Saturday, November 19, 2016

Award-Winning Finalist in the Psychology/Mental Health category of the 2016 Best Book Awards



Overcoming Anxiety and Depression on the Autism Spectrum is available from Jessica Kingsley Publishers, AmazonBarnes & Noble, Book DepositoryBooks-A-Million and other online book retailers.

Get the lowest price on Overcoming Anxiety and Depression on the Autism Spectrum: A Self-help Guide Using CBT from AllBookstores.com.

Lee A. Wilkinson, PhD 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 disorder. 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 CBTHe 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).



Wednesday, November 16, 2016

Best Practice Review: The Social Communication Questionnaire (SCQ)

Best Practice Review: The Social Communication Questionnaire (SCQ)

The Social Communication Questionnaire (SCQ; Rutter, Bailey, & Lord, 2003), previously known as the Autism Screening Questionnaire (ASQ), was initially designed as a companion screening measure for the Autism Diagnostic Interview-Revised (ADI-R; Rutter, Le Couteur & Lord). The SCQ is a parent/caregiver dimensional measure of ASD symptomatology appropriate for children of any chronological age older than fours years. It can be completed by the informant in less than 10 minutes. The primary standardization data were obtained from a sample of 200 individuals who had participated in previous studies of ASD. 

The SCQ is available in two forms, Lifetime and Current, each with 40 questions presented in a yes or no format. Scores on the questionnaire provide an index of symptom severity and indicate the likelihood that a child has an ASD. Questions include items in the reciprocal social interaction domain (e.g., “Does she/he have any particular friends or best friend?”), the communication domain (e.g., “Can you have a to and fro ‘conversation’ with him/her that involves taking turns or building on what you have said?”) and the restricted, repetitive, and stereotyped patterns of behavior domain (e.g., Has she/he ever seemed to be more interested in parts of a toy or an object [e.g., spinning the wheels of a car], rather than using the object as intended?”).
Compared to other screening measures, the SCQ has received significant scrutiny and has consistently demonstrated its effectiveness in predicting ASD versus non-ASD status in multiple studies. A meta-analysis examining the previous research on the utility of the SCQ as a screening instrument found it to be an acceptable screening tool for ASD (area under the curve = 0.885) (Chesnut et al., 2017). The scale has been found to have good discriminant validity and utility as an efficient screener for at-risk groups of school-age children. The lifetime version is recommended for screening purposes as it demonstrates the highest sensitivity value. A threshold raw score of >15 is recommended to minimize the risk of false negatives and indicate the need for a comprehensive evaluation. Comparing autism to other diagnoses, this threshold score resulted in a sensitivity value of .96 and a specificity value of .80 in a large population of children with autism and other developmental disorders. The positive predictive value was .93 with this cutoff. The authors recommend using different cut-off scores for different purposes and populations. Several studies (Allen et al., 2007; Eaves et al, 2006) have suggested that a cut-off of 11 may be more clinically useful (Norris & Lecavalier, 2010).
The SCQ is one of the most researched of the ASD-specific evaluation tools and can be recommended for screening and as part of comprehensive developmental assessment for ASD (Chestnut et al., 2017; Norris & Lecavalier, 2010; Wilkinson, 2010, 2016). The SCQ (Lifetime form) is an efficient screening instrument for identifying children with possible ASD for a more in-depth assessment. For clinical purposes, practitioners might consider a multistage assessment beginning with the SCQ, followed by a comprehensive developmental evaluation (Wilkinson, 2011, 2016). However, cut-off scores may need to be adjusted depending on the population in which it is used. The evidence also indicates that although the SCQ is appropriate for a wide age range, it is less effective when used with younger populations (e.g., children two to three years). It was designed for individuals above the age of four years, and seems to perform best with individuals over seven years of age.

References

Allen CW, Silove N, Williams K, et al. (2007). Validity of the Social Communication Questionnaire in Assessing Risk of Autism in Preschool Children with Developmental Problems. J Autism Dev Disord37, 1272–8.

Chandler, S., Charman, T., Baird, G., Simonoff, E., Loucas, T., Meldrum, D., & Pickles, A. (2007). Validation of the Social Communication Questionnaire in a population cohort of children with autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1324–1332.

Chesnut, S. R., Wei,T., Barnard-Brak, L., & Richman, D. M. (2017). A meta-analysis of the social communication questionnaire: Screening for autism spectrum disorder. Autism, 21, 920-928. https://doi.org/10.1177/1362361316660065
Eaves L, Wingert H, Ho H, et al. (2006). Screening for Autism Spectrum Disorders with the Social Communication Questionnaire. Developmental and Behavioral Pediatrics, 27, 95–103.
Mash, E. J., & Hunsley, J. (2005). Evidence-based assessment of child and adolescent disorders: Issues and challenges. Journal of Clinical Child and Adolescent Psychology, 34, 362-379.
Norris, M., & Lecavalier, L. (2010). Screening accuracy of level 2 autism spectrum disorder rating scales: A review of selected instruments. Autism, 14, 263–284.
Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire. Los Angeles: Western Psychological Services.
Wilkinson, L. A. (2010).  A best practice guide to assessment and intervention for autism and Asperger syndrome in schools. London and Philadelphia: Jessica Kingsley Publishers.
Wilkinson, L. A. (2011). Identifying students with autism spectrum disorders: A review of selected screening tools. Communiqué, 40, pp. 1, 31-33.

