Nombre: __________________________________ Fecha de Nacimiento:_________________________
Gender: __________________________________ Fecha de Evaluación: _____________________
Examiner: ______________________________ Edad Cronológica: _______________________
ADOS-2 Module 4
ADOS-2 Algorithm for DSM 5 ASD Diagnosis
Convert the codes of 3 in the protocol to a score of 2, evaluate as 0 any code that is not 0–3.
Language and Communication
Conversation (A-8) __________
Emphatic or Emotional Gestures (A-10) __________
Reciprocal Social Interaction
Unusual Eye Contact (B-1) __________
Facial Expressions Directed at the Examiner (B-2) __________
Communication of Your Own Emotions (B-5) __________
Understanding Typical Situations and Social Relationships (B-7) __________
Characteristics of Social Initiations (B-9) __________
Quality of Social Response (B-11) __________
Amount of Reciprocal Social Communication (B-12) __________
General Quality of the Relationship (B-13) __________
Social Affection: Total __________
Restricted and Stereotyped Behavior
Speech Abnormalities Associated with Autism (A-2) __________
Stereotyped/Idiosyncratic Use of Words or Phrases (A-4) __________
Unusual Sensory Interest in Toys or People (D-1) __________
Mannerisms of Hands and Fingers and Other Complex Mannerisms (D-2)__________
Excessive Interest or References to Unusual Topics or Objects (D-4) __________
Restricted and Stereotyped Behavior: Total __________
Social Affection and Behavior
Restricted and Stereotyped: Total _________
(Cut-off Point for Autism Spectrum = 8)
Comparative Score_________
Diagnosis
Classification by ADOS: ____________________________________________________________
Diagnóstico General: _______________________________________________________________
ADOS-2, Module 4 Total Scores and by Domain,
Calibrated within the Severity Scale for ages between 9 and 39 years old
Total Score
Total General Score Domain RRB: Domain
1 0-2 0-1 0
2 3-5 2-3 -
3 6-7 4 -
4 8 5 -
5 9 6 1
6 10-11 7-8 2
7 12-13 9-10 3
8 14-15 11-12 4
9 16-19 13-15 5
10 20-29 16-20 6-10