Beyond the EU: DORA and NIS 2 Directive's Global Impact
Best practices in ASD Assessment 1
1. Assessment of Children with Autistic
Spectrum Disorders: Best Practices
for Educators
Kristine Strong, Ph.D.,LEP #2314
Copyright 2012
2. Goals of the Workshop
Increase knowledge and awareness of
effective assessment tools and methods for
ASD
Develop understanding about
multidisciplinary assessment teams
Develop understanding about the importance
of the parent - school relationship and
working effectively with parents
Learn about current evidence based practices
Develop skills in IEP development
3. ASD Is A “Spectrum” Disorder
“Spectrum” ranges from mild (more able) to
severe (less able).
Mild = High-functioning Autism (HFA),
Asperger’s Syndrome, PDD, PDD-NOS
Moderate = Classic Autism (As described by
Kanner)
Severe = Autism with other collateral
conditions such as MR and seizures, Retts
Disorder(females only), Childhood
Disintegrative Disorder (rare), Landau-Kleffner
Syndrome.
3
4. Statistics
Autism is increasing at an
alarming rate.
Department of Developmental
Services study: rates of
autism have risen 210% in the
past 10 years.
Increase of over 600% for
Special Education eligibility
under the autism category
from 1994 to 2003 (US Dept
of Ed).
4
5. Why the Increase?
1975 Education of the Handicapped Act identified
“autism” and “pervasive developmental delay” as
disabling categories. Prior to that change persons were
labeled as MR.
DSM IV broadened the disability to include PDD-NOS,
Autism and Asperger’s Syndrome.
1990 IDEA made autism a qualifying disability category.
Many studies being conducted, with a causation model
including both genetic predisposition and environmental
variables -- no one cause likely
5
6. The Anatomy of Autism
Neuro-imaging (fMRI
and PET scans)
indicate location of
pathology
Multiple brain
systems and brain
functions are
impacted by this
disorder
7. Three Types of Autism?
Center for Autism is considered to
Excellence in have a strong genetic
Developmental component.
Disabilities UC Pattern of onset may be
related to specific type
Davis MIND of autism:
research: Predominant language
Interactive models regression
Predominant social
of ASD include regression
multiple Early onset in both social
environmental and language
variables and gene development
interactions.
8. Deviation In:
Hippocampus and amygdala (emotional
regulation and memory)
Cerebellum (motor coordination, shifting
attention, concept formation, sequencing,
working memory, complex problem solving,
sensory discrimination)
9. Deviations In:
Brain stem (brain/body communication, basic
functions)
Brain size, growth pattern, and white matter (axons
-cables connecting brain cells)
Brain microstructures, minicolumns are narrower and
made up of smaller cells vs. normal brain
Neocortex
Particularly frontal lobe (higher level thinking and executive
functions, early speech acquisition, and integration of
information)
temporal lobes (auditory processing)
10. Understanding Autism Spectrum
Disorders
Neurobiological differences lead to deficits in social
perception, theory of mind and social relatedness,
that in turn lead to problem situations for group
learning, peer interactions, and student-teacher
interactions in school.
Problem behaviors are a result of known
neurobiological differences and environmental
influences but can be addressed through active,
direct teaching of adaptive social skills and problem
solving skills.
11. Social-Emotional Implications of
autism spectrum disorders
Few or no close friends--limited social
interests
Avoidance of socially demanding situations
Difficulty sensing or interpreting emotions in
self and others
Greater likelihood of also having anxiety
and/or depression
12. Social and Emotional
Implications
Impaired non-verbal communication,
including limited facial expressions
Impaired pragmatic language, including
lack of cohesion to conversation
13. Impaired Executive Functioning
An inability to engage
in goal-directed, future-
oriented behaviors including:
planning, flexibility, organized
search, self-monitoring, and
use of working memory.
14. “Behavior Problems” Associated With
Executive Dysfunction
Noncompliance
Off Task Behaviors/Distractibility
Inflexibility or Rigidity
Procrastination
Prompt Dependence
Disorganization
Socially Inappropriate Behaviors
15. Understanding HFA & AD cont.
Deficits in working memory, attention, and
executive functioning, such as organization
and planning, can lead to increased stressors
in school, difficulty completing work, and
escape and avoidance behaviors.
