What Really Happens During an ADOS-2 Autism Test? (It’s Not What You Might Expect)
If your child is scheduled for an ADOS-2 autism test, chances are you have questions. A lot of them. And you’re not alone. Parents regularly turn to social media to ask what to expect.
“Ours is in about 8 days and I’m so jittery,” one parent recently wrote on Reddit, wondering what tests her child would be given and whether his abilities might affect the results.
Another parent, who was preparing for her 3-year-old’s evaluation, had a different concern on Reddit: Her daughter “isn’t a fan of doing things on command.” What if she simply refused to participate?
Other parents worry about masking, separation anxiety or whether their child will behave completely differently with an evaluator than they do at home.
So what actually happens during an autism, or ADOS-2 (Autism Diagnostic Observation Schedule), test/assessment? And what is the clinician looking for?
David Timpanaro, PhD, CEO and founder of Step Up Family Services, has some answers for many concerned parents.
What Really Happens During an ADOS-2 Autism Test?
Timpanaro, who has spent years assessing, diagnosing and supporting people with autism, says an ADOS-2 assessment probably isn’t what most people picture when they hear the word “test.”
There are no answers to study for and no grade at the end. Instead, the clinician creates situations that allow them to observe how someone communicates and interacts. Sometimes that means blowing bubbles.
“The goal is to set up opportunities to measure social skills,” Timpanaro explains.
For younger children, a clinician might bring out toys, play a game or pretend to release a balloon into the air. Older children and adults may spend more time talking or be asked to tell a story, describe an experience, talk about friendships and relationships or discuss emotions.
It may not look like much of a test, but the clinician is watching closely. He/she is observing how someone responds to conversation, interacts during an activity and communicates without words, through gestures, nodding, facial expressions or eye contact.
Questions about friends and family can also help the assessor understand how someone experiences relationships and social situations.
Those observations are rated using standardized ADOS-2 criteria. But Timpanaro emphasizes something important: “You don’t pass or fail an ADOS-2. And it doesn’t diagnose autism on its own. It’s one part of a broader evaluation.”
What Happens After an Autism Assessment?
For many parents, the questions don’t necessarily end when the assessment does.
For one parent whose 8-year-old son was diagnosed after a long process, finally having an answer brought some relief. She described the diagnosis on Reddit as “a sigh a relief to confirm what we had suspected all these years.”
But getting a diagnosis also brought new questions about therapy, school and how others would respond. Most importantly, she wrote, “I want him to know always that who he is is ok and he is amazing.”
“A diagnosis isn’t about changing who someone is,” Timpanaro says. “It can provide families with more information about how a child experiences and interacts with the world and help identify the kinds of support that may be useful.”
A diagnosis can also help people access therapies and educational services and, depending on their insurance plan, coverage that may help pay for treatment.
The ADOS-2 is one of the most widely used standardized assessments for autism, but it is just one part of a broader evaluation.
