Best Practice in Assessment and Intervention for Learners on the Autism Spectrum

The number of children identified with autism has more than doubled over the last decade. School-based professionals are now being asked to participate in the screening, assessment, and educational planning for children and youth on the spectrum more than at any other time in the recent past. Moreover, the call for greater use of evidence-based practice has increased demands that school personnel be prepared to recognize the presence of risk factors, engage in case finding, and be knowledgeable about “best practice” guidelines in assessment and intervention for autism spectrum disorder (ASD) to ensure that students are being identified and provided with the appropriate programs and services.

Best practice guidelines are developed using the best available research evidence in order to provide professionals with evidence-informed recommendations that support practice and guide practitioner decisions regarding assessment and intervention. Best practice requires the integration of professional expertise, each student’s unique strengths and needs, family values and preferences, and the best research evidence into the delivery of services. Professionals and families collaborate and work together as partners to prioritize domains of functioning for assessment and intervention planning. Best practices for school-based practitioners are best practices for students and their families.

There are several important best practice considerations that should inform the assessment and intervention process. For example, a developmental perspective is critically important. While the core symptoms of autism are present during early childhood, ASD is a lifelong condition that affects the individual’s adaptive functioning from childhood through adulthood. Utilizing a developmental assessment framework provides a yardstick for understanding the severity and quality of delays or atypicality. A comprehensive developmental assessment approach requires the use of multiple measures including, but not limited to, verbal reports, direct observation, direct interaction and evaluation, and third-party reports. Interviews and observation schedules, together with an interdisciplinary assessment of social behavior, language and communication, adaptive behavior, motor skills, sensory issues, atypical behaviors, and cognitive functioning are recommended best practice procedures. Assessment is a continuous process, rather than a series of separate actions, and procedures may overlap and take place in tandem. Supporting children and youth with ASD also requires individualized and effective intervention strategies. It is critical that teachers, administrators, and other school personnel have an understanding of those strategies with a strong evidence base and demonstrated effectiveness to adequately address the needs of students on the spectrum and to help minimize the gap between research and practice.

Despite the significant increase in the number of journal articles, book chapters, textbooks, and various publications outlining information regarding educational practices, supports that are reportedly effective for students on the spectrum, the existing literature can often be confusing and at times conflicting. As a result, there continues to be a need for an up-to-date resource that provides school-based professionals and allied practitioners with a best practice guide to screening, assessment and intervention that can be used easily and efficiently in their every day work.

The award-winning book, A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools, 2nd Edition, provides a practical and scientifically-based approach to identifying, assessing, and treating children and adolescents with an autism spectrum disorder (ASD) in school settings. Fully updated to reflect the DSM-5 and current assessment tools, procedures and research, this fully revised and expanded second edition will support school-based professionals in a number of key areas including:

  • Screening and assessing children on the spectrum
  • Identifying evidence-based interventions and practices
  • Developing and implementing comprehensive educational programs
  • Providing family support and special needs advocacy
  • Promoting special needs advocacy

Each chapter features a consolidated and integrative description of best practice assessment and intervention/treatment approaches for learners on the autism spectrum. Combining current research evidence with theory and best practice, the text brings the topics of assessment and intervention together in a single authoritative resource guide consistent with recent advances in evidence-based practice. Illustrative case examples, glossary of terms, and helpful checklists and forms make this the definitive resource for identifying and implementing interventions for school-age children and youth with ASD.

This award-winning guide is intended to meet the needs of professionals such as educational and school psychologists, counselors, speech/language pathologists, occupational therapists, social workers, administrators, and both general and special education teachers. Parents, advocates, and community-based professionals will also find this guide a valuable and informative resource.

 

Lee A. Wilkinson, PhD, is a nationally certified and licensed school psychologist, chartered psychologist, registered psychologist, and certified cognitive-behavioral therapist. He is an Associate Fellow of the British Psychological Society. He has published widely on the topic of autism spectrum disorders and is editor of a text in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools. His book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT, also published by JKP, was honored as an “Award-Winning Finalist in the “Health: Psychology/Mental Health” category of the 2016 Best Book Awards.”

