Assessment of Children with Autism

What is Autism?
- A developmental disorder of variable severity that is characterized by difficulty in social
interaction and communication and by restricted or repetitive patterns of thoughts and
behavior.
- The purpose of the Autism Assessment is to determine whether an individual is on the autism
spectrum and to provide information about their presentation and support needs

Five (5) Types of Autism

1. Asperger syndrome
2. Rett syndrome
3. Childhood Disintegrative Disorder
4. Pervasive developmental disorder
5. Kanner’s Syndrome

1. Asperger syndrome - tend to struggle to understand and interpret social cues, develop intense,
often obsessive two subjects and often display a higher-than-average and even gifted
intelligence.
Characteristics: difficulties like sensitivity to tags on shirts or seams on socks, they do not usually
have delayed speech and have an advance vocabulary for their age.

2. Rett syndrome - this progressive type of autism is only affects girls and begins to become
apparent when they reach about 6 months old.
Characteristics: like delayed speech, repetitive hand and arm flapping, and problems with fine
gross motor skills and growth delayed. More severe symptoms start to appear as the child gets
older.
3. Childhood Disintegrative Disorder - seem to develop normally, meeting all of their milestones
but then suddenly start regressing around age of 2. This type of autism can feel devastating and
confusing for parents. Children often show no sign of developmental delays whatsoever.
Characteristics: will stop talking, stop eye contact and often completely lose the ability to
socially interact with others.

4. Pervasive developmental disorder - Not Otherwise Specified (PDD-NOS) This form can
Cause children to have social or developmental delays, like walking or talking later than most
children.
Characteristics: often learn to cope with their developmental and social challenges more easily
than children with more severe forms of autism.

5. Kanner’s Syndrome - The standard behavior of autism.

 Characteristics: Difficulty of understanding, and communicating with others, limited to
no eye contact, hypersensitivity to noises, touch, light and smell and a strong preference for
routine.
 What are essential and imperative in assessing CWA within the psychoeducational framework?
- When the child is referred for assessment , there exists a suspicion of “ differentness” needing
identification and confirmation. The Child is observed and evaluated from point of normality.
The diagnostician’s initial contact with the child and interview with the parents/caregiver
require a thorough clinical observation and pattern recognition skill.
- The diagnostician relies on symptoms the child exhibits as a basis for his/her direct data
through observation, testing and informal skill survey. Indirect data through interview from the
parents/guardian or from any informants regarding the child’s symptoms. “no symptoms, no
diagnosis”.
- Good assessment dictates that the suspected child with autism be evaluated along different
interrelated developmental areas; like their physical health, psychomotor including chores
performance, psychosocial, language-cognitive/intellectual/achievement and self-help: eating,
dressing and grooming. This is so because autism, being a pervasive developmental disorder,
consists of a cluster of symptoms along these areas.
- In the Philippines, Republic Act No. 7277 (Magna Carta for Disabled Persons and Its
Implementing Rules and Regulations) mandates that persons with disabilities including those
with autism must be provided with a holistic intervention, including the vocational component
based on a comprehensive needs assessment (National Council for the Welfare of Disabled
Person, 1995)

Table 1. Indicator of Autism According to developmental areas

Area Indicators
Physical Health The Child:
1.Is generally healthy
2.Is generally good-looking
3. Is a picky-eater, tends to smell food/objects
and put things in his mouth.
 4.Exhibits disturbed sleeping patterns
5.Does not seek attention when hurt; has high
pain threshold; unable to localize pain

Area Indicators
Gross/fine-motor The Child:
1. Walks on tiptoe especially during early
years
2.Is hyperactive
3.Is fast and strong and does not tire easily
4.Is well-balanced, generally coordinated
but lacks impulse control.
5.Exhibits repetitive movement: body rocking,
hand wriggling, whirling, “ritual” of walking to
and fro, etc.
6.Is either echopraxic (is the involuntary
repetition or imitation of another person's
actions) or non-imitative of gestures

Area Indicators
Psycho-social The Child:
1.Exhibits limited/fleeting eye contact
2. Prefers solitary activities
than group activities
3.Manifests inappropriate emotional
response(s)
4.Demonstrates unusual fear(s)
5.Is socially immature
6.Is maladaptive (inability to adapt) to
changes in food, clothes, routine, routes
or arrangements of things
7.Tends to be self-injurious

PRINCIPLES AND GUIDELINES IN ASSESSING CHILDREN WITH SUSPECTED AUTISM

 Autism among children is observed as early as 1.6between to 2.0 years old and safely confirmed
3.0 and 3.6 years old. History –taking is, therefore, imperative as this enables the diagnostician
to elicit information about the onset of autism. History-taking is particularly necessary when the
child being assessed is beyond preschool age.

