Sunday, October 16, 2016

What Do School Personnel Know About Autism?

Autism spectrum disorder (ASD) affects approximately 1 to 2 % of the school-age population.  The majority of children with autism are educated within the public school system, most often in general education classes, either full- or part-time. Thus, teachers (regular and special education) and other school personnel must be familiar with current best practices for identifying and treating children with ASD. However, many do not have formal training in educating and intervening with this group of children. To address the increased need for services in school settings, it has been recommended that school personnel participate in trainings to develop the skills and competencies necessary to provide effective services to students with ASD. 

Although a review of the literature suggests that school personnel are receiving some specialized training related to autism, there continues to be a pressing need for more continuing education opportunities and improved preparation. It is vital that school personnel understand this complex disorder in order to help students achieve positive outcomes, especially since they share the responsibility of educating the increasing number of children being identified with ASD.
Pilot Study
Although there is a paucity of research focusing on school personnel's perceived and/or factual knowledge of autism, a pilot survey published in the School Psychologist provides us with an exploratory investigation of teacher, counselor, and paraprofessional knowledge of autism. The survey attempted to answer the following questions: (a) To what extent do school personnel (teachers, counselors, and paraprofessionals) perceive that they are competent in their understanding of autism?; (b) What is school personnel's factual knowledge of autism (definition, assessment/diagnosis, and treatments)?; and (c) To what extent do school personnel that work directly with students with autism differ in their perception and factual knowledge of autism in comparison to those who do not work with students with autism?
Fifty-four school personnel from a southwestern state participated in the pilot survey. Participants were school district employees enrolled in various graduate level majors who were attending a small university (within the college of education) in the Southwestern United States. The sample included 26 general education teachers, 14 special education teachers, 7 school counselors and 7 paraprofessionals. Seventy percent indicated that they worked directly with students diagnosed with autism (instructor, interventionist, care-provider, etc.), while approximately 30 percent indicated that they indirectly served students with autism (consultant, academic planning, multidisciplinary team member, etc.). A majority indicated that they had never participated in autism training(s) and when asked whether they would like to take part in future training(s), most indicated that they did not have a desire to participate.
Participants completed two measures developed by the authors, a Perceptions Survey and a Knowledge Survey. Both measures contained items derived from empirically-supported findings in the research literature. The Perceptions Survey items were designed to assess the respondents' perceived competence of their knowledge and ability to implement research findings. The Knowledge Survey items were designed to assess the respondents' factual knowledge of research findings about autism (definition, assessment/diagnosis, and treatment).
The results of the survey indicated that overall, the perceived competence of general and special education teachers, school counselors, and paraprofessional regarding their knowledge of autism was average. Although school personnel that work directly and indirectly with students both reported having average perceived competence, those providing direct service had a statistically significantly higher level of perceived competence. The results of the Knowledge Survey indicated that school personnel who work directly with students correctly defined the disorder, while those that do not demonstrated moderate knowledge with some errors. However, school personnel's factual knowledge about the assessment/diagnosis and treatment of autism was low, regardless of whether services were delivered directly or indirectly.
The findings of this pilot survey raise several important questions about school personnel’s perceived and factual knowledge about autism. A majority of participants indicated they had no prior training and expressed little interest in receiving education related to autism in the future. This is concerning, given that all participants working with students with autism, either directly or indirectly, reported average perceived competence yet demonstrated a low level of factual knowledge. This divergence suggests that teachers, school counselors, and paraprofessionals may overestimate their factual knowledge about autism and as a result, fail to see a need for additional training.
Despite the study’s limitations (e.g., small sample size) and need for further research relating to school personnel’s perceptions and knowledge, the results have significant implications for school-based practice. For example, administrators, supervisors, and support professionals such as school psychologists should exercise caution when assuming that school personnel have an adequate factual understanding and working knowledge of autism. It is also important to recognize that anecdotal reports are insufficient when determing the need for training and that direct assessment of factual knowledge is required. Failure to correctly identify training needs can have a negative effect on screening/assessment and intervention selection, planning, and implementation. The results also raise an important question as to what extent school personnel’s perceived knowledge about autism might limit their willingness to participate in training and contribute to resistance in consultation.
Concluding Comments
There is a critical need for more coordinated efforts among community and school professionals for the training of teachers in evidence-based instruction and behavioral management practices for children with ASD. Because the knowledge base in ASD is changing so rapidly, it is imperative that school personnel remain current with the research and up to date on scientifically supported approaches that have direct application to the educational setting. For example, some intervention and assessment procedures require a specific knowledge base and skills for successful implementation. It is vital that service providers understand best practice procedures across school, community, and home settings. School personnel can help to ensure that students with ASD receive an effective educational program by participating in training programs designed to increase their understanding and factual knowledge about assessment and intervention /treatment approaches.
Williams, K., Schroeder, J. L., Carvalho, C., & Cervantes, A. (2011). School personnel knowledge of autism: A pilot survey. The School Psychologist, 65, 7-9.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist and a certified cognitive-behavioral therapist. He 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 the editor of a best-selling 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 CBT. Dr. Wilkinson's latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)
© Lee A. Wilkinson, PhD