Remember, behaviors happen for a reason
and are likely in large part a symptom of
these underlying deficits and lack of adaptive
skills to respond to these deficits.
16. Model of Problem Behaviors
Core Neuro - Lack
Development Adequate
al Deficits supports
Problem
Behavior
Poor
Poor Social Coping
Skills Skills
17. California Code of
Regulations 3030 g:
A pupil exhibits any combination of the
following autistic like behaviors, to include but
not limited to:
An inability to use oral language for appropriate
communication.
A history of extreme withdrawal or relating to
people inappropriately and continued impairment
in social interaction from infancy through early
childhood.
18. California Code cont.:
Anobsession to maintain sameness.
Extreme preoccupation with objects or
inappropriate use of objects or both.
Extreme resistance to controls
Displays peculiar motoric mannerisms
and motility patterns.
Self stimulating- ritualistic behavior.
19. DSM IV Diagnosis of Autism Spectrum
Disorders
A. 1. Social Interactions (Must have at least 2 of the following)
Impaired use of nonverbal behaviors
Impaired peer relations
Limited sharing of enjoyment
limited social or emotional reciprocity
2. Communication (Must have at least 1 of the following)
Delay of development of spoken language
Impairment in conversation
Repetitive use of language or idiosyncratic language and
prosody
Lack of varied make believe play
3. Restrictive and Repetitive/Stereotyped Patterns of Behavior
(Must have at least 1 of the following)
Restricted interests
Adherence to nonfunctional routines
Stereotyped motor mannerisms
Preoccupation with parts of objects 19
20. DSM IV Diagnosis for Autism Cont.
B. Delays or abnormal functioning in at least one of
the following areas:
1. Social Interaction
2. Language as used in social interactions
3. Symbolic or imaginative play
The disturbance is not accounted for by Rett’s or
Childhood Disintegrative Disorder.
To be diagnosed with Autism, at least six symptoms from A (at
least two from A1 and one each from A2 and A3), one from B,
and C must be present.
To be diagnosed with PDD-NOS, disorders will be apparent in all
areas (A-C), but some will be atypical or sub-threshold. This
disorder is often recognized later than autism.
20
21. DSM IV Diagnosis of Asperger’s
Syndrome (AS)
A. Social Interactions (Must have at least two of the
following)
Impaired use of nonverbal behaviors
Impaired peer relations
Limited sharing of enjoyment
Limited social or emotional reciprocity
B. Activities and Interests (Must have at least one
of the following)
Restricted interests
Adherence to nonfunctional routines
Stereotyped motor mannerisms
Preoccupation with parts of objects
21
22. DSM IV Criteria for Asperger’s Cont...
C. The disturbance causes clinically significant impairment in
social, occupational, or other important functioning.
D. There is no clinically significant general delay in language
(e.g. single words used by age 2, communicative phrases
by age 3).
E. There is no clinically significant delay in cognitive
development or in the development of age appropriate self
help skills, adaptive behavior (other than social
interaction), and curiosity about the environment in
childhood.
F. The criterion are not met for other specific Pervasive
Developmental Disorders or Schizophrenia.
22
23. Autism - utube videos
Samples of autistic like behaviors
24. What is Different about the Assessment
of ASD vs. other Educational
Categories?
More comprehensive because of the
pervasive nature of the disorder
Requires more specialists and service
providers, requiring increases in
communication and collaboration--
systemic challenges
An ASD requires more specialized
services and increasingly more
demands on educators to develop
expertise in autism specific strategies
25. Educators Responsible for Ed.
Code Eligibility
Although the DSM-IV criteria are
important to know and use as a
reference for determining “autistic like”
behaviors, educators do not diagnose
using the DSM-IV.
Autism specific measures use the DSM-
IV diagnostic criteria as a part of their
content validity - so need to be
knowledgeable about DSM-IV criteria
26. What is Different cont.:
Adaptations for standardized tests, including
use of structured reinforcement
Increased use of non-standardized
assessment methods, including both natural
and structured observations
Critical to differentiate between ASD and
other disorders, such as ADHD, Emotional
Disturbance, and Language Disorders--
course of educational planning is different
27. Team Activity
What are the core deficits in children
with ASD?
What do you already know about how to
evaluate those areas?