 The exclusion history involving cases of older children may lead to misdiagnosis. There exists the
risk of diagnosing a “historically” autistic child as having mental retardation or learning disability
because of sole reliance on current data as basis for decision making.
 Early identification of a child as having autism facilitates early placement and intervention. A
diagnostician steeped not only in diagnostic skills but also in intervention competencies and
process knows to well that diagnosis is not an end in itself. Rather it, is beginning of a
developmental process of helping the child achieve whatever his abilities and potentials permit.

Assessment Tools and Strategies

 Assessing children with suspected autism utilizes varied tools and strategies categorized into
direct and indirect data sources.

 Direct data sources enables the diagnostician to get first hand information about the child
through clinical observation and informal skill survey alongside use of appropriate forms,
records, inventories, checklist or scales and formal testing.

 The “testability” of CWA depends upon:

A. age B. attention span C. severity of autism and, D. length of schooling

 If the child is non-testable and direct sources are needed to get information about the child
academic performance, the diagnostician conducts an informal skills survey.

 Through a continuum of planned activities in each of these areas: math reading, language and
writing conducted/administered informally, the diagnostician is able to gauge the child
academic performance.

 Informal skill-survey is criterion-referenced measure as realistic standards/expectations and set

by the diagnostician based on the child current achievement level and development condition.

 Forms and records are used for getting the history of the child while inventories, checklist and
scales are used for assessing the child along all developmental areas.

 There are validated scales for assessing the absence or presence of autism.

 Behavior Rating Instrument for Autistic and Other Abypical Children which consists eight scales:

 These are:

 Relationship to Adult, Communication, Drive for, Vocalization and Expressive Speech, Sound and
Speech Reception, Social Responsiveness, Body Movements and Psychobiological Development
(Ruttenberg, Kalish, Wernes and Wolf , 1976 ).

 Another is the Childhood Autism Rating Scale which consists of fifteen factors(Schopler, Reichler,
and Renner, 1988).These factor area: (a.) relating to people, (b.) imitation (c.) emotional
response, (d.)body use, (e.) object use, (f.) adaptation to change, (g.) visual response, (h.)
listening response, (i.) taste, smell and touch response and use, (j.) felt or nervousness, (k.)
verbal communication, (l.) nonverbal communication,

 (m.) activity (n.) level consistency of intellectual response, and (o.)general impressions.

 The Autism Screening Instrument for Educational Planning consists of five(5) sections one of
which is the Autistic Behavior Scale (ABS) with 57 items. The ABS items are group into these
 categories: (a.)sensory, (b.) relating, (c.) body and object use, (d.)language, and (e.) social/self
help.

 A non-validated scale design for use in the Philippine setting is the Scale for Assessing Autism.
The Factors are: (a.) visual auditory responsiveness (b.) fixation, (c.) repetitive behaviors,
(d.)socialization (e.)atypical behaviors, and (d.)maturation level.

 An interview with the informant the person who knows the child best:

 The duplication of results yielded by direct and indirect data sources is not indicative by of waste
of time and effort. This is, instead, beneficial as confirmation of impressions and diagnosis is
strengthened providing safer reliability of assessment.
 Provision of recommendations along placement and intervention must be an integral
component of assessment.
 An assessment report must be prepared to serve as a basis for individualized planning and
implemention.
 Assessing children is undoubtedly a demanding and rigorous task but certainly a meaningful and
inspiring one. Working with and for children, families, teachers and other professionals earns

Guidelines in Conducting an Interview

 Ready needed materials and guides ahead of time

 Establish rapport with the informant.
 Listen intently and be emphatic
 Be non judgmental about the disclosures of the informant.
 Avoid making premature judgments/diagnoses.
 Use open-ended question/items and not those answerable by yes and no
only.
 Affirm/Recognize informant’s genuine effort of helping the child.
 Provide information when asked for/about facts pertaining to the child’s
disability (e.g.., “What are the causes of autism?”)
 Use leads: direct (e.g.,”Why is the child out of school?” and indirect
(e.g..,”Feel free to explain how your child relates with other children.
the most precious rewards: the inner joy derived from helping others grow and the fulfillment of
our
commitment to child and family welfare.