What is the ADOS-2?
The ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition) is a standardised, evidence-based assessment tool used worldwide to help diagnose autism spectrum condition. It is considered the gold standard for autism assessment and is recommended by NICE guidelines.
The ADOS-2 involves structured activities and conversation designed to observe how a child or young person communicates, interacts and responds in social situations. It is not a test with right or wrong answers — it is a carefully designed way for a trained clinician to observe your child's natural social communication style.
How it fits into the full assessment
At Dr Ziv's practice, the ADOS-2 is one part of a comprehensive three-meeting assessment:
Meeting 1
Initial Assessment
Detailed clinical interview with parents. Developmental history, family background and concerns.
Meeting 2
ADOS-2
Structured observation of your child. Face-to-face only. This is the session described on this page.
Meeting 3
ADI-R Interview
Structured diagnostic interview with parents. Diagnosis discussed and support plan agreed.
What happens during the ADOS-2
The session lasts approximately 1–1.5 hours and takes place face-to-face (this assessment cannot be done remotely). It is conducted by Dr Ziv in a calm, comfortable clinic environment.
The session involves a series of activities tailored to your child's age and language level. These are designed to feel natural and engaging — not like an exam. Activities might include:
Conversation — chatting about interests, daily life, friendships, feelings. The content matters less than how your child communicates.
Storytelling — using a picture book or creating a story together to observe imagination, narrative skills and social referencing.
Imaginative play — for younger children, using toys and props to see how they engage in pretend play.
Social activities — activities designed to observe turn-taking, eye contact, shared attention, and how your child responds to social cues.
Emotional understanding — discussing emotions, facial expressions, or social scenarios to understand how your child processes social information.
The specific activities used depend on which "module" of the ADOS-2 is selected — this is determined by your child's age and language ability. Dr Ziv selects the appropriate module based on the information gathered in Meeting 1.
How to prepare your child
Keep it low-key. You don't need to do anything special to prepare. The ADOS-2 works best when your child is relaxed and behaving naturally.
Use simple language. You might say: "We're going to see Dr Ziv again. She'd like to spend some time with you, playing some games and chatting. There are no right or wrong answers."
Bring a comfort item. If your child has a favourite toy, fidget or snack, bring it along. Feeling comfortable is more important than anything else.
Don't coach. Please don't rehearse social behaviours or remind your child to make eye contact. The assessment needs to see your child's natural style — that's what makes it accurate.
It's okay if your child is anxious. Many children are nervous about new situations. Dr Ziv is experienced at putting children at ease and will take the time needed.
Will parents be in the room?
For the ADOS-2 session specifically, parents are usually not in the room. This is intentional — the assessment observes how your child communicates independently, without the support or prompting that naturally happens when a parent is present.
If your child is very young or very anxious, Dr Ziv will discuss the best approach with you. Some flexibility is possible, and your child's comfort always comes first.
What happens after the ADOS-2
The ADOS-2 is scored using a standardised system. The results are combined with information from Meeting 1 (clinical interview) and Meeting 3 (ADI-R parent interview) to reach a diagnostic conclusion.
Diagnosis is never based on the ADOS-2 alone — it is one piece of a comprehensive clinical picture that includes developmental history, school information, parental observations and the clinician's overall clinical judgement.
Following the full assessment, you will receive a detailed written report with clear conclusions, recommendations and a personalised support plan.
Why the ADOS-2 matters
It's the gold standard. The ADOS-2 is the most widely validated autism assessment tool in the world. It is recommended by NICE and used by leading diagnostic services internationally.
It's fair and standardised. Every child is assessed using the same structured framework, ensuring consistency and reliability.
It captures what questionnaires can't. No questionnaire can replace direct observation of a child's social communication in real time. The ADOS-2 provides information that simply cannot be obtained any other way.
Reports carry weight. A diagnosis supported by ADOS-2 and ADI-R is recognised and respected by schools, local authorities, EHCP panels and other professionals.
Considering an autism assessment?
Gold-standard ADOS-2 and ADI-R assessment by a Consultant Psychiatrist and Paediatrician. Appointments typically available within 2–4 weeks.
Get in Touch for an AssessmentWritten by Dr Shimrit Ziv, Consultant Child and Adolescent Psychiatrist and Paediatrician. Dr Ziv provides private autism assessment using ADOS-2 and ADI-R for children and adolescents aged 5–18 in Cambridge and remotely across the UK.