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Autism Diagnostic Observation Schedule

January 01, 1970

The Autism Diagnostic Observation Schedule (ADOS) is a standardized diagnostic test for assessing autism spectrum disorder. The protocol consists of a series of structured and semi-structured tasks that involve social interaction between the examiner and the person under assessment. The examiner observes and identifies aspects of the subject's behavior, assigns these to predetermined categories, and combines these categorized observations to produce quantitative scores for analysis. Research-determined cut-offs identify the potential diagnosis of autism spectrum disorder, allowing a standardized assessment of autistic symptoms.

Autism Diagnostic Observation Schedule
Purposeassess autism in children, adolescents, and adults

The Autism Diagnostic Interview-Revised (ADI-R), a companion instrument, is a structured interview conducted with the parents of the referred individual to cover the subject's full developmental history. The ADI-R has lower sensitivity but similar specificity to the ADOS.

History edit

The original ADOS was created by Catherine Lord, Michael Rutter, Pamela C. DiLavore and Susan Risi in 1989.[1]

PL-ADOS edit

Responding to the need for diagnostic tools for autism in younger children, researchers developed the Pre-Linguistic Autism Diagnostic Observation Schedule (PL-ADOS).[2] The content of the activities, as well as the general format, were adapted to rely less on conversation.

ADOS-G edit

In 2000, Lord and her colleagues introduced the ADOS-Generic (ADOS-G) as a means to assess a broader developmental range of individuals. The ADOS-G introduced a module format, allowing for different protocols to be used depending on developmental and language factors.[3] It became commercially available in 2001 through Western Psychological Services.[4]

ADOS-2 edit

A second edition was published in 2012 to include updated norms, improved algorithms for Modules 1 to 3, and a new Toddler Module (T) that facilitates assessment in children ages 12 to 30 months.[5][6] Changes were also made to the algorithm to report on domains more in line with the recent changes to diagnostic criteria in the DSM-5. Whereas the ADOS-G determined social, communication, and social-communication domains, the ADOS-2 combined these domains to represent social affect, and added a new domain to assess restrictive and repetitive behaviors (RRB).

Method edit

The ADOS consists of a series of structured and semi-structured tasks that generally takes 30-60 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.[4] Each subject is administered activities from the module that corresponds to their developmental and language level. 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.

Following task administration and observation coding, a scoring algorithm classifies the individual with autism, autism spectrum disorder, or non-spectrum disorder. The toddler module algorithm yields a "range of concern" rather than a definite classification.[7]

Modules edit

Toddler module edit

The toddler module is appropriate for children 12–30 months who use little to no phrase speech. Because social communication and behavioral patterns can be highly variable in the first 2 years of life, the toddler module is typically used to identify areas for continued monitoring rather than to provide a definite diagnosis. The toddler must be able to walk independently.[8] This module consists of eleven primary activities:[7]

  1. Free play
  2. Blocking toy play
  3. Response to name
  4. Bubble play
  5. Anticipation of a routine with objects
  6. Response to joint attention
  7. Responsive social smile
  8. Anticipation of social routine
  9. Functional and symbolic imitation
  10. Bath time
  11. Snack

Module 1 edit

Module 1 is appropriate for children 31 months and older who use little or no phrase speech. This module consists of ten activities:[5]

  1. Free play
  2. Response to name
  3. Response to joint attention
  4. Bubble play
  5. Anticipation of a routine with objects
  6. Responsive social smile
  7. Anticipation of a social routine
  8. Functional and symbolic imitation
  9. Birthday party
  10. Snack

Module 2 edit

Module 2 is appropriate for children six years old or younger who speak in phrases but have not yet developed fluent verbal language. This module consists of fourteen activities:[5]

  1. Construction task
  2. Response to name
  3. Make-believe play
  4. Joint interactive play
  5. Conversation
  6. Response to joint attention
  7. Demonstration task
  8. Description of a picture
  9. Telling a story from a book
  10. Free play
  11. Birthday party
  12. Snack
  13. Anticipation of a routine with objects
  14. Bubble play

Module 3 edit

Module 3 is appropriate for children or young adolescents who are verbally fluent. This module consists of fourteen activities:[5]

