Useful for adolescents and adults, especially those seeking late diagnosis or exploring neurodivergence. 

RAADS-R (Ritvo Autism Asperger Diagnostic Scale – Revised) 

Often used in adult assessments; explores internal experiences and masking. 

AQ (Autism-Spectrum Quotient) 

Short screener; not diagnostic, but a helpful first step

CAT-Q (Camouflaging Autistic Traits Questionnaire) 

Measures masking behaviors; often used in affirming adult assessments. 

Age Range: 3 years - adulthood

Format: Semi-structured, sensory and conversation-based interview

While the ADOS-2 is a respected tool, it is not required for an autism diagnosis. In fact, it may under-identify autism in females, gifted/twice-exceptional individuals, and those who mask or camouflage their traits. These individuals often “pass” the ADOS-2 due to their ability to perform well in structured social settings, even when underlying autistic traits are present.

The MIGDAS-2, by contrast, is specifically designed to capture subtle and internalized traits that may go unnoticed with performance-based measures like the ADOS-2. This makes it a more sensitive and inclusive tool for many neurodivergent individuals.

Affirming and Person-Centered Approach

The MIGDAS-2 aligns with our commitment to neurodiversity-affirming practices. Rather than focusing on deficits, it invites individuals to share their preferred topics, experiences, and sensory profiles. This conversational, strength-based approach reduces the pressure to perform or mask, allowing the clinician to observe more authentic behaviors and thought processes.

As Dr. Marilyn J. Monteiro, Ph.D., creator of the MIGDAS-2, explains:

“The MIGDAS-2 diagnostic interview process invites individuals to share their worldview through the entry point of preferred topics and sensory materials. When social communication demands are minimized and the individual’s worldview is encouraged and respected, masking becomes unnecessary. Many individuals who typically mask report a sense of relief that their experiences are recognized and understood.”

Effective for Gifted and Twice-Exceptional (2e) Individuals

Gifted or twice-exceptional individuals often intuitively understand what’s expected in structured testing environments like the ADOS-2, leading to false negatives. The MIGDAS-2, however, bypasses performative responses and instead explores the individual’s natural communication style, sensory responses, and inner experiences, which are often more revealing in 2e populations.

Our Clinical Philosophy

Our goal is to provide evaluations that are not only clinically accurate, but also respectful, validating, and tailored to the individual. The MIGDAS-2 allows us to meet clients where they are, creating an environment where their authentic self can be seen and understood—free of judgment or artificial expectations.

Age Range: 12 months - adulthood

Format: Structured behavioral observation

The ADOS-2, or Autism Diagnostic Observation Schedule – Second Edition, is a standardized, semi-structured assessment used to evaluate social communication, interaction, play, and restricted or repetitive behaviors associated with Autism Spectrum Disorder (ASD).

What Does the ADOS-2 Do?

The ADOS-2 is used by trained clinicians to observe and score behaviors that are commonly associated with autism. It does not rely on self-report or questionnaires. Instead, the evaluator engages the individual in a series of structured activities and social interactions designed to elicit specific responses. These responses are then rated using a standardized scoring system.

What Is It Used For?

• To support an autism diagnosis as part of a comprehensive evaluation.

• To help clarify diagnostic uncertainty in complex cases.

• Occasionally used in research settings due to its standardized format.

What Makes It the “Gold Standard”?

The ADOS-2 is often referred to as a "gold standard" tool because:

• It is widely used and researched.

• It follows a standardized protocol across different clinicians and settings.

• It allows for direct observation of behaviors related to autism.

However, "gold standard" does not mean it's always the most accurate or most inclusive tool for every person. For example, it may miss autistic traits in females, adults, and people who mask or camouflage their symptoms.

Limitations of the ADOS-2

Despite its strengths, the ADOS-2 has several important limitations:

• May not detect autism in individuals who are:

  • Verbally articulate

  • Highly intelligent or gifted (2e)

  • Female or nonbinary

  • Skilled at masking

• Cultural bias may affect how some behaviors are interpreted.