What parts or aspects of ASD
assessments do you believe are the
most challenging?
28. Case Study: Bobby V.
Transitioning from Early Start
2 years - 10 months
Recent dx of ASD
Highly verbal
Bright
Concurring assessment by NPA
Advocate already involved
29. Case Study cont.
Priority on parent-district relationship
Home visits, natural environment was
primary assessment setting
Critical to respond to parent concerns
Language evaluation utilized a range of
tools - on the surface he looked fine
Teaming was critical - the team was
able to identify core deficits and needs-
got agreement on our assessment
30. Goals of Assessment: Why do we
assess?
Establish eligibility
under Ed. Code.
Identify student
unique needs that
will lead to specific
goals and objectives
Understanding
unique needs
directs team when
determining FAPE
31. Good Data = Good Planning
Team who is
knowledgeable
about the child
develops trust and
credibility with
agencies and
families
Develop appropriate
intervention plans
32. The Autism
Assessment/Intervention Team
TeamMembers should include a
Behavior Analyst, Behavior Specialist,
Speech Therapist, Occupational
Therapist, Classroom teacher, Special
Education Teacher, Nurse, School
Psychologist and Administrator.
33. The Assessment Process: Developmental
Areas and the Trans-Disciplinary Model
Specialists collaborate to provide a multi-
method assessment across developmental
areas
Trans-disciplinary teams design assessment
tasks and activities together for mutual
benefit
The TDT generates rich information about the
child leading to meaningful goals, integrated
services, and a meaningful report to parents
34. Assessment Areas
Health and Medical Social - emotional
Behavioral Cognitive
assessment- functioning
baseline of
behaviors that Adaptive Behaviors
interfere with Communication
learning Pre-academic and
Fine and Gross
academic areas
Motor
Sensori-Integration
35. Assessment Methods
Developmental Standardized
health history Assessments
Natural Parent Interview
Observations Review of
Structured records/reports
Observations
36. Developmental and Medical
History
Initialeligibility assessment requires
extensive parent interview about the
child’s early development and medical
history.
Important to gather data on early signs
of ASD, including, lack of gestures, little
or no babbling, delayed language, lack
of pointing, lack of interest in children,
limited shared attention, lack of eye
contact during feeding and games.
37. Developmental History cont.:
Feeding or sleeping problems
Unusual sensory reactions, ie., noise or touch
Unusual focus or attention toward limited
areas of interest
Range of affect, flat vs. full range
Verbal and nonverbal forms of
communication--intent to communicate needs
Unusual motoric movements
Fine and gross motor development
38. Natural Observations
Occur in several settings such as home,
preschool/school or child care
Take place with no structured activities other
than those that occur naturally within the
setting
Important to observe on more than one
occasion and by multiple observers
When possible, chose one or two “controls” to
observe in relation to student, ie., Tommy
completed the task at the same pace as his
peers, but needed twice as many prompts
39. Structured Observations-Play
Based
Structured
observations
provide specific
tasks to be
performed, such as
putting puzzles
together, imitation
tasks, and pretend
play activities
Activities are play
based - interactive
40. Specific behaviors are elicited, including
Reciprocal turn taking
Pretend play
Social reciprocity
Imitation of novel acts
Ability to be directed by examiners
Use of toys and objects
Use of spontaneous language
Quality of spontaneous and prompted verbal and nonverbal
communication
Play imitation
Joint referencing
Eye gaze, following a point
Eye contact, seeking eye contact to gain attention of others
41. Play-based assessment
Toys and materials Develop a play
of interest to child’s based assessment
age or mental age box or “tool kit”
Variety of toys to Include toys that are
engage and illicit sensory based,
interest symbolic play, cause
Include books, and effect, can be
musical toys, balls, used to prompt
cars, pretend play imitation
42. Standardized Assessments: Uses
and Limitations
Standardized assessments provide
objective data about broad functioning
and abilities in specific developmental
areas.
Important to cross reference
standardized results with observation
data and interview data to make
relevant, as well as to point out where
there are discrepancies.
43. Limitations to
Standardized Tests
ASD children often do not perform well on
these types of measures, and therefore they
can underestimate their ability
Reliability is also an issue due to highly
variable performance of skills
Note in your report the specific limitations of
the results.