  1. Construction task
  2. Make-believe play
  3. Joint interactive play
  4. Demonstration task
  5. Description of a picture
  6. Telling a story from a book
  7. Cartoons
  8. Conversation and reporting
  9. Emotions
  10. Social difficulties and annoyance
  11. Break
  12. Friends, relationships, and marriage
  13. Loneliness
  14. Creating a story

Module 4 edit

Module 4 is appropriate for older adolescents and adults. While similar to module 3, module 4 relies more heavily on questions and verbal responses rather than non-verbal actions observed during play. This module consists of ten to fifteen activities. Activities marked by an asterisk are optional:

  1. Construction task*
  2. Telling a story from a book
  3. Description of picture*
  4. Conversation and reporting
  5. Current work or school*
  6. Social difficulties and annoyance
  7. Emotions
  8. Demonstration task
  9. Cartoons*
  10. Break
  11. Daily living*
  12. Friends, relationships, and marriage
  13. Loneliness
  14. Plans and hopes
  15. Creating a story

Diagnostic accuracy edit

The social communication difficulties that the ADOS and ADOS-2 seek to measure are not unique to ASD; there is a heightened risk of false positives in individuals with other psychological disorders. In particular, an increased false positive rate has been observed in adults with psychosis;[9] while case reports indicate that such false positives may also occur in cases of childhood-onset schizophrenia, which is an exceptionally rare entity with a frequency of 1 in 40000.[10] There is evidence that adults with schizophrenia demonstrate an increased incidence of autistic features compared to the general population, resulting in higher ADOS scores, though schizophrenia patients also experience positive symptoms of psychosis (e.g. hallucinations, delusions, formal thought disorders).[11][12] A 2016 study found that 21% of children with a diagnosis of ADHD (and without a concurrent diagnosis of ASD) scored in the autism spectrum range on the ADOS total score.[13]

A 2018 Cochrane systematic review included 12 studies of ADOS diagnostic accuracy in pre-school children (Modules 1 and 2). The summary sensitivity was 0.94 (95% CI 0.89 to 0.97), with sensitivity in individual studies ranging from 0.76 to 0.98. The summary specificity was 0.80 (95% CI 0.68 to 0.88), with specificity in individual studies ranging from 0.20 to 1.00. The studies were evaluated for bias using the QUADAS-2 framework; of the 12 included studies, 8 were evaluated as having a high risk of bias, while for the remaining four there was insufficient information available for the risk of bias to be properly evaluated. The authors could not identify any studies for the ADOS-2; the scope of the review was limited to preschool age children (mean age under 6 years), which excluded studies of Modules 3 and 4 from the meta-analysis. One included study examined the additive sensitivity and specificity of the ADOS used in combination with the ADI-R; that study found an 11% improvement in specificity (compared to ADOS alone) at the cost of a 14% reduction in sensitivity; however, due to overlapping confidence intervals, that result could not be considered statistically significant.[14]

