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.”

How to help children manage anxiety and embrace their imperfections

Rochel Lieberman, author of Pearla and her Unpredictably Perfect Day, an empowering story that teaches children how to embrace their mistakes and practice resilience, discusses how parents and professionals can use her book to help children who struggle with anxiety and perfectionism.

When I crafted the characters and the story line of Pearla and Her Unpredictably Perfect Day, I visualized creating a tool that can be easily used both at home and at school. My goal as an author was influenced by my perspective as an Executive Speech Coach, where I spend most of my time working with and on behalf of children. In that capacity, I have educated children, their teachers, therapists, principals, and leaders. Above all else, I’ve gone through this journey as a mom, working alongside educators, helping them bring out the best in their own pupils. Thus, I wrote this book with the following vision: for parents, a book that is simple and can be used flexibly in the fine balancing act that is required of parenthood; for schools, a guide for conversations between children and their teachers or therapists.

I have always viewed books as magical instruments, with the power to transcend reality while simultaneously reinforcing our daily experiences. About fifteen years ago, as a college student, I vividly recall riding a New York City bus alongside a mom and her adorable little boy. Like a real New Yorker, she had a great designer bag—yet with an odd rectangular object poking out of the side. My curiosity was short lived, as her son quickly became bored of looking out the window, prompting her to empty some of the treasures from her bag. Amidst the emerging apple sauce and fruit snacks, the large rectangular shape materialized as a children’s book, which allowed her to entertain and delight her son for the remainder of the bus ride. This mom recognized that alongside a cellphone, keys, and snacks, there was a treasure in carrying a children’s book.

Any adult who has ventured into the land of storytelling with a child knows how widespread the benefits can be. Stories let readers connect with characters, like Pearla, who are having similar challenges, but in a nonthreatening way. They open the door to on-the-spot questions and sometimes even deeper conversations about the way life works, even when it’s not working out well. My hope for parents is that by reading this book together with the child in your life, you can reflect on the story and learn to recognize the triggers that caused Pearla distress, such as Pearla’s desire for perfection, and also learn from her healthy ability to strategize in times of stress. Then, you can have a purposeful conversation to relate these ideas, as applicable, to your own child’s obstacles.

For example, if your child struggles with anxiety from a need to perform perfect work, you can engage in a conversation about making mistakes in general and the thoughts and feelings associated with doing so. With Pearla’s fun storyline, my goal is that you can explore these normally sensitive topics in a casual mode, rather than in a “teaching” mode. To facilitate these conversations, I have included suggested questions in the back of the book. Some examples include questions for recognizing perfectionist tendencies (What do you like to have “perfect”?) and questions that allow the child to reframe their thinking about a perceived negative event (When does Pearla start to see that her cookies and cupcakes are perfect just the way they are?)  Keep in mind that these questions can be used as guides to formulate your own question, so that you can speak in a manner that is true to your own communicative style.

As parents, you can use your life experiences or situations other family members have encountered as examples, so your child is reminded that we all make mistakes. You can carry this one step further and talk about the idea that we all expect to make mistakes most every day, and we all have to deal with imperfect situations every day. If you expect to be going to a challenging place, with expected tension or changes of schedule, you can better prepare your child by using words to roleplay the situation and discuss which choices or behaviors are best suited to dealing with the expected encounter. In my experience, these conversations are best done either before or after an event, when the child is not in direct placement of the stressor. Remember, repairs are done after the rainstorm. In the middle of a challenging event, whisper words of encouragement and praise to your child. The longer talks, references to Pearla, and conversational questions can be saved for dry, sunny days.

The character of Pearla arose from my many joyful and zany experiences as a writer, as a mom raising my children, and from my years as a speech language therapist providing services to a wide range of children and adults. Through it all, I observed the growth and powerful learning that clients achieved when they courageously challenged their core beliefs on failure, perfection, and fear of daily challenges. All of us, children, adults, and caregivers alike, are on a journey with many bumps on the surprising road of life. While some of us learn to ride the bumps and face the challenges, others, like Pearla, find it very difficult to handle these imperfections without the help of a caring adult or professional.

A caring therapist, teacher, or allied professional can help children learn to accept impossible-to-avoid changes and challenges in their daily life. Remediating these negative and unhealthy beliefs and feelings is so important, because many times children and adults can carry these painful feelings, along with the ever elusive search for perfection and order, throughout their life’s journey. It is my dream that this book can be used as a tool to foster better social skills by sparking discussions in the classroom or in the safety of a therapist’s office at school or in private practice. The therapist can begin the sessions by attempting to understand the core of the child’s feelings about challenges and beliefs about making mistakes.

Research supports the calming effects of labeling an emotion, as is done in this story (look for the colored phrases in the text). In the privacy of a therapist office, where a child can relate their own story, the therapist can help them label their emotions, using the book as a model. The child and therapist can talk about everyday situations where they may be triggered to experience those emotions. Then, to advance the conversation, the therapist can use the time to problem solve with the child and generate solutions for these everyday experiences.  They can discuss possible scenarios or alternative plans that Pearla may have done that would not have been beneficial, such as screaming, stomping her feet or having a tantrum in front of the customers. This can lead to practical discussions about the consequences for each of the solutions that the child suggested.

In a more structured format, the therapist can probe the child with the following questions from the book’s suggested questions in order to help the child recognize emotions (What part of your body begins to hurt when you feel afraid?), to bring awareness to the words that the child says to himself (What words do you think when you feel afraid?) or to gently elicit support for the child (What thoughts can you think to help you feel less afraid?). These conversations are essential, as research supports that the specific words that you say to yourself  can alter the way you behave. Answers to these questions will slowly open the door to dealing with daily challenges and imperfections. As one client once said to me, “I am good even though I am not perfect.” There is a lot to be learned from the wisdom in those words. Enjoy reading Pearla and Her Unpredictably Perfect Day with the child in your life and let the talking and learning begin.

 

You can learn more, read reviews, or purchase a copy of Pearla and her Unpredictably Perfect Day here. To learn more about the author, visit Rochel Lieberman at www.ariberspeech.com, or connect with her on Facebook or Twitter.