Comprehensive Diagnostic Assessment Using ADI-R and ADOS-2
Fee: SGD $3,800 (inclusive of comprehensive psychological report)
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterised by differences in social communication, social interaction, sensory processing, and patterns of restricted or repetitive behaviours. Early and accurate identification is essential in facilitating timely intervention, educational planning, and support services.
Our Child ASD Assessment utilises internationally recognised gold-standard diagnostic instruments: the Autism Diagnostic Interview – Revised (ADI-R) and the Autism Diagnostic Observation Schedule – Second Edition (ADOS-2).
These measures are widely regarded as the most robust and evidence-based tools for the diagnostic evaluation of autism in children and are routinely used in specialist autism clinics, hospitals, and research centres worldwide. (PMC)
Assessment Components
1. Autism Diagnostic Interview – Revised (ADI-R)
The ADI-R is a structured developmental interview conducted with parents or primary caregivers. It explores the child’s developmental history and current functioning across key areas associated with autism, including:
- Early developmental milestones
- Social reciprocity
- Communication abilities
- Language development
- Play behaviours
- Restricted interests
- Repetitive behaviours
- Sensory differences
- Adaptive functioning
The interview typically takes approximately 2–3 hours to complete.
The ADI-R provides valuable historical information regarding symptom onset and developmental trajectories, which is particularly important because ASD is defined as a neurodevelopmental condition with symptoms present from early childhood.
Research has demonstrated that the ADI-R possesses good psychometric properties, including satisfactory sensitivity, specificity, and diagnostic validity across different populations. (PMC)
2. Autism Diagnostic Observation Schedule – Second Edition (ADOS-2)
The ADOS-2 is a standardised, semi-structured observational assessment designed to evaluate behaviours associated with autism in real-time.
Different modules are selected based on the child’s:
- Age
- Language level
- Communication abilities
- Developmental stage
Activities may include:
- Play-based interaction
- Storytelling
- Conversational tasks
- Problem-solving activities
- Joint attention exercises
- Social communication activities
During the session, the psychologist observes and scores behaviours relating to:
- Eye contact
- Social engagement
- Reciprocal interaction
- Communication style
- Imagination and play skills
- Restricted and repetitive behaviours
Administration typically requires 45–60 minutes.
The ADOS-2 is widely considered one of the most reliable observational measures available for autism assessment and has demonstrated high diagnostic accuracy, with reported sensitivities ranging between approximately 90–97% and specificities between 87–94% in differentiating ASD from other developmental conditions. (PMC)
How the Assessment is Administered
The assessment process generally involves:
Stage 1: Clinical Intake
A developmental and psychosocial history is obtained from parents or caregivers, including concerns regarding communication, behaviour, learning, sensory sensitivities, emotional regulation, and social functioning.
Stage 2: ADI-R Parent Interview
The psychologist conducts the structured ADI-R interview with caregivers to obtain a detailed developmental history.
Stage 3: ADOS-2 Assessment
The child attends an in-person session where age-appropriate activities are administered according to the selected ADOS-2 module.
Stage 4: Diagnostic Integration
Assessment findings are integrated with:
- Clinical observations
- Developmental history
- Behavioural presentation
- DSM-5-TR diagnostic criteria
- ICD-11 diagnostic framework
Stage 5: Comprehensive Report
Families receive a detailed psychological report that includes:
- Assessment findings
- Behavioural observations
- Diagnostic conclusions
- Clinical impressions
- Strengths and challenges profile
- Educational recommendations
- Intervention recommendations
- School accommodation suggestions where appropriate
Who is This Assessment Suitable For?
This assessment is suitable for children who demonstrate:
- Delayed speech or language development
- Difficulty understanding social cues
- Limited peer relationships
- Reduced eye contact
- Repetitive movements or behaviours
- Intense or restricted interests
- Sensory sensitivities
- Challenges with emotional regulation
- Concerns raised by teachers, therapists, or healthcare professionals
- Previous inconclusive developmental assessments
It may also be beneficial for children who are:
- Entering primary school
- Requiring educational support planning
- Seeking access arrangements or school accommodations
- Considering early intervention services
Benefits of Undertaking ASD Assessment
A comprehensive ASD assessment provides families with:
✓ Greater understanding of the child’s developmental profile
✓ Identification of strengths and areas requiring support
✓ Clarification of diagnostic uncertainty
✓ Guidance for evidence-based intervention planning
✓ Recommendations for school accommodations
✓ Eligibility documentation for specialised educational services
✓ Improved access to therapy, behavioural intervention, and support programmes
✓ Enhanced support for long-term academic, social, and emotional development
Early identification has consistently been associated with better developmental outcomes due to earlier access to intervention and tailored educational support. (ACAMH)
Fee
Child ASD Diagnostic Assessment (ADI-R + ADOS-2)
Cost: SGD $3,800
Included:
- Clinical intake interview
- ADI-R administration
- ADOS-2 administration
- Diagnostic formulation
- Comprehensive psychological report
- Personalised recommendations
Selected References
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview–Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.
Lord, C., Rutter, M., DiLavore, P., Risi, S., Gotham, K., & Bishop, S. (2012). Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Torrance, CA: Western Psychological Services.
Lebersfeld, J. B., Swanson, M., Clesi, C. D., & O’Kelley, S. E. (2021). Systematic review and meta-analysis of the clinical utility of the ADOS-2 and the ADI-R in diagnosing autism spectrum disorders in children. Journal of Autism and Developmental Disorders. (PubMed)
Akshoomoff, N., Corsello, C., & Schmidt, H. (2006). The role of the Autism Diagnostic Observation Schedule in the assessment of autism spectrum disorders. Canadian Journal of Psychiatry, 51(7), 439–448. (PMC)
Lecavalier, L., Aman, M., Scahill, L., et al. (2006). Validity of the Autism Diagnostic Interview-Revised. American Journal on Mental Retardation, 111(3), 199–215. (PubMed)
Vanegas, S. B., Magaña, S., Morales, M., & McNamara, E. (2016). Clinical validity of the ADI-R in diverse populations. Journal of Autism and Developmental Disorders, 46(5), 1623–1635. (PMC)