Module 4-Assessment of ASD and Educational Implications PDF

Module 3: Identification and Assessment of ASD. Classroom Implications & Planning Module 3 Reading: Chapter 2 What will we cover today? • Screening Tools • Diagnostic Tools • Assessments for Educational Planning, Intervention, and Outcomes Things to be mindful of: Screening, Diagnostic tools • As...

Module 3: Identification and Assessment of ASD. Classroom Implications & Planning Module 3 Reading: Chapter 2 What will we cover today? • Screening Tools • Diagnostic Tools • Assessments for Educational Planning, Intervention, and Outcomes Things to be mindful of: Screening, Diagnostic tools • Assessments for individuals with autism spectrum disorder (ASD) vary based on their intended purpose. Using the right tool is crucial for accuracy. • Cultural and linguistic backgrounds can also impact assessment accuracy. • The chapter outlines various assessment tools for ASD, including screening, diagnosis, curriculum-based assessments, progress monitoring, and program evaluation, emphasizing their link to educational planning. Screening tools ● Screening aims to identify developmental delays in children compared to standard expectations, especially in ASD, with tools sensitive to detecting risks but specific enough to avoid false identifications (Losardo & Notari-Syverson, 2001; Zwaigenbaum, 2011). ● Early identification through screenings allows timely intervention for better outcomes. ASD-specific screenings at 18 and 24 months, recommended by the American Academy of Pediatrics, facilitate early detection (Cangialose & Allen, 2014; Ibanez, Stone, & Coonrod, 2014). ● Studies show differences in behaviors like gaze, vocalizations, joint attention, and social smiles in infants later diagnosed with ASD as early as 12-18 months, emphasizing the significance of early signs (Ozonoff et al., 2010; Rozga et al., 2011; Rogers & Wallace, 2011). Screening tools ● Although early screenings might result in false positives before 18 months, the value of early intervention outweighs the stress of a positive screen for most parents (Barton, Dumont-Mathieu, & Fein, 2012). ● Initiatives like the "16 Gestures by 16 Months" handout aid in identifying gesture delays, which can be key indicators in infants later diagnosed with ASD (Wetherby et al., 2014). ○ You can find these handouts in Canvas under EDU778>Module 4 ■ This is not a required reading for this class but these may be a great handout for parents who you may be working with who want to know more about signs they should be looking out for to determine if their child is meeting the developmental milestones and if there is a need for a developmental assessment/screening Screening Tools Summary Name of Screening Tool Checklist for Autism in Toddlers (CHAT) & Ages Assessed Screening items/Skills assessed Completed by Items most closely related to diagnosis later on CHAT: 18-30 month olds M-CHAT: 16-30 months CHAT: 9 questions completed by parents 5 Questions completed by medical practitioner Parent(s) or guardian(s) Three items within the CHAT—lack of gaze monitoring, protodeclarative pointing, and lack of pretend play by 18 months—are strong predictors of autism spectrum disorders Modified Checklist for Autism in Toddlers (M-CHAT) M-CHAT: Same as Chat + 9 questions that assess for risk factors for 16 month-18 month olds Format: yes/no questions Early Screening of Autistic Traits (ESAT) 16-48 month olds 14 questions yes or no questions Parent(s) or guardian(s) Play skills, emotions, eye contact Infant-Toddler Checklist (ITC) 6 months-24 month olds 24 items Parent(s) or guardian(s) Assessment divided into 7 categories: Emotion & Eye gaze, Communication,gestures, sounds, words, understanding and object use. Format: Frequency. e.g. “ does your child use his/her index finger to point, to indicate interest in something?” Answer choices: “Not yet” “sometimes” or “Often” Screening Tools Summary Name of Screening Tool Ages Assessed Screening items Completed by Items most closely related to diagnosis later on First Year Inventory (FYI) 12 month olds 63 items Parent(s) or guardian(s) Assesses for 8 constructs: Social Affective Engagement, Imitation, expressive Communication, social orientation and receptive communication, sensory processing, regulatory patterns, reactivity, and repetitive behavior Format: Frequency: Parents report if behaviors “never occur”, occur “seldom”, occur “sometimes” , or occur “often” 24 months and 36 months 12 items Format: scored as either “Pass” or “fail” Medical practitioner Imitation, play, communication-requesting, communication-directing