Formal Psychological Assessment for Autism Spectrum Disorder Diagnosis: A New Methodology to Build An Adaptive Testing System

Maria Chiara Pino1, *, Andrea Spoto2, Melania Mariano1, Umberto Granziol2, Sara Peretti1, Francesco Masedu1, Marco Valenti1, 3, Monica Mazza1, Giulio Vidotto2
1 Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
2 Department of General Psychology, University of Padua, L’Aquila, Italy
3 Reference Regional Centre for Autism, Abruzzo Region Health System, L’Aquila, Italy

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Creative Commons License
© 2018 Pino et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; Tel: 00390862434658; E-mail:



Early identification of Autism Spectrum Disorder (ASD) is of paramount importance in establishing effective interventions. Currently, the accepted gold standard for ASD diagnosis is the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2).


In our research study, we applied a novel approach to the ADOS-2 known as the Formal Psychological Assessment (FPA). The innovation of this methodology comes from the construction of a matrix that allows (1) the identification of the existing relations among items in terms of clinical symptoms and (2) an adaptive assessment of an individual.


The aim of this study was to use a practical application of the FPA on the ADOS-2 and show its potential for psychological assessment of individuals with ASD. Particularly, this research raises some important considerations regarding the evaluation of this population and the authors propose future work to improve the quality of clinical assessment.


Our results suggest potential for the application of this new methodology to the ADOS-2 to support clinicians using diagnostic procedures.


The use of FPA allows analysis of each item of ADOS’s modules based on the presence/absence of clinical elements. This system allows the identification of the critical areas for each individual and reduces the number of items required for the test.

Keywords: Autism Spectrum Disorder (ASD), Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), Diagnosis, Formal Psychological Assessment (FPA), Adaptive testing system, Methodology.