The Autism Diagnostic Observation Schedule (ADOS-2) provides a way for clinicians to observe the social communicative behavior and play/imagination of a participant and to place these observations within a framework of standardized codes. However, the ADOS-2 is not appropriate to be administered via telehealth nor with Personal Protective Equipment (PPE). Therefore, an alternative measure is needed that can be used while COVID-19 restrictions are in place as a part of diagnostic assessments for clinicians and researchers.

The Brief Observation of Symptoms of Autism (BOSA) provides a context of activities that can be presented by an adult (e.g., a parent, therapist) within a 12–14-minute, standardized observation without PPE. Clinicians familiar with the ADOS-2 can observe the BOSA live, virtually through telehealth, or on recorded video, using it to complete many of the ADOS-2 codes that can be used to denote evidence of symptoms of autism on a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) checklist.

In the current project, Catherine Lord and So Hyun “Sophy” Kim aim to refine, standardize and disseminate the BOSA to clinical and research communities. The standardization will be carried out with pre-existing data collected from multiple past and ongoing studies, including a SFARI-funded project that is evaluating the BOSCC (Brief Observation of Social Communication Change), a Center for Autism and the Developing Brain (CADB) study of kindergarteners, CADB early intervention and toddler studies, and CADB adolescent and young adult studies.

The immediate goal of this proposal is to use existing data to develop standardized diagnostic algorithms using ADOS codes made from BOSA observations, which will be released to interested labs and clinics for use. If findings from this study show satisfactory diagnostic validity of the BOSA, the BOSA can be used in conjunction with other standardized instruments, such as the Autism Diagnostic Interview-Revised (ADI-R), to help fill the gap left by not being able to carry out a valid ADOS during the COVID-19 crisis.