Best practices/assessment

Dr. Sally Ozonoff comments on a variety of informal information on the overall assessment process. She explains what is crucial when assessing a child, how we screen for autism, the many red flags to be aware of, and the diagnosis process.

How We Screen forAutism:

It is recommended that the child’s pediatrician screens for autism at 18 month, 24 month and 36 month intervals. It is interesting, and important to note, that if the child passes the screening, they still need to be tested again following these month intervals. This is due to the fact that a child screening may show symptoms initially, but as the child develops symptoms may become evident.

There were many “red flags” mentioned in the video that I found helpful for educators, and especially parents who may have concerns with a child’s development.  Some of the red flags to consider when screening a child include:

1.       Does not respond to his or her own name;
2.       Acts like they are hard of hearing;
3.       Does not smile at others;
4.       Does not point or use gestures by 12 month;
5.       May talk, but cannot communicate with others;
6.       Sudden loss of social and communication skills.

There are other reasons to referral a child for autism screening, including hearing tests and lead tests. After being referred, if the child fails any of the indicators, they may be eligible for early intervention, which involves other comprehensive assessments.

 I found it interesting when Dr. Ozonoff mentioned that one may notice red flags in an infant as young as 6 months.  I find this beneficial to know, especially for new parents who may not be aware of a child’s “typical” developmental stages.  However, having information that explains the meaning of these indicators will be very informative and helpful for new parents.

FBA/ Assessment:
When using a FBA, and other assessment tools, I strongly believe, it is essential to interact with the child on a one on one basis. As mentioned in the video, some assessments are based on parent review questionnaires or video monitoring, where little or no interaction occurs. The down fall for this type of assessment is the assessor may only have a short time with the child in his/her environment, and therefore will be limited with fully determining the child’s behavior.

Another strong connection on how FBA fits into an assessment picture is having access to knowledgeable team members that can work collaboratively in describing the behavior. This team may include persons who have daily interaction with the child, such as a speech therapist, doctor, teachers, daycare provider, psychologist, family members, as well as parents.

Diagnosis Procedure and History:

Dr. Ozonoff explained the diagnostic approach to be very straightforward and clear. Determining if the child meets all requirements for the DSM-4, it is important to collect as much as information as possible from the parents, teachers, and caregivers.  One important question to consider involves what the child’s behavior was like before the parents noticed an issue. It is also essential to determine what the parents’ main concerns are as well.

Some red flags that may be noticeable during the child’s first six months include:

Lack of sleep, not eating, level of activity, as well as appearing irritated and hard to settle down. By the first birthday the child may have difficulty making eye contact, not responding to one’s own name, not pointing or imitating, and demonstrating little interest when playing with others. By three years of age, the behaviors of autism seem more clear and noticeable. The child is usually behind in a variety of developmental milestones, desire to play alone, not respond to other children, not talk, but will exhibit some echolalia, or automatic repetition of sounds made by another person. I believe the best practice for bridging clinical assessment, educational assessment, and classroom practice involves having a scheduled meeting with the assessment team who should meet at least once a month, or more frequently, to discuss the child’s progress and/or concerns. This will enable the team to collaborate with each other about different positive outputs, or new issues, involving the child’s progress.

Identifying autism involves many steps and procedures with each assessment. However, a key factor with this is to recognize the importance of team meetings, and the meaningful impact such a collaboration will have on not only the child, but the family as well.