The Adapted ADOS: A New Module Set for the Assessment of Minimally Verbal Adolescents and Adults

  • Vanessa H. BalEmail author
  • Melissa Maye
  • Emma Salzman
  • Marisela Huerta
  • Lauren Pepa
  • Susan Risi
  • Catherine Lord
Original Paper


Few measures are appropriate to assess autism symptoms in minimally verbal adolescents and adults. The Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2, Lord et al., in Autism diagnostic observation schedule–2nd edition (ADOS-2). Western Psychological Services, Los Angeles, 2012) Modules 1 and 2 were designed and validated with children whose spoken language ranges from few- to- no words to phrase speech. This study describes the development and initial validation of the Adapted-ADOS (A-ADOS), which includes tasks, materials and behavioral codes modified to be suitable for assessing older minimally verbal individuals. A-ADOS algorithms exhibit comparable sensitivity and improved specificity relative to ADOS-2 Modules 1 and 2. Although further validation is needed, the A-ADOS will facilitate research to further understanding of minimally verbal adults and symptom trajectories across the lifespan.


ADOS Minimally verbal Adults Autism spectrum disorder Autism symptoms 



We gratefully acknowledge the contributions of the following people who aided in data collection: Gabrielle Gunin, Whitney Guthrie, Lindsay Harvey, Sophie Manevich, Saara Mahjouri, Steven Schwarzbaum.

Author Contributions

All authors contributed to the study conception and design and data collection. VHB conducted the data analysis and drafted the manuscript. All authors commented on previous versions of the manuscript and approved the final manuscript.


This work was supported by an Autism Speaks Dennis Weatherstone Predoctoral Fellowship, Naomi E. Lohr Award for Excellence in Clinical Psychology and Bay Area Autism Consortium Collaboration Counts Grant to VHB, and the National Institute of Mental Health (K23MH115166 to VHB and R01MH081873 and R01MH081873-04S1 to CL) and the National Institute of Child Health and Development (R01HD081199 to CL).

Compliance with Ethical standards

Conflict of interest

CL and SR receive royalties for the ADOS-2; however, no royalties are generated from the Adapted ADOS at this time. The AADOS is available to sites meeting training and reliability criteria for the cost of materials and shipping.

Ethical Approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in this study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Graduate School of Applied & Professional PsychologyRutgers University–New BrunswickPiscatawayUSA
  2. 2.Center for Health Policy and Health Services ResearchHenry Ford Health SystemDetroitUSA
  3. 3.UCSF Weill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoUSA
  4. 4.Weill Cornell MedicineNew YorkUSA
  5. 5.Felicity HouseNew YorkUSA
  6. 6.Long Island CityNew YorkUSA
  7. 7.Washtenaw Intermediate School District, Early OnAnn ArborUSA
  8. 8.Semel Institute for Neuroscience and Human Behavior, David Geffen School of MedicineUniversity of California, Los AngelesLos AngelesUSA

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