The Adapted ADOS: A New Module Set for the Assessment of Minimally Verbal Adolescents and Adults.
Vanessa H Bal, Melissa Maye, Emma Salzman and 4 others
PMID 31736004WHAT IT FOUND
The Adapted ADOS offers a new assessment for minimally verbal adolescents and adults.
It improved specificity compared to the standard ADOS-2, reducing false positives, though sensitivity dropped slightly but remained above 80%. Algorithms are preliminary and require validation in larger, older samples.
Key findings
01The A-ADOS algorithms showed substantial gains in specificity compared to the ADOS-2 algorithm, at some cost to sensitivity, though sensitivity remained above 80% for all A-ADOS modules.
02Internal consistency was comparable to ADOS-2 modules for the A-ADOS-M1 algorithms, with Cronbach’s alpha ranging from .60 to .90 across domains.
03Inter-rater reliability was strong, with mean exact agreement for items across modules at 83.51% and intraclass correlations for total scores at .93.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was relatively small, particularly for the non-ASD comparison groups in Module 1. The participants were primarily research referrals and skew young, with only 12% of cases aged 22 or older. The non-ASD group had significantly lower nonverbal IQs than the ASD group, which may have influenced the cut-offs and the observed specificity gains. The algorithms are considered preliminary and need validation in larger, more independent samples, including older adults and younger children. Diagnoses were not made independently of the A-ADOS data, though algorithms were derived after data collection.
Declared interests
Two authors receive royalties for the ADOS-2, but no royalties are generated from the Adapted ADOS at this time.
The easy way to misread this
Do not assume the improved specificity means the A-ADOS is more accurate overall. The gain in specificity came with a reduction in sensitivity, and the algorithms are based on a small, young sample with significant differences in nonverbal IQ between groups. It should not replace comprehensive clinical judgment.