Autism in the Schools
More children than ever before are being diagnosed with autism spectrum disorders (ASD). The U.S. Centers for Disease Control and Prevention (CDC) now estimates that 1 in 54 eight year-old children has an ASD. This dramatic increase in the prevalence of children with ASD over the past decade, together with the clear benefits of early intervention, have created a need for schools to identify children who may have an autism spectrum condition. It is not unusual for many autistic children to go undiagnosed until well after entering school. In fact, research indicates that only three percent of children with ASD are identified solely by non-school resources. As a result, school professionals are now more likely to be asked to participate in the screening and identification of children with ASD than at any other time in the past.
IDEA
The Individuals with Disabilities Education Act of 2004 (IDEA) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are the two major systems used to diagnose and classify children with ASD. The DSM-5 is considered the primary authority in the fields of psychiatric and psychological (clinical) diagnoses, while IDEA is the authority with regard to eligibility decisions for special education. The DSM was developed by clinicians as a diagnostic and classification system for both childhood and adult psychiatric disorders. The IDEA is not a diagnostic system per se, but rather federal legislation designed to ensure the appropriate education of children with special educational needs in our public schools. Unlike the DSM-5, IDEA specifies categories of ‘‘disabilities’’ to determine eligibility for special educational services. The definitions of these categories (there are 13), including autism, are the most widely used classification system in our schools. According to IDEA regulations, the definition of autism is as follows:
(c)(1)(i) Autism means a
developmental disability significantly affecting verbal and nonverbal
communication and social interaction, generally evident before age 3, that
adversely affects a child’s educational performance. Other characteristics
often associated with autism are engagement in repetitive activities and
stereotyped movements, resistance to environmental change or change in daily
routines, and unusual responses to sensory experiences. The term does not apply
if a child’s educational performance is adversely affected primarily because
the child has an emotional disturbance, as defined in this section.
(ii) A child who manifests the characteristics of ‘‘autism’’ after age 3 could
be diagnosed as having ‘‘autism’’ if the criteria in paragraph (c)(1)(i) of
this section are satisfied.
This educational definition is considered sufficiently broad and operationally
acceptable to accommodate both the clinical and educational descriptions of
autism and related disorders. While the DSM-5 diagnostic criteria are
professionally helpful, they are neither legally required nor sufficient for
determining educational placement. It is state and federal education codes and
regulations (not DSM-5) that drive classification and eligibility
decisions. Thus, school professionals must ensure that children meet the
criteria for autism as outlined by IDEA and may use the DSM-5 to the extent
that the diagnostic criteria include the same core behaviors (e.g.,
difficulties with social interaction, difficulties with communication, and the
frequent exhibition of repetitive behaviors or circumscribed interests). Of
course, all professionals, whether clinical or school, should have the
appropriate training and background related to the diagnosis and treatment of
neurodevelopmental disorders. The identification of autism should be made by a
professional team using multiple sources of information, including, but not
limited to an interdisciplinary assessment of social behavior, language and
communication, adaptive behavior, motor skills, sensory issues, and cognitive
functioning to help with intervention planning and determining eligibility for
special educational services.
Guidelines
Legal and special education experts recommend the following guidelines to help school districts meet the requirements for providing legally and educationally appropriate programs and services to students with ASD.
1. School districts
should ensure that the IEP process follows the procedural requirements of
IDEA. This includes actively involving parents in the IEP process and adhering
to the time frame requirements for assessment and developing and implementing
the student’s IEP. Moreover, parents must be notified of their due
process rights. It’s important to recognize that parent-professional
communication and collaboration are key components for making educational and
program decisions.
2. School districts should
make certain that comprehensive, individualized evaluations are completed by
school professionals who have knowledge, experience, and expertise in ASD. If
qualified personnel are not available, school districts should provide the
appropriate training or retain the services of a consultant.
3. School districts should
develop IEPs 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.
Evidence-based instructional strategies should also be adopted to ensure that
the IEP is implemented appropriately.
4. School districts should
assure that progress monitoring of students with ASD is completed at specified
intervals by an interdisciplinary team of professionals who have a knowledge
base and experience in autism. This includes collecting evidence-based data to
document progress towards achieving IEP goals and to assess program
effectiveness.
5. School districts should
make every effort to place students in integrated settings to maximize
interaction with non-disabled peers. Inclusion with typically developing
students is important for a child with ASD as peers provide the best models for
language and social skills. However, inclusive education alone is insufficient,
evidence-based intervention and training is also necessary to address specific
skill deficits. Although the least restrictive environment (LRE) provision of
IDEA requires that efforts be made to educate students with special needs in
less restrictive settings, IDEA also recognizes that some students may require
a more comprehensive program to provide FAPE.
6. School districts should
provide on-going training and education in ASD 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.
Adapted from Wilkinson, L. A.
(2017). A best practice guide to assessment and
intervention for autism spectrum disorder in schools. London
and Philadelphia: Jessica Kingsley Publishers.
Key References and Further Reading
Individuals with Disabilities EducationImprovement Act of 2004. Pub. L. No. 108-446, 108th Congress, 2nd Session.
(2004).
Mandlawitz, M. R. (2002). The
impact of the legal system on educational programming for young children with
autism spectrum disorder. Journal of Autism and Developmental
Disorders, 32, 495-508.
National Research Council
(2001). Educating children with autism. Committee on Educational
Interventions for Children with Autism. C. Lord & J. P. McGee (Eds). Division
of Behavioral and Social Sciences and Education. Washington, DC: National
Academy Press.
Wilkinson, L. A. (2010).
Best practice in special needs education. In L. A. Wilkinson, A
best practice guide to assessment and intervention for autism and Asperger
syndrome in schools (pp. 127-146). London: Jessica Kingsley
Publishers.
Wilkinson, L. A. (2017). A best practice guide to assessment and intervention for autism spectrum disorder in schools. London and Philadelphia: Jessica Kingsley Publishers.
Yell, M. L., Katsiyannis,
A, Drasgow, E, & Herbst, M. (2003). Developing legally correct and
educationally appropriate programs for students with autism spectrum disorders. Focus
on Autism and Other Developmental Disabilities, 18, 182-191.
Lee
A. Wilkinson, PhD, is a licensed and nationally certified school
psychologist, and certified cognitive-behavioral
therapist. He 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. 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. 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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