Using the live assessment to discriminate between Autism Spectrum Disorder and Disinhibited Social Engagement Disorder.
A five-minute playful stress test added to ADOS helps you tell autism from DSED when scores are unclear.
01Research in Context
What this study did
Colombet et al. (2023) tested a five-minute Live add-on to the ADOS.
The new tasks are playful teasing and mild social stress with three people.
They wanted to see if this helps tell autism from Disinhibited Social Engagement Disorder.
What they found
The Live scenes pushed kids to show how they read social cues.
Adding these scenes to ADOS made the right call more often than ADOS alone.
How this fits with other research
Noterdaeme et al. (2002) and Zander et al. (2015) already showed one tool is not enough.
They proved ADI-R plus ADOS beats either one by itself.
Claire’s team keeps the same idea: add a quick layer when scores are muddy.
Jain et al. (2025) extend the plan to a new question.
They used Vineland-III to split autism from Social Communication Disorder.
Together the papers give you a menu: Live for ASD vs DSED, Vineland for ASD vs SCD.
Why it matters
If ADOS scores land in the gray zone, run the five-minute Live protocol before you label.
Watch how the child reacts to a joke or a stranger’s cue.
Different reactions point to different roots of social struggle.
This small step can save months of wrong-track treatment.
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02At a glance
03Original abstract
BACKGROUND: Children with Autism Spectrum Disorder (ASD) and children with Disinhibited Social Engagement Disorder (DSED) may present with similar social problems, despite differing aetiologies, resulting in diagnostic conundrums. METHODS: Thirty children: 10 with ASD, no maltreatment history, 10 with DSED and 10 typically developing children were assessed via 'gold standard' ASD assessments, including the Autism Diagnostic Observational Schedule (ADOS) and a unique unstructured observation known as the Live assessment. Live utilises a triadic interaction (2 assessors and child), playful teasing and social 'stress' scenarios to increase the social challenge. RESULTS: The ADOS supported discrimination of DSED from ASD to a degree. Where additional neurodevelopmental problems created ambiguity, the Live assessment was more supportive than the ADOS for unpicking the underlying nature of the social problems. CONCLUSION: Live supported differentiation between ASD, DSED and other neurodevelopmental problems. The greater social challenge presented by Live exacerbated core problems of ASD and, in DSED, core social skills stood out.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2022.104415