References edit

  1. ^ "Autism Diagnostic Observation Schedule." Western Psychological Services. Western Psychological Services. n.d. Web. 6 March 2010.
  2. ^ DiLavore, P; Lord, C; Rutter, M (1995). "Pre-Linguistic Autism Diagnostic Observation Schedule (PL-ADOS)". Journal of Autism and Developmental Disorders. 25 (4): 355–379.
  3. ^ Lord, C; Risi, S; Lambrecht, L; Cook, Jr, E H; Leventhal, B L; DiLavore, P C; Pickles, A; Rutter, M (2000). "The Autism Diagnostic Observation Schedule–Generic: A Standard Measure of Social and Communication Deficits Associated with the Spectrum of Autism". Journal of Autism and Developmental Disorders. 30 (3): 205–223. doi:10.1023/A:1005592401947. PMID 11055457.
  4. ^ a b Akshoomoff, Natacha; Corsello, Christina; Schmidt, Heather (2006). "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 (1). Springer Science and Business Media LLC: 7–19. doi:10.1007/bf03341111. ISSN 1087-3414. PMC 1868476. PMID 17502922.
  5. ^ a b c d Lord C, DiLavore PC, Gotham K, Guthrie W Luyster RJ, Risi S, Rutter M. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Manual. Torrance, CA: Western Psychological Services; 2012.
  6. ^ Lord C, Luyster R, Gotham K, Guthrie W. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Manual (Part II): Toddler Module. Torrance, CA: Western Psychological Services; 2012.
  7. ^ a b McCrimmon, Adam; Rostad, Kristin (February 2014). "Test Review: Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) Manual (Part II): Toddler Module". Journal of Psychoeducational Assessment. 32 (1): 88–92. doi:10.1177/0734282913490916. ISSN 0734-2829. S2CID 145257612.
  8. ^ Esler, Amy N.; Bal, Vanessa Hus; Guthrie, Whitney; Wetherby, Amy; Weismer, Susan Ellis; Lord, Catherine (September 2015). "The Autism Diagnostic Observation Schedule, Toddler Module: Standardized Severity Scores". Journal of Autism and Developmental Disorders. 45 (9): 2704–2720. doi:10.1007/s10803-015-2432-7. ISSN 0162-3257. PMC 4898775. PMID 25832801.
  9. ^ Maddox BB, Brodkin ES, Calkins ME, Shea K, Mullan K, Hostager J, Mandell DS, Miller JS (September 2017). "The Accuracy of the ADOS-2 in Identifying Autism among Adults with Complex Psychiatric Conditions". Journal of Autism and Developmental Disorders. 47 (9): 2703–2709. doi:10.1007/s10803-017-3188-z. PMC 5813679. PMID 28589494.
  10. ^ Reaven JA, Hepburn SL, Ross RG (January 2008). "Use of the ADOS and ADI-R in children with psychosis: importance of clinical judgment". Clinical Child Psychology and Psychiatry. 13 (1): 81–94. doi:10.1177/1359104507086343. PMC 4426195. PMID 18411867.
  11. ^ Barlati S, Deste G, Gregorelli M, Vita A (January 2019). "Autistic traits in a sample of adult patients with schizophrenia: prevalence and correlates". Psychological Medicine. 49 (1): 140–148. doi:10.1017/S0033291718000600. PMID 29554995. S2CID 4020382.
  12. ^ De Crescenzo F, Postorino V, Siracusano M, Riccioni A, Armando M, Curatolo P, Mazzone L (2019-02-21). "Autistic Symptoms in Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analysis". Frontiers in Psychiatry. 10: 78. doi:10.3389/fpsyt.2019.00078. PMC 6393379. PMID 30846948.
  13. ^ Grzadzinski R, Dick C, Lord C, Bishop S (December 2016). "Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5". Molecular Autism. 7 (1): 7. doi:10.1186/s13229-016-0072-1. PMC 4717584. PMID 26788284.
  14. ^ Randall M, Egberts KJ, Samtani A, Scholten RJ, Hooft L, Livingstone N, Sterling-Levis K, Woolfenden S, Williams K (July 2018). Cochrane Developmental, Psychosocial and Learning Problems Group (ed.). "Diagnostic tests for autism spectrum disorder (ASD) in preschool children". The Cochrane Database of Systematic Reviews. 2018 (7): CD009044. doi:10.1002/14651858.CD009044.pub2. PMC 6513463. PMID 30075057.

Further reading edit

  • Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L, Schopler E (June 1989). "Autism diagnostic observation schedule: a standardized observation of communicative and social behavior". Journal of Autism and Developmental Disorders. 19 (2): 185–212. doi:10.1007/BF02211841. PMID 2745388. S2CID 35621472.
  • Gotham K, Risi S, Dawson G, Tager-Flusberg H, Joseph R, Carter A, Hepburn S, McMahon W, Rodier P, Hyman SL, Sigman M, Rogers S, Landa R, Spence MA, Osann K, Flodman P, Volkmar F, Hollander E, Buxbaum J, Pickles A, Lord C (June 2008). "A replication of the Autism Diagnostic Observation Schedule (ADOS) revised algorithms". Journal of the American Academy of Child and Adolescent Psychiatry. 47 (6): 642–51. doi:10.1097/CHI.0b013e31816bffb7. PMC 3057666. PMID 18434924.
  • Luyster R, Gotham K, Guthrie W, Coffing M, Petrak R, Pierce K, Bishop S, Esler A, Hus V, Oti R, Richler J, Risi S, Lord C (September 2009). "The Autism Diagnostic Observation Schedule-toddler module: a new module of a standardized diagnostic measure for autism spectrum disorders". Journal of Autism and Developmental Disorders. 39 (9): 1305–20. doi:10.1007/s10803-009-0746-z. PMC 2893552. PMID 19415479.