44. Parent Interview for Initial
Eligibility
Can be structured or informal -- strongly
recommend including a home visit.
Use of structured interviews such as
The Autism Diagnostic Interview, R
(ADI-R) (can be used for children
through adults) is critical for establishing
clear developmental clusters consistent
with ASD.
45. Family Centered
Family centered
format--this is often the
first impression the
family gets of
educators.
Highly sensitive time for
parents, make sure you
provide ample time to
answer their questions.
46. The Faces of Autism
Parent perspectives reflect the
wide range of needs of children
with ASD and highlight the
individual nature of autism.
47. Areas to Assess: Core Deficits
Reflect - what are What will most
the core deficits? assessment plans
Comprehensive need to consider?
evaluations need to Develop
include all areas assessment plans
related to a with parent input.
suspected disability
48. Team Assessments
Set up stations such as,
fine motor, pretend
play, academic, sensory
Tag team - take turns
observing and
evaluating
Tag team - one team
member with parent,
two with child and then
rotate.
49. Cognitive Assessment
Use good Note the type of
comprehensive support needed to
tools: DAS-2, learn a new task --
WPPSI-2, KABC-2, how many trials
Consider using does the child need
processing tests, ie., to learn new
WRAML-II for older information?
children,and NEPSY Note processing
- can use with 2 1/2 profiles, visual
year olds, DAS-2 memory vs. verbal
50. Cognitive cont.
With young children Focus on the
between 2 and 5, cognitive functioning
important to explain and how areas of
validity of results - deficit may impact
IQ or cognitive learning, ie., verbal
functioning is not yet processing deficits
stable and can likely to impact
change especially ability to take
following intensive teacher instruction
program in a large group
51. Cognitive cont.
Important to let parents know the
possibilities, such as mental
retardation,processing challenges, while
at the same time recognizing that
cognition is difficult to determine at a
young age, and need to see how child
will respond to intervention.
52. Case Study: Mark
Six year old still in preschool NPA program
Transition to school
Standardized evaluation difficult
Standardized results indicate moderate MR,
however, adaptive skills and academic skills
indicate much higher functioning.
Following transition, child is now reading and
able to access general education setting.
53. Adaptive Behavior
Parent and teacher interview are integral to a
comprehensive assessment and often lead to specific
needs to generate goals and objectives.
Cross reference adaptive behavior with other areas of
functioning -- are there discrepancies?
How much support does the student need to perform
these tasks?
Use standardized questionnaires, such as Vineland,
to establish baseline and to provide objective data on
the student’s development.
54. Fine and Gross Motor
Fine and gross motor deficits are often deficit
areas in children with ASD, often requiring
direct assessment and intervention.
Occupational Therapists are best equipped to
provide a comprehensive assessment of
these two areas, in addition to sensory
issues.
Observe child’s grasp, use of writing and
drawing tools, visual-perceptual issues, motor
planning, and ability to keep up with written
motor tasks - pace of instruction.
55. Behavior & ASD Specific
Measures:
Use of standardized measures:
BASC-2
Achenbach Child Behavior Checklist
Childhood Autism Rating Scale - 2 (CARS-2)--very
strong validity
Gilliam ARS (moderate validity)
Social Responsiveness Scale -ages 4 and up
Autism Diagnostic Observation Schedule (ADOS)
The Autism Diagnostic Interview-R (ADI-R)--
highest validity
56. Determine Interfering Behaviors
Observation and data collection:
Target behaviors, or interfering behaviors,
level of intensity, frequency, impact on
learning
Critical to gather baseline data on target
behaviors, determine if a BSP is needed or
FAA
57. Tools Looking at
“Autistic Like Behaviors”
Solid Psychometric Support Adequate Support
The Autism Diagnostic Autism Diagnostic
Interview-R (ADI-R) Observation Schedule (ADOS)
Social Communication Child Behavior Checklist
(CBC)
Questionnaire (SCQ)
Psycho-educational Profile -R
Sufficient Support
(PEP-R)
Childhood Autism Rating Modest Support
Scales (CARS) Autism Behavior Checklist
Social Responsiveness Gilliam Autism Rating Scales
Scales (SRS) (GARS)
Asperger’s Syndrome
Diagnostic Interview (ASDI)
58. A Closer Look at the CARS 2
CARS 2 has high
reliability and validity
Utilizes three data
points: observation
in multiple
environments,
parent
survey/interview/
and teacher survey
and interview
59. Group Think
Sample Reports:
Jigsaw in groups of 3
How are ASD
specific issues
addressed?