2015 Family Choice Award Winner

The Pocket Occupational Therapist for Families of Children With Special Needs won a 2015 Family Choice Award!

Pediatric occupational therapist, Cara Koscinski, MOT, OTR/L, is the author of The Pocket Occupational Therapist for Families of Children With Special Needs. She was just 17 years old when she decided on her life long career. After shadowing an occupational therapist (OT) at a high school career day, her mind was made up. “I decided that day that’s what I wanted to do,” said Cara.” In fact, I applied to a university OT program as a junior in high school and never looked back. I never considered any other career.”

Little did she know that her passion, first ignited as a teen, would serve her so well in both her professional and personal life. Cara practiced occupational therapy, primarily serving an adult population, for years. It wasn’t until she had her sons and they were diagnosed with autism and sensory processing disorder that she made the switch to pediatric OT. Her younger son has mitochondrial disease, a severe case of Eosinophilic Esophagitis and uses a feeding tube for nourishment. At times, he requires a wheelchair to get around.

Cara believes her experience as a special needs mom gives her unique empathy for her clients and their families. “When I give my clients a home activity, I have personally tried it and know it works,” said Cara. “I feel very blessed to have the chance to use my professional expertise to help my own boys.”

As the author of this book, Cara brings her expertise as a pediatric occupational therapist and mother of two special needs children to parents, caregivers, families, and educators in an easy-to-read, easy-to-follow format. “I hope my readers will use the book during many times. For example, this week their child may be having difficulty with washing hair…next week it may be handwriting. The book is designed so that families can pick up the book and find exactly the help that they need.”

“I was surprised and honored to receive the nomination. I’m quite proud of the book and hope that this award will help readers to learn about the benefits of occupational therapy.”

For more information about Cara, visit her website at www.PocketOT.com.

Six steps to finding balance in busy lives

It is important to know that life imbalance is one of the biggest causes of stress in the western world; consequently understanding why we experience imbalance in our modern lives, and finding strategies to help you overcome it, is very useful! Teena Clouston shares 6 steps to finding balance in busy lives from her new book Challenging Stress, Burnout and Rust-out.

Clouston-ChallengingStress-C2W

So what is burnout and rust-out?

Burnout and rust-out are caused by long-term stress; burnout is marked by exhaustion and rust-out by apathy and disengagement. Which of these we experience and when, is variable, dependent on the unique individual and his or her circumstances. Stress and imbalance can be linked to some specific personality traits and thinking patterns that we can unconsciously adopt to manage the daily grind but which, unwittingly, can maintain our state of imbalance and levels of stress.  For example, people who rush around like busy bees, or those that put up with or make excuses for their busyness and overwork are all using different strategies to deal with life conflicts, pressures and time scarcity, but sadly, are failing to diminish stress. Alternatively those that fight back and overcome these pressures seem to be able to live a far more balanced and healthy life because they dare to challenge the status quo and take time to do things they find meaningful or enjoy doing, irrespective of the pressures of work or general over-busyness.

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Resistance is not futile

 

6 steps to achieve a healthy work-life balance

There are several different ideas shared in the book but if I had to choose 6 they would be:

  • Gain some autonomy over your workload
  • Review and adapt your views and attitudes about work so they become congruent with what you really want in life
  • Share your daily responsibilities with others
  • Do something meaningful everyday
  • Live in the moment
  • Walk in nature

These techniques are not a cure-all in terms of work-life or indeed, more general life balance. That’s because, in reality, they all need you to put in a lot of effort in terms of making changes in how you live your life everyday, and that is not easy. For example, if you are going to use mindfulness techniques to try to focus on the moment or cognitive behavioural strategies to change your thinking or attitudes about life balance, then you have to practice that regularly and put some work in every day. That said, you do need to start somewhere and from small moves big things can grow and consequently, with practice, you can really change your sense of balance, your quality of life and ultimately, your well-being; thus practice may not make perfect, as the saying goes,  but it can make life just a little richer and more satisfying.

