best practices in asd assessment 1

Assessment of Children with Autistic Spectrum Disorders: Best Practices

for Educators

Kristine Strong, Ph.D.,LEP #2314

Copyright 2012

Goals of the Workshop

Increase knowledge and awareness of effective assessment tools and methods for ASD

Develop understanding about multidisciplinary assessment teams

Develop understanding about the importance of the parent - school relationship and working effectively with parents

Learn about current evidence based practices Develop skills in IEP development

3

ASD Is A “Spectrum” Disorder

“Spectrum” ranges from mild (more able) to severe (less able). Mild = High-functioning Autism (HFA),

Asperger’s Syndrome, PDD, PDD-NOS Moderate = Classic Autism (As described by

Kanner) Severe = Autism with other collateral

conditions such as MR and seizures, Retts Disorder(females only), Childhood Disintegrative Disorder (rare), Landau-Kleffner Syndrome.

4

Statistics

Autism is increasing at an alarming rate. Department of Developmental

Services study: rates of autism have risen 210% in the past 10 years.

Increase of over 600% for Special Education eligibility under the autism category from 1994 to 2003 (US Dept of Ed).

5

Why the Increase?

1975 Education of the Handicapped Act identified “autism” and “pervasive developmental delay” as disabling categories. Prior to that change persons were labeled as MR.

DSM IV broadened the disability to include PDD-NOS, Autism and Asperger’s Syndrome.

1990 IDEA made autism a qualifying disability category. Many studies being conducted, with a causation model

including both genetic predisposition and environmental variables -- no one cause likely

The Anatomy of Autism

Neuro-imaging (fMRI and PET scans) indicate location of pathologyMultiple brain systems and brain functions are impacted by this disorder

Three Types of Autism?

Autism is considered to have a strong genetic component.

Pattern of onset may be related to specific type of autism: Predominant language

regression Predominant social

regression Early onset in both social

and language development

Center for Excellence in Developmental Disabilities UC Davis MIND research:

Interactive models of ASD include multiple environmental variables and gene interactions.

Deviation In:

Hippocampus and amygdala (emotional regulation and memory)

Cerebellum (motor coordination, shifting attention, concept formation, sequencing, working memory, complex problem solving, sensory discrimination)

Deviations In:

Brain stem (brain/body communication, basic functions)

Brain size, growth pattern, and white matter (axons -cables connecting brain cells)

Brain microstructures, minicolumns are narrower and made up of smaller cells vs. normal brain

Neocortex Particularly frontal lobe (higher level thinking and executive

functions, early speech acquisition, and integration of information)

temporal lobes (auditory processing)

Understanding Autism Spectrum Disorders Neurobiological differences lead to deficits in social

perception, theory of mind and social relatedness, that in turn lead to problem situations for group learning, peer interactions, and student-teacher interactions in school.

Problem behaviors are a result of known neurobiological differences and environmental influences but can be addressed through active, direct teaching of adaptive social skills and problem solving skills.

Social-Emotional Implications of autism spectrum disorders Few or no close friends--limited social

interests Avoidance of socially demanding situations Difficulty sensing or interpreting emotions in

self and others Greater likelihood of also having anxiety

and/or depression

Social and Emotional ImplicationsImpaired non-verbal communication,

including limited facial expressions

Impaired pragmatic language, including lack of cohesion to conversation

An inability to engage in goal-directed, future-oriented behaviors including: planning, flexibility, organized search, self-monitoring, and use of working memory.

Impaired Executive Functioning

“Behavior Problems” Associated With Executive DysfunctionNoncompliance Off Task Behaviors/Distractibility Inflexibility or RigidityProcrastination Prompt Dependence DisorganizationSocially Inappropriate Behaviors

Understanding HFA & AD cont.

Deficits in working memory, attention, and executive functioning, such as organization and planning, can lead to increased stressors in school, difficulty completing work, and escape and avoidance behaviors.

Remember, behaviors happen for a reason and are likely in large part a symptom of these underlying deficits and lack of adaptive skills to respond to these deficits.