What would you
add/change?
Your concerns
questions about
addressing ASD
specific behaviors
60. Assessment Environment
“When clinically indicated, observations of a child in
various settings and at different times increases the
validity of information obtained and assists in
diagnosis, case management and intervention.”
Looking at the child in multiple environments is
beneficial and necessary
Home, preschool, playground, backyard, daycare,
school/clinic
Collaborative assessment with other team members
allows for better observation/data collection
Autism Spectrum Disorders:
Best Practice Guidelines for Screening, Diagnosis and Assessment
California Dept. of Developmental Services 2002
61. ASSESSMENT TOOLS:
Direct/Standardized
1. Preschool Language 5. Comprehensive Assessment
Scale-4 of Spoken Language (CASL)
2. Peabody Picture 6. Reynell Developmental
Vocabulary Test Language Scales
3. Receptive and 7. Goldman Fristoe Test of
Expressive One Word Articulation-2/KLPA-2
Picture Vocabulary 8. Clinical Assessment of
Tests Articulation and Phonology
4. Sequenced Inventory of (CAAP)
Communicative 9. Language Sample
Development-
Revised(SICD-R)
62. Parent Interview and Observation Tools
1.Rossetti Infant Toddler Language Scale
(Linguisystems)
2.Pragmatics Profile of Everyday Communication Skills
in Preschool Children (Hazel Dewart and Susie
Summers )
3.Pragmatic Communication Skills Protocol (Academic
Communication Associates)
4.Functional communication Profile Revised
(Linguisystems)
63. DIRECT ASSESSMENT MEASURES-
LANGUAGE/COMMUNICATION
SKILLS
ROWPVT/EOW
PLS-4 -measures
Auditory PVT-measures
Comprehension receptive
and Expressive single
Communication word/expressiv
for Birth-6-11 e single word
vocabulary(2-
PPVT-measures
18)
receptive single SICD-R
word vocabulary Receptive and
Expressive
portions(4mos-
48 mos)
64. Direct Assessment cont
CASL-Research-based, theory-driven oral language
assessment battery for ages 3-21. Fifteen tests
measure language processing skills,comprehension,
expression, and retrieval—in four language structure
categories:Lexical/Semantic, Syntactic,
Supralinguistic, and Pragmatic. Subtests can “stand-
alone”.
65. PRAGMATICS PROFILE OF EVERYDAY
COMMUNICATION SKILLS/PRESCHOOL
Interview questions Information gathered
Typically done in home can be helpful for
with parent/caregiver parents to understand
4 domain areas: all aspects involved in
communication
Communicative
Information also helpful
Function, Response to
Communication, in identifying specific
Interaction and areas of need, writing
Conversation, goals and planning
Contextual Variation intervention
Website to download profile:
http://wwwedit.wmin.ac.uk/psychology/pp/documents/Pragmatics
%20Profile%20Children.pdf
66. Language Goals
•Important to meet as a team to discuss who
will write which goals
•Behavior specialists/analysts have expertise
in writing ABA type goals
•Language goals should not be addressed
solely in pull-out therapy –Language
opportunities happen all day!!
•Important for classroom teachers/aides to be
familiar with goals and how to implement them
within the classroom.
67. Pre-Academics and Academic
Assessment:
Consider using Note the necessary
criterion referenced accommodations
needed for learning
measures in
addition to
Does the child need
frequent breaks?
standardized, ie., Note level of frustration
Brigance, AEPS, tolerance.
Hawaii Observe how well the
Obtain work child generalizes
samples using age academic information,
level / adjusted age can they respond to a
level curriculum question in circle time?
68. Executive Function
Executive function is becoming a prominent
area for assessment and intervention for a
range of neuro-developmental disorders, in
particular, ASD. Difficult to evaluate in
children younger than 5.
Areas to assess: planning and organization,
anticipating an event and preparing for it,
ie.,forming goals, and strategies to reach
them, attention, memory processing,
cognitive flexibility, cognitive planning.