External links edit

  • Autism Resource - Glossary of Terms

January 01, 1970
autism, diagnostic, observation, schedule, ados, standardized, diagnostic, test, assessing, autism, spectrum, disorder, protocol, consists, series, structured, semi, structured, tasks, that, involve, social, interaction, between, examiner, person, under, asses. The Autism Diagnostic Observation Schedule ADOS is a standardized diagnostic test for assessing autism spectrum disorder The protocol consists of a series of structured and semi structured tasks that involve social interaction between the examiner and the person under assessment The examiner observes and identifies aspects of the subject s behavior assigns these to predetermined categories and combines these categorized observations to produce quantitative scores for analysis Research determined cut offs identify the potential diagnosis of autism spectrum disorder allowing a standardized assessment of autistic symptoms Autism Diagnostic Observation SchedulePurposeassess autism in children adolescents and adults The Autism Diagnostic Interview Revised ADI R a companion instrument is a structured interview conducted with the parents of the referred individual to cover the subject s full developmental history The ADI R has lower sensitivity but similar specificity to the ADOS Contents 1 History 1 1 PL ADOS 1 2 ADOS G 1 3 ADOS 2 2 Method 3 Modules 3 1 Toddler module 3 2 Module 1 3 3 Module 2 3 4 Module 3 3 5 Module 4 4 Diagnostic accuracy 5 References 6 Further reading 7 External linksHistory editThe original ADOS was created by Catherine Lord Michael Rutter Pamela C DiLavore and Susan Risi in 1989 1 PL ADOS edit Responding to the need for diagnostic tools for autism in younger children researchers developed the Pre Linguistic Autism Diagnostic Observation Schedule PL ADOS 2 The content of the activities as well as the general format were adapted to rely less on conversation ADOS G edit In 2000 Lord and her colleagues introduced the ADOS Generic ADOS G as a means to assess a broader developmental range of individuals The ADOS G introduced a module format allowing for different protocols to be used depending on developmental and language factors 3 It became commercially available in 2001 through Western Psychological Services 4 ADOS 2 edit A second edition was published in 2012 to include updated norms improved algorithms for Modules 1 to 3 and a new Toddler Module T that facilitates assessment in children ages 12 to 30 months 5 6 Changes were also made to the algorithm to report on domains more in line with the recent changes to diagnostic criteria in the DSM 5 Whereas the ADOS G determined social communication and social communication domains the ADOS 2 combined these domains to represent social affect and added a new domain to assess restrictive and repetitive behaviors RRB Method editThe ADOS consists of a series of structured and semi structured tasks that generally takes 30 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 4 Each subject is administered activities from the module that corresponds to their developmental and language level 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 Following task administration and observation coding a scoring algorithm classifies the individual with autism autism spectrum disorder or non spectrum disorder The toddler module algorithm yields a range of concern rather than a definite classification 7 Modules editToddler module edit The toddler module is appropriate for children 12 30 months who use little to no phrase speech Because social communication and behavioral patterns can be highly variable in the first 2 years of life the toddler module is typically used to identify areas for continued monitoring rather than to provide a definite diagnosis The toddler must be able to walk independently 8 This module consists of eleven primary activities 7 Free play Blocking toy play Response to name Bubble play Anticipation of a routine with objects Response to joint attention Responsive social smile Anticipation of social routine Functional and symbolic imitation Bath time Snack Module 1 edit Module 1 is appropriate for children 31 months and older who use little or no phrase speech This module consists of ten activities 5 Free play Response to name Response to joint attention Bubble play Anticipation of a routine