Autism and intersectionality: Considerations for school-based practitioners

The purpose of this article is to explore the intersectionality of autism and sociocultural factors as well as discuss the complexities associated with appropriate assessment, diagnosis, and intervention. Based on a review of the literature, the authors present a brief history of the emergence of the term autism and highlight factors that have contributed to current concerns about failures to appropriately recognize autism within diverse populations. Referencing extant research as well as professional practice standards, this article examines aspects of autism and intersectionality, and explores some of the associated challenges related to assessment, diagnosis, and intervention. Further, the authors reflect on the critical importance of carefully considering all aspects of a child's identity when engaging in autism assessment and intervention within the school setting. School-based practitioners are provided with guidance for addressing the needs of diverse populations of students with autism.     

自闭症儿童社会技能评估的研究进展

社会技能评估是自闭症儿童诊断、干预计划制定和效果评价的重要基础。本文回顾了自闭症儿童社会技能评估的学习理论及认知理论,系统梳理了行为观察、角色扮演测验等评估方法,并在此基础上提出了自闭症儿童社会技能评估研究进展的建议：进一步界定社会技能概念的外延及内涵;进一步完善角色扮演测验及编制学前自闭症儿童社会技能评估量表;临床评估中需整合各类方法;进一步将社会技能评估应用于临床实践中。     

From eligibility assessment to intervention for students with autism spectrum disorder

The mean age of identification for autism spectrum disorder (ASD) occurs during the months before children enter kindergarten. The incidence and prevalence of “autistic behaviors” in the general population are not fully understood, however, census-matched studies of these behaviors have yielded important new data. As children presenting with behaviors characteristic of ASD enter school, school psychologists are increasingly faced with the assessment and determination of individuals with disabilities improvement act (IDEIA) eligibility, often with students yet to be formally diagnosed with ASD. In many US states, a clinical diagnosis of ASD is not required for a child's eligibility to be served under the category of other health impaired as autism. Nor does a diagnosis of ASD automatically qualify a student as eligible under IDEIA. Eligibility hinges on educational impact. This article briefly reviews the current state of knowledge as it relates to understanding and evaluating children with suspected ASD in the schools, offers a framework for assessment, and discusses a set of proposed guidelines to assist in effectively utilizing assessment data in the development of individualized education plan goals.     

Assessing anxiety in youth with autism spectrum disorder

Anxiety is now recognized as one of the most common co-occurring conditions in youth diagnosed with autism spectrum disorder (ASD). Despite the prevalence of this comorbid condition, accurate assessment and diagnosis of anxiety in ASD has proven difficult. This paper will address the considerable research literature on assessing anxiety in youth with ASD, including difficulties related to assessment and differential diagnosis. In addition, this paper will describe relevant tools and methods for assessing anxiety in this complex population.     

‘He also has the right to be who he is … ’. An exploration of how young people socially represent autism

An increasing number of young people are being confronted with the concept of autism. Some of them know someone who has been diagnosed as autistic. Others learn about the concept through different forms of media. Nevertheless, little research has been conducted into the meaning which young people give to the concept. In this study, we explored by means of focus groups how a number of young people try to understand what autism is and how they should or want to relate to it. A thematic analysis resulted in three interconnected central themes: (1) Autism is Different; (2) The Different One and the others; and (3) Watch out: the diagnosis of autism actually ‘makes’ a person Different. Although our participants represented autism as a fundamental form of being different, they also reflected on how a diagnosis does not just identify a reality, but also creates a reality. To them, autism is different, but the diagnosis of autism also makes a person different. Based on these results, attention is drawn to the risks of class or group discussions focusing exclusively on what autism is, as such discussions may reinforce the representation that someone with autism is fundamentally different, while possibly spurring exclusion.     

自闭症儿童教育评估在培智学校的实践研究——以海淀培智中心学校为例

自闭症儿童教育的核心是针对自闭症儿童的特点进行有效地评估,使评估成为教师教育训练的科学依据,并制定适合自闭症儿童的教育计划及教育目标。本文从自闭症儿童教育评估的内容、标准、方法、评估的流程等几方面论述了学校进行自闭症儿童教育训练的实践研究以及取得的效果。     

Investigating the social engagement of children with autism in mainstream schools for the purpose of identifying learning targets

The social needs of children with autism are complex, and their inclusion in mainstream schools necessitates a consideration of the nature of a child's participation in peer culture and how it is received by others. The case study reported here sought to investigate the social engagement of a child with autism and his peers using naturalistic methods to provide contextualised and detailed information. A comparative approach was used to study different social contexts: the wider class group, the peer group which included the child with autism, and the individual participation of the child with autism compared with this smaller group. Findings indicate that the child with autism demonstrated a number of competencies in relation to his own social group and that social difficulties were not necessarily seen as a weakness within the peer culture. The importance of careful analysis of social processes and the use of reflective assessment to autism education is highlighted.     

Diagnosis and treatment children and adolescents with autism and ADHD

Attention-deficit/hyperactivity disorder (ADHD) and autism are neurodevelopmental disorders that emerge in childhood. There is increasing recognition that ADHD and autism frequently co-occur. Yet, questions remain among clinicians regarding the best ways to evaluate and treat co-occurring autism and ADHD. This review outlines issues relevant to providing evidence-based practice to individuals and families who may be experiencing difficulties associated with co-occurring autism and ADHD. After describing the complexities of the co-occurrence of autism and ADHD, we present practical considerations for best practice assessment and treatment of co-occurring autism and ADHD. Regarding assessment, this includes considerations for interviewing parents/caregivers and youth, using validated parent and teacher rating scales, conducting cognitive assessments, and conducting behavior observations. Regarding treatment, consideration is given to behavioral management, school-based interventions, social skills development, and the use of medications. Throughout, we note the quality of evidence that supports a particular component of assessment or treatment, highlighting when evidence is most relevant to those with co-occurring autism and ADHD across stages of development. In light of the current evidence for assessment and treatment of co-occurring autism and ADHD, we conclude by outlining practical implications for clinical and educational practice.     

The prevalence and correlates of abuse among children with autism served in comprehensive community-based mental health settings

OBJECTIVE: To determine the demographic and psychosocial correlates of physical and sexual abuse among children with autism. METHODS: Data collected from 1997 to 2000 through the national evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program on 156 children with autism were used. Data included a baseline assessment of child and family psychosocial experiences and presenting problems associated with referral into system-of-care service, demographic information, and a clinical record review to obtain psychiatric diagnosis. Binary and multinomial logistic regression was used to determine the association of different characteristics of children who were abused compared with those who were not abused. RESULTS: Caregivers reported that 18.5% of children with autism had been physically abused and 16.6% had been sexually abused. Physically abused children more likely had engaged in sexual acting out or abusive behavior, had made a suicide attempt, or had conduct-related or academic problems. Sexually abused children more likely had engaged in sexual acting out or abusive behavior, suicidal or other self-injurious behavior, had run away from home, or had a psychiatric hospitalization. In adjusted multivariate models, the relationship between sexual abuse and sexual acting out, running away from home and suicidal attempts persisted. CONCLUSION: Based on the prevalence of abuse and its association with various behaviors, clinicians should be as attuned to the psychosocial histories of children with autism as they are for other children, and consider the potential of abuse when these behaviors are observed.     

Delving deeper into the black box: formative assessment,inclusion and learners on the autism spectrum

This paper explores the implementation of formative assessment through the ‘autism lens’ in order to analyse why the process can be exclusionary for some learners on the autism spectrum. The central thesis of the paper is that, where teachers have no understanding of the autism learning style, they are likely to revert to a normative, ‘majoritarian’ construction of learning. Two problems may flow from this. First, majoritarian assumptions about learning could dominate the inferential process that is the foundation stone of formative assessment. This could lead teachers to mis-read what is going on inside the heads of learners on the autism spectrum, and cause them to make partial and inaccurate inferences about their learning. Second, majoritarian assumptions may also inform the interactive process that underpins formative assessment. Social interaction can be challenging for learners on the autism spectrum and can limit or exclude their participation unless sensitive modifications are made to the social and communication environment. The case is, therefore, made for teacher awareness of a ‘minoritarian’ perspective that foregrounds knowledge and understanding of the autism learning style. Arguably, this knowledge and understanding could enable teachers to adapt the formative assessment process so that it is more effective and inclusive for this group of learners.     

Best practices and emerging trends in assessment of trauma in students with autism spectrum disorder

Children and adolescents with autism have a higher likelihood of being exposed to bullying, abuse, and sexual assault which, through repeated exposure, has been demonstrated to impede academic, social, and physical functioning among this population. However, the complexity of unpacking the characteristics of autism and trauma can pose a challenge for school psychologists in using the most appropriate clinical method of intervention. This paper summarizes the co-occurrence of autism and trauma in an effort to better inform practitioners and recommends the need for valid and reliable assessments that measure adverse experiences for children with autism. A practitioner assessment guide of childhood trauma and autism spectrum disorder is also provided to facilitate a comprehensive assessment process. We conclude that there is a pressing need for more research examining the relationship between autism and trauma by better understanding the relationship of these constructs, and for the development of more effective assessments to provide more evidence-based interventions.     

人机交互技术支持的自闭症儿童评估——基于修订版C-PEP量表与人机交互游戏的评估结果对比

评估是自闭症儿童干预治疗的重要前提。基于此,文章聚焦于人机交互技术支持的自闭症儿童评估问题,从知觉、手眼协调、认知表现、关系情感等四个维度,对比了《心理教育评定量表中文修订版C-PEP》(简称"修订版C-PEP量表")与人机交互游戏的评估结果,发现:人机交互游戏评估结果能正确反映修订版C-PEP量表的评估结果,且评估更加精准、更能吸引自闭症儿童的注意力并做出反应。文章验证了人机交互游戏评估的可行性和有效性,可为自闭症儿童评估、人机交互游戏开发提供参考。     

