Autism Diagnostic Observation Schedule, Second Edition (ADOS-II) Module 1 The ADOS-2 is a standardized, semi-structured diagnostic instrument designed to identify characteristics of autism spectrum disorders. The ADOS-2 involves the use of planned social occasions in which a particular type of behavior is likely to occur. Within these interactive activities, the Facilitator(s) observes the occurrence or non-occurrence of specific behaviors typically associated with individuals with autism spectrum disorders. Student completed Module 1, which consists of 10 activities and 34 accompanying ratings, grouped in the following three areas: Communication, Reciprocal Social Interaction, Restricted and Repetitive Behaviors. Emphasis is given to the areas of communication and social interaction. Within the area of language and communication, Student’s speech was full of utterances with two or more words. Some examples of his speech include, “What’s that?”, “Is it shampoo?”, “Pop the bubbles!”, and “I’m trying to save the day.” The majority of Student’s speech was directed towards the Facilitator, but not consistently. Student spoke with a high-pitched voice throughout the assessment. He did not display immediate or delayed echolalia; however, he did use some words and phrases repetitively during the assessment. He constantly asked “What?” and “Open” during the assessment. Student had a slight cough and rubbed rub his nose a few times during the assessment. When it was time to transition to another activity, he wanted to see the other toys that the Facilitator had in the bag. The Facilitator redirected Student easily; when told to sit in the chair, Student complied. He followed the Facilitator’s cues and gestures during the assessment. Student did take the Facilitator’s hand and directed it towards a desired object and when he wanted the object, he pointed to the object that was out of reach. Student used no descriptive, conventional, instrumental, or emotional gestures during the evaluation. In the area of social interaction, it is important to note that Student has lazy eyes, appeared unfocused on the Facilitator or toys, but he successfully established and maintained eye contact when making requests and during play. When the Facilitator called his name, he did not look at the Facilitator, but on the fourth prompt, he responded to his name by turning his head towards the Facilitator. Student smiled at the Facilitator and laughed during the assessment. During the Bubble Task, Student stated, “Pop the bubbles!” and repeated “Lots and lots and lots of bubbles, more, more, more!” Student ran around the room popping the bubbles and requested the Facilitator several times to blow the bubbles. During the Balloon Task, Student smiled, laughed, and when the Facilitator held up the balloon after the third try, Student stated “Ready, Set, Go!” and ran towards the balloon to give it back to the Facilitator. When the Facilitator brought out the birthday cake items, Student fed cake to the baby and put the baby down for a nap. He did not participate in singing “Happy Birthday”. When playing Peek-a-boo with the Facilitator, he laughed and giggled. On the second interaction, Student got out of his seat to surprise the Facilitator. At the beginning of the assessment, Student played with a variety of toys on his own while the Facilitator watched. Student quickly went to play with the toys on the floor, playing with the blocks, cars, dump truck, pop-up toy, and the telephone. He moved the dial on the phone, picked up the receiver and stated “Hello” several times. When the Facilitator joined in play, Student did not immediately engage with him. The Facilitator continued to comment on what Student was doing then finally, when playing with the cars, Student got excited. Overall, rapport was easily established and maintained throughout the assessment. As the session concluded, Student waved bye to everyone and went back to class. Play skills were evaluated, although these do not factor into the total score for the ADOS-2. Student demonstrated appropriate play with cause and effect toys, such as pushing the car and construction toys. He attempted to manipulate the jack in the box during the assessment and gave the toy to the Facilitator for assistance. He moved a round block through the air as if it was a plane and made noises. He moved the toy frog around on the table and said “Ribbit, Ribbit” as he made the frog jump. He cut a piece of cake for the baby to eat and pretended to feed it to her. During snack, Student appropriately asked what snack he wanted and requested when he wanted more. When he selected the juice to drink, he removed the straw and asked, “What’s this? Can you open it?” He commented on his fruit snacks “That’s an apple fruit snack”. When given goldfish, he counted them aloud and said, “I like goldfish, take a goldfish”. In the area of stereotyped behaviors and restricted interests, Student displayed no unusual sensory interests nor did he engage in sensory-seeking behaviors. He did not demonstrate repetitive movements with his hands, fingers, arms, or whole body. He did not demonstrate any self-injurious behaviors. Student did not have a tantrum when it was time to change to another activity, display negative or disruptive behaviors during the assessment. No anxiety; Student was active during the assessment but able to sit and stand still when expected. Higher scores on each scale of the ADOS-2 indicate that more characteristics of an autism spectrum disorder were observed during the administration. Student’s total score indicates that he falls within the Autism Spectrum Classification with a low level of Autism related symptoms. ADOS-2. Because there is no single test for autism, the multidisciplinary team should carefully consider observations of Student’s behavior in other situations as well as parent and teacher report of what behaviors are typical for him that may or may not have been observed during the ADOS2 administration. Autism. As defined by the Exceptional Children Division of the Public Schools of North Carolina, Autism is a developmental disorder, which is characterized by significant and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, and the presence of restricted and/or repetitive behavior, interests, and activities. This impairment, sometimes called Autism Spectrum Disorder, may include Autistic Disorder, Atypical Autism (Pervasive Developmental Disorder—Not Otherwise Specified), Rhett’s Disorder, Childhood Disintegrative Disorder, or all Pervasive Developmental Disorders. These disorders can co-exist with other disorders such as mental retardation, learning disabilities, attention-deficit hyperactivity disorder, Down Syndrome, or Tourette’s Disorder. To be determined eligible in the category of autism, a child must demonstrate at least three of the four following characteristics: (A) Impairment in communication (B) Impairment in social interaction (C) Unusual response to sensory experiences (D) Restricted, repetitive, or stereotypic patterns of behavior, interests, and/or activities. The disability must adversely affect a child’s educational performance and require specially designed instruction. The IEP Team should meet and determine the most appropriate educational plan for Student based on evaluation results. Results of the current ADOS-2 evaluation should be considered along with results of recent psychoeducational evaluation information. In accordance with current North Carolina State Department of Public Instruction Procedures regarding placement of children in programs for exceptional children, these results may suggest the possible classification Autism for Student for educational purposes. It was a pleasure to have the opportunity to work with Student. If you have questions regarding this evaluation, please contact me at XXX-XXX-XXXX.
