Understanding the Brain

Autism Diagnostic Observation Schedule

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The Autism Diagnostic Observation Schedule is an instrument for diagnosing and assessing Autism. It was created by Catherine Lord, Ph.D., Michael Rutter, M.D., FRS, Pamela C. DiLavore, Ph.D., and Susan Risi, Ph.D. in 1989 [1] and became commercially available in 2001 through the WPS, or Western Psychological Services.[2] The protocol consists of a series of structured and semi-structured tasks that involve social interaction between the examiner and the subject. The examiner observes and identifies segments of the subject's behavior and assigns these to predetermined observational categories. Categorized observations are subsequently combined to produce quantitative scores for analysis. Research-determined cut-offs identify the potential diagnosis of autism or related autism spectrum disorders, allowing a standardized assessment of autistic symptoms. The Autism Diagnostic Interview-Revised (ADI-R), a companion instrument, is a structured interview conducted with the parents of the referred individual and covers the subject's full developmental history.[3] The ADOS should not be used for formal diagnosis with individuals who are blind, deaf, or otherwise seriously impaired by sensory or motor disorders, such as cerebral palsy or muscular dystrophy.[3]


The ADOS generally takes from 30 to 60 minutes to administer. During this time the examiner provides a series of opportunities for the subject to show social and communication behaviors relevant to the diagnosis of autism.[2] Each subject is administered activities from just one of the four modules. The selection of an appropriate module is based on the developmental and language level of the referred individual. The only developmental level not served by the ADOS is that for adolescents and adults who are nonverbal.[1] A revision, the ADOS-2, is currently in development with a release goal date in early 2011. It will include improved algorithms for Modules 1 to 3 and a new Toddler Module that facilitates assessment in children ages 12 to 20 months.


Module 1 is used with children who use little or no phrase speech. Subjects that do use phrase speech but do not speak fluently are administered Module 2. Since these modules both require the subject to move around the room, the ability to walk is generally taken as a minimum developmental requirement to use of the instrument as a whole. Module 3 is for younger subjects who are verbally fluent and Module 4 is used with adolescents and adults who are verbally fluent. Some examples of Modules 1 or 2 include response to name, social smile, and free or bubble play. Modules 3 or 4 can include reciprocal play and communication, exhibition of empathy or comments on others' emotions.[1]


  1. 1.0 1.1 1.2 Autism Diagnostic Observation Schedule.” Western Psychological Services. Western Psychological Services. n.d. Web. 6 March 2010.
  2. 2.0 2.1 Akshoomoff, Natacha, Christina Corsello and Heather Schmidt. “The Role of the Autism Diagnostic Observation Schedule in the Assessment of Autism Spectrum Disorders in School and Community Settings” The California School Psychologist 11 (2006): 7-19. Print.
  3. 3.0 3.1 General references:
    • Lord C, Rutter M, Goode S et al. (1989). "Autism diagnostic observation schedule: a standardized observation of communicative and social behavior". J Autism Dev Disord 19 (2): 185–212. doi:10.1007/BF02211841. PMID 2745388. 
    • Gotham K, Risi S, Dawson G et al. (2008). "A replication of the Autism Diagnostic Observation Schedule (ADOS) revised algorithms". J Am Acad Child Adolesc Psychiatry 47 (6): 642. doi:10.1097/CHI.0b013e31816bffb7. PMID 18434924. 
    • Luyster R, Gotham K, Guthrie W et al. (2009). "The Autism Diagnostic Observation Schedule—Toddler Module: a new module of a standardized diagnostic measure for autism spectrum disorders". J Autism Dev Disord 39 (9): 1305–20. doi:10.1007/s10803-009-0746-z. PMC 2893552. PMID 19415479. 

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