The Autism Diagnostic Observation Schedule, or ADOS for short, is one of the assessment tools we use as part of the overall autism assessment process. It is an assessment that can be used with people of all ages, abilities and language skills. It is a semi-structured, standardised assessment of communication, social skills, play and restricted and repetitive behaviours. It enables us to look at how your child or young person communicates, how they interact with us, how they play and their ability to be creative, and also if they have any restricted or repetitive behaviours or interests.
During the assessment the clinician will play some games with younger children or carry out activities including questions about school, friendships and feelings with older children or young people. By watching the way your child communicates, interacts, plays and behaves during the games and activities it helps us to understand if there are signs of autism.
Your child has been referred for an assessment to look at whether they may have autism. Autism is a lifelong condition that affects the way a person communicates and interacts with other people and how they see the world around them. They may find it hard to understand how people think and feel. They may also find it hard to talk about their own thoughts and feelings. Knowing whether your child has autism may be helpful in supporting them.
The clinicians will be observing how your child responds and interacts with them during the activities, this includes specific behaviours and signs related to the diagnosis of autism. The ADOS assessment is part of an overall assessment process carried out by a multi-disciplinary team, which also includes other ways of gathering information about your child. The multi-disciplinary team includes a Paediatrician, a doctor who specialises in children and young people, along with either a speech and language therapist, a clinical nurse specialist or a clinical psychologist. Should the ADOS not provide sufficient information we will use other methods to gather this.
We will not make a decision about whether your child has a diagnosis of autism at the end of this assessment. This decision will be made the by the multi-disciplinary team at the end of the overall assessment process.
If your child is 5 or under you may be asked to sit in the room while the clinician carries out the assessment.
During the assessment, to ensure we have a reliable and accurate assessment, we ask that you only respond if your child approaches you. Therefore, it is important that you do not join in with the play or activities such as telling your child what to do or giving your child any instructions.
If your child or young person is older, the clinician will play some games, ask questions and have conversations with them. If your child feels comfortable to do so, we may ask you to sit outside the clinic room.
Your child and the clinician will be sat at a table like this or playing on the floor if you have a younger child.
We ask that you and your child do not wear a mask or face covering during the assessment. The clinician will also not be wearing a mask because during the assessment the child or young person needs to see the clinician’s face. Also this assessment would not be valid if a face mask is worn. However, please be assured we take extensive precautions to reduce risks relating to Covid-19, and ensure that you and your child are safe during the appointment.
A set of games will have been selected for your child based on their age and language skills. There will be puzzles, talking about pictures in a book, playing with toys or creating a story with objects, answering questions and having a conversation.
The ADOS assessment usually takes up to an hour.
Don’t worry, we understand that every child is different, and want to reassure you that whatever your child does on the day, it will help us to better understand them. This is also why we have a number of different ways of gathering information as part of the overall assessment process.
We understand that this is an important appointment for you and your child. It’s normal to feel anxious, because you want to do the best for your child. Don’t worry we will be there supporting you and your child through every step of this appointment and the overall assessment process.
We will be taking notes during the appointment and we will be looking out for signs of autism. The assessment may be video-recorded so that the clinician and paediatrician can refer to it if needed. We will ask for your written permission at the start of the appointment if we video-record the assessment.
The ADOS is only one part of the assessment process. After this assessment you will be seen by a paediatrician, at a later date, who will have a discussion with you about your child, and provide feedback on the outcome of the assessment process which includes the views and evidence provided by parents or carers. As part of the assessment process we may also seek the views of other professionals who work with your child, such as members of staff at your child’s nursery or school, or social workers.