Wednesday, October 5, 2016

Approved Online Continuing Education Course for Psychologists

This new 3-hour online continuing education course, Autism Spectrum Disorder: Evidence-Based Screening & Assessment, is APA-approved and available for credit for psychologists. Epidemiological studies indicate a progressively rising prevalence trend for autism spectrum disorders (ASD) over the past decade. School professionals and clinicians must be prepared to recognize the presence of risk factors and/or early warning signs of ASD and be familiar with screening and assessment tools in order to ensure that students are being identified and provided with the appropriate programs and services. The objectives of this course are to identify DSM-5 diagnostic changes in the ASD diagnostic criteria, summarize the empirically-based screening and assessment methodology in ASD, and describe a comprehensive developmental approach for assessing children, adolescents, and young adults with ASD. Course #30-69 | 44 pages | 40 posttest questions. CE Credit: 3 Hours
              Learning Objectives 
  1. Identify the changes in the new DSM-5 criteria for ASD 
  2. Distinguish between DSM diagnosis and IDEA classification schemes 
  3. Identify the three levels of a multi-tier assessment strategy to screen for ASD 
  4. List the components of a comprehensive developmental assessment for ASD 
  5. Name co-occurring conditions commonly found in ASD 
  6. Name key components of programs and services for ASD
 CE Information  

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; by the Continuing Education Board of the American Speech-Language-Hearing Association (ASHA Provider #AAUM) to provide continuing education activities in speech-language pathology and audiology; by the National Board of Certified Counselors (NBCC) to offer home study continuing education for NCCs (Provider #5590); by the Association of Social Work Boards (ASWB Provider #1046, ACE Program); by the National Association of Alcoholism & Drug Abuse Counselors (NAADAC Provider #000279); by the American Occupational Therapy Association (AOTA Provider #3159); by the Commission on Dietetic Registration (CDR Provider #PR001); by the California Board of Behavioral Sciences (#PCE1625); by the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); by the Illinois DPR for Social Work (#159-00531); by the Ohio Counselor, Social Worker & MFT Board (#RCST100501); by the South Carolina Board of Professional Counselors & MFTs (#193); and by the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).
 About the Author
Lee A. Wilkinson, EdD, PhD, NCSP, is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. Dr. Wilkinson is also a university educator and teaches graduate courses in psychological assessment, clinical intervention, and child and adolescent psychopathology. His research and professional writing has focused on behavioral consultation and therapy, and children and adults with autism spectrum disorders. He has published numerous journal articles on these topics both in the United States and internationally. Dr. Wilkinson 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 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).

Tuesday, October 4, 2016

Book Review - "THE LOVING PUSH"

The LovingPush: ​How parents and professionals can help spectrum kids become successful adults 
by Temple Grandin, PhD and Debra Moore, PhD

Young adults on the autism spectrum face significant challenges as they transition to adulthood, with many being socially isolated, unemployed, and lacking services. Unfortunately, research suggests that the vast majority of these young adults will be residing in the parental or guardian home during the period of emerging adulthood. It is clear that more needs to be done to help them thrive to the best of their abilities and attain a high quality of life. "The Loving Push” by Drs. Grandin and Moore addresses these issues with a direct, yet empathetic and positive discussion of ways in which parents and professionals can enhance the potential of "spectrum kids" of any age and help them achieve productive and meaningful adult lives.
The authors convey a critical message that, more than other children and youth, those on the autism spectrum must overcome "learned helplessness" and move beyond their comfort zone in order to reach their full, unique potential. Pushing is necessary,” the authors write, “because those on the spectrum are unlikely to automatically pick up the mundane but necessary tasks of daily life without us intentionally nudging them and providing them with information, encouragement, and persistence.”
"The Loving Push" consists of Three Parts: Part I -The Path to Success Starts Here: Restoring Hope; Part –II: Stretching Your Child & Avoiding Pitfalls; and Part III: Preparing Your Child for Adulthood. Each part features Chapters containing important information, lessons, tips, and advice on how to “Lovingly Push” youth on the spectrum to reach their potential and achieve a successful transition to adulthood. The book begins by sharing 8 inspiring profiles of persons on the spectrum and using their real-life stories to illustrate the three essential components of success: “Avoiding Learned Helplessness, Learning Optimism/Resisting Habitual Negative Thinking, and The Critical Impact of Mentors.” The section on “Getting Families and Schools to Work Together” is especially important, given that transition planning is a critical part of preparing students for life after high school and producing the best outcomes. Young adults on the spectrum are particularly vulnerable during the initial years in the transition to adulthood when there is a shift in service provision after leaving high school. The authors recommend that teachers, parents, and professionals “lovingly” guide, push, and mentor our children and youth as early as possible, and for as long as possible.
The book also addresses the issue of co-occurring anxiety and depression. The authors discuss counseling and evidence-based psychotherapy approaches such as cognitive-behavioral therapy (CBT) and “mindfulness” techniques to reduce stress, and improve mood and psychological well-being. Group support for children, teens, and parents is referenced, as well as important commentary on “Psychotherapy Approaches Not Recommended.” Tips and cautions about medication use for anxiety and depression are also discussed.
“The Loving Push” devotes considerable attention to the problem of compulsive electronic gaming and how it can turn kids on the spectrum into “media recluses” and social isolates. Since children and youth on the spectrum tend to engage in restricted and repetitive behaviors, they are at higher risk for developing addictive game play patterns. Preoccupation with video games and trouble disengaging from them limits the opportunity for learning critical social and problem-solving skills. This Chapter warns parents and educators about the dangers of video games and screen-based media and lists steps they can take to minimize the negative effects of compulsive gaming.
Far too often, parents and teachers of kids on the autism spectrum focus more attention on teaching academic and behavior management skills than on daily living skills. Parents are often surprised to learn that daily living skills are more important than autism symptoms, language or IQ when it comes to employment and life satisfaction. Part III (Preparing Your Child for Adulthood) discusses the building blocks for independent living such as household skills (i.e., cooking, cleaning), driving or using public transportation, educational/vocational preparation, and social/community connection. Explicit teaching of these life skills prior to the transition to adulthood is crucial if we expect kids on the spectrum to have the necessary skills to live independently and negotiate adult life.
The central theme of “The Loving Push” is that the focus of intervention/treatment for spectrum kids must shift to promoting the adaptive behaviors and basic life skills that can facilitate and enhance ultimate functional independence and quality of life in adulthood. This includes helping them learn the skills needed to meet new developmental challenges such as independent living, vocational engagement, post-secondary education, and self-supporting employment. Drs. Grandin and Moore provide a much needed “push” in this direction. As the authors’ note, “With more and more young adults on the spectrum entering adulthood everyday, we don’t have time to lose.”
"The Loving Push” is a valuable resource and must read guide to preparing spectrum kids for a successful transition to self-reliance and independence in adult life. The book is not only highly recommended for parents, caregivers, and families, but also for professionals in private practice, schools, colleges/universities, and community settings who work with children, teens, and adults on the spectrum.

