ADOS ASSESSMENT

[stressedmumto2]

Can I ask how many of your children have had an ADOS assessment done to determine diagnosis

Autistic Diagnostic Observation Assessment

 

In the past my child has had a lot of observations and assessments done on him, independent ones where ed psych and SaLT have spent 5 hours on separate occasions with him in the home state he has ASD/PDA/ADHD, local authority assessment done states he doesn't apart for the SaLT which doesn't diagnose but says he requires a school for ASD.

 

CAHMS are going to review his diagnosis and are going to do this assessment, which will be 4 appointments of 45 minutes and it will be video taped, I have also been told that for this assessment to be successful the child needs to be quite willing to do it (something which my child isn't) I have now just spoken to the independent Speech Therapist and she said that the ADOS very rarely shows ASD in high functioning children so I just wondered if many of your children have been through this assessment, if not how was their diagnosis determined?

 

I am feeling very sceptical now having heard that because at first CAMHS said they would ask school/family/out reach workers to fill in assessment forms (you know that ADHD social and behaviour ones) as well as this but now they have said they will just do this assessment.

 

Have many of your children had this assessment done and are high functioning and did get a diagnosis from it?

 

I am only feeling sceptical because the ADOS results could determine the type of education the local authority are saying he requires. They say just EBD.

[Cat]

My 21 year old son had the ADOS assessment when he was aged 13. This was after we were given a very unhelpful diagnosis which left us on suicide watch for several days. My son was given a diagnosis of Aspergers Syndrome and we were told that he was at the higher functioning end of Aspergers, something that I would strongly dispute now, however at the time we were just relieved that we had a diagnosis. The point is the ADOS will pick up those who are high functioning, my son is.

 

These days the route to diagnosis is said to be best done by a multi-agency assessment (this is stated in the autism exemplar which is part of the National Service Frame work for Children written by the government ) you can find it here http://www.dh.gov.uk/en/Publicationsandsta...able/DH_4094828 )

 

This would still include an ADOS assessment but this would feed into the reports and observations being done by other people like SALT, Autism Outreach Team, Ed Psych. These observations are usually carried out in school and home. All of the main players then meet and discuss their findings. I would want to know the history of the CAMHS Team. Just because they are part of CAMHS does not mean they are experts in ASD. They may well be but I would want to be sure. Having the right team makes all of the difference in the world and I know that from first hand experience.

 

Cat

Edited November 22, 2008 by Cat

[sueeltringham]

My son had a multiagency assessment as part of the CAMHS team. The ADOS was one aspect of the assessment. It was videoed. He came out with a diagnosis of high functioning autism. On bad days, my son is not particularly co-operative, in fact he has totally his own adgenda. Of course he'd co-operated well with other assessments and visits. They had loads of toys in a room and followed his lead. They would then try and distract with other toys. Of course he was 'locked' in his play and would not participate in the role play (this was him at his worst). It was really interesting to watch and the professionals present were quite surprised at the results. We weren't surprised at all -in fact he got the diagnosis we expected. After the assessment, the SALT was quite apologetic that they hadn't listened to us parents two years before! She also admitted that he should perhaps have had earlier intervention. In a way he'd shown some of his worst behaviours and the session ended with him on his back and all legs in the air like a beetle which I had to try and 'pick him up' from. I found it quite upsetting, and ds was totally stressed out, but we got the diagnosis that I'd been telling school all along.

Good luck with your assessment,

 

Sue

[bikemad]

Im glad you have asked this as im awaiting the 1st appointment for my lad for these assessments..not that he wants to even turn up grgh!!!!!

[madme]

My son didnt have this as the Aspergers was a later dx by a specialist team. As they are from a well know hospital I have no doubt about the dx. My Dd was different and she did have the ADos and was dx as Aspergers although she didnt fulfill all the criteria but they did have input from er paed and previous school. What was important in each case was the experience of the dx doctr. With my son he is an expert , we had read enough around the field, so we accepted it. With my DD she was dx last year at age 7 of aspergers. I'm sure that without her brothers dx they would not have dx her now. I know that she is ASd and increasingly this is now a problem. The school however will not look at this and just see her academic abilities. Her Ot report delivered at the start of term has just been filed away. As she is out of borough this is normal apprently.

