¿Es indispensable el ADOS-2 para el diagnóstico de autismo?

The ADOS-2 is often described as the “gold standard” for diagnosing autism, but this label is misleading. The manual itself indicates that it should not be used in isolation to confirm or rule out a diagnosis, but rather as part of a comprehensive clinical evaluation. Its development was based primarily on male samples and does not incorporate sex-specific norms, which leads to significant biases: for example, in adults with a previous community diagnosis, it can exclude up to 50% of women compared to only 19% of men (D’Mello et al., 2022). Furthermore, its specificity is reduced in the presence of other conditions, increasing false positives and negatives. Therefore, relying exclusively on the ADOS-2 does not guarantee accurate or representative identification of all autistic diversity, and its use should always be integrated with clinical judgment, life history, and self-report.