attention, Ages 4 and older 40 questions Parent(s) or guardian(s) Reciprocal social interaction, language and communication, and repetitive and stereotyped communication Screening Tool for Autism in Toddlers and Young Children (STAT ™) Social Communication Questionnaire (SCQ) Two separate versions of SCQ Format: Scored as “present” are available: One for 4 to less or “absent” than 6 year olds and one for 6 years and older Diagnostic Process PARENT/PHYSICIAN ● Diagnostic assessments for ASD are typically prompted by screening outcomes, parental concerns, or pediatrician recommendations. Best practices involve gathering data from various sources and using multiple assessment methods, including family interviews and behavioral observations (Gotham et al., 2011; Sandall et al., 2005). TYPICALLY, IT IS THE PARENT(S) OR PHYSICIANS WHO IDENTIFY CONCERN INFORMAL OBSERVATIONS/PARENT INTERVIEW BY PHYSICIAN OR PHYSICIAN MAKES A REFERRAL TO PSYCHOLOGIST OR PSYCHIATRIST SCREENING ● Clinical judgment by experienced diagnosticians, often psychologists or psychiatrists, complements the data obtained from diagnostic tools, contributing to more accurate ASD diagnoses (Gotham et al., 2011). SCREENING FORMS GIVEN BY PHYSICIAN/PSYCHOLOGIST OR PSYCHIATRIST TO PARENTS 4 DEVELOPMENTAL EVALUATION REFERRAL REFERRAL MADE BY PHYSICIAN/PSYCHOLOGIST OR PSYCHIATRIST (IF THEY ARE UNABLE TO CONDUCT ONE THEMSELVES DUE TO TIME OR LACK OF SPECIALIZATION) TO PARENTS OR MEDICAL INSURANCE 5 DIAGNOSIS DEVELOPMENTAL EVALUATIONS completed by Psychiatrists/licensed psychologists INCLUDE PSYCHOLOGICAL TESTS INCLUDING AUTISM DIAGNOSTIC ASSESSMENTS IMPORTANT NOTE: ● Board Certified Behavior Analysts (BCBAs) cannot make official diagnoses of Autism ● Formal Diagnoses can be completed by licensed psychologists or psychiatrists as well as licensed physicians ○ However, many of the diagnostic assessments require a strong clinical judgement. Strong clinical judgement requires the psychologist/psychiatrist/physician to have experience working with individuals with ASD and other developmental disorders, so that they can evaluate accurately. Diagnostic Assessments Summary Name of Diagnostic Assessment Tool Ages Assessed Screening items/Skills assessed 2 years and up 30 items (Two 15 item Licensed forms)-completed by professional psychologist/p hysician 15 item questions that are not scored but completed by parent/guardian Childhood Autism Rating Scale (CARS) Completed by Skills assessed Format: rating scale between 1 and 4. 1=within normal limits for the age, 2= mildly abnormal, 3= moderately abnormal, 4=severely abnormal use of the behavior for age ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● Diagnostic Interview for Social and Communication Disorders (DISCO) 12 months and above Gilliam Autism Rating Scale (GARS) 3 years to 22 years Semi-Structured interview Format: Questionnaire Licensed psychologist, psychiatrists or pediatricians Interview composed of 42 rating Parent, items (0-3 rating 0=neevr teacher,caregi observed, 3=frequently observed) ver(s) and 13 yes-or no questions regarding development Relationship to people Imitation Emotional response Body use Object use Adaptation to change Visual response Listening response Taste-smell-touch response and use Fear and nervousness Verbal communication Non-verbal communication Activity level Level and consistency of intellectual response General impressions Diagnostic results Result categorized as: Non Autistic, Autism Spectrum: mild-moderate behaviors OR Autism spectrum-severe level of behavior Information about developmental history from infancy to current age to assess delays in milestones and severity of atypical development Results show percentage of different behaviors that are related to ASD sterotyed behaviors, communication, social interaction, and development results indicate whether there is a high/low probability of ASD Diagnostic Assessments Summary Name of Diagnostic Assessment Tool Ages Assessed Autism Diagnostic Toddlers to Observation Schedule adults (ADOS)- considered gold standard diagnostic tool Screening items/Skills assessed Completed by Skills assessed Composed of 2 parts: Licensed clinicians who also have been specifically trained in administering the ADI and ADOS ADI: Autism Diagnostic Interview-Revised (ADI-R): comprises 93 items aligned with DSM-IV and ICD-10 criteria, completed in about 2 hours by skilled interviewers, AND ADOS Format: ADOS: Structured observations with a rating scale across different Modules of development. 