autism spectrum differences, it is typically the
case that one individual has more experience than
the others, and that team member usually serves
as the primary interviewer. A licensed psycholo­
gist often serves as the team leader, as psychologists
typically have the background in clinical assessment
necessary for this role. However, any assessment
professional whose clinical background provides
adequate training and credentials as described
herein may be the team leader.
Using the MIGDAS-2 to enhance the diagnostic
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process Although the MIGDAS-2 process provides
valuable qualitative information and directs evalua­
tors to describe individual behavioral profiles in an
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organized and accessible manner, it does not pro­
vide a formally quantifiable or normative measure
of behavior. As with all assessment measures, the
materials provide guidance in making diagnostic
decisions but do not themselves yield a diagnosis.
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2 Current editions at time of publication are the Childhood Autism Rating Scale, Second Edition (CARSTM2; Schopler, Van Bourgondien,
Wellman, & Love, 2010) and the Social Responsiveness Scale, Second Edition (SRSTM-2; Constantino & Gruber, 2012).
Principles of Use
MIGDAS-2 • W-690M
Instead, it is the responsibility of the professionals
using the materials to consider all sources of infor­
mation when formulating a diagnosis.
Evaluators should consider using the MIGDAS-2
process along with standardized assessment mea­
sures. Standardized autism rating scales, such as
current editions of the Childhood Autism Rating
Scale, designed for use by evaluators, and the Social
Responsiveness Scale, designed to be completed
by parents/caregivers and teachers, are recom­
mended quantitative measures to use along with
the MIGDAS-2.2 For evaluators currently using
the ADOS-2, the MIGDAS-2 process can be used to
expand the clinical behavior sample of the indi­
vidual being evaluated. Specifically, the MIGDAS-2
process elicits sensory-based behaviors and routines,
ideally expanding on the ADOS-2 focus on social
communication. Completing the MIGDAS-2 sensory-
based process prior to formal administration of the
ADOS-2 can enhance rapport with the individual
being evaluated, decrease the individual’s anxiety
in the interview setting, and provide more detailed
information regarding the individual’s drive to pur­
sue sensory topics and activities.
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