Wednesday, May 30, 2012

Test Review: The Pragmatic Language Skills Inventory (PLSI)

The assessment of communication skills is vital component of a comprehensive assessment for children with autism spectrum disorders (ASD). A best practice communication assessment should provide information about the child’s communicative abilities in both the verbal and nonverbal domains, and should not be limited to the formal, structural aspects of language (e.g., articulation and receptive/ expressive language functioning). Particular attention should be given to the pragmatic, social communicative functions of language (e.g., turn taking, understanding of inferences and figurative expressions) as well as to the nonverbal skills needed to communicate and regulate interaction (e.g., eye contact, gesture, facial expression, and body language).
Assessments to identify pragmatic language deficits are not as well developed as tests of language fundamentals. Few standard measures are available to assess these skills in higher functioning children with ASD. Valid norms for pragmatic development and objective criteria for pragmatic performance are also limited. Available standardized instruments that focus specifically on pragmatic language include the Test of Pragmatic Skills (TPS), the Comprehensive Assessment of Spoken Language (CASL), the Test of Pragmatic Language, 2nd Edition (TOPL-2), the Test of Language Competence (TACL), the Children's Communication Checklist-Second Edition (CCC-2) and the Pragmatic Language Skills Inventory (PLSI). 

Description
The Pragmatic Language Skills Inventory (PLSI) is a norm referenced rating scale designed to assess the pragmatic language skills of children between 5 and 12 years of age. It can also be used to specify therapy goals for these children, conduct follow-up evaluations, and document progress. The PLSI consists of 45 items that comprise three subscales (each with 15 items):
  • Personal Interaction Skills (initiating conversation, asking for help, participating in verbal games, and using appropriate nonverbal gestures)
  • Social Interaction Skills (when to talk and when to listen, understanding classroom rules, taking turns in conversations, and predicting consequences) 
  • Classroom Interaction Skills (using figurative language, maintaining topic, explaining how things work, writing stories, and using slang)
The test takes 5 to10 minutes to complete by an adult (e.g., parent, teacher, teacher assistant) who assigns each item a score from 1 to 9 based on his or her knowledge of the child and that of children of the same age and gender regarding a particular skill (e.g., writing a good story, taking turns in conversation, asking for help or favors). The authors specify that the rater should know the child well and be familiar with that child's language skills. Scoring and interpretation are made by a qualified examiner (e.g., speech-language pathologist, school psychologist).
Once the rater has assigned scores for all 45 items, the examiner derives percentile ranks and standard scores (mean = 10, SD = 3) for each of the subscales. Standard scores for the three subscales are summed to determine a child's Pragmatic Language Index (PLI) score (mean = 100, SD = 15) and overall percentile rank. The PLI is considered the best estimate of a student’s pragmatic language ability and the score that should be used by examiners to identify students who may have a pragmatic language deficit. Descriptive scores for the subscales and PLI range from “Very Poor” to “Very Superior.” Generally, scores in the Below Average, Poor, and Very Poor ranges suggest a pragmatic language disorder (PLI < 89).
Psychometric Characteristics
The PLSI was standardized on 1,175 students (610 boys, 565 girls) between 5 and 12 years of age. The sample represents the U.S. population of school-age children with respect to geographic region, gender, race, ethnicity, and disability status. Reliability data are reported in the manual and indicate high levels of internal consistency, excellent interrater agreement, and good test-retest reliability.
The test manual also reports information for content, criterion, and construct validity. Construct validity is reportedly high. Criterion-related validity (concurrent validity) was established by correlating scores of the PLSI with performance on the Test of Pragmatic Language (TOPL). There was a strong relationship between the two measures, indicating that the PLSI and TOPL measure very similar constructs (e.g., pragmatic language). The diagnostic validity of the test was assessed by comparing test scores for a group of 40 students with disabilities (autism, learning disability, attention-deficit/hyperactivity disorder, and mental retardation), a group of 45 gifted and talented students, and the normative sample. As expected, the PLI scores for the students with disabilities were significantly lower than those in the other two groups. Students with autism and mental retardation received the lowest scores among the various diagnostic groups.
Conclusion
Speech-language evaluations for any child with communication concerns should include a screening of the child's social-communication skills. Norm-referenced parent and teacher report measures such Pragmatic Language Skills Inventory (PLSI) provides a time-efficient option for screening children's social-communication skills. If such screening reveals concerns about a child's skills, a more comprehensive evaluation should be completed.
As with all tests, the PLSI has strengths and weaknesses. A strength is its standardization with a representative sample of the U.S. population. The PSLI also demonstrates high levels of internal consistency, excellent interrater agreement, good test-retest reliability, and correlates highly with Test of Pragmatic Language (TOPL). The record forms are clear and easy to follow for the many individuals who are likely to administer, score, and interpret the test. The PLSI has an especially important advantage of sampling pragmatic skills in the child’s natural environment.
A relative weakness involves the selection of an individual who knows a child well enough to accurately rate his or her pragmatic skills. Although no special training is required to make PSLI ratings, the rater is expected to have some basic knowledge and experience with behavior rating scales. According to the manual, the rater should also “have a good grasp of what is typical or average behavior for the child's age and gender.” Consequently, it may be problematic to assume that a parent, teacher's assistant, or classroom teacher would know when a child was advanced, average, or behind on the type of pragmatic abilities assessed on the PLSI. It should be noted, however, that the examiner can complete the PLSI with teachers in a structured interview format. Although the authors conclude that “The work we have done so far should be sufficient to establish the PSLI as a promising new alternative way of identifying students who have a pragmatic language disorder,” further research is needed to examine the instrument’s accuracy (sensitivity) in predicting group membership (normative sample and clinical groups).
In conclusion, the PSLI is a brief, quantitative measure based on naturalistic observations of parents and teachers that can be used as an effective screener in clinical or educational settings, an aid to clinical diagnosis, or a measure of response to intervention.  Of course, the PSLI should not be used in isolation to make decisions regarding classification and intervention planning. Results from other instruments, direct observations, and parent interviews provide valuable information for identifying a pragmatic language disorder.
Gilliam, J. E., & Miller, L. (2006). Pragmatic Language Skills Inventory. Austin, TX: Pro-Ed.
Review of the Pragmatic Language Skills Inventory. Guyette, T. & Kelly, D. (2007)Buros Institute of Mental Measurements, 461-466.
Wilkinson, L. A. (2010).  A best practice guide to assessment and intervention for autism and Asperger syndrome ins schools. London & Philadelphia: Jessica Kingsley Publishers. 

Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.  He is also editor of a text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools, and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHis most recent book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd Edition).
© Lee A. Wilkinson, PhD

Saturday, May 26, 2012

A Parent's Guide to Evidence-Based Practice and Autism


Autism is a disorder with no known cause or cure. Parents of children with ASD will understandably pursue interventions and treatments that offer the possibility of helping their child, particularly if they are perceived as unlikely to have any adverse effects. Unfortunately, families are often exposed to unsubstantiated, pseudoscientific theories, and related clinical practices that are ineffective and compete with validated treatments, or that have the potential to result in physical, emotional, or financial harm. The time, effort, and financial resources spent on ineffective treatments can create an additional burden on families. As a result, parents and caregivers everywhere are eager for credible, research-based information on the most effective treatments for autism spectrum disorders (ASD). To address this need, the National Autism Center has released its newest manual, A Parent's Guide to Evidence-Based Practice and Autism, to help parents and caregivers differentiate empirically validated treatment approaches from treatments that are unproven and/or potentially ineffective.
The 134-page manual focuses on helping parents as they make decisions about how to best help children with ASD reach their full potential. It begins with a review of the autism spectrum, symptoms, and co-occurring conditions, and identifies and describes effective treatments. Other topics include the importance of professional judgment, the role of family preferences and values in the decision-making process, and factors to consider when choosing a team of professionals to help their child.
“Finding information about autism is easy. It is much more difficult to find reliable information that has withstood the rigors of science, is comprehensive in scope, and is accessible and easy to read,” said Hanna C. Rue, Ph.D., BCBA-D, Director of Evidence-based Practice for the National Autism Center and one of the manual’s authors. “Even for a trained professional, sorting through the clutter to find information that is most relevant to a child’s needs is a complicated and challenging process.”
One of the most distinctive and important features of this manual is that it was co-authored by professionals and parents of children with autism. “As professionals, we think about treatment from an entirely different perspective than a parent,” Dr. Rue comments. “We felt it was critical that the parent experience be reflected in every aspect of the manual.”
The manual is the latest in a series of publications by the National Autism Center. Visit the Center’s website to download a free copy, watch a video, or learn more.
About the National Autism Center
The National Autism Center is May Institute’s Center for the Promotion of Evidence-based Practice. It is dedicated to serving children and adolescents with Autism Spectrum Disorders (ASD) by providing reliable information, promoting best practices, and offering comprehensive resources for families, practitioners, and communities.
An advocate for evidence-based treatment approaches, the National Autism Center identifies effective programming and shares practical information with families about how to respond to the challenges they face. The Center also conducts applied research and develops training and service models for practitioners. Finally, the Center works to shape public policy concerning ASD and its treatment through the development and dissemination of National Standards of Practice.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley PublishersHe is also the editor of a new Volume in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools.