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Illustrations by Peter Cronin, ARSMA.

Teena J. Clouston is a Reader in Occupational Therapy and Life Balance at the School of Healthcare Sciences at Cardiff University, UK. Over the last ten years, her research interests have become focused on the meaning and experience of lifestyle balance, and her PhD specifically studied the influences of paid work on finding balance in everyday life. Learn more about Challenging Stress, Burnout and Rust-out here.

No Shame for Extreme Night Owls

Author of An Occupational Therapist’s Guide to Sleep and Sleep Problems, Andrew Green is an occupational therapist specialising in sleep disorders. In a bid to clear the air about the myths that surround the early bird and nightowl stereotypes,  Andrew gently introduces the sleep disorders that are the root of the stereotypes that haunt those of us who just aren’t very good at sticking to ‘normal’ sleeping hours, if such a thing exists.

Green and Brown - sheep logo

 

In 1735, Benjamin Franklin made known the saying ‘Early to bed, early to rise makes man healthy, wealthy and wise’. Over two centuries later it turns out that the opposite may be nearer the truth. By comparing health and socioeconomic data relating to ‘owls’ and ‘larks’, Gale and Martyn (1998) found no evidence that early rising is actually more beneficial, and concluded that early bedtimes and rising times are not linked with ‘health, socioeconomic, or cognitive advantage [and] if anything, owls were wealthier than larks’ (p.1677). It is possible that Franklin learned in his long life that the earlier saying was inaccurate since the following is also attributed to him, presumably in his later years: ‘I wake up every morning at nine and grab for the morning paper. Then I look at the obituary page. If my name is not on it, I get up’.

In any case, the reality is that people are different and the tendency towards being an owl or a lark is inherited. For most people it is just a tendency – part of natural variation that can be accommodated in normal lifestyles, but at the extremes are circadian rhythm disorders. Circadian rhythms are the natural cycles that determine the timing of numerous body functions, including the sleep-wake cycle. When someone’s rhythm is advanced – when they are an ‘extreme lark’ – they tend to wake earlier and go to bed earlier than the norm; it is a very rare condition and Schrader et al. (1993) found no cases of advanced sleep phase disorder in a sample of 10,000 Norwegian adults. However, the same study found 17 individuals who met diagnostic criteria for delayed sleep phase syndrome (DSPS) – or who were ‘extreme owls’: it is therefore still an uncommon condition although the prevalence in adolescents and young adults may be as high as 10% (Wilson and Nutt 2013).

To have DSPS means that a person is unable to sleep until two hours, or longer, after a more conventional bedtime and naturally tends to wake correspondingly later. It might not seem much but is extremely disruptive to life. Someone with DSPS may not know they have it and think they have insomnia, perhaps going to bed at 11 p.m. in the hope of having eight hours of sleep and not sleeping until 2 or 3 a.m. However, they will still need to get up at 7 a.m. for work or school and have to get through the day. Whereas most people can manage after one short night, perhaps because of an early start for a journey, having DSPS is like having to get up at 4 a.m. every day, having gone to bed at 10 or 11 p.m., and then feeling sleepy every afternoon.

Individuals with DSPS complain that it is difficult to get to work reliably in the morning and that employers, and others, do not understand that they are not just being lazy. Some people are very embarrassed by staying in bed for half the morning. Others are able to adapt to some extent; for example, a research student might be able to work in the library during the night, arrange meetings in the afternoon and still have time to meet friends in the evening. The experience of DSPS has been investigated by Wilhelmsen-Langeland et al. (2012) in a qualitative study involving nine young people (age 16–23) in Norway. Participants talked about the difficulty of staying awake at school, and conflicts with others through being late when meeting, or unavailable to help with chores, for example, during the day, but the failure of others to understand was a key observation. Other people might suggest that they could just go to bed earlier – as if they could just try harder to sleep ahead of their biological preference.

