What is the best test for diagnosing Autism?
One of the most widely used observation instruments for the assessment of autism is the Autism Diagnostic Observation Schedule (ADOS) (Lord, Rutter, DiLavore, & Risi, 2008). The ADOS-2 is a semi-structured assessment of social interaction, communication, play, and imaginative use of materials for individuals who may have Autism or other Autism Spectrum Disorder (ASD). The ADOS-2 is a revision of the Autism Diagnostic Observation Schedule, which has been referred to as the gold standard observational assessment in helping diagnose ASD.
How does it work?
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is one of the few standardized diagnostic measures that involves scoring direct observations of the child’s interactions. 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. It has the most empirical support among observation-based diagnostic assessment procedures for Autism and is recommended in the best practice guidelines as the appropriate standardized diagnostic observation tool. The ADOS-2 offers the practitioner a standardized observation of current social-communicative behavior with excellent interrater reliability, internal consistency and test–retest reliability on the item, domain and classification levels for Autism and non-spectrum disorders.
How long does the Autism Evaluation take?
The ADOS-2 is performed in conjunction with parent/caregiver interview and a full review of a child’s developmental and medical history, school functioning, developmental/cognitive testing, and measures of comorbid symptoms. Additionally, an evaluation of the child's cognitive and language abilities and direct observation of the child in both structured and unstructured settings will be performed to rule out other causes of a child’s behavioral and social presentation and delays.
At Elevated Kids, the Autism Evaluation will be performed across two separate visits. The first visit lasts approximately three hours and consists of the interview, examination, and structured play assessment (ADOS-2). The second visit lasts approximately two hours and consists of the results of the assessment and the recommendations for services and supports for the family.
What is the family's role in the Autism Evaluation?
Family involvement during the evaluation is very important and varies for each individual child. The parents or caregivers are asked to provide the necessary information pertaining to the child's developmental history, developmental delays, concerns, and current skills and behavior that will help to guide the evaluation. Your child will be observed in an unstructured setting exploring and playing as usual and then will be assessed in a structured play session (ADOS-2). Depending on your child’s age and response to testing, you may be asked to sit in with your child during the ADOS-2 assessment.
If possible, it is recommended that siblings stay home so that families can give their undivided attention during the evaluation. Understanding that child care is sometimes difficult, when bringing siblings, it may be helpful to bring another adult and activities to occupy the siblings during the evaluation.
What do families need to bring?
• A current photo ID (license)
• Insurance card
• Referral if needed
• A current list of your child’s medications
• Early Intervention reports, plans (MDE, ER, IFSP, IEP)
• Prior evaluations
Please have your child wear loose comfortable clothing, socks and shoes/sneakers.
Your child will be offered a snack during the first session. Please make aware of any allergies or bring a preferred snack for the examiner to offer.
Autism Spectrum Disorder (ASD)
It is so critical to recognize and diagnose ASD as early as possible, when intervention will have the greatest impact on a child's development.
How do I know if my child has signs of ASD?
Trust your parental instincts. Research shows that parents are really good at picking up early signs of ASD. As a parent, you know your child better than anyone else and you are in the best position to observe the early signs. The key is to monitor your child's development and report any delays or concerns to your child's pediatrician immediately.
ASD involves a variety of developmental delays, so keeping a close eye on when—or if—your child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the early signs. While developmental delays don’t automatically point to ASD, they may indicate a heightened risk.
The next step is to take action if you’re concerned. Every child develops at a different pace, and when it comes to development, there’s a wide range of what is considered typical. But, if your child is not meeting the milestones for his or her age, or you have concerns, it is important to share your concerns with your child's pediatrician immediately and ask that your child be screened for developmental delays and/or ASD. You can also use our free ASD screener for toddlers (M-CHAT screening tool) and take the results to your child's pediatrician, local Early Intervention Program, or contact a specialist for an Autism Evaluation.
Early Signs of ASD:
- No social smiling by 6 months
- No one-word communications by 16 months
- No two-word phrases by 24 months
- No babbling, pointing, or meaningful gestures by 12 months
- Poor eye contact
- Not showing items or sharing interests
- Unusual attachment to one particular toy or object
- Not responding to sounds, voices, or name
- Loss of skills at any time