Here are 2 more tips to help you develop the skills you learned on the ADOS-2 training:
My first tip is based on observations of recently trained ADOS-2 clinicians administering activities.
One of the things that many people often find very difficult is giving instructions for tasks. Giving instructions might seem like a minor part of administering activities, but it is really important. When instructions are unclear, incomplete or incorrect, it impacts on the whole task, and it can make the person being assessed feel more anxious as they do not understand what they have to do.
I always recommend buying the ADOS-2 manual. It is quite expensive, but it is an important investment that will help you throughout your career. I am on my fourth manual, and I do not know how anyone manages without one. The manual contains a lot of information but one of the most helpful things is the instructions for each activity and how to administer the ADOS-2 tasks.
Many experienced ADOS-2 clinicians do not say the instructions in the manual word for word, but they are close and they preserve the meaning. However, without the manual, it is much harder to learn instructions for tasks. There is so much to keep in mind when you do an ADOS-2, which is particularly difficult when you begin assessing. Not knowing the instructions adds to the stress and can affect the quality of your ADOS-2.
Tips for learning instructions for ADOS-2 activities:
- Write the instructions down to help you learn them, and read them to yourself when you are on the bus, in the bath, queuing to pay in the supermarket, etc.
- David Beckham used to visualise scoring goals before he played a game. Do a David Beckham and picture doing an ADOS-2 in your head and imagine giving the instructions.
- Practise giving instructions without looking at the instructions, e.g., when you are driving (I practise lots of things when I am driving), when you are in the bath, when you are making dinner.
- Record yourself and listen back to your instructions to help learn them and to reflect on your delivery. I used to record talks I was going to give and listen to them when I was travelling to and from work to help me learn what I was going to say.
- Keep practising until the instructions start getting easier to give, they are more fluent, and you are happy with them.
Another area I have observed recently qualified ADOS-2 practitioners struggle with is note taking.
Note taking can be difficult, e.g., if the child is very active, if you have to adapt your administration a lot to manage the session. When you start doing the ADOS-2, it is even harder because you are not sure what, or how much to note down, which often results in the extremes, i.e., noting down everything or nothing.
Notes are essential for coding and for writing reports, and they depend on your observation skills and knowing what you are looking for. You need to know the items you are going to code very well and recognise what is evidence and what is not during an ADOS-2. This takes time. Spending time working on this is going to help you a lot when you start assessing.
Tips for taking notes during an ADOS-2:
- Make sure you understand what the items are looking for. Make a list of the ones you are not sure about and ask a more experienced clinician or a trainer. It is essential that you know what the descriptors mean and what they are looking for. There is no shame in saying that you are unsure.
- Think about the evidence for items, and what you need to know about this to code it. For example, for emphatic and emotional gestures in Module 4, you need to look out for these gestures throughout the ADOS-2 and note, e.g., the frequency, the range of different types, the quality.
- Think about codeable behaviours you might see in tasks and make a note of these in module booklets to remind you to look for these when you are doing an ADOS-2. For example, for Bubble Play in Module 1 & 2, you might see hand and finger and other complex mannerisms (D2).
- Choose 3 – 4 items coded in ADOS-2, e.g., facial expressions, conversation, quality of overtures. Watch a programme that will have examples of these for a short time, e.g., 10 – 15 minutes and take notes on these to practise capturing what you need to note down. Or do this discretely on the bus or train, when you have the opportunity to watch others. It will develop your observation skills as well as your note taking.
- Look at the abbreviations suggested in the ADOS-2 manual and find ones that work for you – which will probably be your own versions. Practising will help you find what works for you when you take notes, e.g., I draw pictures of hand and finger movements.
I hope you found these tips helpful. You may find joining our multi-disciplinary professional network helpful too, where you can find support and discussion for all professionals working in identification and support of neurodivergent individuals, with a main focus on autism.
