Using the ADOS-2 for autism assessment with children with neurodisabilities: learning points and recommendations

Purpose A significant number of children with neurodisability present with traits and behaviours associated with autism. However, autism assessment tools have largely been standardised with children without complex health needs. This study aims to review the autism assessment process for children with a complex developmental condition, within a complex neurodisability autism assessment service, to help identify learning points from clinical practice that may be beneficial to other practitioners. Design/methodology/approach A clinical audit reviewing team databases and autism assessment records were undertaken to identify the profile of children accessing the neurodisability service and how the ADOS-2 assessment was adapted to meet the needs of this population. Findings The ADOS-2 required adaptations in terms of administration (e.g. how activities are delivered), and consideration needed to be given to how behaviours were coded using the ADOS-2 algorithm (to help consider how features of neurodisability may be captured on the algorithm). Practical implications This study outlines how clinicians can use the ADOS-2 assessment tool for children with complex neurodisabilities. The findings include recommendations related to setting up the room and assessment materials, adapting the administration of some activities and consideration for coding-specific items with reference to a child’s neurodisability and health conditions. Originality/value It is widely recognised that children with neurodisabilities are more likely to be autistic, and identifying this can help ensure that their autism-related needs are also met. This study provides practical recommendations from clinical practice, when, at present, there is no specific clinical guidance or assessment tools for autism assessment for children with neurodisabilities.