By Nicola Stigter, Provisional Psychologist at Minds & Hearts
Many families who make an appointment for their child with a psychologist or specialist, for a diagnostic assessment for Autism Spectrum Condition, are unsure of what to expect and how to prepare ahead of time. It can be a confusing and overwhelming time for many families.
While assessments for Autism Spectrum Disorder (ASD) vary, a common diagnostic tool to assess ASD in children and adolescents is the Autism Diagnostic Observation Schedule 2nd Edition, or more commonly know as, the ADOS.
An ADOS assessment is a semi-structured, standardised process which assesses the following four behaviours:
• Communication
• Social interaction
• Play
• Restricted and repetitive behaviours
An ADOS presents different activities which elicit behaviours directly associated with Autism Spectrum Condition. The clinician will observe and code these behaviours, which will inform diagnosis, treatment planning and education (Lord et al., 2012). An ADOS consists of five modules, and the clinician will pick the appropriate module for your child based on the developmental and language level (Lord et al., 2012).
Preparing for an ADOS
If your child has been referred for an ADOS assessment, an initial appointment will first be scheduled with a clinician. During this appointment, developmental history, background information and information on main concerns will be gathered.
Some families may find this appointment overwhelming and it can be beneficial to make notes or create a diary of your child’s behaviour and any concerns you have before coming in. Parents are also recommended to bring along any reports or previous assessments which may provide further information for the clinician.
It may also be beneficial to bring along a family member or some form of support in case the clinician wishes to speak to you alone without your child present.
What happens on the day?
An ADOS is typically between 40 – 60 minutes long.
For younger and very anxious children, the clinician may wish you to also be present during the assessment, though this will not always be the case. Depending on your child’s age, you may be asked to bring along a snack for the assessment—any requests for snacks and/or carer attendance will be advised to you before the day of the ADOS assessment.
After the ADOS assessment is complete, the clinician will usually schedule a follow up appointment to go through feedback of whether your child is on the autism spectrum and recommendations for areas to address. The clinician will then prepare a written report of your child’s assessment.
Preparing my child
A common question and concern faced by parents throughout the assessment process is what do I say to my child about the appointment? While this will depend upon the age of the child, their level of self-concept, anxiety and negative thinking, we recommend that they be told that they will be coming in to play some games and see someone who wants to get to know their strengths and help them with anything they may find difficult. Communicating with your child in a positive, strength-focused way will help their understanding and attitude towards the appointment.
References
Lord, C. et al. (2012). Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Manual (Part I): Modules 1-4. Torrance, CA: Western Psychological Services.