The ADOS-2
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), is a face-to-face assessment that helps professionals evaluate for possible autism spectrum disorder (ASD). During the ADOS-2, our highly trained teammates carefully observe how your child talks, plays, and interacts with others. Diagnostic professionals can use the results of the ADOS-2 to inform the autism diagnostic process.
What is the ADOS-2?
The ADOS-2 is a standardized, play-based assessment used to observe behaviors associated with autism spectrum disorder. It is one of the most trusted tools for evaluating possible autism in children.
A gold standard
The ADOS-2 is considered a “gold standard” method for helping evaluate a child for ASD. This tool is backed by research and helps clinicians reliably and accurately identify autism symptoms regardless of the child’s age or developmental level.
Play-based
Children have fun participating in the ADOS-2—it’s not like going to the doctor! During the 30 to 60-minute assessment, our clinicians engage in play and activities tailored to the child’s age and developmental abilities.
Scoring
Following the assessment, scores are calculated that indicate how closely the child’s behaviors in fundamental areas match autism characteristics. The score and a summary are sent to the child’s pediatrician or referring provider to include in their diagnostic process and recommendations.
What does the ADOS-2 measure?
The ADOS-2 looks at different areas of a child’s development that are often linked to autism. During the evaluation, the clinician watches how a child acts during play, conversation, and other activities.
Some of the main areas the ADOS-2 measures include:
- Social communication: Things like making eye contact, using gestures, or sharing enjoyment with others
- Play and imagination: How the child uses toys and whether they pretend or act out stories
- Language use: How the child talks and responds during social situations
- Repetitive behaviors or strong interests: Such as repeating movements or being very focused on a certain topic
- Emotional responses: How the child reacts to different feelings and situations
These behaviors are assigned scores to help determine how closely a child’s actions match common signs of autism. The results provide a clearer picture to help guide next steps.
ADOS-2 modules explained
The ADOS-2 is a research-backed assessment that includes five modules, each designed for individuals with different developmental and language abilities. This modular format ensures that the evaluation is tailored to your child’s specific needs.
- Toddler Module: For children 12 to 30 months old who speak little or not at all
- Module 1: For children who do not yet speak in phrases
- Module 2: For children who speak in phrases but are not yet fluent
- Module 3: For verbally fluent children
- Module 4: For verbally fluent adolescents and adults
At Action Behavior Centers, we use the Toddler Module and Modules 1–3 to assess children ages 18 months to 6 years old. Our team selects the appropriate module based on your child’s communication skills and developmental stage.
Understanding the ADOS-2 score
The ADOS-2 is a tool used to help evaluate if a child might have autism. It includes a series of structured activities that encourage talking, social interaction, and play. While your child completes these activities, a trained evaluator watches closely and takes notes on specific behaviors.
ADOS-2 scoring chart
Each behavior is rated using a scale from 0 to 3:
- 0 = Behavior appears typical or shows no concern
- 1 = Behavior seems a little unusual
- 2 = Behavior is clearly different from typical behavior
- 3 = Behavior shows strong signs related to autism
The evaluator then adds up the scores in various areas, such as communication and social interaction. These totals are then compared to standard cutoff scores. If your child’s scores are above these cutoffs, it may suggest that their behaviors are consistent with autism spectrum disorder.
Score range
Classification
0-6
Non-spectrum
7-8
Autism Spectrum
+9
Autism
Note: Cutoff scores vary slightly depending on the module used. These are typical ranges used for Modules 1 – 3.
ADOS-2 score interpretation
The ADOS-2 score reflects how closely observed behaviors align with characteristics of autism spectrum disorder. A higher score indicates a greater number or intensity of autism-related behaviors. However, the score:
- Does not provide a diagnosis on its own
- Must be reviewed alongside other information like:
- Developmental history
- Parent/caregiver interviews
- Other screenings (e.g., M-CHAT, CAST)
Who can take the ADOS-2?
Frequently asked questions
Why is it important to get an autism diagnosis for your child?
A formal autism diagnosis is required before your child can begin to access certain developmental therapies or services through their school, like ABA therapy.
Who conducts the ADOS-2?
The ADOS-2 is conducted by a trained team that meets the publisher’s criteria for administering and scoring the tool. Our teammates receive intensive initial training on the ADOS-2 as well as ongoing training to maintain their clinical skills.
What happens during the ADOS-2?
Throughout the assessment, the teammate calculates a score based on how the child’s behaviors align with signs of autism. When the results are ready, typically within one week, they are sent to the referring pediatric medical provider to inform their evaluation, diagnosis decisions, and recommendations.
Does the ADOS-2 diagnose autism?
The ADOS-2 is a great tool for seeing if a child might have autism, but it does not officially diagnose it. Instead, it informs your child’s provider’s evaluation for autism to make the final diagnosis.
What happens after the ADOS-2?
The ADOS-2 results summary is sent to your child’s treating doctor for review. They will consider all sources of information to determine if your child meets the diagnostic criteria for autism. Your doctor may recommend further steps, such as more in-depth testing with a specialist. If a diagnosis of autism is made, your doctor will make treatment recommendations, such as ABA therapy.
Who can administer the ADOS-2?
Only professionals who have been trained in the tool and meet the publisher's qualifications are allowed to administer the ADOS-2. At Action Behavior Centers, our team members undergo intensive training and ongoing supervision to uphold the highest standards of clinical care.
How often can the ADOS-2 be administered?
The ADOS-2 can be administered more than once. However, repeated assessments are usually spaced out and only recommended when new questions arise about the child’s development or when earlier results were inconclusive.
Does insurance cover the ADOS-2?
We provide the ADOS-2 as a no-cost service to the community.
Schedule the ADOS-2
Contact your nearest Action Behavior location or complete the following form to schedule the ADOS-2. This form helps us match you with a center. Our team will be in touch soon!
