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      Depression, Mental Health and Crisis Support   06/04/2017

      Depression, Mental Health and Crisis Support   Depression and other mental health difficulties are common amongst people on the autistic spectrum and their carers.   People who are affected by general mental health difficulties are encouraged to receive and share information, support and advice with other forum members, though it is important to point out that this exchange of information is generally based on personal experience and opinions, and is not a substitute for professional medical help.   There is a list of sources of mental health support here: <a href="http://www.asd-forum.org.uk/forum/index.php?showtopic=18801" target="_blank">Mental Health Resources link</a>   People may experience a more serious crisis with their mental health and need urgent medical assistance and advice. However well intentioned, this is not an area of support that the forum can or should be attempting to offer and we would urge members who are feeling at risk of self-harm or suicide to contact either their own GP/health centre, or if out of hours contact NHS Direct on 0845 4647 or to call emergency services 999.   We want to reassure members that they have our full support in offering and seeking advice and information on general mental health issues. Members asking for information in order to help a person in their care are seeking to empower both themselves and those they represent, and we would naturally welcome any such dialogue on the forum.   However, any posts which are deemed to contain inference of personal intent to self-harm and/or suicide will be removed from the forum and that person will be contacted via the pm system with advice on where to seek appropriate help.   In addition to the post being removed, if a forum member is deemed to indicate an immediate risk to themselves, and are unable to be contacted via the pm system, the moderating team will take steps to ensure that person's safety. This may involve breaking previous confidentiality agreements and/or contacting the emergency services on that person's behalf.   Sometimes posts referring to self-harm do not indicate an immediate risk, but they may contain material which others find inappropriate or distressing. This type of post will also be removed from the public forum at the moderator's/administrator's discretion, considering the forum user base as a whole.   If any member receives a PM indicating an immediate risk and is not in a position (or does not want) to intervene, they should forward the PM to the moderating team, who will deal with the disclosure in accordance with the above guidelines.   We trust all members will appreciate the reasoning behind these guidelines, and our intention to urge any member struggling with suicidal feelings to seek and receive approproiate support from trained and experienced professional resources.   The forum guidelines have been updated to reflect the above.   Regards,   The mod/admin team
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ADOS Test Tomorrow

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Hi, I have finally got ADOS test tomorrow for 9yr old son. I am really worried. Have had flu like symptoms all week, I think it is stress related. He has already had an ADI.


I have been crying out for a CAMH's appointment for months and they still haven't made an appointment. We couldn't cope, mood swings, wishing he was dead, been through two childminders. He tried to strangle first childminders son. Now saying new childminders daughter- who is 2 and half is bullying him. He is only there an hour.


Now low and behold we are starting to get things moving and guess what he is the most happiest, co-operative and loving child you could ever wish for, things have improved at school. Don't get me wrong I'm really happy about it, but I wish these tests could have all been done when he was in meltdown.


Will I get the results tomorrow re ADOS test?


I feel so low at the moment, I just want all this to be over. I feel like I have kicked up a fuss over nothing.

How easily you forget the awful feeling of I wish I could walk out and never come back.


I just hope he stays this happy.



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Not sure when you get resultsa but i stole this from elsewhere 3.gif


The Autism Diagnostic Observation Schedule -Generic (ADOS-G) is a semi-structured assessment of communication, social interaction and play or imaginative use of materials for individuals suspected of having autism or other pervasive developmental disorders (PDD). It is a combination of two earlier instruments: the Autism Diagnostic Observation Schedule (ADOS: Lord et al., 1989), a schedule intended for adults and children with language skills at a minimum of the three-year-old level, and the Pre-Linguistic Autism Diagnostic Observation Scale (PL-ADOS: DiLavore, Lord & Rutter, 1995), a schedule intended for children with limited or no language, as well as additional items developed for verbally fluent, high-functioning adolescents and adults. The ADOS-G consists of four modules, each of which is appropriate for children and adults of differing developmental and language levels, ranging from no expressive or receptive language to verbally fluent adults. These modules are described in separate sections following this introduction. They are labeled with numerals 1 to 4, with each activity numbered within its module.


