RoseAnnieFlo

I’ve spent the last 3 days attending the ADOS-2 training. It was very informative, and a reminder of how much detail we can observe in a short space of time. One part is nagging me: the examiner offers small social openings, such as a comment about something they did, to see whether the person picks up on them and responds with interest or a question. This runs against the usual social norms of a clinical encounter. Patients are not generally expected to ask a doctor or healthcare professional about their weekend or their interests, and many would consider it inappropriate. So I am left wondering: when someone doesn't take up the invitation, how do we distinguish reduced social reciprocity from a learned respect for professional boundaries? And how much do cultural background, anxiety, or past experiences with healthcare shape that response? Of course, a diagnosis rests on far more than this one observation. But for adults in particular, I wonder whether this task risks picking up social learning rather than social difficulty. I would be interested to hear how experienced ADOS assessors think about this.