Autism Spectrum Disorder in Schools – Online CE Course Includes DSM-5 Diagnostic Changes

Do you work with children and youth on the autism spectrum? If so, this course is for you!

Autism Spectrum Disorder: Evidence-Based Screening & Assessment identifies DSM-5 diagnostic changes in the ASD diagnostic criteria, summarizes the empirically-based screening and assessment methodology in ASD, and describes a comprehensive developmental approach for assessing students with ASD. The DSM-5 conceptualizations of autism require professionals to update their knowledge about the spectrum. This course will prepare you 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 with ASD are being identified and provided with the appropriate programs and services. Course #30-69 | 44 pages | 40 posttest questions.
 
CE Credit: 3 Hours

Course adapted from Wilkinson, L. A. (2016). A best practice guide to assessment and intervention for autism spectrum disorder in schools. London and Philadelphia: Jessica Kingsley Publishers.

Audience: Psychology | Counseling | Social Work | Occupational Therapy | Marriage & Family Therapy | Nutrition & Dietetics | School Psychology |

Reviews 

 

-This was one of the BEST online courses I have taken. The information was both informative and critical to working with ASD individuals. 

-The author did an excellent job of providing thorough information in a clear and concise manner! 

-The information presented will be very helpful in my work with my students, as well as in my consultation with staff and administration. 

-This course was practical and easily applicable to my practice. I feel that I am increasingly up to date on the recent thinking regarding ASD. Thank you. 

-This has been my first exposure to this subject. I have a family member with this condition, my reason for selecting CE credits in this area. In this way, I am in a better position to help this person and others along the way. This course has given me a first and good exposure to this field.

 -Very thorough course.  Clear and concise information without a lot of extraneous information. 

-Excellent at providing the tests needed to provide a comprehensive evaluation.                                         

-I found this course informative and useful.  I will keep this course handy as a good reference. Thank you. 

 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 Spectrum Disorder in Schools (2nd ed.), 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. His book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT, was honored as an “Award-Winning Finalist in the “Health: Psychology/Mental Health” category of the 2016Best Book Awards.

Executive Function (EF) Skills in Autism

Executive Function Skills in Autism

Research evidence suggests that deficits in executive function (EF) are an important feature of autism spectrum disorder (ASD). Executive function is a broad term used to describe the higher-order cognitive processes such as response initiation and selection, working memory, planning and strategy formation, cognitive flexibility, inhibition of response, self-monitoring and self-regulation. It is generally acknowledged that these higher order processes are associated with the prefrontal cortex, which are necessary for regulating and controlling behavior. Executive functions include the many of the skills required to prepare for and execute complex behavior, such as planning, inhibition, organization, self-monitoring, cognitive flexibility, and set-shifting. 

Markers of executive dysfunction may include difficulty initiating action, planning ahead, inhibiting inappropriate responses, transitioning, switching flexibly between response sets, and poor self-monitoring. Indeed, poor performance monitoring and self-regulation may be associated with the core features of ASD such as a lack of social reciprocity, perseverative responses, and intense emotional responses to change (e.g., meltdowns). Moreover, school success depends on mastery of basic EF skills, including remembering and following instructions, completing tasks independently and smoothly transitioning between tasks, and inhibiting inappropriate behaviors. EF plays an important role in the acquisition of knowledge and social skills; the better children are at focusing and refocusing their attention, holding information in mind and manipulating it (i.e., working memory), resisting distraction, and adapting flexibly to change, the more positive the social, adaptive, and academic outcomes.

It is important to note, however, that executive function deficits are not experienced by all individuals on the autism spectrum nor do they appear to play a primary causal role in ASD. Nevertheless, executive dysfunction places a child at-risk and is likely to have an adverse impact on many areas of everyday life and affect adaptability in several domains (personal, social and communication). Therefore, an assessment of executive function can add important information about the child’s strengths and weaknesses and assist with intervention/treatment planning. The following measures may be included in a comprehensive developmental assessment battery for ASD.