69. Assessment of Executive
Function
Behavioral Rating Cognitive
Inventory of Executive
Function (BRIEF), 5 and Assessment System
up (CAS)-ages 5 and
Conner’s-for Attention up-Attention Scale
issues, ages 3-5 Tower Tasks
DAS-2 working memory
ages 5 and up Wisconsin Card
NEPSY Developmental Sorting Test
Neuropsychological Reference (Ozonoff
Assessment-
Attention/Concentration and Schetter)
Scale
70. Sensori-Integration
SI is an important area to assess due to the
high probability of SI problems--about 70% or
> in ASD population.
SI is related to ability to attend, adapt to new
environments, fatigue, and emotional
regulation.
Occupational Therapists are the most
qualified to assess in this area.
include observing response to various
sensory activities, checklists (Sensori-
Integration and Praxis Test, Ayers clinic),
parent interview, and natural observation.
71. HFA vs. AS: How do we tell the
difference?
High functioning autism Asperger’s is
requires the same
DSMIV conditions as typically not
autism, however, high identified until age 7
functioning autism is or 8, and there is no
characterized by higher
cognitive skills, some in discernable delay in
the normal or above language
average range, often acquisition, and
with wide scatter across typically there is
cognitive domains.
Definitive delay in average or above
language acquisition. average intelligence.
72. Assessment Tips
Find out best time of Use preferred activities
day to test (try to throughout
eliminate fatigue) Include caregiver or
Use approved individual who is very
motivators or
reinforcers, ie., favorite familiar with the child to
food or activity participate with you
Give clear directions Assess in teams of two
using abbreviated to three
instructions when Plan on two to three
possible assessment sessions
73. Case Study: Conner
2 years 10 months Team strategies and
Parent referral approach
Four sessions, parent
Ambivalent about present throughout
delays Talked with parent prior
Conflicted about to IEP
getting a dx Presented possibilities
Very young parents, and concerns for parent
to consider
first child
74. Translating Assessment
Information into FAPE
Assessment data needs to be translated
into:
1. Identifying Unique needs
2. Goals that address all areas of need
3. Accommodations/supports for educational
benefit
4. Recommendations for
programming/placement, ie., ABA/EIBT
instruction
75. Unique Needs
What does the assessment data
indicate are unique needs of the child?
Deficit areas/weaknesses
Areas directly related to educational
benefit, ie., those skills needed to
benefit from education
Needs related to learning, accessing
curriculum and instruction, accessing
their environment
76. Goals - The Hallmark of a Good
IEP
Good goals indicate a quality
assessment and knowledgeable team
Goals are the driving force behind
rationale for services, accommodations
and supports
ASD goals need to be comprehensive,
intensive, and designed with a
developmentally sequenced curriculum
Refer to Curriculum Assessment Sheet
developed by Patty Schetter, ABTA
77. Goal activity
Refer to Sample Goals
Look at a set of unique
needs and determine
what type of goals will
effectively address the
needs
Goals set a trajectory
for progress
How can we make
goals meaningful?
78. Rationale for Services/Supports
General education opportunities
Specialized Academic Instruction
Individual Instruction, IA support
Need for intensity, ratio of adult to child
Need for ABA approach or other
DIS services - is the model collaborative,
individual, both?
79. Rationale and LRE
Criticalto know what empirically based
practices (EPBs) are and provide clear
direction for how these can be delivered, and
in what setting they can most be effective in.
Does the child’s needs require a degree of
intensity such as one to one and small group
with highly controlled environment?
Or is the child able to observe and attend to
small and large group instruction and
generalize skills in group settings?
80. Accommodations and Supports
Small group
Instructional Assitant
Verbal cues
Visual supports
Sensory breaks
BSP/BIP?
Visual schedule
Clear routine
Alternative communication-PECS
81. FAPE Considerations:
Data needs to back up
recommendations and provide rationale
for placement considerations
Need to consider a full range of
continuum of options
Tie goals to services - ie., functional
communication needs/goals require …
82. FAPE considerations cont.
Tie unique needs to program
components-what is a good fit or match
to these needs?
Have clear descriptions of
supports/accommodations program can
provide, ie., good ratios, 1:1,
developmentally sequenced curriculum,
systematic instruction,etc.