ProblemBehavior

Core Neuro -Developmental Deficits

PoorCopingSkills

Poor SocialSkills

LackAdequatesupports

Model of Problem Behaviors

California Code of Regulations 3030 g:

A pupil exhibits any combination of the following autistic like behaviors, to include but not limited to: An inability to use oral language for appropriate

communication.A history of extreme withdrawal or relating to people inappropriately and continued impairment in social interaction from infancy through early childhood.

California Code cont.:

An obsession to maintain sameness.Extreme preoccupation with objects or inappropriate use of objects or both.

Extreme resistance to controlsDisplays peculiar motoric mannerisms and motility patterns.Self stimulating- ritualistic behavior.

19

DSM IV Diagnosis of Autism Spectrum DisordersA. 1. Social Interactions (Must have at least 2 of the following)

Impaired use of nonverbal behaviors Impaired peer relations Limited sharing of enjoyment limited social or emotional reciprocity

2. Communication (Must have at least 1 of the following) Delay of development of spoken language Impairment in conversation Repetitive use of language or idiosyncratic language and

prosody Lack of varied make believe play

3. Restrictive and Repetitive/Stereotyped Patterns of Behavior (Must have at least 1 of the following) Restricted interests Adherence to nonfunctional routines Stereotyped motor mannerisms Preoccupation with parts of objects

20

DSM IV Diagnosis for Autism Cont.

B. Delays or abnormal functioning in at least one of the following areas:

1. Social Interaction 2. Language as used in social interactions 3. Symbolic or imaginative playThe disturbance is not accounted for by Rett’s orChildhood Disintegrative Disorder.

To be diagnosed with Autism, at least six symptoms from A (at least two from A1 and one each from A2 and A3), one from B, and C must be present.

To be diagnosed with PDD-NOS, disorders will be apparent in all areas (A-C), but some will be atypical or sub-threshold. This disorder is often recognized later than autism.

21

DSM IV Diagnosis of Asperger’s Syndrome (AS)

A. Social Interactions (Must have at least two of the following)

Impaired use of nonverbal behaviors Impaired peer relations Limited sharing of enjoyment Limited social or emotional reciprocity

B. Activities and Interests (Must have at least one of the following)

Restricted interests Adherence to nonfunctional routines Stereotyped motor mannerisms Preoccupation with parts of objects

22

DSM IV Criteria for Asperger’s Cont...C. The disturbance causes clinically significant impairment in

social, occupational, or other important functioning.D. There is no clinically significant general delay in language

(e.g. single words used by age 2, communicative phrases by age 3).

E. There is no clinically significant delay in cognitive development or in the development of age appropriate self help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood.

F. The criterion are not met for other specific Pervasive Developmental Disorders or Schizophrenia.

Autism - utube videos

Samples of autistic like behaviors

What is Different about the Assessment of ASD vs. other Educational Categories?More comprehensive because of the

pervasive nature of the disorderRequires more specialists and service

providers, requiring increases in communication and collaboration--systemic challenges

An ASD requires more specialized services and increasingly more demands on educators to develop expertise in autism specific strategies

Educators Responsible for Ed. Code EligibilityAlthough the DSM-IV criteria are

important to know and use as a reference for determining “autistic like” behaviors, educators do not diagnose using the DSM-IV.

Autism specific measures use the DSM-IV diagnostic criteria as a part of their content validity - so need to be knowledgeable about DSM-IV criteria

What is Different cont.:

Adaptations for standardized tests, including use of structured reinforcement

Increased use of non-standardized assessment methods, including both natural and structured observations

Critical to differentiate between ASD and other disorders, such as ADHD, Emotional Disturbance, and Language Disorders--course of educational planning is different

Team Activity

What are the core deficits in children with ASD?

What do you already know about how to evaluate those areas?

What parts or aspects of ASD assessments do you believe are the most challenging?

Case Study: Bobby V.

Transitioning from Early Start2 years - 10 monthsRecent dx of ASDHighly verbalBrightConcurring assessment by NPAAdvocate already involved

Case Study cont.

