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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