Education-Based Evaluations for ASD

5 Concepts 5 Minutes

Agenda for Day 2 Review Day 1 – Case Follow Up Observation Practice Cont. Full Evaluation Case Review Addressing Disagreements Evaluation Exercise

Evaluation Case Exercise Review Learning Points

Observation practice, cont.

Evaluation Process REED Identifying the Evaluation Team Evaluation Components Determination of Eligibility Evaluation Report IEP

Evaluation Components Teacher / Staff Interviews Parent / Family Interviews & Home Visit Observations Across Settings Standardized Assessment Domain Considerations

Take notes

Relevant history James – 4 years old Has a younger sister and an older brother with no issues Born 6 weeks early; birth complications, one month Neonatal Intensive Care Other health / developmental milestones unremarkable to18 mo At 18 months, lack of language development resulted in numerous assessments Early On services for language delays then ISD eligibility SLI – attended ECSE program 3-4 years of age, # of Dx of ASD, ADHD, anxiety disorder, ODD; medication treatment & home-based ABA treatment

Teacher / staff interviews Able to follow one and two-step directions Does not volunteer answers to questions, but when called on, does answer and does so correctly Has challenging behaviors 2-3 X per week, especially when redirected from preferred tasks Immature social skills – difficulty sharing Needs lots of redirection – easily distracted and inattentive Below average scores in strength and coordination and fine motor skills Below average scores in receptive / expressive language Likes Blues Clues – brings books from home

Parent interview / home visit Parent believes child presents with ASD characteristics Believes his ABA therapy and medication has resulted in significant improvements in behavior and masking ASD characteristics Child is immature; relies on his peers to initiate rather than initiate himself He has no friends that he can talk about or mention at home. He may play with other children, but does not form an emotional bond. He has limited reciprocal emotions -- understands happy, and often mad, but no other emotions of others– example, family member died and he was not emotional about it, can’t recall person’s name and if you ask him about the family member, says he doesn’t exist….. 

Parent interview / home visit If you ask to see his work, he will bring it to you and be proud sometimes, but does not initiate showing Has lots of meltdowns and does not communicate the problem Doesn’t let you know when he doesn’t feel well – have to rely on “fever” or “runny nose” Is obsessive and needs strict routine—changes cause meltdowns He walks with Blues Clues books everywhere, to school and sleeps with them… or there is a meltdown….  Repeats words, phrases and commercials – right now it is cereal commercials 

observations

observations

James Playing Blues Clues

Additional observation summary Noted to use pointing gesture, held arms up as if to say “I don’t know” Seems oblivious to emotional states of others – another child cries or gets upset, does not respond or react in any way In comparison to peers, uses less direct eye contact but when eye contact is used, appears typical Has difficulty transitioning from preferred activities (e.g. playing Blues Clues) Has some articulation errors making it difficult to understand at times; does not initiate a lot – not clear if due to difficulty with articulation or not? No noted play differences or unusual toy use

Standardized test considerations Met cutoff score on ADOS (Autism Diagnostic Observation Schedule) in the communication and social interaction domains but did not meet the cutoff repetitive behavior domain ASD rating scales completed by parent and ABA therapist showed clinically significant elevations for the presence of ASD; Teacher rating scales showed unlikely ASD Verbal Behavior Milestone Assessment and Placement (VB-MAPP) shows deficits in requesting information using “wh” questions, requesting attention, labeling emotions, and following instructions, sustaining social interaction, and attention to task

Results review meeting Activities Communication Reciprocal Social Interaction OTHER Restrictive and Repetitive Behaviors Sensory Need Additional Information (Describe)

What if there is internal disagreement? Keep true to the process (run the board) Presume Positive Intent Ask questions to obtain a deeper understanding of the disagreement -- PPP Is there a misunderstanding of ASD? Is there a focus on singular behaviors rather than preponderance of evidence? Focus on Dx not current eligibility? Gather additional information/data Add another evaluator / team Write a dissenting report

Case Study – Team Activity

All team members review the case study information and data As a team, conduct a Results Review Meeting (using the board and quadrants) Identify any additional information needed to make a final conclusion of eligibility and how you would go about getting that information Despite missing information (if any), use provided evidence to make a final conclusion of eligibility Write a paragraph summary of the evidence that leads to your conclusion of eligibility Write a bulleted list of intervention recommendations to inform the IEP

March 4: Differential Eligibility Report Writing