Centralized Evaluation Team Process for Determining Whether a Student Meets the Eligibility Criteria of Autism Spectrum Disorder

Centralized Evaluation Team (C.E.T.) Agenda History of the Centralized Evaluation Process C.E.T. Process Observation Forms C.E.T. Report Michigan Definition Team

History of Centralized Evaluation Process Late 80’s & Early 90’s increase in Referrals (A bump) Medical Community Started to Evaluate Educational Eligibility Lead to Center Programs Intermediate School District Dilemma

History Cont’d Real Explosion of Autism hit in 97, 98 C.E.T. Process Replicated in Oakland districts C.E.T. Team Independent of the Referring Team Primary and Only Responsibility of the C.E.T. is to find whether the student meets eligibility criteria of ASD.

Evaluation Challenges Old M.E.T. Form Reliance on standards scores Rating Scales? History Success – Generational Challenge

Determining Eligibility Start with the child not the characteristics Integrate quantitative and qualitative information Within qualitative assessment discover whether student has Autism Spectrum Disorder

The Centralized Evaluation Team A Multidisciplinary Team Team members include: school psychologist, school social worker and a provider of speech and language Various Disabilities Others team members

C.E.T. Roles School Social Worker – Consent for Evaluation, Home Visit, Observations Provider of Speech and Language – Home Visit, Assessments, Observations School Psychologist – Home Visit, Observations and a Variety of Tasks

Evolution of the CET Process Last 15 Years Three Separate Evaluations to One Allows for Collective Opinion Provides Documentation of Eligibility Status –(Yes/No)

The Centralized Evaluation Process – Form to Focus: Assessment Activities – Open to Discover the child within the process.

Initial Referral Special Education Building Team (Referring Team) Pertinent information must be provided by the Special Education Referring Team

A Copy of the Initial Referral Form

Considerations of C.E.T. Team At minimum one experienced support staff on each C.E.T. Strength areas are recognized Developmental considerations Team combinations

Letter and Packet to Support Staff assigned to the C.E.T.

C.E.T. Steps and Sequence Social Worker schedules home visit: Psychologist and Provider of Speech & Language participate. Obtain permission for evaluation at the home visit Complete social history and observations of child in home setting

Consent for Evaluation

REED Review Existing Evaluation Data

C.E.T. Interview Steps with the Referring Team Meet in a room with a dry erase or chalkboard Assign a facilitator Write four MET Categories on board Meeting Dynamics Facilitator interpretation of autism spectrum disorder characteristics

C.E.T. Documentation Form—Referring Team Social1

C.E.T. Steps & Sequence Observations Classroom Observations Unstructured Areas Observation – Recess Interaction with Other Students Observations of Others in Response to the Student Transition Observations

C.E.T. Documentation Form—Student Observation

C.E.T. Decision Making C.E.T. members share all relevant information Utilize all relevant checklist, characteristics, materials to organize information complete relevant rating scales Determine if additional information is needed before completing MET

Decision Making Process Utilize Meeting Mechanics to reveal all relevant documentation related to ASD. Incorporate Individual Perspectives of Relevant Documentation obtained from all Sources

C.E.T. Decision Making

C.E.T. Steps and Sequence Continued Write C.E.T. report, share report with parents Contact referring team and share report prior to MET Meeting Referring team schedules MET and I.E.P. at Least One C.E.T. Member Must Be Present

Multidisciplinary Evaluation Team Form - ASD

Organization of C.E.T. Report Write Report from the ASD M.E.T. Form Details are important – Define characteristics that either support the eligibility of autism or do not support the eligibility of ASD Consistency of MET Form Answers either For or Against the Eligibility of ASD

CET Report CET Report - NO.doc

Emotional Impairment Eligibility EI Eligibility

C.E.T. Report

C.E.T. Report Con’t

C.E.T. Report Con’td

C.E.T Report Con’td

The C.E.T. Member shares the findings once again to the parents and the school personnel

The IEPT Determines Goals and Objectives and then finally Placement

CET Video Available Online at: #1 under RESOURCES / audio & video #2 under INTENSIVE TRAINING / K-12 IT / Modules / CET

Michigan Definition of ASD Continued Age of Eligibility Autism spectrum disorder is typically manifested before 36 months of age. A child who first manifests the characteristics after age 3 may also meet criteria. Autism spectrum disorder is characterized by qualitative impairments in reciprocal social interactions, qualitative impairments in communication, and restricted range of interests/repetitive behavior.