Executive functions and pragmatics in children with high-functioning autism

Children with deficits in executive functions (EFs) and impairments in pragmatic language have a range of cognitive and language difficulties that affect their literacy and educational achievements. As deficits in EFs and pragmatic impairments are characteristics of autism spectrum disorders, this study examined the associations between EFs and pragmatic skills in children with high-functioning autism (HFA). Fifteen children with HFA (5–9 years; M?=?7.44, SD 1.21), matched to 15 typically developing peers on age, gender, and non-verbal intelligence participated in the study. Children completed a pragmatic language assessment protocol, and a rating scale of EFs was administered to parents. Our results point to two main findings: children with HFA presented pragmatic difficulties and EFs impairments when compared with typically developing peers; and, as shown by a significant indirect effect of group on pragmatics via EFs, the poor pragmatics skills of HFA children were associated with their EFs difficulties. These findings may be of clinical relevance for children with pragmatic impairments, such as autism spectrum disorders. Future studies are crucial to further investigate the relationship between impaired pragmatics and EFs.

     

The May Center for Early Childhood Education: description of a continuum of services model for children with autism

Children with autism have complex learning and behavioural challenges which typically require comprehensive educational and therapeutic services. In recent years there have been many developments in the philosophy, methodology, and scope of intervention for this population. Factors such as early intervention, criterion‐referenced assessment, the combination of applied behaviour analysis and developmentally appropriate practices (DAP), parent training, and public school inclusive education have been noteworthy. This article describes a comprehensive continuum of services model for children with autism developed by a human services agency in Massachusetts which incorporates these and additional empirically‐based approaches. Service components, methodologies, and program objectives are described including representative summary data. The article concludes with a discussion of educational, therapeutic, and research issues which address “best practice” approaches toward children with autism.     

‘Let's Talk Autism' –a school‐based project for students to explore and share their experiences of being autistic

Understanding what autism means on a personal level can be an important process for young people on the autistic spectrum, and being able to reflect on this and discuss with autistic peers can be particularly helpful. However, opportunities may be restricted by reluctance to talk about diagnosis and because of difficulties in communication inherent in autism. This article describes a therapeutic media project within an ASD school that attempted to support young people to reflect together about what autism meant for them and create resources to share with others. The process is described and main themes of discussions analysed using thematic analysis. Main themes emerged of making sense of diagnosis, experiences of difference and transition to adulthood. Various strategies to manage diagnosis and negotiate identity also emerged. Issues around informed consent and confidentiality and the therapeutic value of such groups are discussed.     

Differences in the Prevalence,Severity and Symptom Profiles of Depression in Boys and Adolescents with an Autism Spectrum Disorder versus Normally Developing Controls

The prevalence, severity and symptom profiles for major depressive disorder (MDD) were compared in samples of boys and adolescents with and without an autism spectrum disorder (ASD). Self-reports were obtained on the Depression subscale of the Child and Adolescent Symptoms Inventory (CASI-D) with 70 ASD and 50 non-ASD male participants between the ages of 8 and 18 from Queensland, Australia who were matched for age and IQ. Results indicated that the ASD participants had significantly higher total CASI-D scores, a greater proportion of participants who qualified for a diagnosis of MDD, and over 50% higher scores for 8 of the 10 CASI-D symptoms than non-ASD participants. The MDD profiles for the ASD participants were dominated by anhedonia. Issues for assessment and diagnosis of comorbid MDD in young males with an ASD, plus targeted treatment planning that directly addresses their MDD profile, are discussed.     

‘Here I come again’: the cost of success for higher education students diagnosed with autism

This qualitative study used Interpretative Phenomenological Analysis to consult with 16 autistic UK higher education (HE) students about their experiences of success. An in-depth participatory approach encouraged participants to become co-analysts of their data.

Participants offered counter-narratives to deficit-based interpretations of autism, giving accounts of making themselves ‘extra-visible’ as autistic in order to assert their rights. The autism diagnosis was perceived both as an aid to self-understanding and a cause of additional barriers. In raising awareness of their own needs, participants contributed to broader understandings of autism within their academic communities, inadvertently becoming educators and role models. The research highlights the extra effort required by autistic students to thrive within higher education and the barriers imposed by current requirements to both pursue formal diagnosis, and to disclose it in order to receive adjustments. The research was novel in its approach and in its focus on success, revealing original findings in relation to the challenges and barriers faced by high-achieving autistic students, and the implications for a more inclusive higher education curriculum and environment are considered.     

The conceptualisation of a modified formative assessment model for non‐verbal students with autism and severe learning difficulties

The popularity of formative assessment has increased since the publication of work by Black and Wiliam in 1998. Even though it is a useful teaching tool, in most cases it has only been possible to use it for students with high levels of cognitive and communicative ability. The aim of this article is to propose a modified, personalisable model of formative assessment for non‐verbal students with autism and severe learning difficulties. Five students with autism and severe learning difficulties participated in systematic video observations over a period of eight weeks, during which student behaviour and attainment were recorded. The behaviour checklist gave an accurate representation of the students' level of engagement and predicted attainment, but differences in passive learning objectives (those requiring passive co‐operation) and active ones (those requiring active contribution) were noted. The introduction of engaging resources improved engagement, but tangible rewards had a negative effect on attainment. Praise had a positive effect on engagement and attainment.