Transcript Slide 1

AUTISM
EVALUATION PLANNING
AND
ELIGIBILITY
DETERMINATION
Kathy Meredith
Complex Needs Consultant
Purpose of this session
• To learn how to complete the
evaluation process for the purpose of
providing the ARC the sufficient
information necessary to make the
eligibility determination for the
suspected disability of autism.
Autism: Kentucky
Regulations Definition
(5) "Autism" means a developmental disability
significantly affecting verbal and nonverbal
communication and social interaction, generally
evident before age three (3) that adversely affects
a child’s educational performance. Other
characteristics often associated with autism are
engagement in repetitive activities and
stereotyped movements, resistance to
environmental change or change in daily routines,
and unusual responses to sensory experiences.
The term shall not apply if a child’s educational
performance is adversely affected primarily
because the child has an emotional-behavior
disability.
KAR 1:300 §3(2)(3)
Pervasive Developmental
Disorders
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Autistic disorder
Asperger’s disorder
Rett’s disorder
Childhood disintegrative disorder
Pervasive developmental disorder, not
otherwise specified (PDD-NOS)
April 7, 2008
3 Basic Characteristics
• Impairments Communication/Language,
generally evident before the age of three.
• Impairments in Social Interaction
• Restricted, Repetitive, and Stereotyped
Patterns of Behavior, Interests, and
Activities
Early “Red Flags” for ASD
• “Red flags” for ASD (AAP, 2007,
p.1)
– Not turning when parent says
baby’s name
– Not turning to look when parent
points and says, “Look at…”
– Not pointing to show parents an
interesting object or event
– Lack of back and forth babbling
– Smiling late
– Failure to make eye contact with
people
CDC Handout/CHAT Handout
Early Signs of ASD
Additional information about early
signs of ASD
can be found at:
www.cdc.gov/ncbddd/autism/act
early
www.autismspeaks.org/whatisit/l
earnsigns.php
www.firstsigns.org
Communication Activity
View:
Communication>Expressive and Receptive
Language> Expressive and Receptive Language:
Sounds, Words, Prosody> 3, 4, & 5 on First
Signs website
http://www.firstsigns.org/asd_video_glossary/asdvg
_about.htm
Communication
• Expressive and receptive
– Understanding and processing time
• Social communication
• Pragmatics
– reciprocal conversation
• Articulation / oral-motor skills
• Syntax
• Semantics
• Qualitative differences
– echolalia, rhythm, rate, intonation,
stereotyped speech, overly formal,
immature
Impairments in Communication
cont.
• Language characteristics
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Reversing pronouns
Lacking variety in sentence structure
Using simplistic and immature grammar
Inability to generalize
Impairments in Communication
• Difficulty understanding the nonliteral use of words and phrases
• Concrete (literal) thinking
• Poor imaginative play
Impairments in Social
Interaction
• Joint Attention
– use of eye gaze
– in pointing/understanding others’
use of pointing
– in showing others things of
interest
http://www.firstsigns.org/asd_video_glossary/asdvg
_about.htm
Impairments in Social
Interaction
• Difficulty attempting to interact
with others and understanding
social cues.
– recognizing own emotions and beliefs
– understanding other person has thoughts
and feelings that may be different
(theory of mind)
– understanding irony, sarcasm, white lies
and metaphors
– theory of mind
http://www.holah.karoo.net/sallyanne.gif
Impairments in Social
Interaction
Theory of Mind False Belief Task
Example:
A child watches while a puppet named Eddie places a
toy car under a cup and then leaves. After Eddie has
left, another puppet comes along and moves his toy
car into a box, without Eddie witnessing this switch.
When Eddie returns, the child participant is asked
where Eddie will search for the toy, under the cup or
in the box. A typically developing child would say
under the cup. However a child with ASD would say
that Eddie will look in the box, demonstrating
inability to take viewpoint of another.
Engagement in repetitive
activities and stereotypic
movements
– often narrowly focused
– often intense
– content may be unusual
– may interfere with functional
activities
– shifting attention away from special
interest is often difficult
Resistance to change in
environmental or daily routines
• Change in physical structure can cause
anxiety.
