ADOS and what to expect

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For just over two years I was a patient in a secure psychiatric unit owing to a run-in with the law that was initially assumed to be due to untreated bipolar disorder although my psychologist is of the view that my Aspergers (which wasn't diagnosed until I was in the unit) was the cause of most of the actual problem with the bipolar just being the cherry on top. I was discharged five months ago although I still receive hefty support from the unit and the local community mental health team.

Anyway, one of the occupational therapists has been doing the training to allow you to assess for autistic spectrum disorders using the ADOS and as part of her assessment to determine whether she has passed the training and is therefore qualified to administer the ADOS in future she needs to do the structured interview/assessment with someone who has a clinical diagnosis of an ASD.

I'm happy to do it in order to help her out (plus, she's kind of cute) but what can I expect from it? It will be video recorded.

I've been doing some reading on the ADOS and it is supposed to be very good at picking up on social and communication difficulties which I struggle with immensely. There are different modules which can be used dependent upon various factors - I'm assuming she'll be using module four which is for subjects who are adolescents or adults with a high degree of fluency.

What does concern me about it is that I have already have some sort of a rapport with the lass. When I was in the unit, we used to spend a couple of hours a week doing cooking sessions making things like sushi during which she'd engage with me in conversation and we got a perfunctory working relationship in place. As I know her, at least in a professional capacity, i feel much more comfortable engaging in things like eye contact with her although I don't do it much with her.

Would the fact that there exists a degree of rapport impact on the assessment? It's not going to impact on my diagnosis or the help and support I receive plus, despite the fact I know her reasonably well, I have had meltdowns on her before or have just been flat-out refusenik about doing things that she'd like me to do.

I would think for her to obtain a decent and honest success she should only be assessing new people she doesn't know.

I don't think it would have much of an impact, in that, her assessment of you might not be quite what it would have been if she didn't know you, but she still should be able to do an assessment based on your answers to the questions and what she observes in the video. She'll be assessed on how she assesses you using the ADOS guidelines, so as long as she can do that it should be fine. She might even make a note in her assessment that you already have a rapport, if she picks up that your eye contact is better than expected or something like that.

You'll have to answer a bunch of questions about yourself and do some games and tasks. Honestly, I don't think your rapport with her will impact on how comfortable you feel doing some of the tasks. I'd feel just the same doing some of them with a friend watching - in fact, that might even make it worse.

I say go for it.

I agree that it likely would affect the test.
With people I know, and like, and trust, my social crap kinda reverses. I can easily make and hold eye contact, I can easily create and maintain conversations. Physical contact can be a temporary non issue. I'm often even borderline gregarious.
My V-8 may operate on all 10 cylinders.

Social crashes are not inevitable with strangers, but when the do happen they're more devastating.
It's not the good times but the devastating times that are what demonstrate a disability, and that it is adversely affecting one's life.

On the third hand this is their test, I'd expect they know what they should be doing. Perhaps her previous knowledge of you will help her to interpret your responses more accurately.

^ Yeah I think it kind of depends on what the ADOS is testing, and I don't know the answer to that as I've taken it but not learnt about it.

What I mean is, for example, does it assess:
- eye contact?
- eye contact with strangers?
- eye contact with acquaintances/friends?

If it is just testing eye contact in general without considering the relationship between the subject and the observer, then it's not the greatest test anyway since these factors can have an impact. If it's specifically testing eye contact with strangers, then hopefully she is professional enough to realise that your relationship with her might have an impact. She can choose not to test you, and she would know more about the test that you, so I'd leave it up to her to make the call.