Delayed sleep phase syndrome is a disruption of activity cycles and could be considered a disorder of occupation; it should be of interest to occupational therapists. Medical management could involve use of melatonin at night to encourage earlier sleep (supplementing naturally produced melatonin) and bright light (daylight or full spectrum artificial light that mimics natural light) on rising in the morning in order to help ‘reset the body clock’. In addition to these, chronotherapy involves going to bed successively later, a strategy that seems counter-intuitive, until the desired hours of sleep are reached; it is easier to adjust the timing of sleep by lengthening the day – in the same way that is easier to adjust to jet lag when flying east to west. It is then important to consider how the person keeps to more conventional hours.

In many respects maintaining more regular hours is like following advice for managing insomnia: keeping a consistent rising time (essential) – and seeing daylight on waking; avoiding daytime sleep that might delay night time sleep; doing regular exercise and having regular activity; having a clear winding down routine. In winding down it is preferable not only to avoid the mental or emotional stimulation that might accompany use of a computer late at night (and the temptation to play ‘just one more game’, for example) but also to avoid the blue light that is emitted by computer screens and televisions, which can suppress the production of melatonin.

Despite all such effort, however, it is likely that the individual is always going to be later than average and well-advised to avoid work that involves early starts. Finally, extreme owls might remember that there is no need for shame in rising late, which they cannot help. As Gale and Martyn put it, ‘there is no justification for early risers to affect moral superiority’ (p.1677).

References
 Gale, C. and Martyn, C. (1998) ‘Larks an owls and health, wealth, and wisdom.’ British Medical Journal 317, 1675–1677.
 Schrader, H., Bovim, G. and Sand, T. (1993) ‘The prevalence of delayed and advanced sleep phase syndromes.’ Journal of Sleep Research 2, 1, 51–55.
 Wilhelmsen-Langeland, A., Dundas, I., West Saxvig, I., Pallesen, S., Nordhus, I.-H. and Bjorvatn, B. (2012) ‘Psychosocial challenges related to delayed sleep phase disorder.’ The Open Sleep Journal 2012, 5, 51–58.
 Wilson, S. and Nutt, D. (2013) Sleep Disorders, 2nd edn. Oxford: Oxford University Press.

Andrew Green trained in occupational therapy in York and is now a specialist occupational therapist in North Bristol NHS Trust’s sleep disorders service at the Rosa Burden Centre. Learn more about his book An Occupational Therapist’s Guide to Sleep and Sleep Problems here.

On the value of writing with traumatised young people – with Marion Baraitser

Baraitser_Reading-and-Exp_978-1-84905-384-6_colourjpg-printMarion Baraitser demonstrates the power of writing with traumatised children and young people. Marion’s book ‘Reading and Expressive Writing with Traumatised Children, Young Refugees and Asylum Seekers: Unpack My Heart With Words’ is available now from the JKP website.

On the value of writing with traumatised young people:
When disturbed young people have read aloud together a strong text, talked about it with a practiced facilitator in a roomful of trusted community members, discussing characters and subjects that concern their own lives, and then written about it, it can transform their idea of themselves and of their future lives. They are better able to externalize self-hood so they can exist in the world, feeling that their internal being has connected to the outside world through books, in some profound way, a form of ‘being-in-development’, a process of growing and changing the many selves they can uncover by this process. The facilitator brings energy, optimism, warmth and responsiveness, even inspiration, or at least motivation or affirmation, to each session.
Here is Amina on the value of writing in helping her to heal:
Writing is helping me to put down memories, different perspectives, to try to find the line… Talking doesn’t do this. When I write I am having a relationship with my journal. Writing is like having a conversation with yourself. I tend to be more honest… pick up on things that lie deeper. I love myself, in writing… I am lucky to be here… I am lucky to be alive… You must keep going and finding yourself, at the same time staying true to yourself… even though you cannot forget where you started from.

