Autism Assessment with English-Spanish Bilingual Individuals in the United States.
ADOS-2 autism scores stay the same in English or Spanish for bilingual clients.
01Research in Context
What this study did
Maira and colleagues tested the ADOS-2 in both English and Spanish.
They worked with 94 bilingual people already on the spectrum.
Each person took the ADOS-2 twice, once in each language.
The team then compared the autism-severity scores.
What they found
The scores stayed the same no matter which language was used.
Spanish exposure level did not change the numbers either.
In short, the ADOS-2 gives identical severity ratings in either language.
How this fits with other research
Taylor et al. (2017) warned that race and ethnicity can nudge three ADOS items.
Maira’s new data say language alone does not move the total score.
Together the papers tell us: watch cultural context, not just the words you speak.
Magaña et al. (2013) saw lower repetitive-behavior scores on the ADI-R with Latino adults.
Maira now shows the ADOS-2 side is free from that kind of language shift.
Hedley et al. (2010) already proved a Spanish toddler screener works in Mexico.
Maira extends that line: the full ADOS-2 also behaves well in U.S. bilinguals.
Why it matters
You can give the ADOS-2 in Spanish without fear of inflating or hiding scores.
Pick the language the family uses every day; your numbers will still line up.
This saves time, builds trust, and keeps interpreters out of the scoring loop.
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02At a glance
03Original abstract
PURPOSE: There is limited clinical guidance on best autism assessment practices for bilingual individuals. This study aimed to examine whether Spanish-English bilingual participants display varying levels of autism symptoms on the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) when it is administered in English compared to Spanish, and whether these differences are associated with participants' dominant language. Furthermore, we explored how often participants met the ADOS-2 autism cutoff scores on both the Spanish and English administrations and compared percentages. We then used generalized linear models with random effects to examine whether the language of ADOS-2 administration (English or Spanish) predicted autism severity scores, depending on participants' Spanish exposure or usage [1-99%], while controlling for sex, verbal IQ, and autism diagnosis. METHOD: A total of 94 community-referred English-Spanish bilingual participants (age range = 1.5 years- 44.6 years) from predominantly low-income households were included, all with existing diagnoses of autism or other neurodevelopmental or mental health conditions. RESULTS: We found that, on average, the ADOS-2 yields similar severity scores when it is administered in Spanish and English with bilingual individuals. Additionally, language of the ADOS-2 administration does not predict severity scores regardless of percentage of Spanish use or exposure. CONCLUSION: We discuss how findings from this study can inform clinical practice in autism assessment for bilingual individuals, while acknowledging that language is only one aspect of culturally sensitive assessment and must be considered when working with bilingual families.
Journal of autism and developmental disorders, 2025 · doi:10.1007/s10803-025-06965-y