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This Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) assessment template is a comprehensive tool designed to help psychologists document observations during autism evaluations. With Heidi, this template empowers psychologists to:
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 standardised 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 standardised criteria, clinicians can more effectively identify behavioural patterns, compare results across sessions or individuals, and support reliable diagnoses.
This article talks about the criteria for ADOS assessment templates, the DSM-5 and ICD-10-CA frameworks and their role in autism diagnosis, the key components of effective ADOS templates, a step-by-step guide to using them, and ready-to-use AI-enabled templates for your daily practice.
An effective ADOS assessment template must align with the ADOS-2 modules, each tailored to different ages and language abilities. It should include dedicated fields to document key behavioural domains in the DSM-5 criteria such as communication, social interaction, imagination, and restricted or repetitive behaviours, while also reflecting the ADOS scoring structure and behavioural coding format.
To ensure diagnostic accuracy, ADOS assessment templates should also look to established frameworks such as DSM-5 and ICD-10-CA for reference:
DSM-5 is the fifth and most recent edition of a standardised diagnostic criteria for mental disorders, including ASD. Though published by the American Psychiatric Association (APA), it is an internationally recognised resource used by clinicians and researchers worldwide, including in Canada.
The DSM-5 provides clear, detailed descriptions of mental health conditions and their associated signs and symptoms, so that clinicians can diagnose accurately.
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, including physical, mental, and neurodevelopmental disorders.
It gives healthcare systems worldwide a standardised language for clinical diagnosis, health data reporting, and global health research.
In Canadian practice, DSM-5 and ICD serve different roles. Registered psychologists and developmental paediatricians diagnose ASD clinically against DSM-5-TR criteria. Provincial health systems then code and bill using ICD-10-CA, the Canadian modification of ICD-10, where autism-related conditions fall under the F84.x category.
Canada has not yet adopted ICD-11 for routine health system use. ICD-10-CA remains the working coding and billing standard across most provinces.
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-10-CA to get the most accurate diagnosis.
In Canada, obtaining a comprehensive autism assessment (which usually includes an ADOS-2 observation) is the hard part. Public wait times run from roughly 6 months to 3 years, depending on province, health region and service pathway. In Ontario, for example, public waits are commonly reported as 12–30 months, with some regions exceeding 3 years.
A written diagnosis of ASD from a registered psychologist, developmental paediatrician or psychiatrist is the primary gate to provincial funding. Programs like the Ontario Autism Program (OAP) and British Columbia Autism Funding apply their own age, residency and eligibility criteria.
The quality and completeness of the assessment report shape how quickly a family moves through eligibility, secures funding and reaches therapy and school support.
For the clinician, that pressure lands on the report itself, written in the narrow gap between finishing one assessment and starting the next.
Efficient clinical documentation helps ensure accurate, timely ADOS assessments. Manual note-taking makes the process slow and labour-intensive. Clinicians like Dr. Sarah Bellefontaine, a psychologist and clinic director at Four Wings Psychology in Ottawa, often face the challenge of balancing patient care with extensive administrative tasks.
Before Heidi, Dr. Bellefontaine was writing notes after dinner instead of spending that time with her family. Now, Heidi builds her notes from her own templates and picks out what's clinically relevant, so the note is done when the session is. Since then, she has saved over 10 hours per week and has become more present with her clients.
Dr. Bellefontaine shares, "I took a sigh of relief when I finished the day and all my notes were done and looking good. It's allowed me to get out of the office quicker and be more present at home."
An effective ADOS assessment template gives clinicians a structured yet flexible framework for documenting detailed observations and aligning them with ADOS-2 scoring criteria.
Below are the most essential components of ADOS assessments explained:
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.
This section also covers non-verbal cues such as gestures, pointing, and body language.
Example ADOS notes:
Alex demonstrated frequent verbal communication with clear articulation. However, occasional echolalia was noted. Overall quality of language was generally age-appropriate, though brief periods of jargon were present. Non-verbal communication was limited, characterised by infrequent use of descriptive gestures and pointing.
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 a restricted range of facial expressions and affect. Shared enjoyment was fleetingly observed during specific activities, with a consistently delayed response to name. Social overtures were initiated but lacked integration and reciprocal depth. Alex demonstrated difficulty recognizing and regulating emotions, requiring frequent clinical prompting to respond appropriately to social dynamics.
The third section focuses on the presence (or absence) of imaginative behaviours 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 demonstrated emerging creativity during play, engaging in functional pretend play with some directed imaginative elements.
Repetitive behaviours 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 behaviours.
A checklist for physical mannerisms or any unusual motor movements and text fields for observing repetitive themes, topics, unusual sensory interests, or self-injurious behaviours would be an essential include here.
Example ADOS notes:
Alex exhibited distinct motor stereotypies (specifically hand-flapping) and repetitive behaviours, alongside a highly fixated and restricted interest in specific topics (e.g., trains).
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 behaviour, 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-10-CA criteria.
Example ADOS notes:
Based on ADOS-2 quantitative scores and supporting clinical observation, Alex meets the diagnostic threshold for Autism Spectrum Disorder (ASD). Behavioural presentation aligns with DSM-5-TR criteria, indicating a requirement for a moderate level of support (consistent with Level 2 severity).
You can download a copy of this document, or auto-fill it seamlessly with Heidi, your AI care partner.
Splitting attention between observing a patient and writing notes often leads to missed details, inconsistent documentation, and added stress during assessments.
Heidi gives you a faster, more accurate way to complete ADOS assessment notes, without the manual note-taking.
Heidi is an AI Care Partner that helps you complete ADOS assessment templates in real time. With your patient's or their guardian's permission, simply start a session and let Heidi work as you go. Here is what that looks like in practice:
Heidi has given Canadian doctors back 9.2 million hours, and that number keeps growing. It's also PIPEDA-compliant and built for provincial privacy rules, including Ontario's PHIPA and its equivalents in other provinces, so your patients' data stays safe.
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.
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.