Boy

How reading great books together can change lives:
The Nigerian writer Ben Okri, who holds childhood memories of civil war in Nigeria, of his schooling in Lagos 400 miles from his family and of how, on reaching England, he lived rough, by his wits, homeless and miserable. He went to London because of Dickens and Shakespeare, but he also loved African writers like Chinua Achebe and Wole Soyinka. ‘Literature doesn’t have a country. Shakespeare is an African writer… Dickens’ characters are Nigerians.’ (Okri, 1992) As the young people read aloud in the company of a facilitator and a like-minded group, they become the writer, they are taken out of themselves, and if the writer is worth his salt, that encompasses a whole new set of dimensions that can change the way they regard life and their place in it.

Marion’s book ‘Reading and Expressive Writing with Traumatised Children, Young Refugees and Asylum Seekers: Unpack My Heart With Words’ is available now from the JKP website.

 

 

 

Summer Holiday activites for younger children with Autism and other learning difficulties (Day 4).

We want to highlight activities that you can do without having to spend any (or that much) money in order to have fun. This game is a perfect example of ‘no-money fun’ that you can have just using everyday household items and a little bit of imagination.

MONKEY TOES

Primary learning focus

  • Balance, motor planning, crossing the midline.

Materials needed

  • Unbreakable bowl, bucket or tote bag.
  • Cotton balls, pompoms, or other small, soft objects.

Description
Scatter the cotton balls or other objects around a small area, and then have the child remove shoes and socks and collect the objects to place in the container using only his/her feet. If a cotton ball is too far away, have the child retrieve it and then hop on one foot to get to the container.

Variations

  • Use different size or colour pompoms, and have the child collect items according to size. Colour or pattern.
  • Have the child sit on his/her bottom, and use two feet together to pick up objects.
  • Have the child trap a beanbag between both feet, then jump on two feet to get the container without losing the beanbag.
  • Challenge balance skills by doing this activity with arms held over the head, hands in pockets or behind the back, or on a slightly unstable surface (for example, sofa cushions or air mattress).

 

As featured in Simple Low-Cost Games and Activities for Sensorimotor Learning by Lisa A. Kurtz

 

Special Educational Needs and Pastoral Education Autumn 2014

Browse our latest collection of titles in special educational needs and pastoral education. For more information on any of the books inside, simply click the title or cover image to view the full book page.

Summer Holiday activites for younger children with Autism and other learning difficulties (Day 2).

For day two in our list of summer holiday activities grab some chalk, go outside and have some fun 🙂

Pavement Chalking

Aim
To practice and improve early literacy skills

What you will need

  • Chalk (variety of colours)

Draw a circle on the floor and practice taking turns jumping into it.

Pavement chalking provides lots of opportunities for practising early literacy skills; try tasks such as joining up two dots with a straight line (left to right) or joining dots to make wavy zig-zag lines etc.

Chalk different shapes onto the ground and encourage your child to jump onto the requested shape after saying ‘ready…steady…go’. Start with only one shape, then add new ones, one at a time. Vary this with activities such as requesting your child to ‘put the bean bag on the square/circle’, etc. To add further receptive language skills, move on to presenting a choice, for example, bean bag, teddy, brick, and chalk further shapes in different sizes and colours. You might then ask your child to ‘Put teddy on the small circle’ or ‘Put bean bag on the yellow triangle’. Continue to use ‘ready…steady…go’ and rewards where necessary (verbal or otherwise). Remember some children with autism really don’t like over-enthusiastic shrill voices. Be aware if this is the case (he/she may actually see this as a reason not to co-operate). Try using bubbles, tickles or treats instead.

As well as chalk, you can also draw on the ground with sand in a plastic bottle with a hole in, or with water in a squirty plastic bottle (those with a sports sipper cap are ideal).

