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Pre-Linguistic Autism Diagnostic Observation Schedule Adapted for Older Individuals with Severe to Profound Mental Retardation: A Pilot Study

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The Autism Diagnostic Observational Schedule (ADOS) is a semi-structured observational scale developed to assess social interaction, communication and play in individuals who are suspected to have autism. Since the ADOS is not suitable to be used with severely or profoundly mentally retarded adolescents and adults with very limited language skills, materials and some of the tasks of the PL-ADOS and the original ADOS (the former versions of the current ADOS) were adapted. Results indicated that almost all of the overall ratings showed good reliability and discriminative diagnostic validity. Furthermore, the combination of codings into an overall algorithm score on social/communicative behavior resulted in a sensitivity of .82 and a specificity of .85 when using a cut-off score of 15.

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Acknowledgements

This research was supported by a grant to Professor Sir Michael Rutter by the Medical Research Council of the United Kingdom. We are very grateful to the families, and their children for their participations in the study. We would also like to thank Julie Burnell and Stuart Newman for secretarial and computer assistance respectively.

Author information

Authors and Affiliations

  1. Department of Psychology, Middle East Technical University, Ankara, Turkey

    Sibel Kazak Berument

  2. Faculty of Education, University of Windsor, Windsor, Ontario, Canada

    Elizabeth Starr

  3. School of Epidemiology and Health Science, University of Manchester, Manchester, UK

    Andrew Pickles

  4. Child Health and Development Service, Canberra, Australia

    Megan Tomlins

  5. Agia Sophia Children’s Hospital, Athens, Greece

    Katerina Papanikolauou

  6. Autism and Communication Disorders Center, University of Michigan, Ann Arbor, MI, USA

    Catherine Lord

  7. Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, London, UK

    Michael Rutter

  8. Department of Psychology, Middle East Technical University, 06531, Ankara, Turkey

    Sibel Kazak Berument

Authors
  1. Sibel Kazak Berument
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  2. Elizabeth Starr
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  3. Andrew Pickles
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  4. Megan Tomlins
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  5. Katerina Papanikolauou
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  6. Catherine Lord
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  7. Michael Rutter
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Corresponding author

Correspondence to Sibel Kazak Berument.

Appendix: Comparing Adapted-PL-ADOS Tasks with ADOS-G Modules and PLADOS

Appendix: Comparing Adapted-PL-ADOS Tasks with ADOS-G Modules and PLADOS

 

PL-ADOS

ADOS-G Module

Adapted-PL-ADOS tasks

1

2

✔

✔

✔

Warm-up activity: purpose is to allow the client adjust to the room and the examiner. There is no target behavior and coding at this stage.

Modification: Age appropriate materials were introduced. These are a ball and catching plates, wooden beads and a stand to stack them and a color drawing board.

✔

✔

✔

Responding to joint attention: This task is coded on the basis of the client’s attention to the target object.

Modification: Age appropriate materials were introduced. These are small radio controlled car which can go forward and backward as well as spinning around itself and a hologram poster.

✔

–

✔

Make believe play situation: The client’s spontaneous and creative use of miniature objects, the client’s response to examiner’s step and giving help to the examiner are coded.

Modification: Age appropriate materials were introduced. These are a car set (including miniature cars, petrol pumps, garage, road mat and two wire dolls) and a household set (including a horse and its accessories, and picnic set items)

✔

✔

✔

Bedtime routine: Examiner presents a bedtime routine involving having a bath and going to bed , than observes client’s ability to (a) imitate the bedtime routine (b) spontaneously initiating actions related to the routine. Both behaviors relevant to (a) and (b) are coded.

Modification: Birthday party routine in other instruments was replaced with a bedtime routine and age appropriate materials were used. These are miniature bathroom utensils and bedroom furniture.

✔

–

✔

Construction task: Clear indication of need for help is coded.

Modification: An original material (wooden puzzle) was kept but an additional age appropriate material (stacking wooden disks on a stick) was introduced.

✔

–

–

Turn taking: Clear indication of examiner’s turn is coded.

Modification: Age appropriate material (tambourine instead of a drum) was introduced

✔

✔

✔

Initiating joint attention: The client’s ability to initiate joint attention with the examiner or the caregiver is coded.

Modification: no modification

✔

✔

✔

Routine with an object: Client’s ability to anticipate and initiate the repetition of an action routine with the object is coded.

Modification: Age appropriate materials were introduced. These are chattering teeth, windup mouse etc.

✔

✔

–

Social routine: The client’s ability to participate in a social routine and to anticipate the repetition of the routine is coded.

Modification: Age appropriate material (paper mask) was introduced.

✔

–

–

Imitating client’s actions: Whether the client would attend to the imitation of his/her own actions with an object, and imitate the same action back to the examiner and maintain a back and forth interaction with the examiner is coded.

Modification: no modification

✔

✔

✔

Calling the client’s name: Client’s response to his/her own name is coded.

Modification: no modification

✔

–

–

Eliciting a social smile: Client’s responsive smile directed to another person’s face is coded.

Modification: no modification

✔

–

–

Interrupting the client’s behavior: Client’s willingness to get involved with the new activity and client’s social response (e.g. looking at the examiner) is coded.

Modification: no modification

  1. ✔Present in the above schedule.

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Berument, S.K., Starr, E., Pickles, A. et al. Pre-Linguistic Autism Diagnostic Observation Schedule Adapted for Older Individuals with Severe to Profound Mental Retardation: A Pilot Study . J Autism Dev Disord 35, 821–829 (2005). https://doi.org/10.1007/s10803-005-0027-4

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  • DOI: https://doi.org/10.1007/s10803-005-0027-4

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