·   The Delis-Kaplan Executive Function System (D-KEFS; Delis, Kaplan, & Kramer, 2001) was co-normed on a large and representative national sample designed exclusively for the assessment of executive functions, including flexibility of thinking, inhibition, problem solving, planning, impulse control, concept formation, abstract thinking, and creativity. The D-KEFS, is composed of nine stand alone tests that can be individually or group administered that provides a standardized assessment of executive functions in children and adults between the ages of 8 and 89.

·   The Developmental Neuropsychological Assessment, Second Edition (NEPSY–II: Korkman et al., 2007) measures several neuropsychological abilities and was normed on children 3 to 16 years to 11 months of age. The NEPSY-II assesses six domains: 1) Attention and Executive Functioning, 2) Language, 3) Memory and Learning, 4) Sensorimotor, 5) Social Perception and 6) Visuospatial processing. It offers 32 subtests that the examiner can tailor to the specific examinee. In addition to tests of memory and executive functioning, the NEPSY-II also includes tests on Theory of Mind (which assesses the ability to recognize the feelings and thoughts of others) and Affect Recognition (which measures the ability to recognize feelings expressed on faces), both of which should be useful for assessing children on the spectrum.

·   The Wide Range Assessment of Memory and Learning, Second Edition (WRAML-2; Sheslow & Adams, 2003) is a direct assessment of both immediate and delayed memory ability, as well as the acquisition of new learning that can be useful in evaluating learning and school-related problems of students with ASD. This comprehensive measure includes a Core Battery and supplemental subtests that provide index scores for General Memory, Verbal Memory, Visual Memory, Working Memory, and Attention and Concentration. A brief four subtest Memory Screening Form that correlates highly with the full test is also available.

·   The Behavior Rating Inventory of Executive Function, Second Edition (BRIEF- 2; Gioia, Isquith, Guy, & Kenworthy, 2015) is a parent-or-teacher rated questionnaire for children ages 5 to 18 years of age that can be used to assess executive functioning in ASD. The BRIEF-2 is comprised of the following scales: Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan/Organize, Organization of Materials, Task-Monitor, and Self-Monitor. Summary indexes include Behavior Regulation (BRI), Emotion Regulation (ERI), Cognitive Regulation (CRI) and an overall score, the Global Executive Composite (GEC). The BRIEF-2 also includes a self-report measure for children and adolescents 11-18 years of age.

·   The Comprehensive Executive Function Inventory (CEFI; Naglieri & Goldstein, 2013) is an executive function (EF) rating scale for children and youth ages 5 to 18 years. The CEFI is designed to assess EF skills based on self, parent, and teacher reports, and provides specific and individualized intervention recommendations. The CEFI provides an overall full-scale executive functioning standard score and individual subtest standard scores on nine components of EF, including Attention, Emotion Regulation, Flexibility, Inhibitory Control, Initiation, Organization, Planning, Self-Monitoring, and Working Memory.

Because executive functions are important to social competence, academic success, and overall adaptability, these measures enable practitioners to assess impaired multi-task performance, document the impact of executive function deficits on functioning, and to plan educational interventions and classroom accommodations. Further information on best practice guidelines for assessment of ASD is available from the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)

Click here to read a free preview of “A Best Practice Guide…”

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. 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. 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. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Stress Higher for Parents of Girls with Autism

Stress Higher for Parents of Girls on the Autism Spectrum

Parents of children with autism spectrum disorder (ASD) experience higher levels of stress in comparison to parents of neurotypical children and consequently are more susceptible to negative health and social outcomes. For example, they are more likely to experience depression, anxiety, somatic complaints, isolation, and burnout. Previous research also suggests that parental stress is often correlated with child characteristics, locus of parenting control, parenting satisfaction, and social support. Additionally, challenges in obtaining a timely ASD diagnosis and lack of appropriate treatment services and education are factors identified in the literature as contributors to parental stress and dissatisfaction.