Wilkinson, L. A. (2017).  A best practice guide to assessment and intervention for autism spectrum disorder in schools (2nd Edition). London and Philadelphia: Jessica Kingsley Publishers.

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 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

Monday, November 7, 2016

Healthcare Providers Unprepared to Treat Adults with Autism


Healthcare Providers Unprepared to Treat Autistic Adults

It is estimated that nearly a half million youth with autism will enter adulthood over the next decade. As children with autism become adults their primary medical care will move from pediatrics to adult medicine. A survey by the Autism Research Program at Kaiser Permanente Northern California found that many healthcare providers are ill prepared to treat adults on the autism spectrum. The findings were reported at the International Meeting for Autism Research in Salt Lake CityUtah.
Researchers polled providers of adult primary care, mental health, and obstetrics and gynecology services through the insurer’s network. Practitioners were asked about their ability to recognize autism, their knowledge of the disorder, their comfort level in treating those with the condition and their need for training and resources.
Of 922 providers surveyed, 77 percent rated their ability to treat patients on the spectrum as poor or fair. While more that 90 percent of the providers said they would investigate the possibility of autism in patients with limited eye contact, most under-reported the number of people on the autism spectrum who were actually under their care. In addition, only 13 percent of providers indicated that they had adequate tools or referral resources to appropriately accommodate those with autism.
To better understand the providers’ responses, follow-up interviews were conducted with nine primary care physicians. The researchers found that the majority had received limited or no autism training in medical school or during their residencies. All of the providers indicated a need for more education and improvements in the transition from pediatric care providers to adult medicine for those on the autism spectrum.
The preparation of healthcare providers is a pressing issue as an increasing number of individuals with autism are expected to enter adulthood in the coming years. Further research is urgently needed to study the transition from pediatric to adult healthcare and identify strategies that will lead to better medical care for adults on the autism spectrum.

Tuesday, November 1, 2016

Inclusive Education for Students with Autism


Inclusive Education for Students with Autism

The Individuals with Disabilities Education Improvement Act of 2004 (IDEA) (P.L. 108-446) (http://idea.ed.gov/) guarantees a free and appropriate public education (FAPE) in the least restrictive environment (LRE) for every student with a disability. The LRE provision mandates that “to the maximum extent appropriate, children with disabilities, including children in public or private institutions or other care facilities, are educated with children who are not disabled, and special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only when the nature or severity of the disability of a child is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.”  In general, inclusion (or inclusive education) with typical peers is considered to be the best placement option for students with disabilities. It should also be noted that while 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 and intensive level of service.

Research

Child characteristics such as severity of autism symptoms are thought to determine educational placement. However, where a child lives may significantly impact whether they are placed in an inclusive or segregated classroom, a national analysis suggests. The study published online in the journal Focus on Autism and Other Developmental Disabilities examined external factors, including state of residence and state funding formulas, to determine their potential influence on placement outcomes. On average, about 37 percent of students identified with autism spectrum disorder (ASD) spent at least 80 percent of their school day in inclusive environments. But the numbers varied considerably from one state to the next, ranging from just 8 percent in Washington, D.C. to 62 percent in Iowa. 

There was considerable variation among states in placing students with autism in inclusive, mainstreaming, self-contained, and separate schools. Specifically, states varied substantially in the percentage of students with autism educated in each setting, with some states consistently favoring inclusion (Colorado, Connecticut, Idaho, Iowa, Minnesota, Nebraska, North Dakota, West Virginia, and Wisconsin). Other states, however, generally leaned toward more restrictive settings (Alaska, Delaware, Florida, Hawaii, Louisiana, New Hampshire, New Jersey, New York, South Carolina, and Washington, D.C.). States in the Eastern United States tended to have more restrictive placement rates than states in the Western United States. State special education funding was found to have a minimal impact on placement outcomes.
These findings suggest that factors that are external to child characteristics (e.g., severity of ASD symptoms) influence educational placement decisions for students with ASD. “If child-specific factors were solely responsible for education placement decisions, one would expect states to have similar rates of inclusive, self-contained, mainstreaming and separate school placements for students with ASDs,” the author commented. “Instead, … results indicate that educational placement varies by state.” 

Implications

Overall, it is unlikely that child characteristics alone determine placement outcomes. Although School districts should make every effort to place students in integrated settings to maximize interaction with typical peers, analysis of the public data presented in this study suggests that many states are still falling short of including autistic students in general education settings for significant portions of the day. Inclusion with typically developing students is important for a child with autism 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. The argument must shift from should we include autistic students in general education to understanding how to include them successfully. It is critical to identify how practices that benefit students with autism, including structure (visual, communication, and social supports), positive behavior supports, and systematic instruction, can be implemented effectively in general education settings. 
Jennifer A. Kurth,  Educational Placement of Students With Autism: The Impact of State of Residence, Focus on Autism and Other Developmental Disabilities, first published on September 3, 2014 doi:10.1177/1088357614547891.
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered 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 CBTHe 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).

Follow by Email

Top 10 Most Popular Best Practice Posts

Search BestPracticeAutism.com

Blog Archive

Best Practice Books

Total Pageviews