Friday, November 21, 2014

Evidence-Based Practice for Autism in Schools


The Single Best Autism Resource for School-Based Professionals and Clinicians 
AUTISM SPECTRUM DISORDER IN CHILDREN AND ADOLESCENTS:
EVIDENCE-BASED ASSESSMENT AND INTERVENTION IN SCHOOLS
           Edited by Lee A. Wilkinson, PhD
School professionals and clinicians share the challenge of identifying and providing interventions for the increasing number of children with autism spectrum disorder (ASD). Incorporating the many advances made in recent years, this book is an authoritative resource for professionals who need the most current and reliable information on assessing and treating this neurodevelopmental disorder. It includes procedures to help identify children using the new DSM-5 symptom criteria and offers essential guidance for assessing a variety of emotional, behavioral, and academic problems. Comprehensive and timely, the book offers practical, research-based findings that can assist educators and school psychologists in screening and assessing children – and in implementing appropriate intervention strategies. Clearly organized and easy to follow, this new guide is essential reading for anyone working with children who have, or might have ASD.
FEATURES
  • Includes procedures to help identify children with ASD using the new DSM-5 diagnostic criteria.
  • Offers practitioners an evidence-based assessment battery, which includes tests of cognitive, academic, neuropsychological, and adaptive functioning.
  • Employs case vignettes to illustrate best practices in a school setting.
  • Concludes with a primer on ASD-related litigation issues and discusses relationships between special education law, provision of services, and placement decisions.
TABLE OF CONTENTS
Part I. Evidenced-Based Assessment of Autism Spectrum Disorder  1. Overview of Autism Spectrum Disorder  2. Multitier Screening and Identification  3. Comprehensive Developmental Assessment Model  4. Cognitive, Neuropsychological, Academic, and Adaptive Functioning  5. Language and Social Communication  6. Co-Occurring Emotional and Behavioral Problems Part II. Evidence-Based Intervention for Autism Spectrum Disorder  7. Evidence-Based Interventions in the Classroom  8. Continuum of Services and the Individual Education Plan Process  9. Curriculum and Program Structure Ÿ 10. Collaboration Between Families and Schools  11. Legal Issues Under IDEA.
2014. 264 PAGES. HARDCOVER
ISBN: 978-4338-1615-4

REVIEWS
“This fantastic resource is a must-read for professionals and students across many disciplines. Contributors provide critical information on a comprehensive range of topics with an emphasis on evidence-based approaches and practical applications.” - Natacha Akshoomoff, PhD, Associate Professor, Department of Psychiatry and Center for Human Development, University of California, San Diego
“Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools" serves as an excellent resource for professionals working with children with ASD in educational settings and covers many fundamental aspects that need to be considered in assessment and intervention practices. Overall, this book thoroughly integrates current research and theory as well as relevant practice in school settings and will allow practitioners to further their conceptual understanding of assessing and treating ASD.” - Canadian Journal of School Psychology
“This concise book provides a comprehensive and very readable introduction to best practices in the assessment and treatment of ASD in school settings. It succinctly informs the professional reader about the theoretical and research foundations underlying its many suggestions for practice, which are further enhanced by the liberal use of vignettes.” – PsycCRITIQUES

 “Wilkinson has put together a book that is quite readable and interesting. Difficult concepts are explained clearly but concisely. The style and quality of writing is consistently good across chapters. A strength of this book is the breadth of coverage. The authors meet the goal of providing professionals with information on ASD, screening, assessment, and interventions for the classroom.” - Journal of Psychoeducational Assessment

The book is represented in college/university libraries worldwide and serves as an ideal text in graduate-level courses on autism, developmental disabilities, special education, clinical and school psychology and early intervention. This highly readable and evidence-based practitioner resource sets the standard for all professionals working with students and families with ASD. 

Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools can ordered from APA Books, Amazon.com, Barnes & Noble, Books-A-MillionBook Depository, and other booksellersThe book is available in both print and eBook formats. Examination and desk copies are also available to college and university faculty.

Lee A. Wilkinson, PhD, CCBT, NCSP is an applied researcher and practitioner. He is a nationally certified and licensed school psychologist, chartered psychologist, registered educational psychologist, and certified cognitive-behavioral therapist. Dr. Wilkinson is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and 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).

Monday, November 10, 2014

Decision-Making in Adults on the Autism Spectrum



Although there has been a dramatic increase in the research and clinical studies related to children and adolescents, there is a paucity of information regarding more capable adults on the autism spectrum. It is only recently that psychologists have begun to appreciate the complex challenges faced by a “lost generation” of adults with autism spectrum disorders (ASD).  Even though the core symptoms of ASD (impairments in communication and social interaction and restricted/repetitive behaviors and interests) may improve overtime with intervention for many individuals, some degree of impairment typically remains throughout the lifespan.  Consequently, the focus of intervention/treatment must shift from remediating core deficits in childhood to promoting adaptive behaviors that can facilitate and enhance ultimate functional independence and quality of life in adulthood. This includes new developmental challenges such as independent living, vocational engagement, post-secondary education, and family support. 
Decision-making is an important part of almost every aspect of life. However, several autobiographical accounts (e.g., Temple Grandin) suggest that making decisions can present significant problems for individuals with ASD. Likewise, a small number of experimental studies have suggested differences between the decision-making of adults with ASD and their neurotypical counterparts. Despite autobiographical accounts and limited studies, the extent to which, in everyday life, people with ASD experience difficulties with decision-making is largely unknown.  

Current Research 
A recent study published in the journal Autism sought to extend this important area of research by comparing the “real-life” decision-making experiences of adults with and without ASD. The researchers hypothesized that compared with a neurotypical group, participants with ASD would report: (a) more frequent experiences of problems during decision-making (e.g. feeling exhausted), (b) greater difficulty with particular features of decisions (e.g. decisions that need to be made quickly), and (c) greater reliance on rational, avoidant, and dependent styles of decision-making. In addition, it was expected that participants with ASD would report interference from their condition when making decisions.
The participants were 38 adults with ASD and 40 neurotypical comparison adults (with no family history of ASD), aged 16 to 65 years. The groups were matched for age, gender and verbal IQ. All participants completed a novel questionnaire to evaluate their decision-making experiences. The questionnaire asked participants to rate: (a) the frequency with which particular problems in decision-making were experienced; (b) the extent to which they perceived difficulties in relation to particular features of decisions; and finally, (c) the extent to which participants with ASD believed that their condition enhanced or interfered with their own decision-making. Ratings of the frequency of 12 potential problems in decision-making were indicated on a four-point Likert-type scale (from ‘never’ to ‘often’). Participants also completed the General Decision Making Style Inventory (GDMS), a 25-item questionnaire probing reliance on five, non- mutually exclusive, styles of decision-making (rational, intuitive, dependent, avoidant, and spontaneous). Levels of anxiety and depression were assessed using the well- established Hospital Anxiety and Depression Scale (HADS).

Results
The results indicated that compared with their neurotypical peers, the participants with ASD more frequently reported difficulties in decision making. Decisions that needed to be made quickly, or involved a change of routine, or talking to others, were experienced as particularly difficult, and the process of decision-making was reported to be exhausting, overwhelming, and anxiety-provoking. The participants with ASD reported significantly higher levels of anxiety and depression and were more likely to believe that their condition interfered with rather than enhanced the decision-making process. Not surprisingly, the participants with ASD were also more likely to report that they avoided decision-making.

Conclusion and Recommendations
The overall findings of the study suggest that, compared with neurotypical individuals, individuals with ASD experience greater difficulty with decision-making. Decision-making in ASD was associated with anxiety, exhaustion, problems engaging in the process, and a tendency to avoid decision-making. These findings are consistent with previous autobiographical accounts, known features of the condition, and previous studies of decision-making in ASD. In addition, the difficulties reported by the participants with ASD may be exacerbated by higher levels of anxiety and depression. The researchers found that ratings of perceived frequency of interference from ASD increased proportionally with levels of anxiety and depression. Despite limitations of the study (e.g., self-reports), the results are consistent with suggestions from the literature relating to decision-making for people with ASD. Importantly, they also have some practical implications for supporting more capable adults with ASD. For example, it may be useful to: (a) provide additional time to reach a choice, (b) minimize irrelevant information, (c) present closed questions, (d) offer encouragement and reassurance, and (e) address general issues around anxiety. Understanding how adults with ASD experience decision-making is especially relevant for family members and professionals who are involved in providing support to help these individuals achieve greater self understanding, self-advocacy and improved decision-making in lifespan activities such as employment and personal relationships.
Luke, L., Clare, I. C. H., Ring, H., Redley, M., Watson, P. (2012). Decision-making difficulties experienced by adults with autism spectrum conditions. Autism, 16(6), 612–621.
Wilkinson, L. A. (2015). Overcoming anxiety and depression on the autism spectrum: A self-help guide using CBT. London: Jessica Kingsley Publishers.
 
Wilkinson, L. A. (2008). Adults with Asperger syndrome: A childhood disorder grows up. The Psychologist, 21, 764-770.
Wilkinson, L. A. (2007, May). Adults with Asperger syndrome: A lost generation? Autism Spectrum Quarterly.

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