• Performance-based: May not reflect the person’s true day-to-day functioning.

• It’s not required for an autism diagnosis (per DSM-5 criteria).

Age Range: 2.5 years - adulthood

Format: Parent, teacher or self-report

The Social Responsiveness Scale – Second Edition is a standardized questionnaire used to measure social behavior, communication, and repetitive/stereotyped behaviors associated with autism spectrum disorder (ASD). It is widely used for screening, diagnosis support, and treatment planning across children, adolescents, and adults. 

What Does It Measure? 

The SRS-2 evaluates autistic traits across five key domains: 

1. Social Awareness – Ability to pick up on social cues 

2. Social Cognition – Ability to interpret social cues 

3. Social Communication – Expressive social communication skills 

4. Social Motivation – Interest and motivation in social interaction 

5. Restricted Interests and Repetitive Behavior – Rigidity, repetitive actions, preoccupations 

It provides both domain-level scores and an overall Total Score that reflects the severity of social difficulties. 

Versions of the SRS-2 

There are different forms tailored to age and setting: 

• Preschool Form (2.5–4.5 years) 

• School-Age Form (4–18 years) 

• Adult Form (19+ years) 

• Teacher and Self-Report Forms (when appropriate) 

There’s also a short form version with fewer items, useful for settings where time is limited. 

Strengths 

• Quick and easy to administer 

• Captures a range of autism traits, not just diagnostic thresholds 

• Validated across multiple languages and cultures 

• Useful for mild and subclinical presentations, including high-functioning and masking individuals 

Limitations 

• Not diagnostic on its own meant to complement a full clinical evaluation 

• May be influenced by rater bias, especially in school settings 

• Not ideal as a standalone tool for nonverbal or minimally verbal individuals 

In Summary 

The SRS-2 is a valuable tool in autism assessment and research. It helps quantify the severity and nature of social communication difficulties and repetitive behaviors across a wide spectrum of individuals. 

It is most useful when: 

• Screening for autism risk 

• Supplementing diagnostic evaluations (e.g., with ADOS-2 or MIGDAS-2) 

• Tracking changes over time 

Age Range: 2 years +

Format: Observation + parent interview

The CARS-2 (Childhood Autism Rating Scale, 2nd Edition) is a clinician-rated behavioral assessment used to help identify Autism Spectrum Disorder (ASD) in children and adolescents. It is designed to distinguish children with autism from those with other developmental delays or behavioral challenges.

What Does CARS-2 Measure?

The CARS-2 evaluates 15 key behavioral areas commonly associated with autism, including:

• Relating to people

• Emotional response

• Body use

• Object use

• Adaptation to change

• Visual and listening response

• Taste, smell, and touch response

• Verbal and nonverbal communication

• Activity level

• Intellectual response

• General impressions

Each item is rated on a 4-point scale (from “within normal limits” to “severely abnormal”), allowing clinicians to generate both a total score and a severity rating.

Strengths of the CARS-2 

• Flexible across developmental levels – Useful for both minimally verbal and verbal individuals 

• Efficient – Takes less time than many other diagnostic tools (e.g., ADOS-2, ADI-R) 

• Clinician-friendly – Combines observation with caregiver input 

• Provides a severity rating (mild, moderate, severe), which can support treatment planning 

• Good sensitivity for differentiating autism from other developmental delays 

Limitations 

• Less detailed than ADOS-2 or MIGDAS-2 – May not capture more nuanced presentations (e.g., camouflaging, subtle social challenges) 

• Subjective scoring – Relies on clinician judgment and may be influenced by experience level 

• Not ideal for self-report or telehealth settings 

• May under-identify females, gifted/2e individuals, or those who mask well 

Age Range: 2 - 18 years old

Format: Parent and Teacher rating forms

The ASRS is a standardized, norm-referenced questionnaire designed to identify and quantify behaviors associated with Autism Spectrum Disorder (ASD) in children and adolescents. It is often used as part of the initial screening or diagnostic process, particularly in educational and clinical settings. 

