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Transcript
Supporting Identification and
Programming for Individuals
with Autism Spectrum Disorders
(ASD)
Assessment of
Cognitive and Adaptive Domains
Dr. Jane Doelling
Assessment in ASD
• There is no one appropriate assessment
battery; the evaluation plan is always based
on screening and ongoing data collection.
• IDEA requires that the assessment
correspond to problems identified in
screening and that the data be used
to support an individual education plan (IEP).
Utility of Cognitive/Adaptive
Evaluation
• Differential Diagnosis - AD and AS.
• Delays and arrests - Are social
communication delays greater than expected
given cognitive level?
• Assessment of strengths, weaknesses,
differences: verbal and nonverbal
communication patterns; concept formation;
generalization; modeling; imitation; memory.
(Goldstein, Naglieri, & Ozonoff, 2009)
Considerations
Intelligence and adaptive skills
often defined as differences in
every day behavior and
responses; we test using
standard stimuli that are
frequently problematic for this
population.
National Research
Council (2001)
Individuals with ASD have the
most difficulty with language and
social tasks on tests.
Least difficulty on nonverbal tasks
that are not timed and do not
require motor skills, rote
memory, and perception tasks.
Impact of ASD
Additional problems noted in testing:
attending
joint attention
understanding of personal pronouns
imitation
pointing
behavioral regulation
(Ashoomoff, 2006; Dawson et. al, 2004; Rogers et al.,
2003; Sigman, et al., 1986).
Skills/Behaviors Common
to IQ Tests
• memory & problem solving,
• discrimination &verbal skills
• comprehension, spatial & mechanical
aptitude,
• analogies & detail recognition,
• sequencing, induction & vocabulary,
• general information & motor behavior,
• generalization & abstract reasoning
(Salvia & Ysseldyke, 2007)
Considerations: CA & MA
• What is the discrepancy? For individuals with
severe delays can scores be translated into
meaningful descriptions of ability?
• If older individual, would it be best to select
an instrument with a wider age range?
• For a young child would it be better to focus
on mental age scores w/a focus on
developmental level vs. IQ?
• Are families members of young, or very
developmentally delayed, asked to observe
the assessment and confirm findings?
Cognitive Development
• Used interchangeably with intelligence.
• Refers to a variety of mental processes
to include reasoning, memory,
comprehension, judgment.
(Simpson & Zionts, 2000)
Assessment of Cognitive
Ability
No other area of assessment has
generated as much attention,
controversy, and debate as the testing
of what we call intelligence.
(Salvia and Ysseldyke 2007 p. 281)
Cognitive Testing Issues
• Intelligence is an inferred construct
– determination of skills and
abilities may be made from a limited
sample of test behavior.
• May be problems with technical
adequacy (validity issues due to
nebulous nature of the construct;
reliability impacted due to
characteristics of individuals
w/ASD).
Issues: Cognitive Testing
• Emphasis on scores vs. skills not
conducive to comprehensive
programming.
• Individuals w/an ASD exhibit
characteristics that limit the options
w/traditional, norm referenced
instruments.
Best Practices Cognitive
Assessment
Ensure that the test assesses individual
ability to the extent possible
accommodate:
sensory deficits;
communication modes;
medical and motor issues;
as well as cultural factors.
Best Practices
• Use scores as one indicator of
ability.
• Analyze performance across
subtests.
• Increase reliability through
consideration of multiple data
sources.
Best Practices
• Be Aware of the Behaviors/Skills
Sampled By the Test and Interpret
Performance Accordingly.
• Be Aware of Stimulus Response
Demands Making Appropriate Test
Selection and Accommodations.
• Consider Standardized Sample In
An Effort to Control Bias.
Best Practices
• Norm referenced assessment should
minimize, as much as possible, problems
noted in screening (communication,
response time, sustained visual and
auditory attending).
• Cognitive/adaptive behaviors should be
documented through communication,
adaptive, ecological, and ASD specific
instruments and context based
performance tasks (integrated
assessment, multiple data sources).
Ecological Variables
Checklist
• ___cues/prompts needed (visual,
auditory, physical – identify)
• ___ time needed for task
• ___transition aids needed
• ___format and response demands
• ___physical arrangement of setting
• ___communication systems
Adaptive Behavior
The way individuals adapt themselves
to the requirements of their physical
and social environments (p. 559).
(Salvia & Ysseldyke, 2007)
Adaptive Skills
Example: Physical Environment Avoiding or response to danger. Will the
individual w/ASD use environmental cues
to:
• Select clothing appropriate to the climate?
• Respond to visual or auditory cues to
avoid traffic?
• Demonstrate skills w/or w/out cues?
Across settings? With reliability?
Considerations Adaptive
Assessment
• Social & cultural expectations - vary across
cultures, manifest in language usage.
• Age and Adaptation - Different expectations
across the age span.
• Performance vs. ability - Does the
individual know the behavior to be
performed? Is it performed voluntarily and
w/ consistency?
Considerations
Maladaption - Caution when included on
norm referenced tests.
• Absence of maladaptive behavior does
not imply adaptive behavior.
• Maladaptive behavior is determined by
context with a few taboo exceptions.
Considerations: Adaptive
• Context - Appropriates (social
tolerance) w/in the specific situation
a behavior occurs.
Undressing independently a desirable
behavior at home and at bedtime
but does not meet adaptive
standards in the classroom or
workplace.
Adaptive Content &
Considerations
• Frequency and amplitude are
important in determining adaptive skills
or maladaptive behavior.
Behavior - Child slaps head.
What is the context, frequency,
amplitude, consequent behavior?
Issues and Best Practice
Adaptive Assessment
Adaptive skills traditionally assessed by third
person respondent.
– Accuracy/assumes knowledge and non
bias.
– Contextual information may be limited.
– Selective demonstration of behavior that
may not be observed by respondent.
Issues and Best Practice
Adaptive Assessment
• Adaptive assessment typically
implemented when a cognitive ability is
suspected.
• Individuals across the spectrum
demonstrate adaptive deficits
(communication, social, self care, and
more).
Issues and Best Practice
Adaptive Assessment
• Adaptive data may be obtained from
assessment across domains (cognitive,
communication, functional behavior
assessment).
• Analysis of specific skill performances
within context essential to programming.
Common Norm Referenced
Cognitive Tests Pros & Cons
• Wechsler Scales - WISC IV, WAIS-III,
WPPSI-III
• Stanford Binet Intelligence Scale – 5
• Woodcock- Johnson Psycho- Educational
Battery- III (Tests of Cognitive Ability)
• **Leiter – Revised (R)
• **Test of Nonverbal IntelligenceTONI-3
• **Comprehensive Test of Nonverbal
Intelligence - CTONI
Utility & Limitations of
Developmental/Cognitive
Ability Scales
•
•
•
•
Developmental Profile
Differential Ability Scales
Mullen Scales of Early Learning
Baley Infant and Toddler Scales of
Infant and Toddler Development
Common Norm Referenced
Adaptive Scales
•
•
•
•
Vineland
AAMD-ABS
AAMR-S2 School Edition
AAMR Residential and Community
(ABS-RC2)
• Scales of Independent Behavior
(SIB-R)
Additional Sources that Yield
Cognitive/Adaptive Data
Assessments of Executive Functioning
Instruments Specific to Severe &
Profound
Integrated, Multi Domain Tools & CRTs
Autism Specific Instruments
Application to Diagnosis: Case Scenario