Assessment of Autism Spectrum Disorder: Critical Issues in Clinical, Forensic and School Settings PDF
Preview Assessment of Autism Spectrum Disorder: Critical Issues in Clinical, Forensic and School Settings
Contemporary Issues in Psychological Assessment Series Editor: Randy W. Kamphaus Anna P. Kroncke Marcy Willard Helena Huckabee Assessment of Autism Spectrum Disorder Critical Issues in Clinical, Forensic, and School Settings Contemporary Issues in Psychological Assessment Series Editor Randy W. Kamphaus Georgia State University College of Education Atlanta, Georgia USA More information about this series at h ttp://www.springer.com/series/7353 Anna P. Kroncke (cid:129) Marcy Willard Helena Huckabee Assessment of Autism Spectrum Disorder Critical Issues in Clinical, Forensic, and School Settings With Contributions from Jessica S. Reinhardt Anna P. Kroncke Marcy Willard Emerge: Professionals in Autism Emerge: Professionals in Autism Behavior and Personal Growth Behavior and Personal Growth Glendale , CO , USA Glendale , CO , USA Helena Huckabee Emerge: Professionals in Autism Behavior and Personal Growth Glendale , CO , USA Contemporary Issues in Psychological Assessment ISBN 978-3-319-25502-6 ISBN 978-3-319-25504-0 (eBook) DOI 10.1007/978-3-319-25504-0 Library of Congress Control Number: 2015960742 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2016 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper S pringer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com) Acknowledgments Thank you to our editor Randy Kamphaus, Ph.D., distinguished professor and Dean of the College of Education at the University of Oregon, who graciously accepted this book as a part of his Assessment Series and provided us the opportunity to write about what we love to do every day. T hank you to our contributing author, Jessica Reinhardt, Ph.D., who provided a voice in our differential diagnosis and assessment parts of this book with insight into sensory processing, learning disabilities, AD/HD, and behavior and coauthored the school chapters. Thank you to Khalid Mohammad, B.S., who assisted with research and references, compiled tables of measures and appendices with psychometrics, and authored many case studies. We could not have completed this project and kept our clinic going without their support. It is essential to have exemplary team members with new perspectives and energy and we are so grateful for all they do. Thank you to Kirsten Brown, Ph.D., who provided an essential peer review of our text. Special thanks to Allison Margulies, Ph.D., who contributed to the cognitive assessment section and provided valuable information on the selection of intelli- gence measures. W e offer thanks to those researchers, authors, and teachers before us. There are so many individuals who infl uence our work. Thank you especially to Catherine Lord, Ivar Lovaas, Lorna Wing, Fred Volkmar, Deborah Fein, Sally Ozonoff, Tony Attwood, Robert and Lynn Koegel, Shahla Alai-Rosales, Susan Landry, Ami Klin, Judy Reaven, Susan Hepburn, the JFK Partners team, Richard Kelley and countless others who have taught us so much. Thank you to the Autism community, to Temple Grandin, Stephen Shore, and many others who provide a guide and offer hope to our clients as they make their way in the world. T hank you to the families and clients who have provided so much insight over the years and who have also enlightened us and remind us of the importance of early identifi cation and intervention every day. They are forging a path that other families and individuals with autism can learn from and follow. Their strength, dedication, and love is inspiring always. v vi Acknowledgments T hank you to our own families for their support and patience as we dedicated time to this project. Dr. Kroncke would like to thank her husband for his support in this line of work and in the intense research and effort that went into her authorship of this meaningful piece. Dr. Willard offers her appreciation to her husband and two boys, Brad and Brian, who monitored and marveled at the page and word count and gave seemingly endless hours of their mother’s time for this important work. Dr. Huckabee would like to thank her husband and children, Kevin and Kimmy, for inspiring and supporting her to do this work and write this piece that will hopefully illuminate a brighter path for clinicians and the families they serve. She notes proudly that Kevin has her taught more than anyone ever has. Kevin will forever bring much joy, peace and contentment to all those who choose to get to know him. A ll authors would like to express their sincere thanks to the researchers who came before us and the reader who comes after us and will build on this critical knowledge in order to diagnose and serve families on the autism spectrum. Contents Part I Understanding Autism 1 What Is Autism? History and Foundations .......................................... 3 What is Autism? ........................................................................................ 3 History and Foundations of ASD .............................................................. 5 Concluding Remarks on the History and Prevalence of Autism............... 8 2 The Causes of Autism ............................................................................. 11 Genetic Causes .......................................................................................... 11 Vaccines: Not a Cause of Autism .......................................................... 13 Genetic and Environment Interaction Effects ........................................... 14 Inherited and Familial Factors .............................................................. 14 Epigenetics ............................................................................................ 15 Exposure to Toxins and Pesticides ............................................................ 16 Enzymes and Digestive Problems ......................................................... 17 Risk Factors for Autism ............................................................................ 19 Early Identifi cation Mitigates Autism Risk .............................................. 19 3 Optimal Outcomes and Recovery .......................................................... 23 Intelligence ................................................................................................ 25 Language Skills ......................................................................................... 27 Early Intervention ..................................................................................... 29 Adaptive Behaviors ................................................................................... 31 Neurodiversity and Strength-Based ASD Models .................................... 32 4 Autism in the DSM-5 .............................................................................. 35 Changes in Diagnostic Criteria: Pervasive Developmental Disorders to Autism Spectrum Disorder ................................................... 36 Controversies Surrounding DSM-5 .......................................................... 38 Indicating Cognitive or Language Impairments ....................................... 40 Severity Scales for Social Communication and Restricted Repetitive Behaviors ................................................................................. 42 vii viii Contents A Word on Social (Pragmatic) Communication Disorder ........................ 43 A Need for More Research and for Continued Comprehensive Assessment ...................................................................... 44 Summary of Part 1: Understanding Autism .............................................. 45 Part II Conducting an Evaluation 5 Referral and Initial Consult ................................................................... 