Michigan Definition Cont’d Socialization (a) Qualitative impairments in reciprocal social interactions including at least 2 of the following areas: (i) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction. (ii) Failure to develop peer relationships appropriate to developmental level. (iii) Marked impairment in spontaneous seeking to share enjoyment, interests, or achievements with other people, for example, by a lack of showing, bringing, or pointing out objects of interest. (iv) Marked impairment in the areas of social or emotional reciprocity.

(i) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction. The function of non-verbal behaviors Michigan Definition Cont’d Socialization

(ii) Failure to develop peer relationships appropriate to developmental level. Social Skill Deficit vs. Reciprocal Incapacities Typical of ASD Theory of the Mind Sally Anne Experiment

(iii) Marked impairment in spontaneous seeking to share enjoyment, interests, or achievements with other people, for example, by a lack of showing, bringing, or pointing out objects of interest. Joint Attention Video Tape – Human Development Pointing Sharing Showing

Experts on people Experts on things birth Normal ASD Developmental Trajectories

(iv) Marked impairment in the areas of social or emotional reciprocity. The Child Who Couldn’t Play

Michigan Definition Cont’d Communication (b) Qualitative impairments in communication including at least 1 of the following: (i) Delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime. (ii) Marked impairment in pragmatics or in the ability to initiate, sustain, or engage in reciprocal conversation with others. (iii) Stereotyped and repetitive use of language or idiosyncratic language. (iv) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

(i) Delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime. Quantitative/Qualitative - Balance Reciprocity Lorna Wing – Communication Problems

(ii) Marked impairment in pragmatics or in the ability to initiate, sustain, or engage in reciprocal conversation with others. Observations and Interactions XFL - Dan

(iii) Stereotyped and repetitive use of language or idiosyncratic language. Communication is non-reciprocal… stilted, literal and egocentric Walk Don’t Walk – Rain Man Y2K Compliant Airport – Rain Man

(iii) Stereotyped and repetitive use of language or idiosyncratic language. Communication is non-reciprocal… stilted, literal and egocentric Walk Don’t Walk – Rain Man Y2K Compliant Airport – Rain Man

(iv) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level. Compared to Developmental Level Extremely Stilted Embracing Play

Michigan Definition Cont’d Restrictive, Repetitive & Stereotyped Behaviors Restricted, repetitive, and stereotyped behaviors including at least 1 of the following: (i) Encompassing preoccupation with 1 or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus. (ii) Apparently inflexible adherence to specific, nonfunctional routines or rituals. (iii) Stereotyped and repetitive motor mannerisms, for example, hand or finger flapping or twisting, or complex whole-body movements. (iv) Persistent preoccupation with parts of objects.

(i) Encompassing preoccupation with 1 or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus. Chad, Mickey, and Derek

(ii) Apparently inflexible adherence to specific, nonfunctional routines or rituals. Rain Man – Judge Wapner Jeremy – Must Pass 3 Red Cars to Have a Good Day at School Jonathan – No Left Turns

(iii) Stereotyped and repetitive motor mannerisms, for example, hand or finger flapping or twisting, or complex whole-body movements. Cautions – Prioritize Criteria Comprehensive Evidence of ASD

(iv) Persistent preoccupation with parts of objects. Observations and Interactions Over Time Dave – Air Conditioner Parts

Michigan Definition – Sensory (3) Determination may include unusual or inconsistent response to sensory stimuli, in combination with subdivisions (a), (b), and (c) of subrule 2 of this rule.

