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ToughDiamond
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14 May 2009, 3:21 pm

One of the diagnosticians I've contacted says they diagnose using ADOS, which appears to be a set of tasks and practical tests the client is subjected to, leading to (they say) a pretty definite answer as to whether or not the client has AS.

I can't find anything about what sort of tests they actually do, as if it's a big trade secret or something, so I was wondering if anybody knew anything about the details of the tests.

I must say I'm a little skeptical - mostly ADOS seems to be designed for children (all the stuff I've dug up so far refers only to kids), and the diagnostician's description ("'Gold Standard' diagnostic assessments, which are internationally recognised....give a clear indication as to whether a person is on the spectrum or not") seems a little too good to be true. Is this term "Gold Standard" really applicable here, or has it just been made up by those who wish to promote the methods? Who exactly recognises them?

It looks to be an intriguing alternative to the usual kind of DX (though I know little about that either, except that it's probably a set of questions with a bit of observation thrown in) - apparently ADOS isn't conducted by a psychologist or psychiatrist, which might be a step in the right direction.



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14 May 2009, 4:37 pm

I'm in the process of being evaluated, and one of the centers here in town mentioned it. You are correct that the first 3 variants of the test are not for adults. However, the fourth variant, or stage, is designed to test verbal/high functioning adults. Like IQ tests, they have appropriate versions for the stage of development of the test taker. While I don't think tests can tell you everything, I do think something like this could be useful.



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14 May 2009, 4:53 pm

The term "Gold Standard" comes right out of the self-promoting marketing pitch the expensive tests are sold with: http://portal.wpspublish.com/portal/pag ... ema=PORTAL

Look on the page for the words "Gold Standard".

They paid for it, so they think it must be good ;) I have no direct experience, just the cynical me. It's only a 45 minute test?



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14 May 2009, 9:45 pm

ToughDiamond wrote:
One of the diagnosticians I've contacted says they diagnose using ADOS, which appears to be a set of tasks and practical tests the client is subjected to, leading to (they say) a pretty definite answer as to whether or not the client has AS.

I can't find anything about what sort of tests they actually do, as if it's a big trade secret or something, so I was wondering if anybody knew anything about the details of the tests.

It looks to be an intriguing alternative to the usual kind of DX (though I know little about that either, except that it's probably a set of questions with a bit of observation thrown in) - apparently ADOS isn't conducted by a psychologist or psychiatrist, which might be a step in the right direction.



My teen son had the ADOS3 test for teenagers a few months ago while we sat in the room. My son wasn't interested in the props so the developmental pediatrician (DP) just did the interview. He then went through the scoring section with us to see if we agreed with his scores which were something like a to e from yes to occasionally through to always. Those weren't the words used but I have a word-finding impairment so I'm struggling here as I do with all posts.

I wish my memory for details was better, but essentially it was about things like how he communicated, did he initiate conversation, did he stay on the subject, did he use particular types of speech, did he have friends, was he upset when someone close to him left or died, how was his eye contact, imagination etc. I was impressed with the amount of detail the DP noticed. Many items scored nil but it was more about the overall score. No one will have all traits.

The DP also asked about how he was managing his life and imagined his future. Girlfriends, career, social life, study etc. They can't give a diagnosis unless your life is impacted as they are essentially saying you are disabled.

I read somewere in a formal report of some sort that this test was originally used in some study comparing Asperger's subjects to control subjects. The accuracy of the test was so good that it came into use as a diagnostic test. It really just pinpoints the exact communication and social skills that the subject is experiencing.

In regard to the props, the DP wanted my son to look at a book and describe a picture but he was resistant to doing it, so I handed him some art work I had bought along and he did talk about that and answer questions. I would suggest you take something along which would illustrate your intense and detailed interest in your main subject.

The DP said talking to my son was like trying to get blood out of a stone. In contrast it was hard for me to restrict my speech as Asperger's is my current area of interest. My son was given the diagnosis based on the test as the previous interview was inconclusive as he was not typical or obvious as a child as he doesn't have distressing sensate problems.

I would suggest you relax as much as possible and just be yourself. If the diagnostician is skilled, he or she will notice all the tell tale signs due to the highly specific test.

I hope you are happy with the results, good luck, whatever that means.


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15 May 2009, 7:05 am

You are correct to have some skepticism about the ADOS; it has not been extensively tested on adult AS populations, especially those at the milder end. However, it is quite accurate at determining whether someone's on the spectrum.

As a verbally fluent adult, you would be under Module 4.

They will judge things such as your eye-contact, facial expressions, quality of social response, reciprocation, imagination, mannerisms, anxiety, gestures, and a number of other things while you complete the tasks.



ToughDiamond
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15 May 2009, 10:41 am

TobyZ wrote:
The term "Gold Standard" comes right out of the self-promoting marketing pitch the expensive tests are sold with: http://portal.wpspublish.com/portal/pag ... ema=PORTAL

Look on the page for the words "Gold Standard".

They paid for it, so they think it must be good ;) I have no direct experience, just the cynical me. It's only a 45 minute test?

That's a nice-looking box of toys 8) They're not cheap either (check out the training DVD price tag!) but I guess the stuff pays for itself pretty quickly as they charge £600 per DX......not exactly small beer, but good that it's fixed like that; the traditional diagnosticians charge per hour and they tend to shy away from quoting a hard upper limit - they also warn that even at the end of the game, they still might not be sure whether I have it or not.