• Development of routines and insistence on
sameness
– following routines can be comforting
– change in routine can cause anxiety
– transitions often hard
Repetitive cont.
• are common but not universal in
ASD
– are also seen in young, typically
developing children
– frequency and intensity in ASD
differ from those with typical
development
Unusual responses to sensory
experiences
• Definition: Heightened or decreased
experience of sounds, lights, movement,
touch, smell or taste or fascination with
sensory experiences
– Contribute to distractibility, difficulty in shifting
attention
– May lead to avoidance behaviors
– May lead to sensory seeking behavior
– May impact learning, social interactions, behavior
Sensory Issues
Sensory experiences can be overwhelming,
even painful.
“When people touched me, I experienced an
overwhelming drowning wave of over stimulation.
… Certain noises affected me like a dentist’s drill
hitting a nerve. … I often became anxious when
balloons were present because I was afraid they
would pop. Other noises that hurt my ears were
the school bell’s ringing and the hum of the big
industrial vacuum cleaner that was used to clean
the elementary school classrooms.” (Grandin,
2005, pp. 1280-1281)
Sensory Issues
• Assess influence of sensory issues on
learning, development, and
interactions with others
Sensory Issues
• Assess influence of sensory issues on
learning, development, and
interactions with others
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Autism Screenings
Checklists
Observation
Occupational therapists typically assess
atypical sensory responses
Co-occurrence
with Other Disorders
• Intellectual disability
• Seizures
• Genetic syndromes
Fragile X syndrome (25-67% of males with FXS have
autistic behaviors or meet criteria), tuberous sclerosis (1764%), Down syndrome (6-7%)
• Mental health conditions
Phobias, obsessive compulsive disorder, attention deficit
hyperactivity disorder, depression, anxiety
April 7, 2008
CULTURE OF AUTISM
SOCIAL RELATEDNESS
JOINT ATTENTION & RECEPROCITY
COMMUNICATION
Expressive deficits
Problems with intent as well as means
Receptive deficits
Problems with meaning and processing
SENSORY PROCESSING
Integration and modulation of inputs
DIFFICULTY WITH CHANGE
Limited interests, repetitive behavior, rigidity
COGNITIVE STYLE
Problems with organization and sequencing &planning
Problems with attention & relevance
Problems with abstraction & generalization
•Sensory
•Perseveration
•Language and
•Social understanding
communication
•Concrete
•Need for sameness
•Central Coherence
•Distractibility
•Executive
Functioning
•Sequencing
•Relevance
•Organization
•Understanding of
time
•Generalization
•Motivation
•Confusion
•Anxiety
And, don’t forget……..
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Assistive Technology
Transition
English Language Learner
Cultural issues
Cognitive Data
Determination of Eligibility
3. Adverse Affect
To determine adverse affect,
the ARC must compare the
student’s performance to the
performance of peers, in the
same learning environment.
This information can come from
peer comparisons to behavior,
rating scales, and curriculum
based assessment.
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DEVELOPING
THE
EVALUATION
PLAN
Suspecting a Disability
Student experiences problems in:
May consider assessment for:
Communicating with others
Autism, Speech/Language Impairment
Speech and Language
Speech/Language Impairment
Academics
Specific Learning Disability
Behaviors and Emotions
Emotional Behavior Disability
Child development (up to age 9)
Developmental Delay
Cognition (thinking and problem
solving)
Mental Disability (MMD, FMD), Autism
Health
Other Health Impairment
Physical Areas
Orthopedic Impairment
Vision
Blind or Visually Impaired
Hearing
Deaf or Hard of Hearing
Issues due to an old or recent accident
Traumatic Brain Injury
Gallery Walk
1. Look at the eligibility form for autism and the
evaluation planning form
2. Remembering the characteristics and eligibility
definition, brainstorm under each area of the
posters, what types of assessments and the titles
of professionals that will be needed to conduct a
comprehensive evaluation to determine eligibility.
3. Based on what you know about this process, what
else do we need to consider?
Gallery Walk
1. Review the eligibility form for autism and the
evaluation planning form.
2. Using the eligibility definition and the evaluation
planning form, brainstorm under each area on the
posters, what types of assessments and the titles of
professionals will be needed to conduct a
comprehensive evaluation to determine eligibility.