However, less is known regarding how individual child characteristics (i.e. gender), access to comprehensive treatment services, and individual functioning intersect to impact stress levels in parents of children with ASD. The gender gap is one of the most consistent findings in the field, with autism 4 times more common among boys (1 in 37) than girls (1 in 151). Previous research has acknowledged that girls may present differently than boys, making timely diagnosis more difficult given our current understanding and availability of diagnostic instruments. Research has also shown that early intervention is associated with better outcomes for children with ASD. However, if a child is identified later in life, early intervention is less likely to occur, possibly impacting the outcome of treatment services. Consequently, parents of female children with ASD may experience challenges not only in obtaining a timely and accurate diagnosis, but also in connecting to treatment services and identifying sources of social support.

A study in the open access journal Autism Research and Treatment examined the relationship between parental stress and access to services in families of children with ASD, as well as how this relationship differed by the sex of the child. The researchers expected to find that families of female children with ASD have less access to services, and predicted that fewer services would be associated with greater parental stress.

The researchers found that parenting stress was higher for parents of girls than for parents of boys, and for parents of girls (but not boys), fewer services predicted higher parental distress. The implications of this study provide important information for service providers working with children with ASD and their parents. Understanding and targeting parental stress is critical in enhancing well-being and the parent-child relationship. This is especially important for parents of girls with ASD because they may lack mental health services that target and address parental stress. Moreover, difficulty in identifying girls with ASD and focusing on their specific needs may generate additional parental stress. 

Future research comparing services before and after assessment is recommended to better understand the impact of services and support in regard to gender differences, parental stress, and access to services. Likewise, there is a need to focus on specific challenges experienced by parents of female children with ASD, including ways to increase access to comprehensive treatment services and the prevalence of educational and social support. Differences in parental stress experienced between mothers and fathers should also be examined.

Source: Irina Zamora, Eliza K. Harley, Shulamite A. Green, Kathryn Smith, and Michele D. Kipke, “How Sex of Children with Autism Spectrum Disorders and Access to Treatment Services Relates to Parental Stress,” Autism Research and Treatment, vol. 2014, Article ID 721418, 5 pages, 2014. https://doi.org/10.1155/2014/721418.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. 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. 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. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)

Adults with Asperger's Syndrome at Higher Risk for Depression and Suicidal Thoughts

Adults with Asperger's Syndrome at Higher Risk for 
Depression and Suicidal Thoughts

Transition into adulthood for people with Asperger’s syndrome is often accompanied by a lack of support services, and poor outcomes in terms of health and social difficulties, quality of life, limited occupational potential, social exclusion and isolation, and high rates of depression. Adults with Asperger syndrome are much more likely to think about and attempt suicide than those in the general population, according to a study published in The Lancet Psychiatry.

In a clinical cohort study, researchers conducted a retrospective analysis of clinical survey data from adults newly diagnosed with Asperger’s syndrome at a specialist diagnostic clinic in England. Patients completed a self-report questionnaire before clinical assessment, recording lifetime experience of depression, suicidal ideation, and suicide plans or attempts, along with self-reported measures of autistic traits and empathy. The researchers compared the rate of suicidal ideation in the sample with published rates of suicidal ideation in the general population and other clinical groups. They also assessed associations between depression, autistic traits, empathy, and likelihood of suicidal ideation and suicide plans or attempts.

The study found that the lifetime experience of suicidal ideation for adults with Asperger’s syndrome was more than nine times higher than in the general population in England and significantly higher than rates previously reported in other clinical groups with medical and psychiatric conditions. Among adults with Asperger’s syndrome, those with depression were four times more likely to have suicidal thoughts and twice as likely to plan or attempt suicide, compared to those without depression. Those who planned or attempted suicide also had a significantly higher level of self-reported autistic traits than those who did not.