Yes, one module does seem to take about 45 minutes, though the diagnostician says my test (should I choose to buy it) will take between 2.5 and 3 hours - I guess some of that time will be questions about the impact of the traits on my life: as itsallrosie correctly points out, there can be no valid diagnosis of impairment if I'm doing fine in everyday life.

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He then went through the scoring section with us to see if we agreed with his scores which were something like a to e from yes to occasionally through to always. Those weren't the words used but I have a word-finding impairment so I'm struggling here as I do with all posts.

It's OK, I know what you mean. If it's A to E then that's five "degrees of resolution" (as I'd call it), which is a bit more than the AQ test - that just has four (definitely agree, slightly agree, slightly disagree, & definitely disagree). I prefer more because otherwise I feel the results are getting distorted, I always want to tick between the boxes if you know what I mean.

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I hope you are happy with the results, good luck, whatever that means

Thanks - good luck would mean that the result was the correct one, whatever that happens to be. The problem is that my experiences and observations have so convinced me that AS is messing up my life, I don't know what I'd make of being told that it isn't. I've seen so much evidence of my having AS that I think I'd just not believe them, I'd think I'd been ripped off, and I'd be scared that the distress I go through may never get recognised or sorted out. On the other hand, if I'm wrong, I want to know.

Thanks for sharing these experiences and opinions - it's all very useful stuff. 8)



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06 Jun 2009, 5:19 pm

Another question about ADOS:

The people I've been talking to say they are not psychologists and therefore don't look for other conditions apart from autism. To my mind that suggests their method is less rigorous than DSM-IV because the latter requires schizophrenia to be ruled out before a positive DX of AS can be given.

Which got me wondering:
Would an ADOS diagnosis put me onto the Disabled Person's Register or not?

According to my counsellor, inclusion on that list (in the UK) would be key to being able to force an employer to make reasonable adjustments to the employee's working conditions.



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07 Jun 2009, 10:39 am

outlier wrote:
You are correct to have some skepticism about the ADOS; it has not been extensively tested on adult AS populations, especially those at the milder end. However, it is quite accurate at determining whether someone's on the spectrum.


I would disagree with its accuracy in determining ASC. In my experience, both with the ADOS-G and the ADI-R, both tests are too insensitive and are apt to miss lighter variants of HFA and AS.

I personally dislike the use of the ADOS-G + ADI-R as diagnostic tools where the diagnostician will not contradict the results if they so choose. Any single tool or group of tools should be assumed to be imperfect, and so the diagnostician should be able to disagree with the results.

In psychometrics, it's a foundational tenant that no single test or group of tests be truly diagnostic and that the interview portion and the experience of the professional should always have the last say. But unfortunately, both of these tests (which are usually used in tandem) are given such clout that they are basically treated as stand-alone diagnostic tools; they just require a trained and certified professional to administer them.


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07 Jun 2009, 10:41 am

Forgot to mention: As for the different modules 1-4, they're basically the same except that each progressive module is simply updated for older ages. The foundational design of each module is essentially the same, but the tasks vary based on age range.


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11 Aug 2011, 5:35 am

At my local C.A.R.D. office, I was given the test in order to give one of their employees practice. Although it was my first time taking the test, I tried to bend the result towards neurotypical. One way of doing this is that I know that one thing the examiner looks for is repetitive motion. Since I'm a flapper and finger flicker, I made sure to keep my hands behind me or under the table out of her sight unless I needed to use them. I'm also very good at mimicking eye contact, so I used that skill. I have also learned to read facial expressions very well and can even feign empathy. When I need to be, I am a very good actor and can fool most people into believing I'm like everyone else. I used every skill in doing this while taking the A.D.O.S., and guess what? The examiner was not fooled, and she saw right through my act.

While she was studying me, I was studying the ADOS. My examiner knows that I intend to write an article about the ADOS and post it here on WrongPlanet. I want to gather as much information as I can before writing this article in order not to present incorrect information. I have learned how many types of psychological tests work as well as their mechanisms for scoring and diagnostic criteria and from what I have seen, this test is very good at picking up autism. Hopefully, I will have more information about the test in the near future However, the test itself is copyrighted, and I will need to be very careful about revealing any trade secret and not to infringe upon any of the test's copyrights.


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ToughDiamond
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11 Aug 2011, 6:16 am

cyberscan wrote:
Hopefully, I will have more information about the test in the near future However, the test itself is copyrighted, and I will need to be very careful about revealing any trade secret and not to infringe upon any of the test's copyrights.

I look forward to that. Don't take this as gospel, but I don't know of any law that protects trade secrets as such. And maybe if more people knew how it was done, the price would come down a bit.



rickskyscraper
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02 Mar 2013, 2:13 pm

Any more info to be had on this?



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03 Mar 2013, 1:11 am

I had the ADOS test during my diagnosis. It does seem a bit childish, but it is designed for the diagnostician to be able to identify ASD in adults. It was looking for things such as interaction, communication, and other things related to autism. It wasn't so bad. I think the point of you not finding much information online is probably because you are not supposed to prepare for it. It's supposed to be completely natural, so its better left more as a surprise, I think.


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03 Mar 2013, 7:50 am

Yes, the subject needs to be unprepared. I tried another thread / discussion but the single respondent does not understand my question, even after repeated attempts to clarify. I took the test 3 weeks ago and found something odd, and wanted to see what others might know about the particular way I responded to two parts of the test. I was unable to tell the story with the picture-book and only describe details and inconsistencies, and then was able to create a pretty wild story with the 5 objects. It felt odd to me anyway.

I'm just going to stop asking, and wait for the next visit with the psychologist.


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