Key Components of Educational Programs for Autism Spectrum Disorders (ASD)

There has been a dramatic worldwide increase in reported cases of autism over the past decade. Today, autism spectrum conditions affect approximately 1 to 2 % of the school-age population. Mental health professionals, educators, and policy makers recognize that educational programs are essential to providing effective services to children with ASD. Behavioral and educational interventions are currently the benchmark interventions for autism. However, educators are faced with some unique challenges. Children with autism have intellectual and academic profiles that can differ to a large degree. No two children are alike. As a result, no one program exists that will meet the needs of every child with autism. Additionally, children with autism learn differently than typical peers or children with other types of developmental disabilities. To meet the needs of the individual child, it is critical to examine the child’s strengths, weaknesses and unique needs when determining the appropriate educational placement and developing a program of special services. While the components of intervention programs might vary, it is generally agreed that program intensity combined with early identification can lead to substantial improvement in child functioning. The following are key components of a comprehensive educational program for students with ASD.
• An effective, comprehensive educational program should reflect an understanding and awareness of the challenges presented by autism.
• Parent-professional communication and collaboration are key components for making educational and treatment decisions.
• On-going training and education in autism are important for both parents and professionals. Professionals who are trained in specific methodology and techniques will be most effective in providing the appropriate services and in modifying curriculum based upon the unique needs of the individual child.
• Inclusion with typically developing peers is important for a child with ASD as peers provide the best models for language and social skills. However, inclusive education alone is insufficient, empirically-based intervention and training is also necessary to address specific skill deficits.
• Assessment and progress monitoring of a student with ASD should be completed at specified intervals by an interdisciplinary team of professionals who have a knowledge base and experience in autism.
• A comprehensive IEP should be based on the child’s unique pattern of strengths and weaknesses. Goals for a child with ASD commonly include the areas of communication, social behavior, adaptive skills, challenging behavior, and academic and functional skills. The IEP must address appropriate instructional and curricular modifications, together with related services such as counseling, occupational therapy, speech/language therapy, physical therapy and transportation needs. Transition goals must also be developed when the student reaches 16 years of age.
• Teaching social skills in the setting (classroom) in which they naturally occur is the most effective approach and helps the generalization of the skills to new environments.
• No single methodology is effective for all children with autism. Generally, it is best to integrate scientifically validated approaches according to a child’s needs and responses.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.

© Lee A. Wilkinson, PhD

Friday, May 25, 2012

Evidence-Based Practice and Autism in the Schools


School professionals are now expected to participate in the identification and treatment of children with autism spectrum disorders (ASD) more than at any other time in the recent past. Practitioners must be prepared to recognize the presence of risk factors and/or early warning signs of ASD, engage in case finding, and be familiar with assessment tools and interventions in order to ensure that students are being identified and provided with the appropriate programs and services.
There continues to be a pressing need for evidence-based guidance on providing treatment to children with autism spectrum disorders (ASD). Schools today face the challenge of providing appropriate services to a diverse and increasingly numerous student population diagnosed with ASD. In order to achieve this goal, evidence-based practice is essential in the schools. To assist school professionals as they strive to help these students reach their potential, the National Autism Center has produced a comprehensive 245-page manual, Evidence-Based Practice and Autism in the Schools. The manual outlines relevant topics, including the current state of research findings, professional judgment and data-based clinical decision making, values and preferences of families, and capacity building. Each chapter sets a course for advancing the efforts of school systems to engage in evidence-based practice for their students on the autism spectrum.
The National Autism Center has distributed 3,000 printed copies of this manual to school systems around the country. The Educator Manual is also available to individuals on the Center’s website as a pdf at http://www.nationalautismcenter.org/learning/practitioner.php
The National Autism Center is May Institute’s center for the promotion of evidence-based practice. It is a nonprofit organization dedicated to serving children and adolescents with Autism Spectrum Disorders (ASD) by providing reliable information, promoting best practices, and offering comprehensive resources for families, practitioners, and communities.

Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.

Tuesday, May 22, 2012

What Families Want You To Know About Autism Awareness


Autism (autistic disorder) is a neurodevelopmental disorder that typically appears during the first three years of life. It affects development of the brain which causes difficulty with communication, learning, and social interaction. It is one of several autism spectrum disorders or ASD that include Asperger’s disorder (syndrome) and pervasive developmental disorder not otherwise specified (PDD-NOS). Recent statistics from the Centers for Disease Control and Prevention (CDC) indicate that one in every 88 children in the U.S. has an autism diagnosis. Over the past 10 years the rates have steadily risen, from one in 150, to one in 110, and now to one in every 88 children. This represents a 78 percent increase in the number of children identified with an autism spectrum disorder (ASD) over the past decade.
Despite this dramatic increase in prevalence and the explosion of information on the Internet about autism, the disorder is still often misunderstood by many outside the autism community. As part of a recent campaign to raise awareness about autism, the May Institute polled families served by Institute centers and schools about their experiences raising a child with autism. Parents of children with autism enrolled at the Institute’s special education schools were asked to identify hurtful or insensitive remarks that have been directed at them and their families. They also shared suggestions for how the community can be more supportive. Results of the poll reveal feelings of isolation, a sense of being judged, and a significant lack of public understanding and sensitivity.  The following are tips on “what not to say:”
“What’s wrong with her?”
“Why do you let him do that? He is scaring my child.”
“You know, there is no cure.”
“Have you tried ……? If you did, she would be more normal.”
“I don’t know how you do it.”
“Is she getting any better?”
“Why don’t you just leave your kid at home? It would be so much easier for everyone.”
“My child doesn’t know how to play with your autistic child.”
“Funding would be better spent on normal children.”
“Don’t worry – he’ll be okay.”
Parents were also asked about what they believe most people “don’t get” about autism.  The following are factual information points that families of children with autism want others to know about the disorder:
  • Autism is a spectrum disorder – each child is uniquely affected.
  • Autism is not the result of bad parenting or lack of discipline.
  • Autism can “look” like your daughter, son, niece, or grandchild.
  • Parents of children on the spectrum are not paranoid or always overwhelmed with grief. 
  • Just because a child with autism is non-verbal or does not make eye contact, it does not mean he or she doesn’t notice the looks or feel pain from being ignored, bullied, or disregarded.
  • Don’t treat kids with autism as if their diagnosis is contagious.
  • Many people with autism are social and want to interact but don’t know how.
  • Please don’t reference anyone – be it an individual with an autism diagnosis or any other diagnosis – as “retarded.
  • Be kinder than you need to be, because just about everyone is battling something you know nothing about. 
  • Parenting a child with autism is difficult and rewarding, just like it is for parents of typical children. It just takes a little more patience and understanding. 
Community and educational resources are needed to provide support for families of individuals who have autism spectrum disorders (ASD) and the professionals who work with them. Helping professionals and the general community develop a better understanding of the challenges of persons with autism and their families is critical. In the words of one parent, “We need our community to support us. Help us not to feel isolated. Everyone can help in their own way, and everybody’s contribution is appreciated.”  

Recommended Resources:

American Academy of Pediatrics. Understanding Autism Spectrum Disorders [pamphlet]. Elk Grove Village, IL: American Academy of Pediatrics; 2005. <http://www.pediatrics.org>
Autism Society of America <http://www.autism-society.org>
BestPracticeAutism.com <http://bestpracticeautism.com
National Autism Center <http://www.nationalautismcenter.org/>
National Institute of Child Health and Human Development Autism Site <http://www.nichd.nih.gov/autism>
Organization for Autism Research (OAR) <http://www.researchautism.org/>
The National Autism Center is May Institute's Center for the Promotion of Evidence-based Practice. It is dedicated to serving children and adolescents with ASD by providing reliable information, promoting best practices, and offering comprehensive resources for families, practitioners, and communities.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.

Friday, May 18, 2012

Behavioral Challenges in Autism Spectrum Disorders (ASD)


Students with autism spectrum disorders (ASD) who demonstrate serious and persistent behavioral challenges should be provided with an individual behavior intervention plan. The Individuals with Disabilities Education Act (IDEA) stipulates that a functional behavior assessment (FBA) be completed and a behavior intervention (or support) plan (BIP) implemented for students with disabilities when they are the subject of school discipline proceedings or being considered for an alternative placement. IDEA also requires that positive behavioral support programming be provided to eligible students who are in need; particularly when the behavior impedes learning or the learning of others.
Functional behavior assessment (FBA) is an important component of providing positive behavioral support to students with ASD. FBA methods are considered best practice in identifying and designing behavioral interventions. A consistent finding has been that intervention plans developed from functional assessment information are more likely to result in a significant reduction of challenging behavior. An important goal of a functional assessment is to identify antecedents or environmental situations that will predict the occurrence and nonoccurrence of the student’s challenging behavior. Another goal is to obtain and expand information that will improve the effectiveness and efficiency of intervention strategies. FBA identifies the function(s) that the behavior appears to serve for the student. For example, students might exhibit challenging behaviors with the goal of escape or the goal of seeking attention. When the curriculum is difficult or demanding, students may attempt to avoid or escape work through their behavior (e.g., refusal, passive aggression, disruption, etc.). They may also use challenging behavior to get attention from adults and peers. Because students with ASD also have significant social and pragmatic skills deficits, they may experience difficulty effectively communicating their needs or influencing the environment. Thus, challenging classroom behavior may serve a purpose for communicating or a communicative function. When we understand the goal of student behavior then we can begin to teach alternative replacement behavior and new interactional skills. 
The process of conducting an FBA is best described as (a) an strategy to discover the purposes, goals, or functions of a student’s behavior; (b) an attempt to identify the conditions under which the behavior is most likely and least likely to occur; (c) a process for developing a useful understanding of how a student’s behavior is influenced by or relates to the environment; and (d) an attempt to identify clear, predictive relationships between events in the student’s environments and occurrences of challenging behavior and the contingent events that maintain the problem behavior.   

An FBA can be conducted in a variety of ways. There are two general assessment tools to assist in the collection of information about the variables and events that surround the occurrence (or nonoccurrence) of the student’s challenging behavior. The first are interviews and rating scales that provide information from the individuals (parents, teachers) who know the student best, along with the student themselves. The second method is direct observation of the student in his or her natural daily environments. One observation strategy for collecting observational information is the A-B-C format. The observer records the Antecedent to the behavior (what happened immediately before the behavior), describes the Behavior, and the Consequence of the behavior (what happened immediately after). The following steps are a general guide to developing a comprehensive student behavior intervention or support plan.
  • Development of the plan should begin with a functional assessment (FBA) of the problem behavior to understand the student and the nature of the challenging behavior in the context of the environment.
  • Next, the professional team examines the results of the functional assessment and develops hypothesis statements as to why the student engages in the challenging behavior. The hypothesis statement is an informed, assessment-based explanation of the challenging behavior that indicates the possible function or functions served for the student.
  • Once developed, the hypothesis provides the foundation for the development of intervention strategies. The focus of intervention plan is not only on behavior reduction, but for also teaching appropriate, functional (generally communicative) skills that serve as alternative/replacement behaviors for the undesirable behavior. 
  • Following implementation of the BIP, the team regularly reviews and evaluates its effectiveness and makes modifications as needed.      

Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.

© Lee A. Wilkinson, PhD

Thursday, May 17, 2012

Early Intensive Behavioral Intervention (EIBI) for Autism

Early intensive behavioral intervention (EIBI) is considered a central feature of intervention programming for children with autism. EIBI programs are among the most and best researched of the psychoeducational interventions. Several research publications and meta-analysis indicate that early intensive behavioral intervention (EIBI) may improve the quality of life and level of functioning for children with autism spectrum disorders (ASD). EIBI programs are based on applied behavior analysis (ABA), a behavioral approach that is well supported in the research literature. ABA can be thought of as an inclusive term that encompasses a number of concepts and techniques used in the assessment, treatment, and prevention of behavioral problems in children with ASD. Perhaps the best known technique within EIBI is called discrete trial training. This method involves breaking behaviors down into subcategories and teaching each subcategory through repetition, positive reinforcement, and prompts that are gradually removed from the program as the child progresses. The principles of ABA are also incorporated within other interventions and programs such as incidental teaching and pivotal response training.
EIBI programs have typically focused on preschool and young children. Research now suggests that school-age children with ASD may benefit as much as younger children from this approach and that EIBI programs can be successfully adapted to school settings. Although there is little professional disagreement that EIBI is an effective treatment, on average, for children with autism, we should be mindful that it does not produce significant changes in all areas of children’s functioning or result in similar gains for all children. Moreover, EIBI may not be appropriate for all children. While EIBI is an important and effective intervention approach, there is a need for further research documenting the maintenance of gains of EIBI and long-term outcomes.

Further information on evidence-based treatment/intervention for autism is available from the National Autism Center.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers. He is also editor of a text in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools, and author of the book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, (2nd Edition).

© Lee A. Wilkinson, PhD

Sunday, May 6, 2012

Book Review: Autism and Asperger Syndrome in Schools


Book Review: A Best Practice Guide to Assessment and Intervention For Autism and Asperger Syndrome in Schools 

L. A. Wilkinson  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools. Philadelphia, PA: Jessica Kingsley, 2010.
Reviewed by: Adam W. McCrimmon, University of Calgary, Calgary, Alberta, Canada DOI: 10.1177/0829573510393154
Brief Introduction
A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools is a new book providing comprehensive and detailed information pertaining to school-based assessment and treatment of Pervasive Developmental Disorders (also commonly referred to as autism spectrum disorders). Written by Dr. Lee A. Wilkinson, a practicing school psychologist, professor, and established researcher in the field of autism spectrum disorders, the book contains seven chapters, each focusing on a specific aspect of working with and supporting individuals in this population (e.g., screening, assessment, interventions). In line with its title, the focus of the book is on the implications for practice and the implementation of best-practice approaches by mental health professionals working in a school setting. It serves as a resource for parents and mental health professionals who work with individuals with autism or Asperger syndrome within a school setting (e.g., school psychologists, educational psychologists, clinical psychologists, counseling psychologists, social workers).
Content and Structure
The initial chapter contains an overview and description of the pervasive developmental disorders, the common presenting symptomatology (the “autistic triad”), and the prevalence rates of each disorder. This initial description is thorough and provides the reader with explicit and relevant information on the common characteristics of each disorder as well as the important clinical and behavioral differences among them. Many readers will appreciate the detail taken in these descriptions and will likely be better informed about the specific features of each disorder and the broader category of pervasive developmental disorders as a whole.  
Following from this, the book focuses on autism and Asperger syndrome specifically, beginning with a systematic description of the best practices approach to assessment through the processes of initial screening and formal assessment. Specific measures related to each of these processes are described and compared, providing the reader with evidence-based information pertaining to the utility of specific screening and diagnostic measures/tools as well as effective and efficient diagnostic process. The author then progresses on to a discussion of best practices in intervention and educational supports, including a description of the existing evidence base for a variety of commonly used approaches and strategies. The author concludes with a discussion of future research directions and specific areas in need of targeted investigation.
Critique
The focus of this book is on providing practitioners and caregivers more in depth information pertaining to autism and Asperger syndrome. The layout of the book is easy to read as it is written for a varied audience. The coverage of important and relevant topics is thorough and provides targeted information for individuals interested in learning more about this class of childhood disorders. Indeed, the chapters on screening and formal assessment provide information pertaining to specific measures and their utility. Similarly, the chapters on interventions and academic supports provide a succinct overview of current popular approaches and strategies. Furthermore, important information is highlighted through diligent use of text boxes (e.g., best practices processes and procedures within several chapters) that allow the reader to discern key information at a glance. This approach is best observed in the chapter pertaining to intervention and treatment in which the author presents information on the current empirical evidence for a variety of interventions, providing the reader with a quick overview of each and a summary of the supporting evidence, or lack thereof.
Another strength of the book is its focus on the screening process prior to formal assessment. The description of a best practices approach to quick and effective screening of individuals presented in this chapter is likely to be of particular benefit to educators and school psychologists. Indeed, if used, the measures and screening processes described in this chapter could reduce workload and increase the effectiveness of many such professionals by enabling them to provide the appropriate services (e.g., formal assessment, behavior management strategies, and/or consultation) efficiently.  
A noteworthy feature of the book is its use of two clinical case studies that are interwoven throughout several chapters. These cases provide the reader with insight regarding relevant background information, presenting symptomatology, assessment results and interpretation, and suggested intervention activities for individuals with autism or Asperger syndrome. Indeed, these case studies will likely afford greater understanding of the information provided in the book by parents, professionals, and individuals affected by autism or Asperger syndrome themselves.
A final strength of the book is its inclusion of recent research and clinical information. As such, much of the reviewed literature is up to date, providing the reader with appropriate information regarding the current state of affairs for each disorder. This inclusion of recent empirical evidence is especially important given the rapid pace of research and findings and the typical delay between development and publication of volumes such as this one.
Despite the many strengths of the book, two limitations are noted. First, the majority of information is psychological in nature, and classroom-based individuals will find little suited for their purposes. For example, the book contains very detailed and prescriptive information pertaining to psychological screening, formal assessment, and development of intervention planning. However, there is no information pertaining to specific “red flags,” behavioral indicators that teachers or other such school professionals should make note of. As many teachers, particularly those in the early elementary school years, keenly desire more information on how they can facilitate the identification of students with a possible pervasive developmental disorder, this book would seem to be an excellent resource to provide such important information. Moreover, as school psychologists are increasingly advocating for a larger consultative role in their work, and less of a role as a designated “tester,” providing such information that could then be passed along to teachers would afford greater consultative opportunities for school psychologists and enhance the working relationship with teachers. However, the lack of this information reinforces teachers’ continued reliance on psychologists or other mental health professionals to work with children in this population. 
Second, the two case studies provide an adequate picture of higher functioning aspects of individuals with a pervasive developmental disorder (e.g., “high-functioning autism” or Asperger syndrome) through the screening and formal assessment processes. However, no contextual examples of those individuals more typical of the autism population are provided. Specifically, the majority of individuals with autism demonstrate cognitive challenges and associated limitations in functioning across a variety of domains. As such, their behavioral presentation is typically much different that those described in the case studies. As well, only one of these case studies was integrated into the chapter on interventions, providing limited contextual information for the reader regarding this essential component to service delivery and support. Additional case studies may have resulted in a more inclusive and comprehensive presentation of this broad category of disorders. Thus, although the majority of the case studies provide enlightening and important information, these two specifically are more limited in scope and clinical usefulness.
Overall, this book presents readers with an excellent overview of autism and Asperger syndrome. The author has expertly formatted the book and each chapter so that the reader is provided with an excellent resource of recent and relevant information pertaining to screening, formal assessment, and interventions with individuals in this population. The use of two case studies helps to highlight some of the information presented throughout the book. Although the majority of information will be useful from a clinical or psychological perspective and is representative primarily of the higher functioning end of the autism spectrum, it is believed that many school-based professionals will be able to make use of this excellent resource.
Canadian Journal of School Psychology 2011 26: 257  DOI: 10.1177/0829573510393154
The online version of this article can be found at: http://cjs.sagepub.com/content/26/3/257.citation
Canadian Journal of School Psychology 26(3) 257–259
© 2011 SAGE Publications
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.


Autism Florida: Your First Source for Autism Information

Florida’s Center for Autism and Related Disabilities (CARD) at Florida Atlantic University (FAU CARD) has announced the launch of Autism Florida.  Autism Florida is a new statewide website designed to serve as a central point of access to information on autism to help families, individuals with autism spectrum disorders (ASD), and the professionals who serve them.
Autism Florida offers simplicity of use and ease of navigation to locate information about autism quickly and find resources in Florida that can help from the time of suspecting autism through screening, evaluation, treatment, and transitioning to adult years. As a centralized, single entry point for Florida autism information, the website provides a directory e-resources, websites, specific topics, and a list of frequently asked questions (F & Q). Links to existing resources include information from Florida’s Center for Autism and Related Disabilities (CARD), state agency websites, the Dan Marino Foundation, and other organizations. The website was developed by the Florida State University Autism Institute at the request of the Governor’s Task Force on ASD in collaboration with CARD and the Florida Department of Health. The Task Force recognized the need to create a website to provide Florida Families easily accessible and useful information about autism and related disabilities. Autism Florida is a work in progress and content will be added and updated regularly.
Florida’s Center for Autism and Related Disabilities (CARD) has provided services to individuals with autism and related disabilities, their families, and to the professionals who work with them since 1993. CARD’s purpose is to enhance the lives of individuals by helping them become valued members of their communities. CARD offers supports within the natural contexts of homes, residences, child care programs, schools, and communities at no cost. The Florida State Legislature allocates funds that are administered to the following seven regional CARD sites through the state’s Department of Education.
Florida’s Center for Autism and Related Disabilities (CARD) has provided services to individuals with autism and related disabilities, their families, and to the professionals who work with them since 1993. CARD’s purpose is to enhance the lives of individuals by helping them become valued members of their communities. CARD offers supports within the natural contexts of homes, residences, child care programs, schools, and communities at no cost. The Florida State Legislature allocates funds that are administered to the following seven regional CARD sites through the state’s Department of Education.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.
© Lee A. Wilkinson, PhD

Thursday, May 3, 2012

DSM-5 Changes for Autism: Final Call for Comments


The American Psychiatric Association's (APA) new diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for autism has been widely publicized. While final decisions are still months away, the recommendations reflect the work of many of the nation’s best scientific and research minds and are supported by more than a decade of intensive study and analysis. The proposal by the DSM-5 Neurodevelopmental Work Group recommends a new category called Autism Spectrum Disorder which would incorporate several previously separate diagnoses, including autistic disorder, Asperger’s disorder (syndrome), childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (PDD-NOS). This new category reflects members’ conclusion that a single spectrum disorder better describes our understanding about the pathology and clinical presentation of the neurodevelopmental disorders.
For the next 6 weeks, the public will once again be offered the opportunity to submit comments on the draft fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The preliminary draft revisions to the current diagnostic criteria for autism as well as revisions to the diagnostic criteria for other psychiatric diagnoses is open for final public comment from May 2nd through June 15th, 2012. This commenting period marks the third and final time DSM-5 draft criteria will be available for your feedback. Following this period the site will remain viewable with the draft proposals until DSM-5’s publication. Release of DSM-5 is scheduled for May 2013, culminating a 14-year revision process.
To learn more about the proposed changes to the criteria for autism and take part in this historic process, please visit the DSM-5.org Web site. Comments on the proposed revision to Autism Spectrum Disorder can be made directly via the Neurodevelopmental Disorders page.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.
© Lee A. Wilkinson, PhD


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