ADOS & ADIR Flashcards
Can diagnosis of ASD occur across the lifespan?
Yes, diagnosis can occur from age 2 to older adults
Diagnosis is not limited to a specific age range.
What are comorbid conditions in the context of ASD?
Conditions that occur alongside autism, such as:
* Intellectual disability
* Language disorder
Higher support needs in ASD often include these comorbid conditions.
What is the expected average profile for assessing ASD?
to normative group
Using standardized tools that compare performance to a normative group
The comparison group can be challenging to define.
What is the right comparison group for norms in ASD diagnosis?
There is no definitive right comparison group
Groups may vary based on severity and other psychiatric conditions.
In ASD assessment, should we focus on deficits or excesses?
Both, looking for atypical behaviors and absence of normal behaviors
There is also overlap between social and communication difficulties.
What is a key limitation of diagnostic tools for ASD?
They tend to be most accurate for verbal individuals aged 4-12
Tools may not effectively capture symptom presentations in non-verbal individuals.
What is the challenge regarding the reliance on a single tool for diagnosing ASD?
No one tool can diagnose ASD
Multiple measures and sources of information are necessary.
What are the components of effective ASD assessment?
Assessment should involve:
* Multiple measures
* Multiple sources of information
* Multiple settings
* Experienced assessors
This approach ensures comprehensive evaluation.
What was the purpose of the standards and guidelines established in BC for ASD diagnosis?
To provide specific procedures for diagnosis and referral
These were established in response to increasing ASD rates and funding issues.
What is the tiered service model of assessment for ASD?
A triage model consisting of:
* Tier 1: Community concerns and initial referrals
* Tier 2: Specialized assessments (OT, language)
* Tier 3: Formal medical assessments
* Tier 4: Specialized assessments for complex cases
This model helps streamline the assessment process.
Who must be involved in the ASD assessment team for children under age 6?
At least:
* Pediatrician
* Speech-language pathologist
* Psychologist
Occupational therapists are often included but not required.
What specific tools are required for ASD diagnosis?
Only specific published tools can be used for diagnosis
This includes standardized interviews and observations.
What is the role of the Autism Diagnostic Observation Schedule (ADOS)?
To provide a controlled environment for observing behaviors related to ASD
ADOS has different modules based on age and language proficiency.
What is the reliability of the ADOS tool?
High inter-rater reliability and adequate test-retest reliability
This means different assessors get similar scores.
What are the key components of the psychological assessment in ASD evaluation?
Includes:
* Cognitive testing
* Adaptive behavior testing = how they function independantly - communicatoin, interaction, practical skills
* Mental health assessment
These components help identify other conditions that may be confused with ASD.
True or False: Adults require ADOS/ADIR for ASD assessment.
False
Standards for adults are less stringent, but good practice suggests using these tools.
What is the importance of gathering a detailed history and record review in ASD assessment?
To integrate all previous assessments and identify patterns
This helps ensure a comprehensive understanding of the individual’s development.
What are the specialized measures used in speech-language assessment for ASD?
Includes:
* Language samples
* Standardized measures for vocabulary and comprehension
These assessments help evaluate pragmatic language skills.
What should a mental health assessment rule out in the context of ASD?
Other mental health conditions that may cause similar symptoms
Important conditions to consider include anxiety and depression.
What is a major limitation of autism-specific assessment tools?
Some tools may be problematic and not very accurate
- bc its in a controled environment so kids may not act how they usually do
They can over-elevate scores and may not reflect true behaviors.
Fill in the blank: The ADOS provides a controlled _______ world in which to observe behaviors related to autism spectrum.
social
What is the purpose of the toothbrush task?
To assess if a person can demonstrate how to brush their teeth using gestures and words.
What is being evaluated in a comic strip of 5-6 cards?
The ability to tell a story in sequence and pick up the emotions and gestures of the characters.
True or False: The ADOS 2/3 is a face-valid test.
False
What kind of information should a child share during storytelling from a picture book?
Narrative, spotting emotions, humor, and assigning emotions to characters.
What is the significance of free play in the assessment?
To observe if children can represent something else in their play, such as a pretend birthday party.
In older kids, how is snack time referred to?
‘Break’
What does the anticipation of a routine involve for little kids?
Using objects like a bubble play gun.
What does the ADOS Module 4 assess?
Communication, echolalia, imagination, and repetitive behaviors.
What is the main focus of the Autism Diagnostic Interview Revised (ADI-R)?
A semi-structured, interviewer-guided diagnostic interview.
What are the three functional domains covered by the ADI-R?
- Developmental history * Language * Social behavior
What age range does the ADI-R focus on for assessing behaviors?
4-5 years old.
What is the reliability of the ADI-R?
High interrater reliability.
Fill in the blank: The ADI-R uses a ______ scale from 0 to 3.
Likert
What is a common issue with rating scales used for ASD?
They are subjective and filled out based on parent/caregiver perspectives.
What is the importance of the sample ADIR social interaction item?
