Supporting Identification and Programming for Individuals with Autism Spectrum Disorders ASD

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• Supporting Identification and Programming for
  Individuals with Autism Spectrum Disorders (ASD)
• Assessment of
• Cognitive and Adaptive Domains
• Dr. Jane Doelling

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Assessment in ASD

• There is no one appropriate assessment battery
  the evaluation plan is always based on screening
  and ongoing data collection.
• IDEA requires that the assessment correspond to
  problems identified in screening and that the
  data be used
• to support an individual education plan (IEP).

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Utility of Cognitive/Adaptive Evaluation

• Differential Diagnosis - AD and AS.
• Delays and arrests - Are social communication
  delays greater than expected given cognitive
  level?
• Assessment of strengths, weaknesses, differences
  verbal and nonverbal communication patterns
  concept formation generalization modeling
  imitation memory.
• (Goldstein, Naglieri,
  Ozonoff, 2009)

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Considerations

• Intelligence and adaptive skills often defined as
  differences in every day behavior and responses
  we test using standard stimuli that are
  frequently problematic for this population.

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National Research Council (2001)

• Individuals with ASD have the most difficulty
  with language and social tasks on tests.
• Least difficulty on nonverbal tasks that are not
  timed and do not require motor skills, rote
  memory, and perception tasks.

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Impact of ASD

• Additional problems noted in testing
• attending
• joint attention
• understanding of personal pronouns
• imitation
• pointing
• behavioral regulation
• (Ashoomoff, 2006 Dawson et. al, 2004 Rogers et
  al., 2003 Sigman, et al., 1986).

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Skills/Behaviors Common to IQ Tests

• memory problem solving,
• discrimination verbal skills
• comprehension, spatial mechanical aptitude,
• analogies detail recognition,
• sequencing, induction vocabulary,
• general information motor behavior,
• generalization abstract reasoning
• (Salvia Ysseldyke,
  2007)

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Considerations CA MA

• What is the discrepancy? For individuals with
  severe delays can scores be translated into
  meaningful descriptions of ability?
• If older individual, would it be best to select
  an instrument with a wider age range?
• For a young child would it be better to focus on
  mental age scores w/a focus on developmental
  level vs. IQ?
• Are families members of young, or very
  developmentally delayed, asked to observe the
  assessment and confirm findings?

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Cognitive Development

• Used interchangeably with intelligence.
• Refers to a variety of mental processes to
  include reasoning, memory, comprehension,
  judgment.
• (Simpson Zionts, 2000)

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Assessment of Cognitive Ability

• No other area of assessment has generated as much
  attention, controversy, and debate as the testing
  of what we call intelligence.
• (Salvia and Ysseldyke 2007 p. 281)

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Cognitive Testing Issues

• Intelligence is an inferred construct
  determination of skills and abilities may be made
  from a limited sample of test behavior.
• May be problems with technical adequacy (validity
  issues due to nebulous nature of the construct
  reliability impacted due to characteristics of
  individuals w/ASD).

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Issues Cognitive Testing

• Emphasis on scores vs. skills not conducive to
  comprehensive programming.
• Individuals w/an ASD exhibit characteristics that
  limit the options w/traditional, norm referenced
  instruments.

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Best Practices Cognitive Assessment

• Ensure that the test assesses individual ability
  to the extent possible accommodate
• sensory deficits
• communication modes
• medical and motor issues
• as well as cultural factors.

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Best Practices

• Use scores as one indicator of ability.
• Analyze performance across subtests.
• Increase reliability through consideration of
  multiple data sources.

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Best Practices

• Be Aware of the Behaviors/Skills Sampled By the
  Test and Interpret Performance Accordingly.
• Be Aware of Stimulus Response Demands Making
  Appropriate Test Selection and Accommodations.
• Consider Standardized Sample In An Effort to
  Control Bias.

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Best Practices

• Norm referenced assessment should minimize, as
  much as possible, problems noted in screening
  (communication, response time, sustained visual
  and auditory attending).
• Cognitive/adaptive behaviors should be documented
  through communication, adaptive, ecological, and
  ASD specific instruments and context based
  performance tasks (integrated assessment,
  multiple data sources).

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Ecological Variables Checklist

• ___cues/prompts needed (visual,
• auditory, physical identify)
• ___ time needed for task
• ___transition aids needed
• ___format and response demands
• ___physical arrangement of setting
• ___communication systems

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Adaptive Behavior

• The way individuals adapt themselves to the
  requirements of their physical and social
  environments (p. 559).
• (Salvia Ysseldyke, 2007)

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Adaptive Skills

• Example Physical Environment -
• Avoiding or response to danger. Will the
  individual w/ASD use environmental cues to
• Select clothing appropriate to the climate?
• Respond to visual or auditory cues to avoid
  traffic?
• Demonstrate skills w/or w/out cues? Across
  settings? With reliability?

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Considerations Adaptive Assessment

• Social cultural expectations - vary across
  cultures, manifest in language usage.
• Age and Adaptation - Different expectations
  across the age span.
• Performance vs. ability - Does the individual
  know the behavior to be performed? Is it
  performed voluntarily and w/ consistency?

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Considerations

• Maladaption - Caution when included on norm
  referenced tests.
• Absence of maladaptive behavior does not imply
  adaptive behavior.
• Maladaptive behavior is determined by context
  with a few taboo exceptions.

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Considerations Adaptive

• Context - Appropriates (social tolerance) w/in
  the specific situation a behavior occurs.
• Undressing independently a desirable behavior at
  home and at bedtime but does not meet adaptive
  standards in the classroom or workplace.

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Adaptive Content Considerations

• Frequency and amplitude are important in
  determining adaptive skills or maladaptive
  behavior.
• Behavior - Child slaps head.
• What is the context, frequency, amplitude,
  consequent behavior?

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Issues and Best Practice Adaptive Assessment

• Adaptive skills traditionally assessed by third
  person respondent.
• Accuracy/assumes knowledge and non bias.
• Contextual information may be limited.
• Selective demonstration of behavior that may not
  be observed by respondent.

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Issues and Best Practice Adaptive Assessment

• Adaptive assessment typically implemented when a
  cognitive ability is suspected.
• Individuals across the spectrum demonstrate
  adaptive deficits (communication, social, self
  care, and more).

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Issues and Best Practice Adaptive Assessment

• Adaptive data may be obtained from assessment
  across domains (cognitive, communication,
  functional behavior assessment).
• Analysis of specific skill performances within
  context essential to programming.

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Common Norm Referenced Cognitive Tests Pros Cons

• Wechsler Scales - WISC IV, WAIS-III, WPPSI-III
• Stanford Binet Intelligence Scale 5
• Woodcock- Johnson Psycho- Educational Battery-
  III (Tests of Cognitive Ability)
• Leiter Revised (R)
• Test of Nonverbal IntelligenceTONI-3
• Comprehensive Test of Nonverbal Intelligence -
  CTONI

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Utility Limitations of Developmental/Cognitive
Ability Scales

• Developmental Profile
• Differential Ability Scales
• Mullen Scales of Early Learning
• Baley Infant and Toddler Scales of Infant and
  Toddler Development

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Common Norm Referenced Adaptive Scales

• Vineland
• AAMD-ABS
• AAMR-S2 School Edition
• AAMR Residential and Community (ABS-RC2)
• Scales of Independent Behavior (SIB-R)

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Additional Sources that Yield Cognitive/Adaptive
Data

• Assessments of Executive Functioning
• Instruments Specific to Severe Profound
• Integrated, Multi Domain Tools CRTs
• Autism Specific Instruments

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• Application to Diagnosis Case Scenario