Posting for traffic as I'm currently with my friends whose DD had their long awaited ADOS this morning. Their DD is 7 and any difficulties or reclusive at school is passed off by school as shyness, despite them clearly have put measures in to help her such as never moving her from her seat in the classroom, letting her eat lunch away from the other children, taking her out when she can't cope and so on. The person doing the assessment said they can't give any feedback but their DD said she answered 'don't know' or 'not sure' to pretty much all the questions. What happens in this case, if a child hasn't really engaged with the ADOS?
Would it be worth asking the school to put into writing the measures they put in place for her before the next appointment, do you think? Or will the decision to diagnose or not have been made before they arrive at the next appointment?
The ADOS is so much more in-depth than just questions. I sat in on DD2's (11) ADOS as she wouldn't go in without me. Even though I was there the whole time, reading her report was really enlightening.
They pick up on tone of voice, body language, eye contact, reactions to stuff they say, and what they don't say.
If it's a complete ASD assessment, they will probably do a parental interview anyway (3DI), which asks for a history of development from birth until now. So your friend will have an opportunity to say everything that concerns her.
There is more to ados than just how a child answers questions, as has been already mentioned. They pick up on a lot more subtle behaviours. That being said, ados only picks up around 80% of kids with asd, with girls being a big percentage of those it doesn't pick up due to them being better at masking than boys. My daughter 'failed' ados and was immediately sent away as having no asd. Two subsequent asd assessments (don't ask) confirmed she did indeed have asd. Don't let them palm you off if you feel there is something there.
My DD2 did the very same thing, and I was worried about her ADOS as she is a whizz at masking. The results really surprised me as they concluded more obvious symptoms than I'd even imagined! If they've not suggested it, your friend could question the possibility of school observation too so they can evaluate her in that scene too.
Just to reassure you, I was saying I had concerns about DD2 from the age of 3. Preschool said she was copying her DS (SN). Her first school said she was malingering because her difficulties made her ill. Her second school recognised she was stressed, put her in nurture group, but then a SALT said that she was 'not having difficulties in every day life' despite obvious difficulties with language. Her third school saw her ASD traits and we finally referred to CAMHS. She was diagnosed 2 years later at age 11.