ADOS for girls?

Hi,  I'm looking for advice regarding the ADOS for my 11 year old through CAMHS.  My daughter has done this assessment but couldn't do a couple of the tasks, she just didn't do them, didn't say anything as she was not sure what to do.  I'm wondering if this will make any difference to the result?. Her school have not seen anything to suggest she is autistic.  She is also anxious and has selective mutism so I am worried how accurate this is going to be.  

Parents
  • Ugh, these stupid activities!!

    But yes, I think her choices would have helped. A NT child might have revelled in making up a story with the bits, and would have asked what to do if unsure. 

  • Yes, she told me she couldn't do the story because she couldn't think of one using the objects on the table but Im worried the assessor doesn't know the reason she didn't do it, she told me but not the assessor.  They may think she didn't do it because of her anxiety of speaking as she has selective mutism too and gets stressed talking in front of people.


  • Yes, she told me she couldn't do the story because she couldn't think of one using the objects on the table but Im worried the assessor doesn't know the reason she didn't do it, she told me but not the assessor.  They may think she didn't do it because of her anxiety of speaking as she has selective mutism too and gets stressed talking in front of people.

    Failing to engage in imaginative activities would have been assessed as part of the diagnostic schedule ~ as would also in their own rights have been failures to engage in verbal and gestural communications etcetera, in respect of all being collectively narrowed and instinctively restricted ranges of social interaction.

    Hence stating:


    I think not being able to complete those particular tasks would be supportive of an autism diagnosis, rather than the opposite.

Reply

  • Yes, she told me she couldn't do the story because she couldn't think of one using the objects on the table but Im worried the assessor doesn't know the reason she didn't do it, she told me but not the assessor.  They may think she didn't do it because of her anxiety of speaking as she has selective mutism too and gets stressed talking in front of people.

    Failing to engage in imaginative activities would have been assessed as part of the diagnostic schedule ~ as would also in their own rights have been failures to engage in verbal and gestural communications etcetera, in respect of all being collectively narrowed and instinctively restricted ranges of social interaction.

    Hence stating:


    I think not being able to complete those particular tasks would be supportive of an autism diagnosis, rather than the opposite.

Children

  • Thank you.

    I am very glad to have been of some assistance ~ perhaps let us know how things turn out, or if you have any further questions let us know.



  • So these areas would have been assessed through other tasks too?

    Through the entire questionnaire, interview and observation process, yes ~ along with all the referral data as well. 


    Sorry, my level of comprehension is poor.

    Not a problem at all ~ here is a copy of the (American) Diagnostic Statistics Manual (DSM) version V/5 criteria for an autistic diagnosis, which is more generally referred to being that is more 'readable' for many:


    DSM-5TM Diagnostic Criteria

    Autism Spectrum Disorder 299.00 (F84.0)

    A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):

    1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

    2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

    3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

    Specify current severity:

    Severity is based on social communication impairments and restricted, repetitive patterns of behavior (see Severity Listings 1, 2 and 3 below).

    B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):

    1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes,
    lining up toys or flipping objects, echolalia, idiosyncratic phrases).

    2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal
    behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns,
    greeting rituals, need to take same route or eat same food every day).

    3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

    4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement). Specify current severity:

    Severity is based on social communication impairments and restricted, repetitive patterns of
    behavior (see 'Severity level [listings] for autism spectrum disorder' below).

    C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).

    D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

    These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

    Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic)
    communication disorder.

    Specify if:

    With or without accompanying intellectual impairment

    With or without accompanying language impairment

    Associated with a known medical or genetic condition or environmental factor
    (Coding note: Use additional code to identify the associated medical or genetic condition.)

    Associated with another neurodevelopmental, mental, or behavioral disorder
    (Coding note: Use additional code[s] to identify the associated neurodevelopmental, mental, or behavioral disorder[s].)

    With catatonia (refer to the criteria for catatonia associated with another mental disorder for definition)
    (Coding note: Use additional code 293.89 [F06.1] catatonia associated with autism spectrum disorder to indicate the presence of the comorbid catatonia.)

    Severity level [listings] for autism spectrum disorder:

    Severity level 3 “Requiring very substantial support”

    Social communication.
    Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches.

    Restricted, repetitive behaviors
    Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.

    Severity level 2 “Requiring substantial support”

    Social communication.
    Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication.

    Restricted, repetitive behaviors
    Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/ or difficulty changing focus or action.

    Severity level 1 “Requiring support”

    Social communication.
    Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to-and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.

    Restricted, repetitive behaviors
    Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.

    https://images.pearsonclinical.com/imag ... sorder.pdf


    And a link for the International Classification of Diseases (ICD) version 10 ~ if you feel inclined:


    https://www.icd10data.com/ICD10CM/Codes/F01-F99/F80-F89/F84-/F84.0


    Some practices use both the DSM and ICD manuals together ~ being that the ICD is referenced in the DSM, and as such some practices use just the DSM directly and therefore the ICD indirectly, or vice versa.


  • So these areas would have been assessed through other tasks too? Sorry, my level of comprehension is poor.