Michigan Definition – Sensory Not a primary area in the MI definition Sensory issues – Not Primary Reason for Eligibility Sensory Issues should be addressed through the 3 primary areas Not a defining characteristic – Appears in too many other disability areas

Michigan Definition Cont’d Other Considerations (4) While autism spectrum disorder may exist concurrently with other diagnoses or areas of disability, to be eligible under this rule, there shall not be a primary diagnosis of schizophrenia or emotional impairment. (5) A determination of impairment shall be based upon a comprehensive evaluation by a multidisciplinary evaluation team including, at a minimum, a psychologist or psychiatrist, an authorized provider of speech and language under R (d), a school social worker.

Michigan’s Definition Includes Eligibility for Services for Students with Asperger Syndrome

Filed with the Sec. of State on , and took effect on 9/15/04. R Autism spectrum disorder defined; determination. Rule 15. (1) Autism spectrum disorder is considered a lifelong developmental disability that adversely affects a student’s educational performance in 1 or more of the following performance areas: (a) Academic (b) Behavioral (c) Social DEPARTMENT OF ED / STATE BOARD OF ED SPECIAL EDUCATION PROGRAMS & SERVICES

Socialization (a) Qualitative impairments in reciprocal social interactions including at least two of the following areas: (i) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction. (ii). Failure to develop peer relationships appropriate to developmental level (iii) Marked impairment in spontaneous seeking to share enjoyment, interests, or achievements with other people, for example, by a lack of showing, bringing, or pointing out objects of interest. (iv) Marked impairment in the areas of social or emotional reciprocity.

Communication (b) Qualitative impairments in communication including at least one of the following: (i) Delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime. (ii) Marked impairment in pragmatics or in the ability to initiate, sustain, or engage in reciprocal conversation with others. (iii) Stereotyped and repetitive use of language or idiosyncratic language. (iv) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

Restrictive, Repetitive & Stereotyped Behaviors Restricted, repetitive, and stereotyped behaviors including at least one of the following: (i) Encompassing preoccupation with 1 or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus. (ii) Apparently inflexible adherence to specific, nonfunctional routines or rituals. (iii) Stereotyped and repetitive motor mannerisms, for example, hand or finger flapping or twisting, or complex whole-body movements. (iv) Persistent preoccupation with parts of objects.

Definition Cont’d – Other Areas (3) Determination may include unusual or inconsistent response to sensory stimuli, in combination with subdivisions (a), (b), and (c) of subrule 2 of this rule. (4) While autism spectrum disorder may exist concurrently with other diagnoses or areas of disability, to be eligible under this rule, there shall not be a primary diagnosis of schizophrenia or emotional impairment. (5) A determination of impairment shall be based upon a comprehensive evaluation by a multidisciplinary evaluation team including, at a minimum, a psychologist or psychiatrist, an authorized provider of speech and language under R (d), a school social worker.

Next Steps Components of CET Pro’s and Con’s of CET Implementation

Components of CET

Sole purpose for or against autism Independent Team One Report Trans-disciplinary approach Concise meeting time 4 Squares (Domains) Not Standardized Score Based Report Shared with the parents ahead of time Qualitative Sensory not assumed Three person team Objective – don’t know kids All doing Observations in all settings Home visits (all three go) Showing deficit does not have to be academic Report follows MET criteria

CET Components Components that can be immediately implemented Components that can be implemented in a reasonable amount of time but that need some planning. Components that have major barriers for our district / ISD.

ACTION PLAN WHO Will do WHAT By WHEN To implement components of CET

Report Out Evaluations

Components of CET Sole purpose for or against autism Independent Team One Report Trans-disciplinary approach Concise meeting time 4 Squares (Domains) Not Standardized Score Based Report Shared with the parents ahead of time Qualitative Sensory not assumed Three person team Objective – don’t know kids All doing Observations in all settings Home visits (all three go) Showing deficit does not have to be academic Report follows MET criteria

CET Components PROS and CONS Do it tomorrow Need planning Concerning Components

ACTION PLAN WHO Will do WHAT By WHEN To implement WHAT components of CET