0-3 rating scale: 0= regular use of typical behavior, 3= lack of skills or behavior Diagnostic results ADOS: The levels of ASD Module 1: preverbal/Single words, Module Diagnostic criteria as 2: for individuals with some language, detailed by the DSM V Module 3: For individuals with language and some social skills, Module 4: for Adolescents and adults who are high functioning and asses for daily living skills and personal plans and goals Assessments for Educational Planning, Intervention, and Outcomes Assessments for Educational Planning and Interventions ● Usage of Educational Assessments: Educators and related service professionals, like speech-language pathologists, utilize assessments for educational planning and intervention. ● Considerations for Autism Spectrum Disorder (ASD) Learners: Effective use of assessments for learners with ASD involves making specific accommodations such as preparation, scheduling, minimizing distractions, employing structured systems, and acknowledging nonstandard responses. However, caution is advised in using certain assessments with minimally verbal or younger children with ASD, prompting the need for specialized measures to capture their strengths and weaknesses accurately. Assessments for Educational Planning, Intervention, and Outcomes Summary Name of Assessment Ages Assessed Uses Completed by Skills assessed Autism Screening Instrument for Educational Planning (ASIEP-2) 18 months to adults Used for diagnosing, setting placement, educational program planning, and monitoring progress School/licensed psychologists/teachers complete the observational assessments Vocal behavioral skills, learning rate, educational assessment completed by teachers includes measures on expressive and receptive language, body concept, and speech imitation Includes Autism Behavior Checklist (ABC) Autism Behavior Checklist (ABC) completed by parent(s)/Caregiver(S), and/or teachers Psychoeducational Profile (PEP) 6 months- 7 years Comprised of two parts: the Caregiver Report and the Performance Profile. Psychologist and/or teachers and parents Performance Profile: Administered by educators, this component consists of subtests evaluating cognitive, language, motor skills, and maladaptive behaviors. The results allow identification of strengths and areas needing focus for educational planning, emphasizing the use of individual strengths when designing curricula. TEACCH Transition Assessment Profile (T-TAP) 13 years and above Tailored treatment goals for older individuals with autism spectrum disorders. It focuses on transition needs, assessing functional areas through direct observation and interviews targeting communication, vocational skills, behavior, and independence. psychologists and/or teachers and parents Direct observations and 2 interviews asses for: functional skills at home and school, functional communication, play/leisure skills, vocational skills and behavior, interpersonal skills and independent functioning Assessments for Educational Planning, Intervention, and Outcomes Summary Name of Assessment Ages Assessed Uses Completed by Skills assessed Vineland birth and above Different forms available for different age ranges Monitoring development across various domains of adaptive functioning Parent(s)/Caregiver(s) and/or teacher(s) Expressive and receptive language, social/leisure skills, daily living skills, self-help skills, coping skills, social-emotional skills, community skills Mullen Scales Birth-68 months Determine level of cognitive functioning and measure outcomes of therapy by administering Mullen scale prior to intervention and after intervention Psychologist and/or teachers and parent(s)/caregiver(s) Skills and behaviors across developmental stages Functional Emotional Assessment Scale (FEAS) 7 months to 4 years Two different versions are used: 1 for clinical purposes and 1 for research purposes Parent(s)/Caregiver(s) 6 functioning developmental levels: self-regulation and interest in the world, forming relationships, attacjet, and engagements, two-way purposeful communication, behavioral organization, problem solving, and internalization, representational capacity, representational differentiation Transition planning questionnaire conducted with a team team composed of the individual with ASD and their loved ones and/or team Questions about their developmental history, individual's goals and dreams along with fears about their present and future. Strengths and weaknesses Educational planning and suggestions for accommodations for educational and social success in the IEP process. Provides suggestions for writing IEP goals Family interview along