 

From Playing, Laughing and Learning with Children on the Autism Spectrum by Julia Moor

Summer Holiday activites for younger children with Autism and other learning difficulties (Day 1).

We realise the importance of keeping children occupied over the summer holidays and with that in mind will be featuring a different activity that you can do with your kids every day this week. These will be interesting, low-cost activities for parents with younger children – first up today is a drawing exercise that can involve the whole family (including the family pet).

 

MIRROR DRAWING

Primary learning focus

  • Auditory perception, visual-motor integration

Materials needed

  • Paper and markers or crayons
  • File folder or other object to use as a visual barrier

Description

In this game, the child attempts to draw a picture that looks the same as the adult’s picture, given only auditory clues. The adult and child each have paper and drawing materials. Place the file folder or other barrier in between the child and the adult, so they cannot see each other’s paper. The adult then draws one item at a time, giving a verbal direction for the child to do the same thing. For example, the adult might say “Draw a large square in the center of the paper, with a small circle inside the square. Next make a smiley face in the top left hand corner of the paper.” After several directions, remove the barrier and compare the two pictures, discussing how they are different or similar. Let the child take turns being the one to give directions to the adult.

Variations

  • Use lined paper and give directions to copy sequences to encourage memory skills (for example, “Let’s draw circles to make this pattern: red, blue, green, red, blue, green”)
  • While shapes and colors are easier to describe, this game is also fun when you make it more creative. For example, give directions for drawing the family pet, but add silly directions, like making a green tongue, or wearing dog mittens.
  • Draw while lying on your belly, or at a vertical surface to strengthen upper body skills.

 

As featured in Simple Low-Cost Games and Activities for Sensorimotor Learning by Lisa A. Kurtz

Reconnecting, establishing safety, empowerment with humour – extract from ‘Unpack my Heart with Words’ By Marion Baraitser

In this extract, Marion Baraitser provides activities for both younger and older children in order to explore their feelings of safety and the importance of humour.
‘Reading and expressive writing with traumatised children, young refugees and asylum seekers – Unpack my heart with words’ is available now from the JKP website. 

Baraitser_Reading-and-Exp_978-1-84905-384-6_colourjpg-printYoung adults’ group

Reconnecting, establishing safety, empowerment with humour

1. Read aloud together Sholem Aleichem’s story On Account of a
Hat (1953). It is about a young man from the shtetl returning
home on a train anxious not to be late for his wife’s celebratory
dinner, who finds to his horror that he has by mistake picked
up the hat of the important official sitting next to him on thestation. Everyone treats him with a deference entirely false to
him. He is forced to return to the station, replace the hat and
arrive home late for dinner, to an enraged wife.

2. Ask the group to talk about their own humorous incidences of
frustration within their everyday lives that involve their need for
finding a safe place.

3. Write about stories they know about how to face dangerous
and frustrating situations realistically, and how to find workable
solutions that give a measure of empowerment.

4. Read these aloud and share.

5. Enact them.

Young children’s group

1. As a warm-up, pass an endearing stuffed animal around the
group, with each child saying how they are feeling and what
they would like to talk about.

2. Create a safe place in the room and ask them to create a pose,
then tap each person to ask them to show and tell the group
what their space looks like, what it contains and what they are
doing there.

3. Ask each person to make sculptures, using ‘characters’ that
threaten them. Then ask them to step away and make changes,
telling their feelings to the group. Or they may create a wax
museum containing characters from their past that reflect their
feelings and situations about a theme such as anger or hate and
the others can walk through it.

4. Enact these ‘characters’. The rest of the group should question them.
Write stories about them.[AQ]

I was on my mettle – after a lifetime spent with literature, I needed to sift and sort the books I knew that were of great truth and impact, to find appropriate texts that applied to, or transformed, traumatised young people’s problems in a way they could absorb and use them effectively. This meant trawling through not only English literature, but also world literature in translation.

‘Reading and expressive writing with traumatised children, young refugees and asylum seekers – Unpack my heart with words’ is available now from the JKP website.