Evaluation Planning Form
KAR 1:300 §3(2)(3)
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Develop the Evaluation Plan
Based on referral information & eligibility
requirements, determine additional
information needed;
1.Determine needed areas of evaluation;
2.Determine types of personnel to
complete evaluation components;
3.Target specific areas for observation;
4.Determine the need for Assistive
Technology Evaluation; and
5.Determine the need for modifications
to evaluation procedure(s).
Complete the
Form based on
group results on
flip charts
KAR 1:300 §3(2)(3)
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Evaluation Planning Form
KAR 1:300 §3(2)(3)
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Evaluation Planning Form (cont.)
KAR 1:300 §3(2)(3)
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Evaluation Planning
The child shall be assessed in all areas
related to the suspected disability,
including, if appropriate:
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health, vision, hearing, and motor
social and emotional status
general intelligence
academic performance
communicative status
707 KAR 1:300 Section 4 (10)
34 CFR 300.304 (c) (4)
IDEA Guidelines for
Assessment of ASD
• Components that must be included
in assessments
Vision and hearing screenings
Cognitive assessment
Speech-language assessment
Adaptive behavior assessment
Social-emotional and behavioral
assessment
– Developmental and health history
– Observation (school, home,
social/community)
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34 CFR 300.304 (c) (4)
ARC’s make
educational
eligibility
determinations, not
medical diagnoses.
KAR 1:300 §3(2)(3)
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Diagnosis vs Eligibilty
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What Do the Results of
Screening Tell Us?
• Indicates level of risk for delay or disability
• Provides guidance on need for additional
evaluation or services
• Does not provide sufficient information for
diagnosis or determination of educational
eligibility
Selected Measures for
Assessment of ASD
• Autism Diagnostic Observation
Schedule (ADOS)
• Autism Diagnostic Interview –
Revised (ADI-R)
• Childhood Autism Rating Scale
(CARS)
Commonly Used Screening
Measures for ASD
• Autism Spectrum Screening Questionnaire
(ASSQ)
• Gilliam Autism Rating Scale (GARS) – 2nd
Edition
• Modified Checklist for Autism in Toddlers
(M-CHAT)
• Pervasive Developmental Disorders Screening
Test – II (PDDST-II)
• Screening Tool for Autism in Two- Year-Olds
(STAT)
• Social Communication Questionnaire (SCQ)
Assessment of Adaptive
Behavior
• Assess independence in specific
areas:
– Motor
– Communication
– Social
– Personal / self-help
• Assess generalization of skills
• Assess amount of support
needed
Asperger’s Screenings
• Asperger Syndrome Diagnostic Scale
• Australian Scale for Asperger Syndrome
(ASAS)
• Childhood Asperger Syndrome Test (CAST)
• Gilliam Asperger’s Disorder Scale
• Krug Asperger’s Disorder Index (KADI)
Resources for examples of
information gathering
• Wisconsin Department of Public Instruction home
page: http://dpi.wi.gov
• Autism: http://dpi.wi.gov/sped/autism.html
• Cognitive Disability: http://dpi.wi.gov/sped/cd.html
• Speech/language disability:
http://dpi.wi.gov/sped/speech.html
• Functional Behavioral Assessment:
http://dpi.wi.gov/sped/sbfba.html Special Education
Index (includes links to disability areas, Information
Updates (bulletins), What’s New, statutes, and many
other resources):
• http://dpi.wi.gov/sped/tm-specedtopics.html
• www.autisminternetmodules.org
Activity
• Look at all of our posters and
information.
• Is there anything that we need
to add?
ELIGIBILTY
DETERMINATION
Do you have sufficient information?
Eligibility Determination
The ARC uses information from a variety of sources,
including:
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(a) response to scientific, research-based interventions;
(b) vision, hearing, and communication screenings;
(c) parental input;
(d) aptitude and achievement tests;
(e) teacher recommendations;
(f) physical condition;
(g) social or cultural background;
(h) adaptive behavior; or
707 KAR 1:310 Section 1 (3)
34 CFR 300.306 (c)(1)(i)
(i) behavioral observation.
Reminder!
A previous diagnosis of autism
from a private sector does not
automatically qualify the student
for eligibilty of autism or other
special education services.