The ADOS-G consists of standard activities that allow the examiner to observe the occurrence or non-occurrence of behaviors that have been identified as important to the diagnosis of autism and other pervasive developmental disorders across developmental levels and chronological ages. The examiner selects the module that is most appropriate for a particular child or adult on the basis of his/her expressive language level and chronological age. Structured activities and materials, and less structured interactions, provide standard contexts in which social, communicative and other behaviors relevant to pervasive developmental disorders are observed. Within each module, the participant's response to each activity is recorded. Overall ratings are made at the end of the schedule. These ratings can then be used to formulate a diagnosis through the use of a diagnostic algorithm for each module. In effect, the ADOS-G provides a 30 to 45 minute observation period during which the examiner presents the individual being assessed with numerous opportunities to exhibit behaviors of interest in the diagnosis of autism/PDD through standard 'presses' for communication and social interaction. 'Presses' consist of planned social occasions in which it has been determined in advance that a behavior of a particular type is likely to appear (Murray, 1938).


The modules provide social-communicative sequences that combine a series of unstructured and structured situations. Each situation provides a different combination of presses for particular social behaviors. Module 1, based on the PL-ADOS, is intended for individuals who do not consistently use phrase speech (defined as non-echoed. three-word utterances that sometimes involve a verb and that are the child's spontaneous, meaningful word combinations). Materials for Module 1 have been selected for young children, but materials from other modules may be substituted if desired. Module 2 is a combination of the ADOS and PL-ADOS and is intended for individuals with some phrase speech who are not verbally fluent. Module 3 is based on the ADOS and is intended for children for whom playing with toys is age- appropriate, (usually under 12 - 16 years of age) who are verbally fluent. Verbal fluency is broadly defined as having the expressive language of a typical four year-old child: producing 4. range of sentence types and grammatical forms, using language to provide information about events out of context and producing some logical connections within sentences ( e.g., "but" or "though"). There may be some continued grammatical errors. Module 4 includes the socioemotional questions of the ADOS as well as additional tasks and some interview items about daily living. It is intended for verbally fluent adolescents and adults. The difference between Modules 3 and 4 lies primarily in whether information about social-communication is more appropriately acquired during play or a conversational interview. The modules overlap in activities, but together contain a range of tasks from observing how a young child requests that the examiner continue blowing up a balloon in Module 1 to a conversation about social relationships at school or work in Module 4. Modules 1 and 2 will often be conducted while moving among different places around a room, reflecting the interests and activity levels of young children or children with very limited language; Modules 3 and 4 take place sitting at a table and involve more conversation and language without a physical context. Though the superficial appearance of the different modules is quite varied, the general principles involving the deliberate variation of the examiner's behavior using a hierarchy of structured and unstructured social behaviors are the same.


Because the focus of the ADOS-G is on observation of social behavior and communication, the goal of the activities is to provide interesting, standard contexts in which interactions occur. Standardization lies in the hierarchy of behavior employed by the examiner and the kinds of behaviors taken into account in each activity during the overall ratings. The activities serve to structure the interaction; they are not ends in themselves. The object is not to test specific cognitive abilities or other skills in the activities, but to have tasks that are sufficiently intriguing that the child or adult being assessed will want to participate. What the examiners do not do (such as deliberately waiting to see if the participant will initiate an interaction or try to maintain it) is often as important as what they do.


In general, each module should stand on its own in providing a range of tasks and social presses. However, an examiner may need to shift from one module to another if the language level of the individual is different than expected or, if for another reason, the tasks seem generally inappropriate. If in doubt, it is better to err in choosing a module that requires fewer language skills than an individual possesses than to risk confounding language difficulties with the social demands of the instrument. As is discussed later within the four modules, the order of tasks, pacing and materials can be varied, depending on the needs of the individual being assessed.