83. National Autism Center
Resources: Educator’s Manual
Evidenced Based Practices, National
Standards Project
84. Established Treatments from National Standards
Project:
◖◖ Antecedent Package
◖◖ Behavioral Package
◖◖ Comprehensive Behavioral Treatment for Young
Children
◖◖ Joint Attention Intervention
◖◖ Modeling
◖◖ Naturalistic Teaching Strategies
◖◖ Peer Training Package
◖◖ Pivotal Response Treatment
◖◖ Schedules
◖◖ Self-management
◖◖ Story-based Intervention Package
85. National Professional
Development Center On Autism
Spectrum Disorders
What are Evidence-Based
Practices (EBP)?While many
interventions for autism exist, only some
have been shown to be effective
through scientific research.
Interventions that researchers have
shown to be effective are called
evidence-based practices. The NPDC
has identified 24 evidence-based
practices.
87. The Report
Consider team report-
pros & cons
Reports need to provide
specificity, be
comprehensive yet
readable for parent
Clear headings,
meaningful sequence
Clear summary and
conclusions
Clear recommendations
for IEP team to use in
determining FAPE
88. Journey of Hope:
Parent Interview
Listen to the core message of this parent
and reflect on your practice of working
with parents.
89. Parent Collaboration
Establish a positive rapport at the
earliest point possible in the referral
process
Explain the roles of each examiner, and
explain what the assessment process
will look like and the IEP process
Find out what the parent’s interests are
90. Parent Input
Find out their long term goals are
Establish shared interests based on the
child’s needs
Establish common goals
Refrain from making assumptions
Provide frequent follow-up and an
established routine of communication
91. Parent Collaboration cont.:
Provide regularly scheduled
communications, such as quarterly
review dates, monthly phone call,
weekly note home.
When things get diverted, bracket knee
jerk reactions, and redirect the
discussion to the child’s needs and
goals.
92. Parent Input cont.
Acknowledge parent concerns and
needs -- communicate that you want to
understand their perspective so that
you can work jointly on behalf of their
child.
Emphasize areas in which there is
agreement and areas of common
interest.
93. Parent Perspective
Important to convey to a parent that their
input is valued-How do we do this?
This is their child for the rest of their lives -
the issues for them are truly intense
Parents feel an urgency - they are in a crisis
For a parent, trust is the most critical aspect,
with trust you can move forward
Building relationships is critical to any
successful team - even when there is
disagreement
94. When there is
disagreement
Remember, there is no “winner” in an
argument
Goal is to maintain a positive relationship
Shift from a framework that is argumentative
to one that is trying to gain common
understanding of the child
Look for opportunities to build agreement
Recognize when there is not agreement and
provide an environment where this is okay
Recognize when mediation will be helpful
95. Parent shoes
Put yourself in the parent’s shoes -
relate to having a child with an ASD like
you would having a child or spouse with
a life threatening disease or illness --
what are your likely emotions, actions,
and needs?
96. Teaming: What does it mean?
Define “team”
Reflect on positive
team experiences:
what were the core
elements of that
experience? What
are effective “team”
behaviors?
What are the key
characteristics of a
strong team?
97. Your Team: Next Steps
Identify three goals in the next three
weeks
What are potential barriers or road
blocks?
What strengths do you bring to your
team? -- dyad exercise
98. It’s the Journey not the
Destination
The assessment
process is like a
journey, discovering
unique needs,
learning about
families, and
continuous new
challenges as well
as successes.
Editor's Notes
Who is in the audience -- who have started teams?
Autism is a very heterogenous disorder -- Three types of autism - R. Hansen, there seems to be three distinct subtypes or endophenotypes and several mechanisms of autism, Early Onset, Regression-Both Social and Language, Regression-Either Social or Language
New rates suggest 1 in 150 last year, to now less than 1 in 100
To highlight the wide range of needs and issues for children on the spectrum -- dvd -- the many faces of autism
Leo - make point that resolved without going to due process
Assessment areas depend on referral concerns, ie., not always need OT
Also important to note regression in either or both language/social
LUNCH BREAK
From the National Autism Center, 2007 report
kaden
Autism Faces - DVD
PARENT EDUCATION WORKSHOP-- will be available through mind online next year.