Our testing psychologist, Dr. Colleen Crooms, recently completed her second training in the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2). Dr. Crooms had previously received training and began incorporating this assessment in her evaluations for adolescents and adults. Since starting with Fundamental Psychology, Dr. Crooms wanted to further explore and practice this assessment to use with all age ranges including young children. Dr. Crooms has had significant training and experience with other Autism assessment measures including both the ADOS-2 and CARS-2. In this blog we’ll describe each assessment briefly, explain why we utilize the MIGDAS above other autism assessments and share our approach to testing here at Fundamental Psychology.
ADOS-2 is a semi-structured standardized diagnostic measure that involves scoring direct observations of the child’s interactions and that accounts for the developmental level and age of the child. It includes a standardized administration of interactive activities introduced by the examiner, designed to elicit social interactions, communication, and repetitive behaviors for the purpose of diagnosing an autism spectrum disorder.
CARS-2 is a diagnostic measure that involves an experienced professional rating the child’s behavior after direct observation. CARS-2 is a behavioral rating scale designed to differentiate autistic disorder from other developmental disorders and assess the severity of autism. The items are reflective of the definition of autistic disorder from a wide range of references and various diagnostic criteria. Scoring this measure requires some training.
There are limitations with each measure which is why it is crucial to have multiple sources of information when completing an assessment. CARS-2 is a 15-item rating scale administered by the examiner which can be completed in a brief amount of time. The ADOS-2 provides a structured, examiner driven social communication measure. Whereas the MIGDAS is a sensory based interview and provides a more individualized assessment process driven by the client.
How does the MIGDAS differ from other autism tests?
Unlike other tests for identifying forms of autism, the MIGDAS is an interview process that teaches evaluators to follow the agenda of the child to explore that child’s sensory-driven worldview as the child plays with toys and discusses preferred topics with a group of adults. It is a method that involves dynamic interaction between the evaluators and the child. The sensory toys and topics used will vary depending on the individual child’s particular interests.
With the MIGDAS, the evaluators gather systematic, descriptive information about the child in three key areas: language and communication, social relationships and emotional responses, and sensory use and interests. The descriptive profile of the child’s behavior can be compared to the behaviors typically seen in children who do and who do not have autism spectrum disorders. The MIGDAS interview protocol does not provide a score or a standardized set of numbers.
Most tests require the child to conform to the agenda of the evaluators. Children with high-functioning forms of autism are adept at following adult prompts and may not show enough of their underlying pattern of developmental differences in standardized test situations. MIGDAS allows for a neurodiversity affirming approach to follow the clients lead and symptom presentation.
Psychological evaluations follow evidence based best practices. They are comprehensive, multidimensional, and look at the whole individual. The best practices for autism evaluations has been ever adapting since the development of autism specific assessments. For years, evaluators focused on scores and numbers to quantify autism. This has been in line with traditional testing measures and guided care; however, this can be particularly difficult and cause great misunderstanding for those who do not have formal training in assessment. It also gave way to misinterpreting individuals’ functioning level based on their strengths and needs.
At Fundamental Psychology, we strive to provide neuro-affirming evaluations and care. We utilize the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2). One of the great things about this assessment is that the results are done in a more strength based narrative. Each evaluation allows the evaluator to develop a behavior profile for each individual by conducting a sensory-based interview. It also incorporates collateral information from caregivers and/or family members when applicable. The MIGDAS is a qualitative approach to the observations during evaluation and reported data from a diagnostic interview, which is then utilized in conjunction with a thorough developmental history and other autism rating scales.
In the past, the focus of autism evaluations has relied heavily on behaviors we see during testing and to make recommendations on how to improve them. As we learn more about autism and the autistic experience it is becoming more apparent that behaviors observed serve a greater purpose and do not need to be diminished. Focusing on strength based approach to understanding an individuals’ sensory needs can be more empowering and helpful for their functioning across setting. Another positive about this particular assessment is that it less structured and allows the individual more freedom as well as a supportive environment within the testing session.
Find more information about MIGDAS directly from the source: