As we prepare for the new school year, this question will be asked with ever increasing frequency. Yes. Professionals such as school psychologists and speech/language pathologists can diagnose or classify a child with an autism spectrum disorder (ASD) within the school context. The dramatic increase in the prevalence of children with ASD over the past decade, together with the clear benefits of early intervention, have created a need for schools to identify children who may have an autism spectrum condition. It is not unusual for children with milder forms of autism to go undiagnosed until well after entering school. In fact, research indicates that only three percent of children with ASD are identified solely by non-school resources. As a result, school professionals are now more likely to be asked to participate in the screening and identification of children with ASD than at any other time in the past.
The Individuals with Disabilities Education Act of 2004 (IDEA) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV) are the two major systems used to diagnose and classify children with ASD. The DSM-IV is considered the primary authority in the fields of psychiatric and psychological (clinical) diagnoses, while IDEA is the authority with regard to eligibility decisions for special education. The DSM-IV was developed by clinicians as a diagnostic and classification system for both childhood and adult psychiatric disorders. The IDEA is not a diagnostic system per se, but rather federal legislation designed to ensure the appropriate education of children with special educational needs in our public schools. Unlike the DSM-IV, IDEA specifies categories of ‘‘disabilities’’ to determine eligibility for special educational services. The definitions of these categories (there are 13), including autism, are the most widely used classification system in our schools. According to IDEA regulations, the definition of autism is as follows:
(c)(1)(i) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 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 does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in this section.
(ii) A child who manifests the characteristics of ‘‘autism’’ after age 3 could be diagnosed as having ‘‘autism’’ if the criteria in paragraph (c)(1)(i) of this section are satisfied.
This educational definition is considered sufficiently broad and operationally acceptable to accommodate both the clinical and educational descriptions of autism and related disorders. While the DSM-IV diagnostic criteria are professionally helpful, they are neither legally required nor sufficient for determining educational placement. It is state and federal education codes and regulations (not DSM IV-TR) that drive classification and eligibility decisions. Thus, school professionals must ensure that children meet the criteria for autism as outlined by IDEA and may use the DSM-IV to the extent that the diagnostic criteria include the same core behaviors (e.g., difficulties with social interaction, difficulties with communication, and the frequent exhibition of repetitive behaviors or circumscribed interests). Of course, all professionals, whether clinical or school, should have the appropriate training and background related to the diagnosis and treatment of neurodevelopmental disorders. The identification of autism should be made by a professional team using multiple sources of information, including, but not limited to an interdisciplinary assessment of social behavior, language and communication, adaptive behavior, motor skills, sensory issues, and cognitive functioning to help with intervention planning and determining eligibility for special educational services.
Life Journey through Autism: A Parent’s Guide to Assessment. Arlington, VA: Organization for Autism Research.
American Academy of Pediatrics. Understanding Autism Spectrum Disorders [pamphlet]. Elk Grove Village, IL: American Academy of Pediatrics; 2005.
National Institute of Child Health and Human Development Autism Site
National Research Council (2001). Educating Children with Autism. Washington, DC: National Academy Press.
Wilkinson, L. A. (2010). A best practice guide to assessment and intervention for autism and Asperger syndrome in schools. London: Jessica Kingsley Publishers.
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Best Practice Books
- National Research Council (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. C. Lord & J. P. McGee (Eds). Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.
- Attwood, T. (2006). The complete guide to Asperger’s syndrome. London: Jessica Kingsley Publishers.
- Baker, J. (2008). No More Meltdowns: Positive Strategies for Managing and Preventing Out-Of-Control Behavior. Arlington, TX: Future Horizons.
- Baron-Cohen, S. (2008). Autism and Asperger syndrome: The facts. New York: Oxford.
- Bashe, P. R., & Kirby, B. L. (2005). The OASIS guide to Asperger syndrome: Advice, support, insight, and inspiration. New York: Crown Publishing.
- Bellini, S. (2006). Building Social Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and Other Social Difficulties. Shawnee Mission, KS: Autism Asperger Publishing Company.
- Gaus, V. L. (2007). Cognitive-behavioral therapy for adult Asperger syndrome. New York: Guilford.
- Klin, A., Volkmar, F. R. & Sparrow, S. S. (Eds.). (2000). Asperger’s syndrome. New York: The Guilford Press.
- Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Baltimore, MD: Paul H. Brookes Publishing.
- Ozonoff, S., Dawson, G., & McPartland, J. (2002). A parent’s guide to Asperger syndrome and high-functioning autism: How to meet the challenges and help your child to thrive. New York: Guilford Press.
- Stone, W. L. (2006). Does my child have autism? A parent’s guide to early detection and intervention in autism spectrum disorders. San Francisco, CA: Jossey Bass.
- Twachtman-Cullen, D., & Twachtman-Bassett, J. (2011). The IEP from A to Z: How to create meaningful and measurable goals and objectives. San Francisco, CA: Jossey-Bass.
- Twachtman-Cullen, D., & Twachtman-Reilly, J. (2003). How Well Does Your Child's IEP Measure Up? Quality Indicators for Effective Service Delivery. London: Jessica Kingsley Publishers.
- Volkmar, F. R., Paul, R., Klin, A., & Cohen, D. (Eds.) (2005). Handbook of autism and pervasive developmental disorders (3rd. ed.) (Vols. 1 & 2). Hoboken, NJ: John Wiley & Sons.
- Wilkinson, L. A. (2010). A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools. London: Jessica Kingsley Publishers.
- Wilkinson, L.A. (Ed.). (2014). Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. Washington, DC: American Psychological Association.
- Wilmshurst, L. & Brue, A. (2010). The complete guide to special education: Expert advice on evaluations, IEPs, and helping kids succeed (Second Edition). San Francisco, CA: Jossey-Bass.
Best Practice Articles
- Ozonoff, S., Goodlin-Jones, B. L., & Solomon, M. (2005). Evidence-based assessment of autism spectrum disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 523–540.
- Simpson, R.L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20(3), 140-149.
- Wilkinson, L. A. (spring, 2012). Relationship – The fourth “R” in our schools. Autism Spectrum Quarterly, 8-10.
- Wilkinson, L. A. (2005). Supporting the inclusion of a student with Asperger syndrome: A case study using conjoint behavioural consultation and self-management. Educational Psychology in Practice, 21, 307-326.
- Wilkinson, L. A. (2006, September-October). Self management: A proactive strategy for students with Asperger syndrome. Autism-Asperger’s Digest Magazine, 32-38.
- Wilkinson, L. A. (2007, May). Adults with Asperger syndrome: A lost generation? Autism Spectrum Quarterly.
- Wilkinson, L. A. (2008). Adults with Asperger syndrome: A childhood disorder grows up. The Psychologist, 21, 764-770.
- Wilkinson, L. A. (2008). Self-management for high-functioning children with autism spectrum disorders. Intervention in School and Clinic, 43, 150-157.
- Wilkinson, L. A. (2008). The gender gap in Asperger syndrome: Where are the girls?
- Wilkinson, L. A. (2010). Facilitating the identification of autism spectrum disorders in school- age children. Remedial and Special Education.
- Wilkinson, L. A. (2010). School-Age Children with Autism Spectrum Disorders: Screening and Identification. European Journal of Special Needs Education, 25, 211-223.
- Wilkinson, L. A. (2011). Identifying students with autism spectrum disorders: A review of selected screening tools. Communiqué, 40, pp. 1, 31-33.
- Wilkinson, L. A. (2011). Mindblindness. In S. Goldstein & J. Naglieri (Eds.), Encyclopedia of Child Behavior and Development. New York: Springer.
- Wilkinson, L. A. (2011). Pragmatics. In S. Goldstein & J. Naglieri (Eds.), Encyclopedia of Child Behavior and Development. New York: Springer.
- Wilkinson, L. A. (summer, 2008). Suffering in silence: Girls with Asperger syndrome. Autism Spectrum Quarterly, 20-24.
Best Practice Links
- Association for Science in Autism Treatment
- Autism Parenting Magazine
- Autism Research Centre
- Autism Society of America
- Autism Speaks
- Center for Autism and Related Disabilities
- First Signs
- Global and Regional Asperger Syndrome Partnership (GRASP)
- National Autism Center
- National Autistic Society
- National Professional Development Center (NPDC) on ASD
- Organization for Autism Research
- Parent Coaching for Autism
- Research Autism
- Special Needs Book Review
- The Autism Place at Illinois State University
- Thriving With Autism
- Yale Child Study Center