We are excited to share that starting January 2026, our clinic will be offering ADOS-2 (Autism Diagnostic Observation Schedule – Second Edition) assessments and comprehensive written reports. These assessments will be completed by our occupational therapist (OT), who brings clinical experience supporting children with autism, ADHD, sensory processing challenges, developmental delays, and intellectual disability.
As a parent, caregiver, or professional working with a child, you may be wondering whether a formal autism assessment could offer clarity, direction, and support. Our new service aims to guide families through this process in a warm, informed, and functional way, with a focus on understanding your child as a whole person.
What Is the ADOS-2?
The ADOS-2 is the gold standard observational assessment used during autism evaluations. Rather than a paper-and-pencil test, it involves structured, play-based tasks designed to encourage natural communication, social interaction, imagination, and problem-solving.
Why the ADOS-2 is Unique
The ADOS-2 is:
- Play-based and engaging – Activities use toys, games, conversations, and real-life social interactions.
- Standardised and reliable – Every child completes tasks designed specifically for their age and language level.
- Flexible across ages and abilities – Modules exist for children who are non-speaking through to highly verbal teenagers.
- Focused on real-time behaviour – It provides insight into how a child interacts socially in the moment.
What the ADOS-2 Observes
The Occupational Therapist will observe:
- How your child shares attention, initiates interaction, or responds to social cues.
- Eye contact, facial expressions, gestures, and body language.
- Use of language for social purposes.
- Play skills, imagination, and problem-solving.
- Sensory responses, repetitive behaviours, or rigid patterns.
- Emotional expression and regulation.
The ADOS-2 does not diagnose on its own, but it is one of the most important tools used to support autism evaluations, alongside history, developmental information, and other assessments.
Signs That a Formalised Autism Assessment May Be Helpful
Autism looks different in every child. Some children show obvious signs early on; others present with more subtle behaviours or mask their difficulties. Below are signs (both common and lesser-recognised) that may indicate an assessment could be useful.
1. Social Communication Differences
These may include:
- Limited or inconsistent eye contact.
- Preferring predictable interactions over spontaneous ones.
- Difficulty initiating conversations or play.
- Talking “at” others rather than “with” them.
- Repeating phrases (echolalia) or using memorised scripts.
- Challenges understanding jokes, sarcasm, idioms, or unspoken social rules.
- Strong verbal skills but struggles with social communication.
- Difficulty recognising when others are bored, upset, or confused.
Some children may appear social but rely heavily on copying peers or rehearsed scripts, making challenges harder to identify.
2. Sensory and Behavioural Differences
These differences often affect comfort, mood, and participation.
Children may:
- Be highly sensitive to noise, clothing textures, water on skin, lights, or crowds.
- Seek sensory input by touching everything, spinning, jumping, or rocking.
- Have strong preferences for certain foods or avoid many textures.
- Become overwhelmed in busy environments.
- Show unusually high or low pain tolerance.
- Display repetitive movements (hand flapping, pacing, toe walking, finger fluttering).
3. Rigid Routines and Deep Interests
Children may show:
- Intense, highly detailed interests (e.g., dinosaurs, trains, astronomy, characters, maps, animals, violence).
- A need for predictability; distress when routines change.
- Difficulty shifting attention from preferred activities.
- Strong emotional reactions to unexpected events.
- Rigid play patterns (lining up toys, repeating the same game, scripting scenes).
4. Emotional Regulation & Internal Signs
Some children, especially those who mask, may internalise their struggles.
You may notice:
- After-school meltdowns or shutdowns from holding it together all day.
- Anxiety about social situations.
- Extreme fatigue, irritability, or “burnout”.
- Difficulty identifying or describing their emotions.
- Avoiding school or social events due to overwhelm.
- These signs are equally important as outward behaviours.
How Autism May Present Differently in Boys and Girls
Autism is not “one size fits all” and gender can play an important role in how traits are expressed.
Boys often show more obvious or outward behaviours, such as:
- Visible repetitive movements.
- Difficulty understanding social rules.
- Strong, sometimes unusual special interests.
- More noticeable behaviour changes when routines shift.
- Clear developmental communication differences.
- Because these signs are well known, boys are often referred for assessment sooner.
Girls are frequently under-diagnosed or diagnosed much later because their signs may be more subtle, such as:
- Mask or imitate others to fit in.
- Have strong social motivation but struggle with the “unwritten rules”.
- Develop deep, intense interests that appear typical (e.g., animals, books, celebrities, crafts).
- Hide their sensory struggles to avoid standing out.
- Internalise distress – leading to anxiety, perfectionism, or exhaustion.
- Be seen as “shy,” “quiet,” “daydreamy,” or “well behaved” rather than autistic.
Without assessment, these girls often go unsupported for years.
Understanding Masking: Why Autism Can Be Hard to See
Masking is when a child hides their autistic traits to blend in. This can be conscious or unconscious.Children who mask may:
- Copy classmates’ social behaviour.
- Force themselves to make eye contact.
- Rehearse phrases or scripts.
- Stay quiet to avoid mistakes.
- Suppress stimming.
- Use intense focus and effort to appear “typical”.
Masking can lead to:
- Exhaustion.
- Anxiety.
- Mood challenges.
- Burnout.
- Meltdowns at home after a long day.
A formal assessment like the ADOS-2 helps reveal underlying challenges, even when traits are partially hidden.
Our Assessment Process, What Families Can Expect
We aim for a clear, supportive, and family-centred experience.
1. Initial Information Gathering
We meet with you to learn about your child’s development, challenges, strengths, and daily routines. With your permission, we may also collect information from:
- Teachers
- Paediatricians
- Speech pathologists
- Psychologists or therapistsThis builds a complete and accurate picture.
2. Additional Standardised Assessments (If Needed)
To support a thorough evaluation, the OT may use:
- Sensory Profile 2 – to understand your child’s sensory processing patterns.
- Vineland-3 Adaptive Behaviour Scales – to assess communication, daily living skills, socialisation, and motor abilities.
These help strengthen diagnostic clarity and practical recommendations.
3. ADOS-2 Session With Your Child
Your child attends a structured, play-based ADOS session with our trained OT. Activities are designed to encourage social communication, creativity, and interaction in a comfortable environment.
4. Comprehensive Report & Recommendations
Following the assessment, the OT prepares a detailed written report including:
- ADOS-2 results.
- Findings from additional assessments.
- A functional analysis of day-to-day impacts.
- Brief recommendations for supports and next steps.
This report can be shared with your child’s paediatrician or psychiatrist to support a formal diagnosis.
Why Having an OT Complete the ADOS-2 Is Beneficial
Occupational therapists bring a unique, functional lens to autism assessment. OTs look beyond the diagnosis to understand:
- How autism affects self-care
- Play, emotional regulation, and relationships
- School participation
- Sensory needs throughout the day
- Family routines and stressors
A sensory-informed perspective
Autism and sensory processing differences often overlap. An OT is well-positioned to observe, interpret, and explain those connections.
Practical, meaningful recommendations
Your report will include strategies that are:
- Relevant
- Realistic
- Tailored to your child’s everyday environment
The goal is to help your family understand not just what is happening, but why, and what supports will make life easier and more fulfilling for your child.
Ready to Learn More or Book an Appointment?
Appointments for January assessments are now open. If you have concerns about your child’s development or have been encouraged to explore an autism assessment, we are here to guide you through every step with compassion and clarity.
Please contact our clinic to book, ask questions, or discuss whether an ADOS-2 assessment is right for your child.
Find out more about ADOS assessment.