 

[teachermum1]

My son had this, last year. He is 7 now and was dx'd ADHD at 4. CAMHS started to query was it also autism at 6 - I'd not had a clue. The psych said the ADOS might not show ASD as he is so verbal and we'd taught him superficial social skills which she felt masked a lot of his difficulties - she said he was so high-functioning that he might come out as borderline.

 

Well...he had the ADOS and was completely himself - refused to co-operate, kept trying to leave the room, wanted to be totally in charge, wouldn't really have a conversation etc.etc.

 

He ended up scoring almost as high as you can get (the higher the score, the more severe the autism - in theory!).

 

He IS very high-functioning in many ways, but behaviourally he is severe. What the ADOS does is picks up on the subtleties - the odd eye contact, the eogcentric talking, the oddness of detail picked out when looking at the book on one of the tasks, the quality of rapport, the give and take in conversation, the normality of facial expressions and gestures...even a high functioning kid will have social and communication defecits, because those are part of the criteria for having ASD, and that's what the test picks up on.

 

I think it's a good test. It got the right dx and the right dx led to the right support.

 

Good luck.

[cmuir]

Hi

 

My son was 4.5 and it resulted in a diagnosis 10 days after it was carried out.

 

I wasn't present during the actual assessment. Instead I asked my son's social/key worker to go in with him (that way no one could say I had any influence). I remember thinking that his consultant and SALT were going to get nothing from it as R struck me as being rather tired that day and was actually quite compliant, etc. During the ADOS his consultant asked his key worker if he was presenting himself as he does normally - she was able to say that she thought he was tired and quite subdued and that he's usually very different! The ADOS was carried out over 1.5 hours and throughout R was fairly complaint and then there were times when they had to work very hard indeed to gain compliance. Having obtained a copy of the session, compliance isn't imperative. They're looking for things like eye contact, reciprocal language, imaginative play, etc. I also think that the ADOS itself did not solely lead to the diagnosis - previous background reports (all variable - one actually ruled out AS, yet that's what R was diagnosed with!), a diary which I'd kept, etc all contributed to the diagnosis.

 

During the ADOS, R was given various toys - a wooden fire engine/house/people. SALT sat back to see if R would play with the toys and make up a typical fire/rescue scenario, but he didn't. SALT told R that it was her birthday and she had a lovely cake. R didn't respond. She tend asked R what he got for his birthday - he said Spiderman cake (and failed to mention that I'd hired a fire engine for a couple of hours!). Basically, R didn't ask her any questions. She then asked R what makes him happy - he said fireworks (he's petrified of them!) and what makes him sad - he said when his dog died (we don't have a dog!). R's eye contact throughout was variable - very good/non-existent/fixed stare/etc. R asked to to see the toilets - SALT asked if he needed - he said no, he just wanted to look. Throughout R was given breaks where the SALT would write notes and it was noted that R opted for a pin art toy and a spinning top (classic apparently). All sorts came out.

 

We didn't get the results there and then. After the assessment (apparently the consultant had to have a lie down and the SALT needed a very strong cup of coffee straight after it!). They retired for the afternoon looking back through reports and analysing the ADOS assessment pretty much frame by frame. I was fortunate to get a copy of the report and the DVD and it made interesting reading. Have to say to the untrained eye there would ahve been a lot that I would have missed. Thankfully, it was carried out by someone that knows what to look for. An appointment was made 10 days later and that's when we were given the diagnosis.

 

EDITED: I forgot to add...

 

I should have added that the ADOS came 1.5 years into my quest for answers/diagnosis. Numerous people had seen R and I had a pile of reports, but no answers, just 'complex little boy'. Some of the reports pointed to possibility of an ASD, some categorically ruled this out. Multi-agencies were involved and in our case I think that was part of the problem. There was no consistency in that someone would see R in nursery for 20 minutes on a good day. If that same person saw him a week later, there would perhaps have been more chance of them seeing something.