with objects Responsive social smile Anticipation of a social routine Functional and symbolic imitation Birthday party Snack Module 2 edit Module 2 is appropriate for children six years old or younger who speak in phrases but have not yet developed fluent verbal language This module consists of fourteen activities 5 Construction task Response to name Make believe play Joint interactive play Conversation Response to joint attention Demonstration task Description of a picture Telling a story from a book Free play Birthday party Snack Anticipation of a routine with objects Bubble play Module 3 edit Module 3 is appropriate for children or young adolescents who are verbally fluent This module consists of fourteen activities 5 Construction task Make believe play Joint interactive play Demonstration task Description of a picture Telling a story from a book Cartoons Conversation and reporting Emotions Social difficulties and annoyance Break Friends relationships and marriage Loneliness Creating a story Module 4 edit Module 4 is appropriate for older adolescents and adults While similar to module 3 module 4 relies more heavily on questions and verbal responses rather than non verbal actions observed during play This module consists of ten to fifteen activities Activities marked by an asterisk are optional Construction task Telling a story from a book Description of picture Conversation and reporting Current work or school Social difficulties and annoyance Emotions Demonstration task Cartoons Break Daily living Friends relationships and marriage Loneliness Plans and hopes Creating a storyDiagnostic accuracy editThe social communication difficulties that the ADOS and ADOS 2 seek to measure are not unique to ASD there is a heightened risk of false positives in individuals with other psychological disorders In particular an increased false positive rate has been observed in adults with psychosis 9 while case reports indicate that such false positives may also occur in cases of childhood onset schizophrenia which is an exceptionally rare entity with a frequency of 1 in 40000 10 There is evidence that adults with schizophrenia demonstrate an increased incidence of autistic features compared to the general population resulting in higher ADOS scores though schizophrenia patients also experience positive symptoms of psychosis e g hallucinations delusions formal thought disorders 11 12 A 2016 study found that 21 of children with a diagnosis of ADHD and without a concurrent diagnosis of ASD scored in the autism spectrum range on the ADOS total score 13 A 2018 Cochrane systematic review included 12 studies of ADOS diagnostic accuracy in pre school children Modules 1 and 2 The summary sensitivity was 0 94 95 CI 0 89 to 0 97 with sensitivity in individual studies ranging from 0 76 to 0 98 The summary specificity was 0 80 95 CI 0 68 to 0 88 with specificity in individual studies ranging from 0 20 to 1 00 The studies were evaluated for bias using the QUADAS 2 framework of the 12 included studies 8 were evaluated as having a high risk of bias while for the remaining four there was insufficient information available for the risk of bias to be properly evaluated The authors could not identify any studies for the ADOS 2 the scope of the review was limited to preschool age children mean age under 6 years which excluded studies of Modules 3 and 4 from the meta analysis One included study examined the additive sensitivity and specificity of the ADOS used in combination with the ADI R that study found an 11 improvement in specificity compared to ADOS alone at the cost of a 14 reduction in sensitivity however due to overlapping confidence intervals that result could not be considered statistically significant 14 References edit Autism Diagnostic Observation Schedule Western Psychological Services Western Psychological Services n d Web 6 March 2010 DiLavore P Lord C Rutter M 1995 Pre Linguistic Autism Diagnostic Observation Schedule PL ADOS Journal of Autism and Developmental Disorders 25 4 355 379 Lord C Risi S Lambrecht L Cook Jr E H Leventhal B L DiLavore P C Pickles A Rutter M 2000 The Autism Diagnostic Observation Schedule Generic A Standard Measure of Social and Communication Deficits Associated with the Spectrum of Autism Journal of Autism and Developmental Disorders 30 3 205 223 doi 10 1023 A 1005592401947 PMID 