Many of the ratings made at the end of each schedule are similar across modules, with some identical items and some that are relevant only for a subset of modules. Separate algorithms for the different modules have been generated and are presented at the end of each section. Adequate inter-rater reliability for items has been established. However, this work has been carried out in small samples; thus, replication from independent samples will be very important.


In the following pages, the manual is organized around the four modules. Within each module, there is a general introduction, a description of tasks, a list of the materials needed and guidelines for overall ratings. Separate coding sheets contain the ratings and provide a recording form for notes made during each activity. These sheets include a summary of the purpose of each activity and the focus of observations targeted during each task. Notes should be taken during administration of each schedule. All modules, even if videotaped, should be rated immediately after they are administered. Earlier research with the PL-ADOS and ADOS showed that ratings of items made after live administration of the scales were equal or greater in reliability (and never less) than ratings from videotapes because the ratings involve social nuances of behavior that are not always observable or interpretable on a screen (such as distinguishing appropriate eye contact from looking over one's shoulder). Within a clinic or research group, examiners should obtain inter-rater reliability with each other before using the instruments for research. Our recommendation has been for 80 percent agreement on individual items and mean kappas greater than .60 (when sample sizes and distributions permit) for raters for three consecutive joint scorings.


The examiner needs to be sufficiently familiar with the ratings and the activities that she can focus her attention on observation of the individual being assessed, rather than on administration of the tasks. This requires practice in administering the activities, scoring, and observation. Notes need to be sufficiently detailed to be interpretable but not so lengthy that they interfere with administration.


The ADOS-G offers clinicians and researchers the opportunity to observe social behavior and communication in standardized, well-documented contexts. These contexts are defined in terms of the degree to which the examiner's behavior structures the individual participant's response and social initiative. For purposes of diagnosis, use of this instrument should be accompanied by information from other sources, particularly a detailed history from parents whenever possible (see Lord, Rutter & Le Couteur, 1994). Its goal is to provide standardized contexts in which to observe the social-communicative behaviors of individuals across the life span in order to aid in the diagnosis of autism and other pervasive developmental disorders. For this reason, it may not be a good measure of response to treatment or developmental gains especially in the later modules. On the other hand, some items have been deliberately included across several modules, even though they have diagnostic utility only in one (e.g., response to joint attention). It may be that developmental or treatment gains will be measurable using these items. An alternative strategy to measure absolute gains is to re-administer the same modules over time, as well as administering the developmentally appropriate module.


scoring results for the ados

some testers do not tell you what the numbers mena at the end of the session this is how they judge it


over 12 is 'classic' autistic disorder. Anything lower than that (but above the PDD cutoff) is one of the other PDDs - PDD-NOS or Asperger's. The tool doesn't distinguish between the two.


5 out of 8 communication a score of 2 or more indicates the possibilty of ASD


6 out of 14 social interaction a score of 4 or above indicates the possabilty of ASD


imagination 8 out 14 a score of 4 or more indicates a possibilty


aspergers will only be diagnosed if there has never been any speech delay


pdd/nos is given when not all of the diagnostic criteria is present but enough problems to cause impairments




if speech problems = HFA




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Usually there is a delay of a week or 2 for the results. When my DD did the ADOS test there were 2 test people - a psychologist and an special needs pedagogue - they also videotaped the results. The psychologist conducted the test which was a collection of puzzles, tasks and games while the other person took notes. I was allowed to be in the room but aked no to become involved in the test. After the test we were told that it would take a week or so for the staff to compare notes and watch key parts of the tape again.



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Oh my god.


Got to centre today H unresponsive would not even go into the room to do ADOS test. They took me and husband in for chat and said they were happy to go for diagnosis on history. As long as pead agrees, then feedback meeting will be arranged and diagnosis will be Asperger's. I can't believe it was as simple as that. She said it was suspected at first meeting but they had to go down official route. Now CAMH's meeting has been arranged 1st April. I am just oh my god at the moment.

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