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.
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 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 organisations 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 assessments. Through a structured format that follows standardised 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.
The State of ADOS Assessments in the UK
The state of ADOS evaluations in the UK is under pressure. Demand continues to rise with growing waiting lists and care teams are being asked to do more with limited time and resources.
Factors influencing this are:
Backlogs
A timely autism assessment helps people and families understand what support is needed at home, in school and across care settings. In England, NHS data shows 270,701 open referrals for suspected autism early this year with almost 90% waiting longer than the recommended 13 weeks.
NHS England has set out clearer standards for assessment, but many independent care boards (ICBs) are still working with limited funding, stretched capacity and recruitment gaps.
Regional Resource Inequalities
Some ICBs are managing long assessment waits with limited staff and patchy data, while others have clearer demand tracking. This means patients and families can face very different timelines for the same support. When local pathways cannot keep pace, families start looking for a faster route to answers.
As a result, more people turn to independent assessments or use NHS Right to Choose to move around local waiting lists. This widens the gap between those who can push for faster access and those left waiting.
Underfunding for Initiatives
Over the past seven years, UK autism diagnostic services have come under serious pressure as referrals have increased twelvefold. NHS England has responded with multi-year planning and clearer performance measures to help services manage demand more consistently.
Planning and performance targets set the direction, but consistent diagnoses still depend on what happens in the assessment room. Much of that comes down to the tools UK clinicians use, and a well-structured ADOS assessment template is one of them, giving them the same clear framework to observe, code and record against.
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.
Autism diagnoses are classified in line with ICD-11, the diagnostic framework used across NHS services and recommended by NICE. DSM-5, published by the American Psychiatric Association, is also referenced internationally and may be used alongside ICD-11 in some clinical and research contexts:
DSM-5 Explained
DSM-5 is the fifth and most recent edition of a standardised diagnostic criteria for mental disorders, including ASD. It is published by the American Psychiatric Association (APA) and is primarily used in the United States, but it is also an internationally recognised 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 clinicians 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 standardised language for healthcare systems worldwide.
What ADOS-2 Score Indicates Autism?
Each ADOS-2 module has its own scoring algorithm and diagnostic threshold. In the UK, an ADOS-2 total score of 7 or higher becomes an indicator for an Autism Spectrum Disorder (ASD) classification.
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 practise, 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 characterise 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:
During the assessment, Oliver spoke using complete sentences with clear articulation but occasionally repeated the clinician's questions before answering (echolalia). Conversation centred on his favourite topic of London Underground lines, with limited reciprocal exchange. Gestures were infrequent, with minimal use of pointing to direct another person's attention, and eye gaze was not consistently coordinated with communication.
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:
Oliver made brief but inconsistent eye contact throughout the session. The individual rarely looked towards the clinician to share interest or enjoyment. His response when his name was called was delayed on several occasions. He responded to direct questions but initiated very little spontaneous social interaction and required prompts to expand on his responses.
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:
Oliver used the toy figures appropriately but demonstrated limited spontaneous imaginative play. When encouraged to create a story, he preferred arranging objects in a logical sequence rather than developing a narrative.
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:
Oliver displayed repetitive finger movements during periods of excitement and frequently redirected conversation towards railway journeys and London Underground maps despite changes in topic.
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, Oliver 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.
Watch how AI is reshaping clinical practise across the UK.
ADOS Assessment Template Example
You can download a copy of this document, or auto-fill it seamlessly with Heidi, your AI care partner.
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 your AI Care Partner, built 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 verbalise, you can type it under context notes to be considered later.
- Customise – 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.
Heidi complies with jurisdiction-specific regulations, ensuring data localisation for clinicians and care teams in the United Kingdom and beyond. Read more about our compliance here.
Free ADOS Assessment Templates
Child Assessment Session
This template provides a structured framework for documenting observations, exploring the child’s emotional needs, and making recommendations. This is designed for clinician use.