Modified COSMIC 14
To demonstrate specificity of the new measure, comparison was made between M-
COSMIC broad codes and the ADOS-G Restricted Interests/Stereotyped Behaviour algorithm
total, with the expectation that no significant associations would be apparent.
The following modifications to the ADOS and M-COSMIC scoring systems were also
adopted:
1. ADOS-G item and algorithm scores were reversed to permit greater ease of comparison with
the M-COSMIC rates of social communication, with higher scores thereby representing greater
ability on both measures.
2. To further permit meaningful comparison, some ADOS-G item scores were simplified. For
example, Overall Level of Non-Echoed Language was transformed into a 3-point ordinal scale,
with resultant scores indicating no words (original score of 8, recoded to 0), single words
(original scores of 3 and 2 combined and recoded to 1), and phrases (original scores of 1 and 0,
combined and recoded to 2), thereby paralleling the coding options available on the M-COSMIC.
ADOS-G Requesting, Showing, Spontaneous Initiation of Joint Attention, and Response to Joint
Attention were all recoded into 2-point binary items so as to similarly facilitate comparison with
the relevant M-COSMIC codes. For example, in examining ADOS-G Response to Joint
Attention, we were interested in whether children responded to the examiner’s gaze or point
(original scores of 0 and 1 combined and recoded as 1) or did not do so (original scores of 2 and
3 combined and recoded as 0). The two ADOS-G items Pointing and Gestures were reversed
scored and then combined to permit comparison with the M-COSMIC code which similarly
combines these forms.