with checklists completed by teachers/school psychologists Academic development, social/emotional development, social skills, communication, behav Rating scale: 0= not at all observed/very brief, 2=consistently present/observed many times) McGill Action Planning System (MAPS) Adolescents and above Choosing Outcomes and 3 years -21 years Accommodations for Children (COACH) Curriculum Based Assessments Curriculum-Based Assessment Curriculum-Based Assessment (CBA) Overview: CBA links assessment to curriculum and instruction, evaluating educational success through student progress within key curriculum indicators, primarily determining instructional needs. Application and Objectives Measurement: CBA is recommended for young children, students with disabilities, and those from diverse backgrounds. It involves selecting curriculum objectives, measuring initial skills, and periodic probes to gauge progress after intervention begins. IMPORTANT NOTE: Most Curriculum Based assessments can be completed by Board Certified Behavior Analysts and/or Students who are in their Master’s programs working toward their BCBA (only under the guidance and training of a BCBA) Curriculum-Based Assessment Continued… Ongoing Evaluation and Best Practices: Continuous data collection within CBA is crucial for assessing intervention efficacy and monitoring progress. It's considered a best practice for educators working with students with disabilities and English language learners, aligning with recommended practices for authentic and collaborative assessments. Integrated Approach and Learner Variability: Shapiro and Elliott's four-step model for an integrated curriculum-based approach involves assessing the academic environment, curriculum placement, instructional modifications, and short- and long-term progress monitoring. Published assessment tools help educators gauge current performance and skill hierarchies, especially beneficial for learners with autism spectrum disorders, considering their varied skill development across domains. Curriculum Based Assessments for Infants and Preschoolers Name of Assessment Ages Assessed Uses Completed by Skills assessed Hawaii Early Learning Profile (HELP) two forms: Birth-3 year olds 3-6 year olds provides assessment profile for assessing a client’s skills via observations during contrived and naturally occurring situations Parent(s)/Caregiver(s) and/or teacher(s), BCBA/BCaBA/students in their ABA Master’s programs Expressive and receptive language, social/leisure skills, daily living skills, coping skills, social-emotional skills, maladaptive behaviors Assessment Evaluation, and Programming System (AEPS) Birth - 6 years Determining functioning level and determining goals for IEP and for ABA therapy Teacher(s), psychologists, BCBA/BCaBA/students in their ABA Master’s programs Six core domains: social, social-communication, fine motor, gross motor, adaptive, and cognitive, with each item having a goal and objective, along with a success criterion. Carolina Curriculum for Infants Birth to 4 years and Toddlers with Special Needs and Carolina Curriculum for Preschoolers with Special Needs Developing ABA therapy or IEP goals. Also allows for offers daily routines and functional activities to aid skill development, including group activity recommendations Parent(s)/Caregiver(s) Categorizes child behaviors within six developmental domains. The Creative Curriculum Offers guidance on structuring the learning environment. It emphasizes integrating goals and objectives seamlessly into everyday activities Teacher(s), psychologists, BCBA/BCaBA/students in their ABA Master’s programs Adaptive skills and maladaptive behaviors Infants and preschoolers Curriculum Based Assessments for Preschool and older Individuals Name of Assessment Ages Assessed Uses Completed by Skills assessed Determining functioning level across verbal behavior development, determine IEP and/or ABA goals, and monitor progress Teacher(s), psychologists, BCBA/BCaBA/students in their ABA Master’s programs, SLPs Requesting (manding), labeling (tacting), intraverbals, social skills, play skills, motor skills, concept development, writing, imitation skills Assessment of Basic Language 2 years-12years and Learning Skills (ABLLS-R) Determining functioning level across Adaptive behavior development, determine IEP and/or ABA goals, and monitor progress Teacher(s), psychologists, BCBA/BCaBA/students in their ABA Master’s programs basic social skills, academic skills, self-help skills, motor skills SCERTS, Ziggurat and CAPS Assessments usually used with the School districts