What Does the ASRS Measure?

The ASRS is designed to evaluate autistic traits across multiple domains, aligned with DSM-5 criteria. It captures both core symptoms and associated behaviors commonly observed in autism.

Key scales include:

Main Scales:

1. Social/Communication

2. Unusual Behaviors

3. Self-Regulation

Subscales (examples):

1. Peer socialization

2. Social/emotional reciprocity

3. Stereotypy

4. Behavioral rigidity

5. Attention/self-regulation

Each item is rated on a 5-point Likert scale (from “Never” to “Very Often”), assessing frequency and severity of specific behaviors.

Strengths of the ASRS

• Norm-referenced: Compares an individual's scores to a large, representative sample

• Multi-rater perspective: Combines parent and teacher input

• DSM-5 aligned: Supports modern diagnostic criteria

• Useful for early identification, especially in school settings

• Quantifies symptom severity to assist with treatment decisions and IEP planning

Limitations

• Not diagnostic on its own—meant to be part of a comprehensive evaluation

• May miss subtle traits in high-masking individuals or those with high verbal IQ

• Relies on rater accuracy can be biased by the observer’s experience or expectations

• Less effective for non-speaking children or those with limited observable behavior in a school setting

In Summary

The ASRS is a versatile, evidence-based tool for evaluating autism-related behaviors in children and adolescents. Its structured format and strong psychometric properties make it especially useful for:

• Initial screenings

• Progress monitoring

• School-based evaluations

• Diagnostic support when used alongside other tools (e.g., ADOS-2, MIGDAS-2, Vineland-3)

Age Range: 6 months - adulthood

Format: Remote-friendly behavioral observation

Developed during COVID as an alternative to ADOS: flexible for telehealth

Age Range: 2 years - adulthood

Format: Structured parent interview

The ADI-R (Autism Diagnostic Interview–Revised) is a comprehensive, semi-structured clinical interview used to help diagnose Autism Spectrum Disorder (ASD) based on the individual’s developmental history and current behavior. It is often used in combination with the ADOS-2 or other diagnostic tools as part of a multidisciplinary evaluation.

What Does the ADI-R Assess?

The ADI-R focuses on three core areas of functioning as defined by the DSM-IV and compatible with DSM-5 criteria:

1. Social interaction

2. Communication and language

3. Restricted and repetitive behaviors and interests

Additionally, it includes questions about early development, behavioral history, and onset of symptoms—making it especially valuable for differentiating autism from other neurodevelopmental conditions.

Structure of the Interview

The ADI-R consists of 93 items, including both structured questions and open-ended prompts. The clinician rates each response on a 0–3 scale based on symptom severity and relevance to the autism criteria.

Sample Topics Covered:

• Reciprocity and emotional sharing

• Use of eye contact, gestures, and facial expressions

• Peer relationships

• Language development and abnormalities

• Repetitive use of objects or phrases

• Unusual sensory responses

• Early developmental delays

Strengths of the ADI-R

Developmentally comprehensive - Captures lifetime history, not just current behavior

Gold-standard status - Often paired with ADOS-2 in research and clinical settings

Strong psychometric support - High reliability and validity

Helpful in complex or subtle cases - Especially when direct observation is inconclusive

Culturally flexible - Available in many languages and validated internationally

Limitations of the ADI-R

Time-intensive - Takes 1.5–2.5 hours; may be burdensome for families

Requires extensive training - Not for casual or untrained use

Heavily reliant on caregiver memory - Can be limited by recall accuracy, especially in older clients

Less useful in adults with no clear developmental history - Limited applicability for late-diagnosed adults or those estranged from family

Focused on childhood behaviors - May under-represent how autism manifests in females, gifted/2e individuals, or those who mask

In Summary

The ADI-R is a powerful diagnostic tool that provides a deep, structured exploration of developmental history and autism-related traits. It is best used:

• In combination with the ADOS-2, MIGDAS-2, or other clinical observations

• When the diagnostic picture is unclear or complex

• For research settings requiring standardized diagnostic criteria