Screen, Investigate, Evaluate: Early Screening and Assessment for ASD Lauren K. Giovingo Florida State University

Federal Ruling Federal Judge Rules that Asperger’s Syndrome is a Disability January 31, 2006 January 31, 2006 Initially denied services “since there was no adverse impact on her academic progress.” Initially denied services “since there was no adverse impact on her academic progress.”

Federal Ruling Special education services were granted regardless of their academic performance. Special education services were granted regardless of their academic performance. Consequence: Psychologists in the schools will have to begin equally focusing on the social and behavioral component as well as the academic Consequence: Psychologists in the schools will have to begin equally focusing on the social and behavioral component as well as the academic If it stands: Number of milder variant ASD students receiving services will easily double. If it stands: Number of milder variant ASD students receiving services will easily double.

StudyN=AnalysisCBCL Version Rescorla, 1988N= year olds 79=Autistic Cluster AnalysisCBCL 6-11 (1978) Bolte, Dickhunt, & Postuka, 1999 N= = Autistic MANCOVACBCL German Version 1993 Duarte et al., 2003 N= =Autistic Principle Factor Analysis, Logistic Regression CBCL Brazilian Version Sikora et al., 2008N= months 79=Autistic 18=ASD ANOVA, MANCOVA CBCL Research: CBCL with ASD

Level I: Routine Developmental Surveillance Screening: PEDS, ASQ, CDI, BRIGANCE Screening: PEDS, ASQ, CDI, BRIGANCE RED FLAG INDICATORS: RED FLAG INDICATORS: –No babling, pointing, or other gestures (12m) –Non single words (16m) –No 2-word spontaneous phrases (24m) –Loss of language or social skills (any age)

Level I: Routine Developmental Surveillance PASSED SCREENING: Rescreen PASSED SCREENING: Rescreen FAILED SCREENING: FAILED SCREENING: –Laboratory Investigation –Specifically screen for Autism

Screening Tools Systematic Observation of Red Flags (Wetherby, 2002) Systematic Observation of Red Flags (Wetherby, 2002) MCHAT: Modified Checklist for Autism in Toddlers MCHAT: Modified Checklist for Autism in Toddlers CHAT: Checklist for Autism in Toddlers CHAT: Checklist for Autism in Toddlers Social Communication Questionnaire Social Communication Questionnaire Autism Behavior Checklist Autism Behavior Checklist Developmental Behavior Checklist: Autism Algorithm Developmental Behavior Checklist: Autism Algorithm Gilliam Autism Rating Scales Gilliam Autism Rating Scales

Screening Tools (Continued) Pervasive Developmental Disorders in Mentally Retarded Persons (PDD: MRs) (2005) Pervasive Developmental Disorders in Mentally Retarded Persons (PDD: MRs) (2005) First Year Inventory (2007) First Year Inventory (2007) Pervasive Developmental Disorders Rating scale (PDDRS) (1993) Pervasive Developmental Disorders Rating scale (PDDRS) (1993) Autism Spectrum Quotient (ASQ) (2001)-HFA Autism Spectrum Quotient (ASQ) (2001)-HFA Social Responsiveness Scale Social Responsiveness Scale Early Screening of Autistic Traits Questionnaire (2006) Early Screening of Autistic Traits Questionnaire (2006)

Level I: Routine Developmental Surveillance PASSED SCREENING: Level II as indicated PASSED SCREENING: Level II as indicated FAILED SCREENING: FAILED SCREENING: –Refer to Early Intervention or LEA –PROCEED TO LEVEL II

LEVEL II: Diagnosis and Evaluation for ASD Medical and Neurologic Concerns Medical and Neurologic Concerns –Familial Prevalence –Head Circumference –TSC and FraX associations

Level II: Diagnosis and Evaluation for ASD Specific Deficits Specific Deficits –Speech and Language Communication –Cognitive Deficits –Sensorimotor Deficits –Neuropsyhological –Behavioral –Academic

Level II: Diagnosis and Evaluation of ASD Laboratory Investigations Laboratory Investigations –Genetic Testing –Metabolic Testing –Electrophysiologic Testing –Neuroimaging –Other

Diagnostic Tools Autism Diagnostic Observation System (ADOS-G) Autism Diagnostic Observation System (ADOS-G) Autism Diagnostic Interview-Revised Autism Diagnostic Interview-Revised (ADI-R) (ADI-R) Childhood Autism Rating Scale (CARS) Childhood Autism Rating Scale (CARS) Psychoeducational Profile (PEP) Psychoeducational Profile (PEP) Clinical Observation and Interview Clinical Observation and Interview