Modules 1 through 4
by Catherine Lord, Ph.D., Michael Rutter, M.D., FRS, Pamela C. DiLavore, Ph.D., Susan Risi, Ph.D., Katherine Gotham, Ph.D., and Somer L. Bishop, Ph.D.
Toddler Module
by Catherine Lord, Ph.D., Rhiannon J. Luyster, Ph.D., Katherine Gotham, Ph.D., and Whitney Guthrie, M.S.
This revision improves an instrument already viewed as "the gold standard" for observational assessment of autism spectrum disorder (ASD). With updated protocols, revised algorithms, a new Comparison Score, and a Toddler Module, the ADOS-2 provides a highly accurate picture of current symptoms, unaffected by language. It can be used to evaluate almost anyone suspected of having ASD--from 1-year-olds with no speech to adults who are verbally fluent.
Like its predecessor, the ADOS-2 is a semi-structured, standardized assessment of communication, social interaction, play, and restricted and repetitive behaviors. It presents various activities that elicit behaviors directly related to a diagnosis of ASD. By observing and coding these behaviors, you can obtain information that informs diagnosis, treatment planning, and educational placement.
5 Modules
The ADOS-2 includes five modules, each requiring just 40 to 60 minutes to administer. The individual being evaluated is given only one module, selected on the basis of his or her expressive language level and chronological age. Following guidance provided in the manual, you choose the module that's appropriate for the individual you're evaluating.
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Toddler Module--for children between 12 and 30 months of age who do not consistently use phrase speech
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Module 1--for children 31 months and older who do not consistently use phrase speech
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Module 2--for children of any age who use phrase speech but are not verbally fluent
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Module 3--for verbally fluent children and young adolescents
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Module 4--for verbally fluent older adolescents and adults
Each module engages the examinee in a series of activities involving interactive stimulus materials (all included in the ADOS-2 Kit). To illustrate, activities in Module 3 are listed below:
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Construction Task
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Make-Believe Play
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Joint Interactive Play
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Demonstration Task
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Description of a Picture
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Telling a Story From a Book
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Cartoons
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Conversation and Reporting
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Emotions
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Social Difficulties and Annoyance
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Break
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Friends, Relationships, and Marriage
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Loneliness
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Creating a Story
Standardized Administration, Coding, and Scoring
Each ADOS-2 module has its own Protocol Booklet, which structures the administration and guides you through coding and scoring. As you administer activities, you observe the examinee and take notes. Immediately afterward, you code the behaviors observed. Then you use the Algorithm Form for scoring.
In Modules 1 through 4, algorithm scores are compared with cutoff scores to yield one of three classifications: Autism, Autism Spectrum, and Non-spectrum. The difference between autism and autism spectrum classifications is one of severity, with the former indicating more pronounced symptoms. In the Toddler Module, algorithms yield "ranges of concern" rather than classification scores.
Improved Protocol Booklets, Revised Algorithms, and a New Comparison Score
Administration and coding procedures for the ADOS-2 are functionally identical to those for the ADOS. Modules 1 through 4 retain the same basic activities and codes, though some codes have been expanded and several new codes have been added. Protocol Booklets for these modules have been significantly improved--they now provide clearer, more explicit administration and coding instructions.
In the ADOS-2, algorithms for Modules 1 through 3 have been revised to achieve more accurate and useful results. These updated algorithms provide a more uniform basis for comparing results across the three modules that are used with children and young adolescents.
A new Comparison Score for Modules 1 through 3 allows you to compare a child's overall level of autism spectrum-related symptoms to that of children diagnosed with ASD who are the same age and have similar language skills. This score also makes it easier to monitor an individual's symptoms over time. A continuous metric, the Comparison Score ranges from 1 to 10. However, to facilitate clinical interpretation it can also be expressed as one of four descriptive categories--from "no evidence of autism spectrum-related symptoms" to "a high level of autism spectrum-related symptoms."
The new ADOS-2 scoring program helps you choose the correct algorithm, converts item codes to algorithm scores, adds up the algorithm, calculates the Comparison Score, and quickly arrives at an ADOS-2 classification or "range of concern."
The New Toddler Module
The Toddler Module is designed specifically for children between 12 and 30 months of age who do not consistently use phrase speech. Existing ADOS-2 components have been revised, and new components added, to more accurately identify toddlers at risk for ASD.
The Toddler Module engages the child with loosely structured activities involving highly motivating materials. The goal, again, is to see if the child demonstrates behaviors associated with ASD. As in Modules 1 through 4, observations are coded immediately following administration, and the codes are converted to algorithm scores. However, Toddler Module algorithms provide "ranges of concern" rather than cutoff scores. These ranges help you form clinical impressions, but they avoid formal classification--which may not be appropriate at such a young age. The Toddler Module quantifies risk for ASD and signals the need for continued monitoring.
The Most Accurate Picture of Current ASD Symptoms
With improved algorithms, the ADOS-2 demonstrates strong predictive validity. It gives you a highly accurate picture of current ASD-related symptoms, based on real-time observations. Physicians, clinical psychologists, school psychologists, speech-language pathologists, and occupational therapists rely on ADOS-2 results to inform diagnosis, intervention, educational placement, and treatment planning. Because it can be used with a wide range of children and adults, the ADOS-2 is an essential addition to any hospital, clinic, or school that serves individuals with developmental disorders.
Training Options
ADOS-2 administration and coding are highly standardized. Therefore, valid assessment requires training. Three training options are available:
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ADOS-2 DVD Training Package (W-605DVD)
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ADOS-2 DVD Training Upgrade Package (W-606DVD)
CE credits are available for all three training options.
Clinicians with no previous ADOS training should attend an ADOS-2 Clinical Workshop or purchase the ADOS-2 DVD Training Package.
Clinicians who have been trained to use the original ADOS should purchase the ADOS-2 DVD Training Upgrade Package.
Those who plan to use the ADOS-2 in research need to attend in-person clinical and research workshops.