According to study co-leader Dr. Sarah Cassidy, of the Autism Research Centre at Cambridge University, these findings lend support to anecdotal reports of increased rates of suicidal ideation in adults with Asperger’s syndrome, and depression as an important potential risk factor for suicidality in adults with this condition. Because adults with Asperger’s syndrome often have many risk factors for secondary depression (e.g., social isolation or exclusion, and unemployment), the findings emphasize the need for awareness and appropriate service planning and support to reduce risk in this group of individuals.

Cassidy, S., Bradley, P., Robinson, J., Allison, C., McHugh, M., & Baron-Cohen, S. (2014). Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: a clinical cohort study. Lancet Psychiatry, 1, 142–47.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. 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. 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. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition)

Designing Positive Behavior Support Plans for Learners on the Autism Spectrum

Positive Behavior Support (PBS)

The problem behaviors of children on the autism spectrum are among the most challenging and stressful issues faced by schools and parents. The current best practice in treating and preventing unwanted or challenging behaviors utilizes the principles and practices of positive behavior support (PBS). PBS has been demonstrated to be effective with individuals across a wide range of problem behaviors and settings. 

Although used successfully both in the classroom and school-wide, PBS is not a specific intervention per se, but rather an approach that has evolved from traditional behavioral management methods. PBS refers to a set of research-based strategies that are intended to decrease problem behaviors by designing effective environments and teaching students appropriate social and communication skills. PBS utilizes primary (universal, school-wide), secondary (targeted group), and tertiary ( individual support) levels or tiers of intervention, each level providing an increasing level of intensity and support. 

Functional Behavior Assessment (FBA)

An essential component of PBS is a functional behavior assessment (FBA) to help determine the events that influence and maintain an individual student’s persistent and challenging behavior. FBA methods are considered best practice in identifying and designing behavioral intervention plans for students who demonstrate serious problem behaviors that require more intensive and individualized supports. 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, a student might exhibit challenging behaviors with the goal of escape or the goal of seeking attention. When the curriculum is difficult or demanding, he or she may attempt to avoid or escape work through challenging behavior (e.g., refusal, passive aggression, disruption, etc.). Similarly, they may use challenging behavior to get focused attention from adults and peers, or to gain access to a preferred object or participate in an enjoyable activity. Problematic behavior may also occur because of sensory aversions. 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). 

Behavior Intervention Plan (BIP)

The following steps are a general guide to developing a comprehensive student behavior intervention or support plan. 

• The behavior support plan should be developed collaboratively and begin with a functional behavior functional behavior 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. This includes a description of the behavior, triggers or antecedents for the behavior, maintaining consequences, and purpose of the problem behavior.
• 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. Changes should be identified that will be made in the classroom or other setting to reduce or eliminate problem behaviors. Prevention strategies may include environmental arrangements, personal support, changes in activities, new ways to prompt the student, and changes in expectations. These strategies should be integrated into the student's overall program and daily routines, rather than being separate from the curriculum.  

• A positive behavior intervention plan must be implemented as planned (with integrity). Following implementation of the plan, the team regularly reviews and evaluates its effectiveness and makes modifications as needed.      

Research indicates that PBS can be effective for reducing and preventing problem behaviors of children with ASD. For example, a review of published research studies found that in cases where PBS strategies were used, there was as much as an 80% reduction in challenging behavior for approximately two-thirds of the cases studied. The Individuals with Disabilities Education Act (IDEA) has endorsed PBS as a preferred form of intervention for managing the problematic behavior of students with disabilities and requires that "positive behavioral interventions, strategies, and supports" be used when addressing the needs of students who demonstrate persistent challenging behavior that impedes their learning or the learning of others. 

Adapted from Wilkinson, L. A. (2016). A best practice guide to assessment and intervention for autism spectrum disorder in schools. London and Philadelphia: Jessica Kingsley Publishers.

👉 Click here to read a free preview of “A Best Practice Guide…”

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, registered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. 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. 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. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).