Saturday, October 1, 2016

School Psychologists Need More Training in Assessment and Intervention for Autism

More children than ever before are being diagnosed with autism spectrum disorder (ASD). The U.S. Centers for Disease Control and Prevention (CDC) now estimates that 1 in 68 eight year-old children has an ASD. The occurrence of autism is also evident in the number of students with ASD receiving special educational services. Data collected for the Department of Education indicate that the number of children ages 6 through 21 identified with autism served under the Individuals With Disabilities Act (IDEA) quadrupled between 2000-01 and 2009-10; rising from 93,000 to 378,000 students and increasing to 5.8 percent of all identified disabilities.
Given the dramatic increase in ASD, school psychologists and other school-based professionals are now more likely to be asked to participate in the screening, identification, and educational planning for students with ASD than at any other time in the past. Moreover, the call for greater use of evidence-based practice has increased demands that school psychologists be knowledgeable about evidence-based assessment and intervention strategies for students with ASD. Guidelines and standards have been developed recommending best practice procedures for the assessment and treatment of ASD. There is a large and expanding scientific literature base that documents the existence of two major elements of evidence-based practice: assessments shown to be psychometrically sound for the populations on whom they are used and interventions with sufficient evidence for their effectiveness. Although school psychologists are often called on to assume a leadership role in evaluating, identifying, and providing interventions for students with ASD in our schools, there is little research to show how closely school psychologists align their practices with the parameters of best practice. Due to the increase in the number of children receiving special education services under the classification of autism, research is needed regarding the preparedness of school psychologists and schools to address the needs of children with ASD. 

