1. Education-Based Evaluations for ASD

2. 5 Concepts Minutes

3. Agenda for Day 2 Review Day 1 – Case Follow Up
Observation Practice Cont.
Full Evaluation Case Review
Addressing Disagreements
Evaluation Exercise

4. Evaluation Case Exercise Review Learning Points

5. Observation practice, cont.

6. Evaluation Process REED Identifying the Evaluation Team
Evaluation Components
Determination of Eligibility
Evaluation Report
IEP

7. Evaluation Components
Teacher / Staff Interviews
Parent / Family Interviews & Home Visit
Observations Across Settings
Standardized Assessment Domain Considerations

9. Take notes

10. Relevant history James – 4 years old
Has a younger sister and an older brother with no issues
Born 6 weeks early; birth complications, one month Neonatal Intensive Care
Other health / developmental milestones unremarkable to18 mo
At 18 months, lack of language development resulted in numerous assessments
Early On services for language delays then ISD eligibility SLI – attended ECSE program
3-4 years of age, # of Dx of ASD, ADHD, anxiety disorder, ODD; medication treatment & home-based ABA treatment

11. Teacher / staff interviews
Able to follow one and two-step directions
Does not volunteer answers to questions, but when called on, does answer and does so correctly
Has challenging behaviors 2-3 X per week, especially when redirected from preferred tasks
Immature social skills – difficulty sharing
Needs lots of redirection – easily distracted and inattentive
Below average scores in strength and coordination and fine motor skills
Below average scores in receptive / expressive language
Likes Blues Clues – brings books from home

12. Parent interview / home visit
Parent believes child presents with ASD characteristics
Believes his ABA therapy and medication has resulted in significant improvements in behavior and masking ASD characteristics
Child is immature; relies on his peers to initiate rather than initiate himself
He has no friends that he can talk about or mention at home.
He may play with other children, but does not form an emotional bond.
He has limited reciprocal emotions -- understands happy, and often mad, but no other emotions of others– example, family member died and he was not emotional about it, can’t recall person’s name and if you ask him about the family member, says he doesn’t exist….. 

13. Parent interview / home visit
If you ask to see his work, he will bring it to you and be proud sometimes, but does not initiate showing
Has lots of meltdowns and does not communicate the problem
Doesn’t let you know when he doesn’t feel well – have to rely on “fever” or “runny nose”
Is obsessive and needs strict routine—changes cause meltdowns
He walks with Blues Clues books everywhere, to school and sleeps with them… or there is a meltdown…. 
Repeats words, phrases and commercials – right now it is cereal commercials 

14. observations

15. observations

16. James Playing Blues Clues

17. Additional observation summary
Noted to use pointing gesture, held arms up as if to say “I don’t know”
Seems oblivious to emotional states of others – another child cries or gets upset, does not respond or react in any way
In comparison to peers, uses less direct eye contact but when eye contact is used, appears typical
Has difficulty transitioning from preferred activities (e.g. playing Blues Clues)
Has some articulation errors making it difficult to understand at times; does not initiate a lot – not clear if due to difficulty with articulation or not?
No noted play differences or unusual toy use

18. Standardized test considerations
Met cutoff score on ADOS (Autism Diagnostic Observation Schedule) in the communication and social interaction domains but did not meet the cutoff repetitive behavior domain
ASD rating scales completed by parent and ABA therapist showed clinically significant elevations for the presence of ASD; Teacher rating scales showed unlikely ASD
Verbal Behavior Milestone Assessment and Placement (VB-MAPP) shows deficits in requesting information using “wh” questions, requesting attention, labeling emotions, and following instructions, sustaining social interaction, and attention to task

19. Results review meeting Activities
Communication
Reciprocal Social Interaction
OTHER
Restrictive and Repetitive Behaviors
Sensory
Need Additional Information (Describe)

20. What if there is internal disagreement?
Keep true to the process (run the board)
Presume Positive Intent
Ask questions to obtain a deeper understanding of the disagreement -- PPP
Is there a misunderstanding of ASD?
Is there a focus on singular behaviors rather than preponderance of evidence?
Focus on Dx not current eligibility?
Gather additional information/data
Add another evaluator / team
Write a dissenting report

21. Case Study – Team Activity

22. All team members review the case study information and data
As a team, conduct a Results Review Meeting (using the board and quadrants)
Identify any additional information needed to make a final conclusion of eligibility and how you would go about getting that information
Despite missing information (if any), use provided evidence to make a final conclusion of eligibility
Write a paragraph summary of the evidence that leads to your conclusion of eligibility
Write a bulleted list of intervention recommendations to inform the IEP

23. March 4:
Differential Eligibility
Report Writing