To assess the frequency and spontaneity of sharing behavior.
What does the ADIR RB’s item assess?
Hand/finger mannerisms and their interference with activities.
What does the diagnostic algorithm in ADOS determine?
Whether the behaviors meet the ASD threshold.
What is the role of algorithms in ASD assessment?
To evaluate scores and determine thresholds for ASD.
What does the Social Responsiveness Scale 2 measure?
Social responsiveness related to ASD.
What are the two types of assessments mentioned for children?
ADOS: like who are you doing asessment with
- Parent/caregiver assessments * Teacher assessments
What was the child’s early developmental history noted in the example?
Delayed language milestones and trouble with behavior.
What is a key characteristic of the ADOS results in the case example?
Unusual phrases and limited gestures.
True or False: The child in the example met the ASD threshold according to ADIR.
False
What kind of interests did the child demonstrate during the assessment?
Intense interests, such as in Bob the Builder.
What was noted as a behavior that disrupted family life?
Sensory interests and inappropriate social behaviors.
What is one of the difficulties noted in the child’s social interactions?
Lack of reciprocal conversation.
What is the significance of gathering more information in assessments?
To clarify the child’s behavioral and developmental history.
What is the borderline IQ range mentioned in the content?
Borderline IQ
Typically refers to an IQ score between 70 and 84
What behavioral problems were noted in preschool?
Behavior problems, aggression, focus issues, lack of play
Early signs of potential developmental issues
What were the notable behaviors in kindergarten?
Intrusive, loud, physical aggression, hand flapping, spinning transitions, lack of eye contact
Indications of social difficulties and possible ASD traits
What type of play did the individual engage in during grade 4?
Parallel play
Indicates difficulty in engaging in reciprocal play with peers
What were the cognitive testing results?
Normal IQ (Low Average), normal language
Suggests no significant cognitive impairment
What was the result of adaptive behavior testing?
Very low adaptive behavior
Indicates challenges in everyday functioning
What were the observations during testing?
Odd eye contact, cheerful but rambles, echolalia, finger twirling motions
Highlights potential communication and social interaction issues
What does ADIR stand for?
Autism Diagnostic Interview-Revised
A tool used to assess autism traits through parent interviews
What does ADOS stand for?
Autism Diagnostic Observation Schedule
A tool for observing behaviors associated with autism
What are two criteria for restricted/repetitive patterns of behavior?
- Hand flapping
- Echolalia
Common behaviors associated with autism spectrum disorders
What is the significance of the early developmental period in diagnosis?
Symptoms must be present in early developmental period
Important for establishing a diagnosis of ASD
What does DSM stand for?
Diagnostic and Statistical Manual of Mental Disorders
A manual used by mental health professionals for diagnosis
True or False: The individual was assessed for intellectual disability.
True
Important to rule out other disorders when diagnosing ASD
What might cause discrepancies between ADOS and ADIR results?
Subjectivity of ADIR, normalization of behaviors by parents, social masking
Different perspectives can lead to varying results in assessments
What is an example of social masking?
Adapting behavior to fit in socially, making it harder to see true symptoms
Can affect the accuracy of assessments like ADOS
What is a potential limitation of the ADOS assessment?
May not capture range of repetitive behaviors due to short duration
Often only 45 minutes long, may miss behaviors not seen in that time
What is the importance of gathering information from multiple sources?
To provide a comprehensive view and not rely solely on assessment tools
Essential for accurate diagnosis of conditions like ASD
Fill in the blank: The assessment tools ADOS and ADIR are considered ______.
gold standard
Widely used for diagnosing autism spectrum disorders
What is a common sensory behavior mentioned?
Hypo or hypersensitivity
Can include behaviors like licking or visual sensory issues
What does the term ‘echolalia’ refer to?
Repetition of phrases or sounds heard
Often seen in individuals with autism
What is a characteristic of the individual’s social interactions?
Did not initiate or respond to social interactions
Indicates challenges in social communication
What assessment strategies does the ADOS 1 + 2 use?
- play based
- focused on communication and social interaction
- play
- imaginative use of materials
What do the four different modules of the ADOS (1-4) differ by?
- developmental level
-chronical age
-language proficiency
What is the rating system of the Ados?
Likert scale
0 (nonASD) - 3 (prototypically ASD)
What do ADOS modules 2/3 focus on?
- construction taks
- response to name
- make believe play
- joint interactive play
- conversastion
- response to joint attention
- demonstration task
- commit strip
- description of a picture
- telling a story from a book
- free play
- birthday party
- snack
- anticipation of a routine with objects
- bubble play
Briefly describe the 5 modules of the ADOS
- toddler module (2 and under),
- module 1(young kids and those without functional speach)
- module 2 (some speech, but still quite young)
- module 3 (most
commonly used - for poeople with fluent phrase speech [age 5-16]) has some toys but not little kid toys, more language
associated with it. person has to use 2 clauses in speach. meet with person before to make sure appropriate. - module 4 - 16+ no toys, emphasis on interview (experiences and perspectives)