Although there is a paucity of research focusing on the delivery of school psychological services for students with ASD, there are several national and state-wide surveys which provide exploratory information regarding school psychologists’ level of knowledge in the area of autism assessment and intervention; assessment methods, measures, and techniques; level of training; and perceived level of preparation and confidence.
  • Aiello & Ruble (2011) investigated school psychologists’ knowledge and skills in identifying, evaluating, and providing interventions for students with ASD. A total of 402 participants from 50 states completed their survey. Results indicated that despite a limited amount of training received during their graduate education or pre-service training for working with the autism population, most school psychologists’ self-reported knowledge of ASD was in the expected direction for agreement. However, there were gaps in knowledge regarding the differences between emotional and behavioral disorders and autism, developmental delays and autism, and special education eligibility versus DSM-IV diagnoses that need to be addressed through more training. The survey also indicated the need for additional training opportunities in providing interventions, strategies, and supports for students with autism in the following areas: developing family-centered educational plans; training peer mentors; and translating assessment information into teaching goals and activities.
  • Rasmussen (2009) also completed a national survey of school psychologists to determine their level of knowledge in the area of autism assessment; level of training; and perceived preparation and confidence in providing services to children with ASD. Results indicated that training positively affected school psychologists’ knowledge about autism; their levels of involvement with students with autism; and their perceived levels of preparation to work with this population. Of the 662 participants, the majority accurately identified diagnostic features and true and false statements about autism, suggesting an adequate understanding of autism. Participants with more training reported an increased level of involvement on multidisciplinary teams and an ability to diagnose autism when compared to those with less training. Brief rating scales were among the most commonly used instruments, while more comprehensive and robust instruments were among the least-often employed, suggesting school psychologists are either not trained or are limited in the time and resources needed to use evidence-based instruments. Participants felt more prepared to provide consultation and assessment services and less prepared to provide interventions. Although a majority (96.5%) of the respondents reported they had attended workshop presentations or in-service trainings on autism, less than half (43.7%) had completed formal course work in autism in their training program and less than one third (32.3%) had internship or residency experience with autism. These data and previous research suggest school psychologists need more formal training and experience in meeting the needs of individuals identified with autism.
  • Singer (2008) surveyed 199 school psychologists regarding the frequency with which they were called upon to provide services to students with an autism spectrum disorder (ASD); services they actually provided to those students; and their perceptions of the training and experience they had pertaining to the assessment and treatment of ASD. Additionally, the study surveyed 72 graduate programs in school psychology to determine the extent to which these programs prepared new school psychologists to work with children who have ASD. A majority of respondents (64%) reported using only brief screening instruments to identify students. Although able to identify the “red flag” indicators of ASD, very few school psychologists perceived their training as adequate. Only 12.6 % of respondents indicated that they had sufficient coursework in ASD and only 21% indicated that they had sufficient practicum experience. Just 15% indicated that their overall training with ASD was “completely adequate.” Only 5 of the 72 (16.9%) school psychology programs surveyed offered a specific course in ASD; most indicating that the topic was addressed in other courses. According to the author, the survey data suggest that school psychologists lack adequate knowledge about evidence-based instruments and procedures available to screen, assess, and intervene for ASD.
  • Pearson (2008) surveyed a group of Pennsylvania school psychologists regarding their training, knowledge and evaluation practices when assessing and diagnosing ASD. The aim of the study was to determine the extent to which school psychologists are prepared to meet the rapidly increasing demand for using best practice procedures when assessing and diagnosing ASD. An electronic survey was sent to 1,159 certified school psychologists with 243 completed surveys returned. Survey results found the majority of respondents indicated that they rely on the use of brief screening instruments and do not use or recommend "gold standard" instruments with students suspected of having ASD. Only 32.2% of the respondents reported they were very much prepared to recommend an IDEA classification of Autism. Less than 5% of the school psychologists surveyed received formal training in ASD at graduate institutions or internships. The overwhelming majority of school psychologists surveyed believed there is         a need for more training for school psychologists concerning the characteristics of ASD, best practice in the assessment of ASD, and differentiating ASD from other developmental or coexisting disorders.
  • Small (2012) used an online survey of 100 members of the Massachusetts School Psychology Association (MSPA) to obtain information pertaining to demographics, participants' experiences with the ASD population, participants' knowledge of ASD, as well as their use, competency, and feelings of usefulness of various assessment techniques and treatments/interventions. The results indicated that overall, school psychologists demonstrated adequate knowledge of ASD, felt competent conducting assessments, and reported that the assessment tools were useful. School psychologists spent less time on treatment/intervention and while they considered many of the treatments/interventions helpful, they did not feel competent implementing them. The results suggest that school psychologists need more training in ASD, especially regarding treatments/interventions, at the pre-service level through graduate school training and experiences (e.g., practica and internships), as well as at the practitioner level through professional development opportunities.
