What is the MIGDAS-2 tool for diagnosing autism?

1st November 2024

The MIGDAS-2 (Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition) is a diagnostic tool designed to identify Autism Spectrum Disorder (ASD) in children, adolescents, and adults. It offers a unique approach to diagnosis by focusing on sensory-based, individualised observations that differ from conventional diagnostic tools, such as the ADOS.

What is the MIGDAS-2?

The MIGDAS-2 is a qualitative assessment tool developed to guide clinicians through an autism diagnostic process that is tailored to each individual. Unlike many traditional tools, which rely on standardised tests and observation checklists, the MIGDAS-2 allows clinicians to focus on the individual’s sensory responses, communication style, and social interactions. It is particularly beneficial for children and adults who may not fit neatly into diagnostic categories or exhibit typical behaviours associated with ASD.

The Process

The approach includes an interview, typically involving the individual and their parent or caregiver. It is designed to be naturalistic and conversational, which helps reduce the stress or anxiety that might come with traditional clinical assessments. This atmosphere may make it easier for clinicians to observe the individual’s social communication and sensory responses, and allows the individual to describe their own experiences in their own words. This may help provide a unique insight into their developmental and social functioning.

Unlike tools that primarily assess behavioural patterns, the MIGDAS-2 emphasises sensory processing which reflects a more individualised approach that is understanding of how individuals interact with their environment.

Instead of relying on structured tests or pre-set questionnaires, the MIGDAS-2 allows clinicians to observe the individual in more flexible settings, such as family interactions. These observations can uncover autistic traits that may not be apparent in more structured or formal assessments (Klin, 2006).

Who Might Benefit from the MIGDAS-2?

The MIGDAS-2 is especially valuable for individuals who may not present with more obvious behavioural markers of autism or may mask in everyday life. It can be particularly beneficial for:

• Children with complex sensory profiles: Some children may exhibit significant sensory sensitivities but do not necessarily display the traditional signs of autism, such as social communication difficulties.

• Verbal individuals with autism: Individuals with high verbal ability, especially those who are highly articulate, may be overlooked by traditional diagnostic tools that focus on behaviour, imagination, and creativity. The MIGDAS-2’s focus on sensory and social communication patterns provides a more nuanced view, making it suitable for those with subtle signs of autism.

• Adults seeking late diagnosis: Many adults, especially women or individuals with atypical autism presentations, can go undiagnosed for years. The approach of the MIGDAS-2 can be effective for those who may have been overlooked in childhood or by other diagnostic tools.

Read here for a more detailed overview of the MIGDAS.

References

Monteiro, M. J. (2018). MIGDAS-2: Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition. WPS Publishing.