ADOS-2 Module 3 Guide

Communication Sample: ____________________________________________________________

1) Construction Task
Items Needed: Block puzzle and printed design - Requesting
Instructions: Place materials on the desk. Place the design and a few blocks, “I want you to put these - Eye contact
pieces together to fill in this picture. You are supposed to use all the pieces. You can start with these (hand child - Gestures
some pieces). Let me know when you need more pieces.” and gesture to blocks out of reach. If no request, look - Vocalization
deliberately at child for 3 seconds, then say “Are you doing alright?” of “How are you doing?” (pause) “Do you
need more pieces?”
Notes: After the task is complete, put the container on the table and open it. Put a few pieces into the bag and say “Let’s move on to
something else” and watch to see if the child helps.
Observations:

Eye Contact

Gesture

Requesting

2) Make-Believe Play - Creative Play

Items Needed: Doll family (5), furniture, mini book, small spoons & plates, little teapot or pitcher, mini - Imaginative
food, car, rocket, small ball, hologram disk, cloth, jewelry box. Play/Sequences
Instructions: Place the toys on the table. “Here are a princess, a wrestler, a solider, and their pet dinosaur. Here - Doll Play
are some of their things. Can you play with these for a while?” Introduce them by appearance. If the child does
not play, say, “I’ll play with these.” and demonstrate limited, creative play w/o including the child, then gesture and ask “What are you
going to do with yours?”
Throughout task, comment and show interest, but do not lead play. Asking questions can help, “That looks interesting – what are you
doing there?” “Who is this?” “Where did he come from?”
Notes: For an older child, it can be framed as a TV show or video game.
Observations:

3) Joint Interactive Play

Items Needed: Toys from make-believe play - Reciprocity
Instructions: After make-believe play is sufficient, ask “Can I play too? Who should I be?” or “Now I’d - Develops
like to join you.” and IMMEDIATELY proceed to produce a press for JI play (hand something to child’s doll). play
Notes: Make collaboration obvious. Helpful: “Who do you want to be? I’ll be the wrestler. Can you be the army - Joint
guy?” or “ Oh, Can I do that too?” Modify play as appropriate. interaction
JI Presses:
(give 4 objects)
Observations:

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4) Demonstration Task
Items Needed: Hand towel and soap - Gesture w/language
Instructions: “Now we’re going to play a different kind of pretend game. Let’s pretend that I - Miming pretend
don’t know how to brush my teeth, and I need you to teach me!” and set up play scene with appropriate objects
gestures. “Let’s pretend that this is the sink, this is the hot water, and this is the cold water.” Pretend to - Report familiar event
draw the sink with faucet. “This is the toothbrush. This is the toothpaste. And this is the cup.” Pretend to
draw these items. “Now I want you to SHOW ME and TELL ME how to brush my teeth. Start right at the beginning. You’ve just come
into the bathroom to brush your teeth. What do you do now?”
If gesture only: “That’s great. Now, TELL me AND show me again right from the beginning – from when you first came into the
bathroom.” Or “That’s great. Now can you try it again, but this time SHOW me AND tell me at the same time.”
If no response: The scene may be described once more if needed. If still not understood, demonstrate ANOTHER event before re-setting
the scene, such as driving a car or washing your hands.
Second Trial: Set pretend soap, wash cloth, face towel and sink. Say, “Now I want you to teach me how you wash your hands using
soap.” If no response, use real towel and soap.

Instructions: Demo & Inst.:

Observations:

Gestures

Language

5) Description of a Picture - Spontaneous

Items Needed: American montage scene & resort scene. Language
Instructions: “Let’s look at this picture now. Can you tell me about it? What is happening here?” - Communicative
Show interest, but do not provide more info about picture after comments. Encourage relation to own Behaviors
experiences. (I’ve never been on one have you? You’re right. Have you ever been to X?) - Interests
Notes: The focus is on language at any level, not just abstract. If minimal or no response, model one complex
observation. (Look over here. That man on the tractor must be a farmer. He’s next to a big ear of corn.” If no response, ask specific
questions. (What’s this? Who is this? What is he doing? What is happening over here?)
Observations:

6) Telling a Story from a Book - Follow &

Items Needed: Either of two picture story books. comment on story
Instructions: “Let’s look at this book. It tells a story in pictures. See, its starts out with...(describe - Affect & Social
first picture). Can you tell me the story as we go along? You go first and I’ll take a turn.” Prompt as necessary relationships
to continue the story and turn the page. After the child has told some of the story, switch and complete the story,
saying, “That was great. Now I’ll take a turn.”
Notes: Give NO MORE THAN TWO Specific prompts to start the story. (I wonder what happens next. What are all the pictures
about?)
Observations:

