This second edition improves an instrument already viewed as the “gold standard” for observational assessment of autism spectrum disorders (ASDs). 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 semistructured, standardized assessment of communication, social interaction, play, and restricted and repetitive behaviors. By observing and coding these behaviors, you can obtain information that informs diagnosis, intervention, treatment planning, and educational placement.
Five 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.
- Toddler Module—for children between 12 and 30 months of age who do not consistently use phrase speech
- Module 1—for children 31 months and older who do not consistently use phrase speech
- Module 2—for children of any age who use phrase speech but are not verbally fluent
- Module 3—for verbally fluent children and young adolescents
- 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, Module 3 activities are as follows:
- Construction Task
- Make-Believe Play
- Joint Interactive Play
- Demonstration Task
- Description of a Picture
- Telling a Story From a Book
- Cartoons
- Conversation and Reporting
- Emotions
- Social Difficulties and Annoyance
- Break
- Friends, Relationships, and Marriage
- Loneliness
- 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, or 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.
Algorithms for Modules 1 through 3 have been revised to achieve more accurate and useful results and to provide a more uniform basis for comparing results across the three modules used with children and young adolescents.
A new Comparison Score for Modules 1 through 3 allows you to look at a child’s overall level of autism spectrum–related symptoms in relation to those 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.
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. Observations are coded immediately following administration, and the codes are converted to algorithm scores. 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 provides guidance if continued monitoring is needed.
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 can use 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.
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*Contains small parts that may be a choking hazard for children under the age of 3. Administration to children less than three years of age should be done only under the close supervision of the test administrator. A trained adult examiner must always closely supervise the administration of the test and use of manipulatives by children. 