11055457 a b Akshoomoff Natacha Corsello Christina Schmidt Heather 2006 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 1 Springer Science and Business Media LLC 7 19 doi 10 1007 bf03341111 ISSN 1087 3414 PMC 1868476 PMID 17502922 a b c d Lord C DiLavore PC Gotham K Guthrie W Luyster RJ Risi S Rutter M Autism Diagnostic Observation Schedule Second Edition ADOS 2 Manual Torrance CA Western Psychological Services 2012 Lord C Luyster R Gotham K Guthrie W Autism Diagnostic Observation Schedule Second Edition ADOS 2 Manual Part II Toddler Module Torrance CA Western Psychological Services 2012 a b McCrimmon Adam Rostad Kristin February 2014 Test Review Autism Diagnostic Observation Schedule Second Edition ADOS 2 Manual Part II Toddler Module Journal of Psychoeducational Assessment 32 1 88 92 doi 10 1177 0734282913490916 ISSN 0734 2829 S2CID 145257612 Esler Amy N Bal Vanessa Hus Guthrie Whitney Wetherby Amy Weismer Susan Ellis Lord Catherine September 2015 The Autism Diagnostic Observation Schedule Toddler Module Standardized Severity Scores Journal of Autism and Developmental Disorders 45 9 2704 2720 doi 10 1007 s10803 015 2432 7 ISSN 0162 3257 PMC 4898775 PMID 25832801 Maddox BB Brodkin ES Calkins ME Shea K Mullan K Hostager J Mandell DS Miller JS September 2017 The Accuracy of the ADOS 2 in Identifying Autism among Adults with Complex Psychiatric Conditions Journal of Autism and Developmental Disorders 47 9 2703 2709 doi 10 1007 s10803 017 3188 z PMC 5813679 PMID 28589494 Reaven JA Hepburn SL Ross RG January 2008 Use of the ADOS and ADI R in children with psychosis importance of clinical judgment Clinical Child Psychology and Psychiatry 13 1 81 94 doi 10 1177 1359104507086343 PMC 4426195 PMID 18411867 Barlati S Deste G Gregorelli M Vita A January 2019 Autistic traits in a sample of adult patients with schizophrenia prevalence and correlates Psychological Medicine 49 1 140 148 doi 10 1017 S0033291718000600 PMID 29554995 S2CID 4020382 De Crescenzo F Postorino V Siracusano M Riccioni A Armando M Curatolo P Mazzone L 2019 02 21 Autistic Symptoms in Schizophrenia Spectrum Disorders A Systematic Review and Meta Analysis Frontiers in Psychiatry 10 78 doi 10 3389 fpsyt 2019 00078 PMC 6393379 PMID 30846948 Grzadzinski R Dick C Lord C Bishop S December 2016 Parent reported and clinician observed autism spectrum disorder ASD symptoms in children with attention deficit hyperactivity disorder ADHD implications for practice under DSM 5 Molecular Autism 7 1 7 doi 10 1186 s13229 016 0072 1 PMC 4717584 PMID 26788284 Randall M Egberts KJ Samtani A Scholten RJ Hooft L Livingstone N Sterling Levis K Woolfenden S Williams K July 2018 Cochrane Developmental Psychosocial and Learning Problems Group ed Diagnostic tests for autism spectrum disorder ASD in preschool children The Cochrane Database of Systematic Reviews 2018 7 CD009044 doi 10 1002 14651858 CD009044 pub2 PMC 6513463 PMID 30075057 Further reading editLord C Rutter M Goode S Heemsbergen J Jordan H Mawhood L Schopler E June 1989 Autism diagnostic observation schedule a standardized observation of communicative and social behavior Journal of Autism and Developmental Disorders 19 2 185 212 doi 10 1007 BF02211841 PMID 2745388 S2CID 35621472 Gotham K Risi S Dawson G Tager Flusberg H Joseph R Carter A Hepburn S McMahon W Rodier P Hyman SL Sigman M Rogers S Landa R Spence MA Osann K Flodman P Volkmar F Hollander E Buxbaum J Pickles A Lord C June 2008 A replication of the Autism Diagnostic Observation Schedule ADOS revised algorithms Journal of the American Academy of Child and Adolescent Psychiatry 47 6 642 51 doi 10 1097 CHI 0b013e31816bffb7 PMC 3057666 PMID 18434924 Luyster R Gotham K Guthrie W Coffing M Petrak R Pierce K Bishop S Esler A Hus V Oti R Richler J Risi S Lord C September 2009 The Autism Diagnostic Observation Schedule toddler module a new module of a standardized diagnostic measure for autism spectrum disorders Journal of Autism and Developmental Disorders 39 9 1305 20 doi 10 1007 s10803 009 0746 z PMC 2893552 PMID 19415479 External links editAutism Resource Glossary of Terms FAQs on the ADOS The ADOS test from a Parents Point of View Retrieved from https en wikipedia org w index php title Autism Diagnostic Observation Schedule amp oldid 1209613911, wikipedia, wiki, book, books, library,

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