Friday, January 18, 2019

Transition Planning for Students with Autism

Transition Planning for Students on the Autism Spectrum
Once the young person with autism leaves the school system, the educational entitlements of the Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004) are no longer available. The need for supports and services to help adolescents transition to greater independence has become a critical issue as a growing number of youth face significant challenges, with many on the spectrum unemployed, isolated, and lacking services (Orsmond, Shattuck, Cooper, Sterzing, & Anderson, 2013). Research indicates that outcomes are almost universally lower for youth on the autism spectrum compared to their peers. According to the National Autism Indicators Report: Transition into Young Adulthood (Roux, Shattuck, Rast, Rava, & Anderson, 2015): (a) only about one in five lived independently (without parental supervision) in the period between high school and their early 20s; (b) approximately 26 percent of young adults and 28 percent of those unemployed and not in school received no services which could help them with employment, continue their education, or live more independently; (c) Over one-third (37 percent) of young adults were disconnected during their early 20s, meaning they never got a job or continued education after high school; and (d) transition planning, a key process for helping youth build skills and access services as they enter adulthood, was frequently delayed. Just 58 percent of youth had a transition plan by the federally required age.
The Transition Plan
The transition from school to adulthood is a process that begins when students and their parents begin planning for their post high school life. A transition plan is critical for young people with autism to be successful and participate to the fullest extent possible in society. The focus of intervention planning must shift from addressing the core deficits in childhood to promoting adaptive behaviors that can facilitate and enhance functional independence and quality of life in adulthood. This includes new developmental challenges such as independent living, self-advocacy, vocational engagement, postsecondary education, and family support.
IDEA requires that transition plan activities for students with disabilities begin no later than the first IEP to be in effect when the child turns 16, or younger if determined appropriate by the IEP team or state education agency. Transition services are a coordinated set of activities that focus on improving the academic and functional achievement of the student with a disability to facilitate the movement from school to post-school activities, including postsecondary education, vocational education, integrated employment (as well as supported employment); continuing and adult education, adult services, independent living, or community participation. Responsibilities of the IEP team include coordinating communication and services between school and community-based service providers; addressing environmental, sensory, behavioral and/or mental health concerns; identifying potential careers and employers; and teaching work behaviors, job skills, and community living skills (Virginia Department of Education, 2010). Just as with other educational services in a student’s IEP, schools must provide the services necessary for the student to achieve the transition goals stated in the IEP. The IEP must include: (a) appropriate measurable postsecondary goals based upon age-appropriate transition assessments related to training, education, employment and, where appropriate, independent living skills; (b) the transition services (including courses of study) needed to assist the child in reaching those goals; and (c) beginning not later than one year before the child reaches the age of majority under state law, a statement that the child has been informed of the child’s rights under Part B, if any, that will transfer to the child on reaching the age of majority. The school must also invite the student to his or her IEP meeting if a purpose of the meeting will be the consideration of the postsecondary goals for the child and the transition services needed to assist the child in reaching these goals (IDEA, 2004).
Conclusion
Students with autism face significant challenges as they transition to adulthood. Postsecondary outcome studies reveal poor long-term outcomes in living arrangements, employment, and community integration when compared to their peers with other types of disabilities. Research indicates that many are socially isolated and that the vast majority of young adults with ASD will be residing in the parental or guardian home during the period of emerging adulthood (Anderson, Shattuck, Cooper, Roux, & Wagner, 2014; Orsmond, Shattuck, Cooper, Sterzing, & Anderson, 2013). A consistent theme for parents of adolescents with autism is the fear that their child will “fall through the cracks” when transitioning from child to adult services. Unfortunately, access to needed supports and services drops off dramatically after high school - with many receiving little or no assistance.
As we know, no two people on the autism spectrum are alike. The characteristics, strengths and challenges, and severity of impairments vary widely across individuals. Support and service needs also differ and continually change as individuals with autism age. Comprehensive transition planning and support for students leaving high school and exiting special educational programming, each with unique strengths, interests, and challenges, is an urgent task confronting our communities and schools (Roux, Shattuck, Rast, Rava, & Anderson, 2015). Greater emphasis must be placed on transition planning as a key process for helping youth build skills and access services as they leave school and enter adulthood. This includes a focus on independent living skills, self-advocacy, vocational engagement, postsecondary education, family support, and a continuum of mental health services for those experiencing comorbid (co-occurring) mental health problems (Lake, Perry, & Lunsky, 2014). 