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7) Cartoons
Items Needed: Series A & B cartoons - Narrate a story
Instructions: The participant is told that they will now be shown some cartoons and will be asked to - Enacts gestures
retell it w/o looking at the pictures. Give a general overview of the pictures, say, “This is a story about a - Integrates gaze
fisherman and a cat,” or “This is a story about two monkeys.” Allow the participant to look through the with language
pictures and encourage him or her to comment on what is happening in each card. Clarify the story only if - Affect & Social
needed. Ask the participant to stand and retell the story. relationships
Notes: Place the participant away from anything they may lean on. Ask to retell to parent if present. (Give it a try
first, and I’ll hold up a card to help you remember if you really need it.)
Observations:

Gestures

Language

8) Conversation & Reporting - Less structured

Items Needed: None conversation
Instructions: Provide sufficient leads, guides and prompts on a topic, but not of specific interest to the - Back & Forth
participant. - Initiate new topic
Notes: Avoid stereotyped or question & answer. Provide information about self to allow follow-up. Pause to - Gaze & expression
see if continued.
Observations:

Followed Lead

Asked ?

9) Emotions - Description of own emotions

Items Needed: None - Identify concept of emotions
Instructions: Say, “Now I’d like to ask you a few questions.” - Social relationships
Notes: Two emotions must be fully discussed.
Happy: What do you like doing that makes you feel happy and cheerful? What kinds of things make you feel this
way? How DO you feel when you’re happy? Can you describe it?

Fear: What about things you’re afraid of? What makes you feel frightened or anxious? How does it feel? What do you
do?

Anger: What about feeling angry? What kinds of things make you feel that way? How do you feel “inside” when
you’re angry?

Sad: Most people have times when they feel sad. What kinds of things make you feel that way? How DO you feel when
you’re sad? What is it like when you’re sad? Can you describe that?

Content: How about feeling relaxed or content? What kinds of things make you feel that way?

- Responsibility for actions

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- Appropriateness & implications
 ADOS-2 Module 3 Guide
10) Social Difficulties and Annoyance
Items Needed: None
Instructions: Ask the following questions:
Have you ever had problems getting along with people at school (or work)? How about at home with your family? Do
you ever get in trouble? Why? What for?

Are there things that other people do that irritate or annoy you? What are they?

What about things you do that annoy others? If no response, (What about your brothers, sisters, or parents?)

Have you ever been teased or bullied? Why, do you think?

Have you ever tried to change these things? Have you ever done anything so that others wouldn’t tease you? How has
it worked?

Are there other kids/people you know who get teased or bullied?

11) Break
- Break from questions
Items Needed: Shape puzzle, drawing paper, 8 markers, pin art, spin pen, small radio,
- Observe unstructured
newspaper & magazine, material from “Make-Believe” Play
behaviors
Instructions: When appropriate, “Let’s take a break!” “I need to make some notes for a few
- Response to withdrawal –
minutes.” If no interest is shown, demonstrate a few objects. If still no interest, a snack may be
any interaction
provided if necessary. Move chair back and “take notes” for at least 2 minutes. If the participant
- Method of occupation
interacts, respond positively but briefly.
After a few seconds, engage eye contact and smile encouragingly.”I’ll be just a few more minutes.”
When finished, make it clear you have finished making notes.
Notes: If snack is offered, set two plates, but do not take food unless offered.
Observations:

12) Friends and Marriage - Insight into current and future

Items Needed: None. relationships
Instructions: Ask the following questions:
Notes: The focus is not on whether the participant has friends, but whether or not they understand the concept.
Do you have some friends? Can you tell me about them? (names, ages)

What do you like doing together? How did you get to know them? How often do you get together?

What does being a friend mean to you? How do you know someone is your friend?

How is a friend different from someone whom you just go to school with?

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Do you have a boyfriend or girlfriend? (Do you know someone who has a g/f or b/f? (name, age)

When did you last see him/her?

What is s/he like? What do you like to do together?

How do you know s/he is your boyfriend/girlfriend?

Where do you want to live when you get older? What kind of place (apartment, house, condo)?

Whom do you think you would like to live with? Your family, a roommate, by yourself?

Do you ever think about getting married when you’re older?

Why, do you think, do some people get married when they grow up?

What would be nice about it? What might be difficult about being married?

13) Loneliness
Items Needed: None. - Insight into social situation &
Instructions: Ask the following questions: reaction to it
Do you ever feel lonely?

Do you think other kids your age ever feel lonely?

Are there things that you do to help yourself feel better? What about things other people do to help themselves feel
better when they’re lonely?

14) Creating a Story - Creativity

Items Needed: 6 items with a definite purpose, 6 items with no clear purpose
Instructions: “Now you and I are going to make up stories using some of these objects. First I will pick five
things and use them to make up a story, and then you will have a turn to make up a story using five different things.” Chose five items
and create a simple, imaginative story: Use 3 objects in a novel way or not for their intended use and use 2 objects as they were intended
to be used. Remove the used item and allow the participant to take their turn.
Notes: Do not be too long or complex. Use different materials.
Observations:

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