ADOS Assessment Template with Examples

ADOS Assessment Template

This AI-enabled Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) assessment template is a comprehensive tool designed to help psychologists document observations during autism evaluations. It adheres With Heidi, this template empowers psychologists to:

• Capture key social communication behaviors during the ADOS-2 session, including verbal and non-verbal communication patterns, interaction quality, and emotional engagement with the examiner. 
• Identify strengths and challenges across core domains such as eye contact, facial expressions, joint attention, imaginative play, and restricted or repetitive behaviors.
• Outline diagnostic observations, including level of rapport, insight into social relationships, stereotyped behaviors, and symptom severity based on ASD diagnostic criteria. 

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What is an ADOS Assessment Template?

An ADOS Assessment Template is a structured document used by clinicians to record observations and evaluations during an Autism Diagnostic Observation Schedule (ADOS) assessment. The ADOS is a standardized tool used to assess and diagnose Autism Spectrum Disorder (ASD) in individuals across different age groups and language levels.

These templates are developed by licensed clinicians, psychologists, or healthcare organizations to align with the standard structure of the latest version of the ADOS protocol, ADOS-2.

ADOS assessment templates are essential for ensuring consistency, accuracy, and completeness in documenting observations during autism evaluations. Through a structured format that follows standardized criteria, clinicians can more effectively identify behavioral patterns, compare results across sessions or individuals, and support reliable diagnoses.   

In this article, we’ll talk about the specific criteria for ADOS assessment templates, discuss the classification and diagnostic systems DSM-5 and ICD-11 and their role in autism diagnosis, explain the key components of effective ADOS templates, give a step-by-step guide to using them and most importantly, share ready-to-use, AI-enabled templates for use in your daily practice.

Criteria for ADOS Assessment Templates

An effective ADOS assessment template must align with the ADOS-2 modules; each tailored for different ages and language abilities across patients. It should include dedicated fields to document key behavioral domains in the DSM-5 criteria such as communication, social interaction, imagination, and restricted or repetitive behaviors, while also reflecting the ADOS scoring structure and behavioral coding format.

To ensure diagnostic accuracy, ADOS assessment templates should also look to established frameworks such as DSM-5 and ICD-11 for reference:

DSM-5 Explained

DSM-5 is the fifth and most recent edition of a standardized diagnostic criteria for mental disorders, including ASD. Though it’s published by the American Psychiatric Association (APA) and is primarily used in the United States, it’s an internationally recognized resource used by clinicians and researchers globally.

The DSM-5 contains clear and detailed descriptions of mental health conditions, as well as the signs and symptoms associated with them; making it easier for healthcare providers to accurately diagnose conditions. 

ICD-11 Explained

ICD-11, also known as the International Classification of Diseases, 11th Revision, is a global diagnostic system developed by the World Health Organization (WHO) to classify and code health conditions; this includes physical, mental, and neurodevelopmental disorders.

It was created to support clinical diagnosis, health data reporting, and global health research by providing a standardized language for healthcare systems worldwide.

What ADOS-2 Score Indicates Autism?

Each ADOS-2 module has its own scoring algorithm and diagnostic threshold. Generally, however, a total score at or above the clinical cut-off suggests an ASD diagnosis. For example, in Module 3, used for verbally fluent children and adolescents, a total score of 8 or more on the algorithm often indicates the presence of autism, while scores between 7 and 8 may be interpreted as falling within the broader autism spectrum.

It’s important to note that ADOS-2 is not meant to be a standalone diagnostic tool. ADOS-2 scores must be interpreted alongside the patient’s developmental history, other applicable assessment results, and the diagnostic frameworks DSM-5 or ICD-11 to get the most accurate diagnosis.

The efficiency of clinical documentation plays a significant role in ensuring accurate and timely ADOS assessments. The entire process of completing them can be time-consuming, especially when it involves a lot of manual note-taking. Clinicians like Emmah Madondo, an advanced clinical practitioner in community mental health services, often face the challenge of balancing patient care with extensive administrative tasks.

Before using Heidi, Emmah struggled with the administrative burden of clinical work, spending extra time revising and polishing her notes to meet standards. But with the help of AI-powered transcription and custom templates, Heidi transformed her workflow, saving her up to a day and a half per week and enabling her to focus more on patient care.

Emmah shares, “I’m happier knowing that I don’t have any admin. Absolutely nothing. I’m able to finish my work on time. I’m able to just do a lot more in terms of my consultations without having to worry about the time.”

Key Components of Effective ADOS Assessment Templates with Examples

An effective ADOS assessment template should provide clinicians with a structured yet flexible framework that allows them to capture detailed observations and align them with ADOS-2 scoring criteria. Below are the most essential components of ADOS assessments explained: 

Language and Communication

The opening section covers verbal and non-verbal communication behaviors since they are central to identifying social-communication differences that characterize ASD. This should include text fields to note the frequency, quality, and clarity of verbal communication and have prompts for documenting the patient’s use of echolalia, jargon, and unusual pitch or intonation.

Non-verbal communication cues such as gestures, pointing, and body language, are also detailed in this section.

Example ADOS notes:‍

Alex demonstrated frequent verbal communication with clear articulation, though there was occasional echolalia. The quality of language was generally appropriate, with some use of jargon. Non-verbal communication included limited gestures and pointing.

