Understanding ADOS
How Autism is Assessed in Children in the UK
How Autism is Assessed in Children in the UK
In this article, we’ll explain what ADOS is, how it’s used during an Autism assessment in the UK, and what parents can expect if their child is referred for an evaluation.
The Autism Diagnostic Observation Schedule (ADOS) is a standardised, play-based assessment used by clinicians to observe and evaluate behaviours commonly associated with Autism. It was developed to help professionals diagnose ASD in children and adults of various developmental levels and ages.
ADOS is not a questionnaire or a medical test—it’s an interactive assessment where a trained clinician engages directly with your child using a series of structured activities. These activities are designed to elicit behaviours related to:
- Social interaction
- Communication
- Play skills
- Imagination
- Repetitive behaviours
ADOS is widely considered the "gold standard" for Autism diagnosis and is commonly used in both NHS and private assessments across the UK.
Here’s why it’s trusted by clinicians:
- Standardised Format: It allows professionals to assess behaviours consistently across children of different ages and language levels.
- Direct Observation: Rather than relying solely on parent reports or questionnaires, ADOS enables clinicians to observe behaviours in real time.
- Flexible Modules: The assessment can be tailored to the child’s age and communication ability, making it suitable for toddlers through to teens and adults.
1. Referral Stage
Children in the UK are typically referred for an Autism assessment by a GP, health visitor, school SENCO, or paediatrician. Once referred, they may be placed on a waiting list for a neurodevelopmental assessment—either via the NHS or a private provider.
2. Multi-Disciplinary Assessment
ADOS is usually one component of a multi-disciplinary diagnostic assessment, which might also include:
- Developmental history interview with parents
- School or nursery reports
- Cognitive and language assessments
- Other tools like the ADI-R (Autism Diagnostic Interview-Revised)
3. The ADOS Session Itself
The ADOS session typically lasts 30–60 minutes, depending on the child’s age and the module used. During the session, a trained clinician (usually a psychologist, paediatrician, or speech and language therapist) will guide your child through various play and conversation activities.
Examples might include:
- Playing with a toy set (e.g., dolls, animals, or cars)
- Telling a story from a picture book
- Pretend play
- Responding to questions or conversation
The clinician observes your child’s:
- Use of eye contact
- Response to social cues
- Imaginative play
- Repetitive or restrictive behaviours
- Communication style (verbal or non-verbal)
4. Scoring and Diagnosis
After the session, the clinician scores the ADOS using a structured algorithm that reflects the likelihood of Autism. However, ADOS alone does not provide a diagnosis—it is interpreted alongside other assessments, interviews, and professional judgement.
1. You Don’t Need to Prepare Your Child
It’s best to allow the session to unfold naturally. The activities are designed to observe spontaneous behaviour—so there’s no need to rehearse or coach.
2. It’s Not a “Pass or Fail” Test
ADOS is not an exam. It simply helps professionals understand how your child responds to social situations and communication prompts.
3. Bring Supporting Information
While ADOS is an observation tool, clinicians also rely on developmental history and parent insight. Be ready to discuss early milestones, behaviours, and any concerns you or the school have observed.
4. ADOS Is Part of a Bigger Picture
The final diagnosis—whether confirming Autism or not—will be based on a combination of evidence from various sources, not just the ADOS results alone.
The Autism Diagnostic Observation Schedule (ADOS) is a powerful and respected tool that plays a central role in diagnosing Autism in children in the UK. It helps clinicians see beyond what’s written on paper, providing insight into a child’s social and communicative world.
For parents, understanding the role of ADOS can reduce anxiety around the assessment process and bring clarity to what can sometimes feel like a confusing path.
If you’re facing long NHS waiting lists or just want to better understand your child’s needs sooner, a private Autism assessment that includes ADOS might be the right next step. At Atypically, we’re here to support you every step of the way.
Written by Ben Friedman, Founder of Atypically.
Ben has years of first hand experience as a father of an autistic son and a SEND advocate. All content is thoroughly researched to help parents to be as informed as possible when navigating private assessments and meaningful interventions for their neurodiverse children. Ben also holds a CPD Accredited Certification in the Treatment and Management of Additional Needs Children with Neurodevelopmental Disorders.
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