Form 6.
16
Autism Diagnostic Observation Schedule, Second Edition (ADOS–2), Module 3, Fluent Speech,
Child/Adolescent Algorithm
ADOS–2, Module 3, Fluent Speech, Child/Adolescent Algorithm:
Table 1
Social Affect (SA) Domain Item Summary
Item Code Examinee’s Algorithm Examinee’s
rating code rating score algorithm
range range score
Report of Events (A-7)a 0–3 -- 0–2 --
Conversation (A-8)a 0–3 -- 0–2 --
Descriptive, Conventional, Instrumental, 0–3 (8c) -- 0–2 --
or Informational Gestures (A-9)a
Unusual Eye Contact (B-1)b 0–2 -- 0 or 2 --
Facial Expressions Directed to Examiner 0–2 -- 0–2 --
(B-2)b
Shared Enjoyment in Interaction (B-4)b 0–3 -- 0–2 --
Quality of Social Overtures (B-7)b 0–3 -- 0–2 --
Quality of Social Response (B-9)b 0–3 -- 0–2 --
Amount of Reciprocal Social 0–3 -- 0–2 --
Communication (B-10)b
Overall Quality of Rapport (B-11)b 0–3 -- 0–2 --
Social Affect (SA) Algorithm Score -- -- 0–20 --
Total
Note. Higher code ratings and algorithm scores indicate greater signs of autism. SA totals are in
bold text. -- denotes not applicable.
a
Communication grouping item. bReciprocal Social Interaction grouping item. cCodes of 8
denote that the item is not applicable in this case due to limitations imposed by a physical
disability; codes of 8 are transformed into algorithm scores of 0.
Table 2
Restricted and Repetitive Behavior (RRB) Domain Item Summary
Item Code Examinee’s Algorithm Examinee’s
rating code rating score algorithm
range range score
Stereotyped/Idiosyncratic Use of Words 0–3 -- 0–2 --
or Phrases (A-4)
Unusual Sensory Interest in Play 0–3 -- 0–2 --
Material/Person (D-1)
Hand and Finger and Other Complex 0–3 -- 0–2 --
Mannerisms (D-2)
Excessive Interest in Unusual Topics/ 0–3 -- 0–2 --
Objects or Repetitive Behaviors (D-4)
Restricted and Repetitive Behavior -- -- 0–8 --
(RRB) Algorithm Score Total
Note. Higher codes and algorithm scores indicate greater signs of autism. RRB totals are in bold
text. -- denotes not applicable.
Table 3
Module 3 Fluent Speech Algorithm Score Total Summary
Aggregation
Overall Algorithm Score Total --
(SA + RRB)
Note. Higher algorithm scores indicate greater signs of autism. SA = Social Affect; RRB =
Restricted and Repetitive Behavior. Overall algorithm score total is in bold text.
Table 4
Module 3 Fluent Speech Diagnostic Summary
ADOS–2 Classification Non-spectrum; Autism spectrum; Autism
ADOS–2 Comparison score = # Level = Minimal-to-no-evidence; Low;
Moderate; High
Note. ADOS–2 classification assignments: 0–6 = non-spectrum; 7–8 = autism spectrum; 9–28 =
autism. ADOS–2 comparison scores and levels: 1–2 = minimal-to-no evidence; 3–4 = low; 5–7
= moderate; 8–10 = high. All diagnostics are in bold text.
Interpretation:
Administrative Note: Module 3 was selected in this case because it consists of objects and
activities most appropriate for individuals ranging in age from older childhood through younger
adolescence (i.e., age 15 years).
Classification: Module 3 items consist of objects and activities most appropriate for an older
child/younger adolescent up to about age 15 years of age, hence being the principal reason it was
selected for administration in this case. Based upon …..’s social interaction, communication,
and other pertinent behaviors manifested and observed during the ADOS–2 administration, the
overall algorithm score total resulted in a classification of non-spectrum classification/autism
spectrum/autism.
Comparison: The ADOS–2 comparison score is used to measure the level of autism spectrum-
related symptoms that is adjusted for chronological age (CA) and expressive language ability;
that is, …..’s ADOS–2 overall algorithm score total is compared to other individuals of the same
CA and expressive language ability with confirmed diagnoses of autism. Based upon …..’s
comparison score, his/her level of symptoms can be described as minimal-to-no-evidence/
low/moderate/high, hence providing an estimated of degree or severity level.
Item analysis: Analysis of the SA items shows a consistent pattern/a variable pattern of autism-
related symptoms, including ……/Analysis of the SA items shows a consistent absence of
autism-related symptoms. Analysis of the RRB items shows a consistent pattern/a variable
pattern of autism-related symptoms, including ……/Analysis of the RRB items shows a
consistent absence of autism-related symptoms.
Therefore, the SA and RRB symptoms are similar in level, being most consistent with being in
need of support/substantial support/very substantial support according to DSM–5
guidelines./Therefore, the SA and RRB symptoms are discrepant in level, with SA/RRB being
significantly more severe, hence being in need of relatively more very/substantial support.
