Autism Diagnostic Observation Schedule in the Assessment of Cognitive Outcome in Children with Autism Spectrum Disorder in a Tertiary Medical Center of Bangladesh
Autism Diagnostic Observation Schedule in the Assessment of Cognitive Outcome in Children with Autism Spectrum
Keywords:
Autism Spectrum Disorder (ASD), Autism Diagnostic Observation Schedule (ADOS), Cognitive Assessment, Developmental Outcomes, Behavioral EvaluationAbstract
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Background: Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by social communication deficits, restricted interests, and repetitive behaviors. Accurate cognitive assessment in children with ASD is essential for guiding individualized treatment strategies, yet traditional tools often fall short in evaluating their distinct cognitive and social profiles. The Autism Diagnostic Observation Schedule (ADOS) is a standardized, play-based assessment designed to capture behavioral features of ASD, and may also offer insights into cognitive functioning. Both the generic version (ADOS-G) and the second edition (ADOS-2), including Module 1 and Module 2, were administered. Objective: This study aimed to explore the utility of ADOS in assessing cognitive outcomes among children diagnosed with ASD and to examine correlations between ADOS scores and results from standardized cognitive assessments. Materials and Methods: A cross-sectional observational study was conducted at the Institute of Paediatric Neurodisorder and Autism, Bangladesh Medical University. A total of 161 children aged 1 to 16 years, diagnosed with ASD based on DSM-5 criteria, were included. Each child was assessed using the ADOS module appropriate for their age and language level. Cognition level was measured by using BSID- Ⅱ/ⅠⅡ scales. Data on demographics, clinical characteristics, ADOS scores, and cognitive assessment outcomes were collected and analyzed using SPSS-26. Results: The mean participant age was 4.34 ± 2.17 years, with a male predominance (78.3%). Delayed or non-functional speech was reported in 64.1% of children. Key presenting issues included poor responsiveness (76.4%), limited eye contact (55.9%), and speech delay (49.7%). ADHD was the most common comorbidity (56.5%). Significant correlations were identified between ADOS communication and social interaction scores and cognitive performance, especially in language and adaptive behavior. Conclusion: ADOS proves valuable not only for diagnosing ASD but also in capturing cognitive and behavioral patterns. When integrated with standard cognitive assessments, it enhances understanding of individual developmental trajectories, informing more tailored interventions. Longitudinal studies are recommended to validate these findings and assess intervention outcomes.
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