Image courtesy of http://advocacyinaction.net/autism-preparing-your-child-for/
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.
Anderson, K. A., Shattuck, P. T., Cooper, B. P., Roux, A. M., & Wagner, M. (2014). Prevalence and correlates of postsecondary residential status among young adults with an autism spectrum disorder. Autism, 18, 562-570.  doi: 10.1177/1362361313481860
Individuals with Disabilities Education Improvement Act of 2004. Pub. L. No. 108-446, 108th Congress, 2nd Session. (2004).
Lake, J. K., Perry, A., & Lunsky, Y. (2014). Mental health services for individuals with high functioning autism spectrum disorder. Autism Research and Treatment, Volume 2014, Article ID 502420. doi:10.1155/2014/502420
Orsmond, G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A. (2013). Social participation among young adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 270-2719. doi 10.1007/s10803-013-1833-8
Roux, A. M., Shattuck, P. T., Rast, J. E., Rava, J. A., & Anderson, K. A. (2015). National Autism Indicators Report: Transition into Young Adulthood. Philadelphia, PA: Life Course Outcomes Research Program, A.J. Drexel Autism Institute, Drexel University. Available from http://drexe.lu/autismindicators
Ohio Center for Autism and Low Incidence (OCALI). Transition to Adulthood Guidelines.
http://www.ocali.org/project/transition_to_adulthood_guidelines
Virginia Department of Education, Office of Special Education and Student Services (October, 2010). Autism Spectrum Disorders and the Transition to Adulthood.
Wagner, S. (2014). Continuum of services and individualized education plan process. In L. A. Wilkinson (Ed.). Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 173-193). Washington, DC: American Psychological Association.
Wilkinson, L. A. (2017). A best practice guide to assessment and intervention for autism spectrum disorder in schools. Philadelphia & London: Jessica Kingsley Publishers.
Wrightslaw. Transition Planning. http://www.wrightslaw.com/info/trans.index.htm
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 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).

Thursday, January 3, 2019

Autism and Special Education: What Parents and School Professionals Should Know

Autism and Special Education: What you Should Know
The number of children identified with autism in the United States has more than doubled over the last decade. This progressively rising prevalence trend, together with the clear benefits of early intervention, has created a sense of urgency among educators and parents to ensure that students on the autism spectrum are provided with the appropriate programs and services. This article focuses on special education eligibility and educational planning for children who may have an autism spectrum disorder (ASD). It includes guidelines to help parents and school professionals understand the requirements for providing legally and educationally appropriate programs and services to students who meet special education eligibility for autism.
Special Education

The Individuals with Disabilities Education Improvement 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 a free, appropriate education (FAPE) for all 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. Autism now ranks fourth among all IDEA special education categories and accounts for approximately 1% of the overall student population 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.
While the DSM-5 diagnostic criteria for ASD are professionally helpful, they are neither legally required nor sufficient for determining educational placement. A medical diagnosis from a doctor or mental health professional alone is not enough to qualify a child for special education services. It is state and federal education codes and regulations (not DSM-5) that drive classification and eligibility decisions. In fact, the National Research Council (2001) recommends that all children identified with ASD, regardless of severity, be considered for special education eligibility under the IDEA category of autism. Therefore, it’s especially important for administrators, parents, advocates, teachers and non-school professionals to keep in mind that when it comes to special education, it is state and federal education codes and regulations (not DSM-5 criteria) that determine eligibility and IEP planning decisions. 

