AFFIRMING NEURODIVERSITY
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"But the only reason I even thought to self-diagnose was because people kept telling me. It was usually after a show. People would just come up to me and say, “I think you have autism.” To be fair to every single person that’s ever done that to me in my life, I think they were all on the spectrum. Because that’s how we roll. Pretty much, it’s like, “I have a piece of information you seem to be missing. You may or may not be ready to hear this information, but I’ll tell you, because knowledge is power, ignorance is a cage. and feelings can be dealt with. I bid you good day.”
-How Hannah Gadsby's High-Functioning Autism Works​
Diagnosing Adults
The Autism Spectrum Quotient (AQ) is a self-assessment that has been used for a long time and is reasonably reliable

Autistic Women has a lot of good materials on self-diagnosis - if you can't view them, joining the Facebook group is worth it:
1. Getting Diagnosed  
2. My Diagnosis
3. Understanding the Spectrum
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​The following are intended to be for psychologists to choose from among the different assessments available for diagnosing children.

  • Assessing behavioral needs​​
It may be helpful to analyze each behavior using the IRIS model’s Antecedent, Behavior, Consequence (ABC) model to discover the function of troubling behaviors and how best to motivate individuals to change problematic behaviors (IRIS Center. (2009). Functional Behavioral Assessment: Identifying the Reasons for Problem Behavior and Developing a Behavior Plan. Retrieved from https://iris.peabody.vanderbilt.edu/module/fba/).

The Autism Diagnostic Observation Schedule (ADOS) is used to assess communication, social interaction, and play. 
The Autism Diagnositic Interview-Revised (ADI-R) is another data collection tool to measure language and communication, reciprocal social interactions, and repetitive behaviors and interests.  The Childhood Autism Rating Scale (CARS) can be used to determine severity of autism.  It is one thing to determine an individual struggle with one item of an autism diagnosis, but another entirely to comprehend how much that one item could de-rail one's entire day.  It is possible that small irritants that no one else perceives could be disturbing to the point that one is almost non-functional.  Often times understanding just how much of an impact each challenge has on the individual allows for a growth of compassion and empathy among others.  Lack of understanding of such issues may lead to degenerative cycles of teacher irritation, punishment of student, and student disengagement, which often leads back to behaviors that the teacher first became irritated by.  Allowing time to not only understand the items one struggles with, but the depth to which they impact one's daily living will be an important factor in determining interventions. (Mehling, M.H., Tase, M.J. (20016). Severity of Autism Spectrum Disorders: Current Conceptualization, and Transition to DSM-5. Journal of Autism & Developmental Disorders. 46:2000–2016).

  • Assessing sensory needs
​Assessing for sensory challenges requires many tools to understand accurately the situation for any individual.  Sensory issues are one of the causes of one the core symptoms of ASD as noted in the DSM-V: ‘restricted, repetitive patterns of behavior, interests, or activities’.  To get a quality assessment, multiple areas of sensory features could be assessed including Sensory Reactivity and Unusual Sensory Interests, Sensory Perception, Auditory Perception, Visual Perception, Somatosensory Perception, Proprioception, and Sensory Integration.  Behavioral responses to sensation can be measured by The Short Sensory Profile (McIntosh) to get quick data from questionnaires.  Sensory perception and integration can be measured by the Sensory Integration and Praxis Test (SIPT), which is used in children age 4-8 to assess multisensory integration (Schaaf, R.C., Lane, A.E. (2014).  Toward a Best-Practice Protocol for Assessment of Sensory Features in ASD,  Autism Dev Disord Vol 45 p. 1380–1395).

  • Assessing communication and language needs
​​Language is one of the core troubles for individuals diagnosed with autism.  Social communication, pragmatic language use, and language reciprocity are components that many people on the spectrum struggle with.  Speaking primarily in echoics and needing close proximity to comply with prompts are signs of a possible deficit in receptive language skills.  To assess for dynamic language issues, an SLP can work with individuals on speech reciprocity while recorded.  A psychologist could then use the Autism Behaviour Coding System (ABCS) system to collect data in the form of videos of the individual interacting with family and/or the SLP.  These videos would be analyzed to look for social reciprocity deficits and then interventions could be crafted specifically for the deficits that the individual exhibits.  The video format is often useful to have another team member analyze the situation without their own personal experience OF the situation.  (Dima, D, Lazari, O., Schmeck, K., Spiegel, R., Bronnimann, A., Goth, K., Herbrecht, E., (2017). Assessing symptoms during comprehensive interventions for young children with autism spectrum disorder: Development and preliminary analysis of the Autism Behaviour Coding System (ABCS). Psychiatry Research 247, 63-67.)