Reciprocal Social Interaction

Social reciprocity helps clinicians assess how a child or adult engages with others, including emotional connection and awareness of social cues. This is why the subsequent section covers behaviors related to social engagement, emotional responsiveness, and interpersonal awareness.

This section should also include clinician prompts for observing eye contact, facial expressions, and social smiling, along with a checklist or narrative field for observations regarding shared enjoyment, response to name, and use of joint attention.

Example ADOS notes:‍

Alex displayed inconsistent eye contact and had a limited range of facial expressions. Shared enjoyment was observed during specific activities, though responses to name were delayed. Social overtures were present but lacked depth. Alex showed difficulty in recognizing and expressing emotions, often requiring prompts to react appropriately in social interactions.

Imagination and Play

The third section focuses on the presence (or absence) of imaginative behaviors from the patient, along with their observed creativity in play-based scenarios, since these are key indicators of flexible thinking, creativity, and social development in younger patients.

Include prompts for describing the patient’s reaction to pretend play and role-playing and text fields to note their use of objects in imaginative or symbolic ways.

Example ADOS notes:

‍Alex showed creativity during play, engaging in pretend play with some imaginative elements.

Stereotyped Behaviors and Restricted Interests

Repetitive behaviors and restricted interests are hallmark features of ASD and must be observed for diagnostic accuracy. Dedicate a section for documenting the patient’s repetitive, sensory-seeking, or fixated behaviors.

A checklist for physical mannerisms or any unusual motor movements and text fields for observing repetitive themes, topics, unusual sensory interests, or self-injurious behaviors would be an essential include here.

Example ADOS notes:

‍Alex exhibited hand-flapping and repetitive actions, with a strong fixation on specific topics such as trains.

Overall Impression and Diagnostic Summary

The clinician’s diagnostic summary ties together all behavioral data and clinical judgment, forming the basis for the next steps and the patient’s support needs. Therefore, the concluding section should support diagnostic reasoning by summarizing patterns and linking observations to clinical frameworks.

Include a free text section for the clinician’s summary of behavior, and the patient’s support needs, as well as prompts to indicate whether ADOS scores meet the diagnostic threshold for ASD. Clinicians should also include notes on how their observed behavior aligns with DSM-5 and/or ICD-11 criteria.

Example ADOS notes:

‍Based on ADOS-2 scores, Alex meets the criteria for an Autism Spectrum Disorder Diagnosis. Autism symptoms are consistent with other children diagnosed with ASD, indicating a moderate level of support is required. 

ADOS Assessment Template Example

It’s difficult to observe patients for signs of ASD while simultaneously writing notes. This often leads to missed details, inconsistent documentation, and added stress during assessments.

Thankfully, our AI-powered solution streamlines this process by giving clinicians a faster and more accurate way to fill out ADOS assessment notes, minus the manual note-taking. 

Easily Complete ADOS Assessment Templates with Heidi

Heidi is our cutting-edge AI medical scribe designed to help clinicians complete ADOS assessment templates in real time. With your patient’s or their guardian’s permission, simply hit record and let Heidi work as you go. Here’s how Heidi helps you complete your ADOS assessment notes:

• Transcribe – Open Heidi on your computer or mobile device and press Start so Heidi can capture your conversation in the background. For information that you don’t want to verbalize, you can type it under context notes to be considered later. 
• Customize – Post-session, simply select your preferred ADOS assessment template and watch as Heidi perfectly transcribes the details of our observation and context notes in the appropriate format!
• Transform – After generating your completed ADOS assessment, you can ask Heidi to give additional documentation, including clinical notes as needed. 

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Heidi complies with jurisdiction-specific regulations, ensuring data localization for customers in Australia, Canada, the United States, the United Kingdom, and beyond. Read more about our compliance here. 

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Free ADOS Assessment Templates

ADOS-2 Assessment Template

This ADOS-2 template is designed to help psychologists assess communication and social interaction in individuals with Autism Spectrum Disorder (ASD). It guides clinicians in documenting key aspects such as speech abnormalities, echolalia, and social communication skills. 

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Adult ADOS Assessment Report Template

This Adult ADOS Assessment Report template is designed to assist clinical psychologists and psychiatrists in outlining a patient’s developmental history, along with their professional observations, ADOS-2 scoring and interpretation, and notes on follow-up appointments and further recommendations during autism spectrum assessment sessions.

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FAQs About ADOS Assessment Templates

How long does an ADOS assessment typically take?

The usual ADOS assessment session takes between 40 to 60 minutes depending on the module being used, and the patient’s level of communication and engagement. 

How should I prepare my patient for an ADOS assessment?

Let your patient or their guardians know that the session will involve structured activities, conversation, and play. It would be helpful to reassure them that there are no “right” or “wrong” answers; just a chance to observe natural behavior. 

How do I customize an ADOS assessment template for different age groups?

First select the appropriate ADOS-2 module based on the individual’s age and language abilities, then tailor the template fields to match the developmental expectations and observation criteria for that module. In Heidi, you can either create your own custom template from scratch, or modify an existing one from our Template Community. For more information, you can review our guide for creating custom templates.