Getting An Autism Diagnosis

Autism Diagnosis with the ADOS-2

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is one of the most widely used and trusted tools for diagnosing autism spectrum disorder (ASD). It is considered part of the gold standard for autism testing, alongside developmental history interviews and other parent/teacher questionnaires. Children as young as 12 months can be tested for an autism spectrum disorder (ASD).

The ADOS-2 evaluates communication, social interaction, play, and restricted or repetitive behaviors using structured tasks and materials (toys, puzzles, and games). A trained clinician observes and scores behaviors during a session lasting about 30 to 60 minutes.

It is important to note that the ADOS-2 is not used in isolation. Autism diagnosis requires a comprehensive evaluation, including clinical interviews, rating scales (such as BASC-3, Conners, or Vineland), developmental history, and professional judgment.

Early Signs of Autism in Children

While only a professional evaluation can confirm autism, families often notice early signs of autism at home or in school. These behaviors do not always mean a child has ASD, but they may be important to discuss with a professional.

• Limited or no eye contact (this may vary across cultures)
• Delayed speech or limited use of words, gestures, or sounds to communicate needs
• Difficulty understanding language
• Limited or repetitive play with toys and objects
• Lack of imitation of adults or peers
• Difficulty with joint attention (e.g., not looking where a parent points, not showing objects of interest)
• Not responding to their name
• Absence of gestures such as waving, pointing, or nodding
• Difficulty asking for help
• Limited interest in others’ activities
• Engaging in repetitive movements, sounds, or routines
• Distress or tantrums during transitions to new activities or places
• Self-injurious behaviors

If you notice any of these behaviors, requesting an autism evaluation can provide clarity and guidance on next steps. However, it does not mean your child will meet criteria for the diagnosis!

Autism Therapy & Support Services

Children diagnosed with autism often benefit from behavioral therapy such as Applied Behavior Analysis (ABA) or Intensive Behavioral Health Services (IBHS) in Pennsylvania. These therapies help children build independence and reduce challenging behaviors.

Common Areas of Focus:

• Social skills: responding to their name, recognizing social cues, forming friendships
• Communication skills: using words, PECS boards, sign language, or communication devices
• Self-care skills: bathing, brushing teeth, dressing, and hygiene
• Toilet training: evidence-based ABA methods for toilet training
• School readiness: supporting attention, learning, and behavior

Challenging Behaviors ABA Can Address:

• Tantrums
• Aggression
• Self-injury
• Disruptions to the environment

With the right therapy plan, children can make significant progress in daily living, reducing difficult behaviors, and improving overall family functioning.

Autism Diagnostic Criteria (DSM-5-TR)

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), all of the following criteria must be met for an autism spectrum disorder diagnosis:

• Persistent deficits in social communication and social interaction, including challenges with social reciprocity, nonverbal communication, and making or maintaining relationships.
• Restricted or repetitive behaviors, such as repetitive movements or speech, insistence on routines, restricted interests, or unusual sensory responses.
• Symptoms appear in early development, though they may become clearer as social demands increase.
• Symptoms cause significant impairment in daily functioning across settings.
• Not better explained by intellectual disability (ID) or developmental delay. When both ASD and ID are present, social communication deficits are more severe than expected.
• ASD may be diagnosed with or without language impairment.