Testing for pragmatic language use poses challenges to construct rich and varied standardized language use prompts to test for.  It will be important to gather data through naturalistic observations as well as actual standardized assessments to see how the child interacts with peers and the classroom environment without being prompted. (Santhanam, S. P., Hewitt, L. E. (2015).  Evidence-based assessment and autism spectrum disorders: A scoping review.  Evidence-Based Communication Assessment and Intervention, 9.4, 140–181.)

  • Assessing social skills
To assess for socio-emotional skills, the Social Skills Q-Sort (SSQ) can be utilized to understand an individual's ability to understand social cues and engage in interpersonal exchanges and collect standardized assessment data from teacher, family, and assessor.  The SSQ will assess social pragmatics such as turn taking, an individual's ability to start and maintain conversations with peers, and theory of mind, or the ability to understand someone else’s point of view or experiences.  (Locke, J., Kasari, C., & Wood, J. J. (2013). Assessing Social Skills in Early Elementary-Aged Children With Autism Spectrum Disorders. Journal of Psychoeducational Assessment, 32(1), 62-76.)

Social skills are such a crucial point for ASD individuals to be able to function well in a typical classroom or work setting.  To assess social skills in one more way, the Autism Social Skills Profile (ASSP) is one more assessment that could be used to quickly identify specific social skills deficits (Bellini, S. & Hopf, A.  (2007).  The Development of the Autism Social Skills Profile: A Preliminary Analysis of Psychometric Properties.  FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES, 22.2, p 80–87).

Lastly, the Social Responsiveness Scale (SRS) could be used to assess an individual's specific social communication deficits and identify areas of social functioning strengths and areas for improvement.  It is important to be able to identify social impairment due to autism and distinguish impairment due to autism from possible other factors.  Some people insist that an individual simply has “bad behavior” unless they have data from a report such as the SRS (Mehling, M.H., Tase, M.J. (20016). Severity of Autism Spectrum Disorders: Current Conceptualization, and Transition to DSM-5. Journal of Autism & Developmental Disorders. 46:2000–2016).

  • Collaborating in Assessment
A multidisciplinary team will be essential to address all of an individual's needs and get a complete picture of their strengths and best interventions to help.  Autism is a combination of previously separately diagnosed conditions, and those diagnosed with autism are not in any way a homogeneous group.  The variance in ASD requires the care of a team of professionals to effectively assess with communication between family, teachers, and support team to get a holistic impression of each individual's experience with their environment and how best to create interventions (Xavier, , J., Bursztejn, C., Stiskin, M., Canitano, R., Cohen, D. (2015). Autism spectrum disorders: An historical synthesis and a multidimensional assessment toward a tailored therapeutic program. Research in Autism Spectrum Disorders 18. 21-33).  

Collaboration should first and foremost be done including in autistic individual in discussions and planning so they feel like their input matters for their own future.  Person-centered planning around the individual's own goals and interests means that the team is more likely to get quality results.  Incorporating family or caregivers in as much capacity as is possible will contribute to family buy-in of the recommendations in the interventions and a greater likelihood that the intervention will be reinforced at home, making his interventions more effective.  It is very important that the support team communicates effectively with each other and shares each other’s reports with one another so that each member may draw connections to their own assessments from work that team members have done.  When the individual them self, team members, and teachers/professors communicate and are in agreement as to the individual's best interests, the whole group of stakeholders are more likely to support the interventions recommended and implement them consistently and effectively (Hagner, D.,May, J., Kurtz, A., Cloutier, H. (2014). Person-Centered Planning for Transition-Aged Youth with Autism Spectrum Disorders.  Journal of Rehabilitation 80.1, 4-10).
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  • Home
  • About
  • Assessing Autism
  • Resources + Support
  • Environments
  • Research
  • Contact
  • Blog: Vignettes From Autism
  • Characteristics of Autism & EBB