and Community support agencies- have detailed information on reinforcement/reinforcers, prompt levels, accommodations, visual/tactile supports along with goal ideas for IEP or ABA Teachers/school psychologists Social skills, social/emotional skills, self-regulation, joint attention, communication skills, interpersonal skills and problem solving, daily activities The Verbal Behavior Milestones Birth to 6 years Assessment and Placement Program (VB-MAPP) ● recognized by most US insurance companies SCERTS-birth-6 years Ziggurat: 6 years-adulthood CAPS: 7 years-18 yeqars Goal Monitoring Importance of Ongoing Progress Monitoring: ● Educational teams prioritize goals post-assessment and embed objectives into activities for skill-building. ● Continuous progress monitoring is crucial to assess engagement and intervention effectiveness, allowing timely adjustments if progress is slow. ● Implementing progress monitoring systems requires personnel valuing ongoing assessment, administrative backing for program design with such systems, and skilled team members in monitoring progress and modifying interventions. Goal Monitoring Curriculum Activity Embedding and Monitoring Tools: Guides and resources, like Sandall and Schwartz's book, offer ideas for modifying curriculum activities to embed Individualized Education Program (IEP) objectives. Manuals like Webber and Schetermann's Quick Start Manual provide comprehensive guidance on implementing applied behavior analysis strategies, including step-by-step instructions and various data collection forms for ongoing progress monitoring. Data Sheets and Resources for Progress Monitoring: Books like Leon-Guerrero, Matsumoto, and Martin's work offer numerous examples of data sheets specifically tailored for ongoing progress monitoring in young children with ASD, derived from extensive experience in an inclusive educational program at the University of Washington. Goal Attainment Scaling Goal Attainment Scaling Overview: ● Goal attainment scaling creates personalized, measurable goals like those in Individualized Education Programs (IEPs) for comparison across various goals and students. ● Utilized initially in mental health contexts, this approach is now employed in research to measure intervention impact on individualized goals, employing a scoring system based on measurability, equidistance, and difficulty level factors. ● Scaling involves a uniform five-point scale from the baseline performance to exceeding the goal, allowing progress tracking based on specific dimensions like behavior frequency or context. Goal Attainment Scaling Application and Challenges in Education: ● Despite recognition of the importance of progress monitoring systems, many public school classrooms lack comprehensive data collection and evaluation processes. ● Educators often lack expertise in data collection and interpretation, hindering the implementation of ongoing curriculum-based programs. ● Noteworthy instances, like Penelope Wong Bonggat's success in developing a monitoring system for preschoolers, including those with autism spectrum disorders, demonstrate the feasibility of implementing such systems. Program Evaluation Program Evaluation Essentials: Program evaluation involves assessing outcomes to determine if a program effectively meets its stated objectives, especially in educational interventions. Successful implementation of evidence-based practices within a supportive environment is crucial for program effectiveness, with factors such as school policies and practices significantly impacting the outcomes. Components of Effective Programs: Effective programs are characterized by several factors: implementation of positive behavior support plans, efficient instructional time management, a data-driven accountability system, regular student feedback, high expectations, and positive, supportive interactions with students, as outlined by Dunlap et al. in 2008. The Autism Environmental Rating Scale (APERS) The Autism Environmental Rating Scale (APERS), developed by the NPDC (National Professional Development Center on ASD), assesses program components for implementing evidence-based practices across preschool-elementary and middle-high school settings. It involves record reviews, interviews, and observations to gauge environmental arrangements, teamwork, and the effectiveness of evidence-based practices, aiming to identify strengths and areas for improvement in ASD programs. Parents and educators can seek information on program outcomes and evidence-based practices described in Chapters 3 to 6. Questions? Thank you!