 

Both myself and R's two teachers had to fill out a Connor's Scale (behaviour/concentration - ADHD?) after the ADOS. The process was very much ongoing.

 

Hope this helps.

 

Caroline.

Edited November 23, 2008 by cmuir

[av16]

Hi, our son had ADOS and was diagnosed AS at age of 8, we also had ADI- a long questionnaire. A paediatrician and child psychiatrist were involved plus observations of him at school. He's a bright boy but the ADOS picked up his monotonous voice, lack of eye contact/ interest in the objects in front of him,general lack of social awareness. We thought it was a good way of picking up that sort of thing without him realising.

Good luck

[stressedmumto2]

Thanks for all of your replys, this has been very helpful <'> . I am not looking forward to the assessment as this could be the decider on the most appropriate placement for my son and could go against the advice of highly specialist professionals who all say he requires ASD provision.

[bikemad]

Hope it goes well for you...im not looking forward to it either with my lad. <'>

[stressedmumto2]

Hi, Just wanted to come back to this post.

 

I have been given the dates for the ADOS assessment, we have one appointment scheduled in, then another two weeks later, then another a week later, they have been scheduled for 20 minutes each. I'm feeling very sceptical if his ASD will be picked up in this time frame, but going to give it a go.

 

I had an appointment with CAMHS last week, THE CAMHS nurse we used to see has written in many reports that son does have many features of ASD but whether we will be given a dx he wasn't sure as son is very complex. The new lady we are under now and has only seen my son once for 20 minutes, has read all of his reports independent and otherwise and is concluding that she feels he doesn't have ASD, but we have to wait for the ADOS assessment. The independent specialists whom I have high regard for are adamant he has ASD and is very complex and that education provision should be a ASD school placement. The local SaLT whom has not made a dx of ASD and was never asked to but was asked to compile a report based on his therapy needs has all along put in her report he requires......

input from a multi-disciplinary team of people who are highly skilled in the area of complex communication disorder.ASD, sensory programmes and pro-active support strategies. The OT who works with Children with learning disabilities was asked to compile a report based on his sensory needs, she has stated he has significant sensory modulation problems and that OT needs to be part of the daily routine.

 

I do not understand why the local CAMHS are going against the advice of highly specialist professionals. I do know that many professionals may feel parents pay for the private dx, but when I first got my son assessed independently the ed psych who spent 5 hrs with us in the home told me I would need to have SaLT assessment done as he was confused by my son's complex difficulties and wanted to be sure of the dx.

 

I know I have harped on about this dx business and I am boring myself with it now, lol, but to me having the ASD dx is going to be the difference in son maybe accessing a school who will understand him and effectively manage him or a school that may not as the approaches that the schools use could be different and already the approaches one would use with EBD behaviours has already failed. I also know that the local authority will prefer their own evidence which could all point to a EBD residential school unless I go back to tribunal and challenge this, this could be disastrous for him, again it may not be, I don't know.

 

I also think that CAHMS have taken on board far too much of what the school have said to be the way he is acting, yet they are not willing to take on board what other professionals are saying, including our out-reach team. I know the school and the local authority will not want to admit he was wrongly placed, considering I went to two tribunals and a high court case for him not to be in the school, whom have now said they can't meet his needs.

 

It all seems that it's going to hinge on this dx and that I should be prepared to go back to tribunal.

[bikemad]

I so know how you feel and how damn ###### frustrating it is..sounds like your cahms are like mine...a load of ######!!!! <'>

[jlp]

Both of my sons (5 and 9) have had the ADOS - ds#1 at 4 and ds#2 at 5.

 

Ds#1 did not score as ASD on the ADOS, yet the professionals realised that the ADOS wasn't a definative test for ASD and went on to diagnosis him with ASD / Aspergers.

 

DS#2 confusingly DID score as having ASD but wasn't diagnosed with ASD due to having particularly good eye contact on the school visit (he was checking the Drs were watching before doing his 'thing' - breaking toys, turning the taps on, pulling work off the wall etc). He was diagnosed with PDA and ODD.