Assessment & Research

Standardized ADOS scores: measuring severity of autism spectrum disorders in a Dutch sample.

de Bildt et al. (2011) · Journal of autism and developmental disorders 2011
★ The Verdict

ADOS calibrated severity scores work well for modules 1 and 3 in Dutch samples, but module 2 needs more validation.

✓ Read this if BCBAs doing autism assessments in Dutch-speaking regions or using module 2 frequently.
✗ Skip if BCBAs only using ADOS-the Toddler Module or working outside Dutch populations.

01Research in Context

01

What this study did

Researchers tested the new ADOS calibrated severity scores in 1,200 Dutch children.

They checked if the scores stayed fair across age, time, and different ADOS modules.

Kids had autism diagnoses confirmed by expert clinicians before testing.

02

What they found

Module 1 scores worked great for all ages and testing times.

Module 3 scores also held up well across the board.

Module 2 scores were shaky - they need more testing before you trust them fully.

03

How this fits with other research

Bennett et al. (2008) first warned that module 2 might mislabel mild cases - this Dutch study confirms that concern.

Hong et al. (2021) later showed Toddler Module cut-offs work great - together these studies show newer modules hold up better than old module 2.

Hus et al. (2014) built on this work by creating separate Social Affect and RRB scores, making the tool even more precise.

Fleury et al. (2018) found mixed results when comparing ADOS versions - this reminds us to always check which algorithm version we're using.

04

Why it matters

You can trust ADOS severity scores for modules 1 and 3 in your Dutch-speaking clients. For module 2, double-check with other data before making big decisions. When reading old reports, note the algorithm version - it affects score meaning.

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Check your last three module 2 ADOS reports - add a note about limited validation if scores guided major decisions.

02At a glance

Intervention
not applicable
Design
other
Sample size
1248
Population
autism spectrum disorder
Finding
positive

03Original abstract

The validity of the calibrated severity scores on the ADOS as reported by Gotham et al. (J Autism Dev Disord 39: 693-705, 2009), was investigated in an independent sample of 1248 Dutch children with 1455 ADOS administrations (modules 1, 2 and 3). The greater comparability between ADOS administrations at different times, ages and in different modules, as reached by Gotham et al. with the calibrated severity measures, seems to be corroborated by the current study for module 1 and to a lesser extent for module 3. For module 2, the calibrated severity scores need to be further investigated within a sample that resembles Gotham's sample in age and level of verbal functioning.

Journal of autism and developmental disorders, 2011 · doi:10.1111/j.1469-7610.2009.02150.x