Conclusion and Recommendations
As more and more children are being identified with ASD and placed in general education classrooms, school psychologists will play an ever increasingly important role in identification and intervention, as well as offer support, information, consultation, and recommendations to teachers, school personnel, administration, and families. Therefore, it is essential that they be knowledgeable about evidence-based assessment and intervention strategies for this population of students.  Despite the limitations inherent in survey research, the data from these studies suggest that school psychologists are not adequately prepared to provide evidence-based assessment and intervention services to children with ASD. The survey research illustrates a significant discrepancy between best practice (evidence-based) parameters and reality when it comes to the practice of school psychology and ASD in the schools. Federal statutes require that school districts ensure that comprehensive, individualized evaluations are completed by school professionals who have knowledge, experience, and expertise in ASD. Although surveys indicate sufficient knowledge of the signs and symptoms associated with ASD, there is a critical need for school psychologists to be trained and develop competency in evidence-based assessment and identification practices with children who have or may have an ASD. For example, a majority of survey respondents reported using brief screening measures such the GARS and/or GADS in assessment and identification, both of which are not recommended for use in decision-making (Brock, 2004; Norris, M., & Lecavalier, 2010; Pandolfi, Magyar & Dill, 2010; Wilkinson, 2010). In contrast, evidence-based tools such as the ADOS, ADI-R, CARS, and SCQ were used less a third of the time in ASD assessment. Thus, while evidence-based instruments are available for the reliable, thorough assessment of students with ASD, school psychologists either do not have access or lack sufficient training to make them a part of their practice in the schools.
Because the knowledge base in ASD is changing so rapidly, it is imperative that school psychologists remain current with the research and up to date on scientifically supported approaches that have direct application to the educational setting. School psychologists can help to ensure that students with ASD receive an effective educational program by participating in training programs designed to increase their understanding and factual knowledge about best practice assessment and intervention /treatment approaches. Recommendations culled from the survey findings include the following: (a) school psychologists need more in-depth, formal training complete with supervision and consultation; (b) school psychology training programs should focus more energy on teaching intervention strategies for students with autism and include a separate course in ASD as part of the curriculum; (c) increase the use of more psychometrically sound autism instruments such as the ADOS and ADI-R in schools to provide better identification and more complete intervention strategies; (d) consider resident ASD specialists within the school and train teams of school professionals to work as a unit with the autism-related cases to ensure that the personnel are well-trained and have the experience necessary to conduct reliable and valid assessments and treatment planning; (e) provide training for all school psychologists on best practice guidelines for screening and assessment of ASD and identify measures with and without empirical support; and (g) develop closer relationships with ASD experts and service providers in the community. School districts may also want to consider levels of training, levels of education, and years of experience when assigning school psychologists who work with children who have ASD.  Finally, the National Association of School Psychologists (NASP) may consider developing guidelines and recommendations regarding the minimal competencies needed in order to work with special populations such as students with ASD.
Aiello, R., & Ruble, L. A. (2011, February). Survey of school psychologists’ autism knowledge, training, and experiences. Poster presented at the annual convention of the National Association of School Psychologists, San Francisco, CA.
Brock, S. E. (2004). The identification of autism spectrum disorders: A primer for the school psychologist. California State University, Sacramento, College of Education, Department of Special education, Rehabilitation, and School Psychology.
Norris, M., & Lecavalier, L. (2010). Screening accuracy of level 2 autism spectrum disorder rating scales: A review of selected instruments. Autism, 14, 263-284.
Pandolfi V., Magyar C. I., & Dill C. A. (2010). Constructs assessed by the GARS-2: factor analysis of data from the standardization sample. Journal of Autism & Developmental Disorders, 40, 1118-30. 
Pearson, L. M. (2008). A survey of Pennsylvania school psychologists' training, knowledge and evaluation practice for assessing and diagnosing autism spectrum disorders. PCOM Psychology Dissertations. Paper 112.
Rasmussen, J. E. (2009). Autism: Assessment and intervention practices of school psychologists and the implications for training in the united states. Ball State University). ProQuest Dissertations and Theses, 192. UMI Number: 3379197
Small, S. H. (2012). Autism spectrum disorders (ASD): Knowledge, training, roles and responsibilities of school psychologists. University of South Florida). ProQuest Dissertations and Theses, 220. ISBN: 9781267519658 UMI Number 3308958
Wilkinson, L. A. (2010). A best practice guide to assessment and intervention for autism and Asperger syndrome in schools. London: Jessica Kingsley Publishers.

Wilkinson LA  (2013) School Psychologists Need More Training in Providing Services to Students with Autism Spectrum Disorders (ASD). Autism 3: e117. doi:10.4172/2165-7890.1000e117

Wilkinson, L.A. (Ed.). (2014). Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. Washington, DC: American Psychological Association.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He 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 best-selling 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 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

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