The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) test is a newly updated semi-structured, standardized measure of communication, play/imagination, social interaction, and restricted or repetitive behaviors. The ADOS-2 has been mostly referred to as a “gold standard” measure of observational assessment for autism spectrum disorder (ASD). The second edition makes use of revised algorithms, a new Comparison Score, updated protocols, and a Toddler Module. The ADOS-2 follows similar administration and coding procedures just like that of the ADOS.
There are five different modules labeled Module 1, 2, 3, 4, and Toddler Module where one of them is chosen is based on the chronological age or expressive language level of the child. Module 1 to 4 yields algorithm scores which are usually compared with the cutoff scores that yield one of three classifications that include autism, non-spectrum, and autism spectrum (ASD). The Toddler Module yields a varying range of concern rather than simply classification scores. The new Comparison Score allows the examiner to compare the overall level of autism spectrum-related symptoms with that of another child of the same age that shows similar expressive language skills.
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Reliability Concepts
The ADOS-2 has been found to have good psychometric properties and have a high-reliability measurement. It has excellent interrater reliability, internal consistency, and good test-retest reliability. The interrater reliability measures the degree of agreement among different raters or examiners. ADOS-2 has been found to have a high homogeneity and consensus based on the ratings of various judges. The internal consistency measures how well the test addresses different constructs and delivers reliable scores. The ADOS-2 has a high consistency in measuring various aspects of autism. The test-retest reliability measures the closeness of the agreement between results of successive measurements of the same measurand carried out within the same condition of measurement. An individual that has been diagnosed with autism under ADOS-2 has a higher chance of being diagnosed with the condition after some time.
Strengths and Weaknesses
One of the strengths of ADOS-2 is that it is perceived as highly reliable and accurate in diagnosis children with ASD. Additionally, the tool captures other ASD-specific behaviors. The ADOS-2 creates a social world where behaviors that are related to the autism spectrum can be observed and operationalized based on a specific measure. The findings also show that there is a high degree of validity and reliability. These characteristics make it quite useful in individual clinical diagnostics of ASD and in scientific research. The test has been classified into different modules that can be used to measure autism among individuals of different ages. For instance, Module 4 is considered as a standard for measuring autism among adults while the Toddler Module is considered as a standard for measuring autism among toddlers that may not be able to communicate. The ADOS-2 can thus be used to measure autism for an individual of any age.
One of the disadvantages of ADOS-2 is that it has been found to classify children that could have other forms of disorders. While the diagnosis of autism could be correct, it could miss out on identifying any other disorders. This is because the ADOS-2 is specific in measuring autism and cannot identify other disorders. Other weaknesses of ADOS-2 are that the cost of the toolkit is high and it can take time to administer the measure.
The Resourcefulness of the Tool
The ADOS-2 is resourceful for the target population because it provides a way for accurate diagnosis of individuals. Through the test, the individual and family can have access to appropriate intervention services such as educational and behavioral programs. Having an accurate diagnosis is the first step for a clinician to define a treatment plan. Official diagnostic reports from ADOS-2 completed by a licensed clinical psychologist are required by the state to help obtain financial benefits and to obtain special education accommodations.