Children with a clinical diagnosis of ASD do not automatically receive special education, nor are students who are eligible for special education under the IDEA category of autism required to have a clinical diagnosis of ASD. An evaluation assessing eligibility for special education does not replace a clinical diagnosis of ASD, nor does a clinical diagnosis of ASD determine eligibility for special education. Although clinical diagnoses, psychiatric reports, and treatment recommendations can be helpful in educational planning, the provisions of IDEA are the controlling authority (not DSM-5) with regard to decisions for special education eligibility and placement. The child is eligible for services only by meeting the criteria for autism or another disability category under IDEA, and any applicable state criteria that are consistent with the IDEA definition.
School professionals must ensure that children meet the criteria for autism as outlined by IDEA or state education agency (SEA) and may use the DSM-5 to the extent that the diagnostic criteria include the same core behaviors. 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.

Legal Issues

Research indicates that the proportion of published court decisions attributable to the autism classification under IDEA has risen rapidly. For example, children with autism were found to account for nearly one third of a comprehensive sample of published court decisions concerning the core concepts of free appropriate public education (FAPE) and least restrictive environment (LRE) under IDEA. Overall, the FAPE/LRE court cases were over 10 times more likely to concern a child with autism than the proportion of these children in the special education population. The disproportionate growth of autism litigation is likely due in part to school systems’ challenges in effectively addressing this complex disability and providing effective programs for individual children with autism. As more children are identified with autism, school districts are facing significant budgetary constraints and shortages of qualified personnel while parents are requesting additional and more expensive services. FAPE also invites autism litigation due to the uncertainty of the complexity and the diversity of the condition. Likewise, confusion between the legal (educational) classification of autism and the clinical definition of ASD has contributed to eligibility and placement controversies. Given the disparity between parent concerns and school practices, together with high costs, treatment/intervention controversies, and the complexity of ASD, it is understandable why parents of children with autism tend to be more prone to litigation than the parents of children with other disabilities (Zirkel, 2014). In order to address these legal issues, state and local policymakers must become more knowledgeable and sensitive about the legal and appropriate educational supports critical to children with autism and their families.
Guidelines

Legal and special education experts recommend the following guidelines for providing legally and educationally appropriate programs and services to students who meet special education eligibility for autism.
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 accommodations and 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 Education Improvement Act of 2004. Pub. L. No. 108-446, 108th Congress, 2nd Session. (2004).

Kabot, S., & Reeve, C. (2014). Curriculum and program structure. In L. A. Wilkinson (Ed.), Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 195-218). Washington, DC: American Psychological Association.
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. WashingtonDCNational Academy Press.

Twachtman-Cullen, D., & Twachtman-Bassett, J. (2011). The IEP from A to Z: How to create meaningful and measurable goals and objectives. San Francisco, CA: Jossey-Bass.

Wagner, S. (2014). Continuum of services and individualized education plan process. In L. A. Wilkinson (Ed.). Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 173-193). Washington, DC: American Psychological Association.
Wilkinson, L. A. (2017). Best practice in special education. In L. A. Wilkinson, A best practice guide to assessment and intervention for autism spectrum disorder in schools (pp. 157-200). London: Jessica Kingsley Publishers.

Wilmshurst, L. & Brue, A. (2010). The complete guide to special education: Expert advice on evaluations, IEPs, and helping kids succeed (2nd edition). San Francisco, CA: Jossey-Bass.
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.
Zirkel, P. A. (2014). Legal issues under IDEA. In L. A. Wilkinson (Ed.). Autism spectrum disorder in children and adolescents: Evidence-based assessment and intervention in schools (pp 243-257).WashingtonDC: 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 also a university educator and trainer, and has published widely on the topic of autism both in the US and internationally. 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, both published by Jessica Kingsley Publishers. He is also editor of a best-selling text in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and InterventionHis 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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