49 Making a Referral ..................................................................................... 51 How Referrals are Made ....................................................................... 51 What Should Referring Professionals Know? ...................................... 51 The Initial Consultation ............................................................................ 55 Who Should Attend? ............................................................................. 56 Conducting the Initial Consultation ...................................................... 57 Questions Asked During the Initial Consultation ................................. 57 Paperwork ............................................................................................. 62 Choosing Initial Assessments ............................................................... 65 Dynamic Assessment Battery ............................................................... 66 Checklists of Measures by age of Client ............................................... 70 Assessment Preparation ............................................................................ 72 6 Testing Begins .......................................................................................... 73 Testing Begins ........................................................................................... 74 Observations During the Assessment Process .......................................... 74 Appearance ............................................................................................... 75 Behavioral Presentation ............................................................................ 75 Language ................................................................................................... 76 Eye Contact and Gesture in Communication ............................................ 77 Play/Interests ............................................................................................. 78 Social Reciprocity ..................................................................................... 78 Attention ................................................................................................... 79 Motor Skills .............................................................................................. 79 Mood and Affect ....................................................................................... 80 Naturalistic Observations .......................................................................... 80 Cognitive Testing Observations ................................................................ 81 Facilitators–Inhibitors ........................................................................... 81 Internal Facilitator–Inhibitors ............................................................... 81 External Facilitator–Inhibitors .............................................................. 84 Challenging Behavior: Behavior Management during a Diagnostic Evaluation ................................................................. 85 Utilizing ABA Principles ...................................................................... 85 Sensory Sensitivities ............................................................................. 87 Classical Conditioning .......................................................................... 89 Visually Tracking Progress ................................................................... 90 Effective Reinforcement ....................................................................... 91 Reinforcement Schedules ...................................................................... 93 Contents ix Premack Principle ................................................................................. 93 Behavioral Momentum ......................................................................... 94 Concluding Remarks on Observations and Behavior Management ......... 95 7 Comprehensive Evaluation .................................................................... 97 Referral ..................................................................................................... 98 Assessing Core Areas .............................................................................. 102 Cognitive ............................................................................................... 102 Language ............................................................................................... 102 Social ..................................................................................................... 103 Sensory .................................................................................................. 103 Data Analysis ............................................................................................ 104 Autism Alone or Comorbid? ..................................................................... 105 Assessing Additional Areas ...................................................................... 105 Visual Spatial ........................................................................................ 106 Motor ..................................................................................................... 106 Attention ............................................................................................... 106 Executive Functions .............................................................................. 107 Memory ................................................................................................. 107 Emotional/Behavioral ........................................................................... 108 Adaptive ................................................................................................ 108 Ruling Autism Out .................................................................................... 109 Adequate Communication Skills .............................................................. 110 Appropriate Social and Communicative Reciprocity ............................... 110 Varied Interests .......................................................................................... 111 Diagnosing Disordered Social Interactions in the Absence of ASD ........ 111 Push–Pull Interactions .......................................................................... 112 Anxious Interactions ............................................................................. 113 Disengaged or Blunted Interactions ...................................................... 114 Angry, Defi ant, or Irritable Interactions ................................................ 115 Concluding Remarks on Comprehensive Evaluations .............................. 116 Summary of Part 2: Conducting an Evaluation ........................................ 118 Part III Data Analysis 8 Cognitive and Language Assessment .................................................... 127 Assessing for Cognition ............................................................................ 128 Vignette #1 Derick: Cognitive Assessment of a Child with a Language Delay ......................................................................... 129 Vignette #2 Clark: Cognitive Assessment of a Teenager with a Gifted Intellectual Profi le ........................................................... 129 Cognitive Assessment as It Applies to Autism ..................................... 130 Usefulness of FSIQ Scores in ASD ...................................................... 131 Cattell–Horn–Carroll Theory of Intelligence ........................................ 132 Mullen Scales of Early Learning (MULLEN) ...................................... 133 DAS-II ................................................................................................... 134
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