Priority on parent-district relationshipHome visits, natural environment was

primary assessment settingCritical to respond to parent concernsLanguage evaluation utilized a range of

tools - on the surface he looked fineTeaming was critical - the team was

able to identify core deficits and needs-got agreement on our assessment

Goals of Assessment: Why do we assess? Establish eligibility

under Ed. Code. Identify student

unique needs that will lead to specific goals and objectives

Understanding unique needs directs team when determining FAPE

Good Data = Good Planning

Team who is knowledgeable about the child develops trust and credibility with agencies and families

Develop appropriate intervention plans

The Autism Assessment/Intervention TeamTeam Members should include a

Behavior Analyst, Behavior Specialist, Speech Therapist, Occupational Therapist, Classroom teacher, Special Education Teacher, Nurse, School Psychologist and Administrator.

The Assessment Process: Developmental Areas and the Trans-Disciplinary Model

Specialists collaborate to provide a multi-method assessment across developmental areas

Trans-disciplinary teams design assessment tasks and activities together for mutual benefit

The TDT generates rich information about the child leading to meaningful goals, integrated services, and a meaningful report to parents

Assessment Areas

Health and Medical Behavioral

assessment- baseline of behaviors that interfere with learning

Fine and Gross Motor

Sensori-Integration

Social - emotional Cognitive

functioning Adaptive Behaviors Communication Pre-academic and

academic areas

Assessment Methods

Developmental health history

Natural Observations

Structured Observations

Standardized Assessments

Parent InterviewReview of

records/reports

Developmental and Medical HistoryInitial eligibility assessment requires

extensive parent interview about the child’s early development and medical history.

Important to gather data on early signs of ASD, including, lack of gestures, little or no babbling, delayed language, lack of pointing, lack of interest in children, limited shared attention, lack of eye contact during feeding and games.

Developmental History cont.:

Feeding or sleeping problems Unusual sensory reactions, ie., noise or touch Unusual focus or attention toward limited

areas of interest Range of affect, flat vs. full range Verbal and nonverbal forms of

communication--intent to communicate needs Unusual motoric movements Fine and gross motor development

Natural Observations

Occur in several settings such as home, preschool/school or child care

Take place with no structured activities other than those that occur naturally within the setting

Important to observe on more than one occasion and by multiple observers

When possible, chose one or two “controls” to observe in relation to student, ie., Tommy completed the task at the same pace as his peers, but needed twice as many prompts

Structured Observations-Play Based Structured

observations provide specific tasks to be performed, such as putting puzzles together, imitation tasks, and pretend play activities

Activities are play based - interactive

Specific behaviors are elicited, including Reciprocal turn taking Pretend play Social reciprocity Imitation of novel acts Ability to be directed by examiners Use of toys and objects Use of spontaneous language Quality of spontaneous and prompted verbal and nonverbal

communication Play imitation Joint referencing Eye gaze, following a point Eye contact, seeking eye contact to gain attention of others

Play-based assessment

Toys and materials of interest to child’s age or mental age

Variety of toys to engage and illicit interest

Include books, musical toys, balls, cars, pretend play

Develop a play based assessment box or “tool kit”

Include toys that are sensory based, symbolic play, cause and effect, can be used to prompt imitation

Standardized Assessments: Uses and LimitationsStandardized assessments provide

objective data about broad functioning and abilities in specific developmental areas.

Important to cross reference standardized results with observation data and interview data to make relevant, as well as to point out where there are discrepancies.

Limitations to Standardized Tests ASD children often do not perform well on

these types of measures, and therefore they can underestimate their ability

Reliability is also an issue due to highly variable performance of skills

Note in your report the specific limitations of the results.

Parent Interview for Initial EligibilityCan be structured or informal -- strongly

recommend including a home visit.Use of structured interviews such as

The Autism Diagnostic Interview, R (ADI-R) (can be used for children through adults) is critical for establishing clear developmental clusters consistent with ASD.

Family Centered

Family centered format--this is often the first impression the family gets of educators.

Highly sensitive time for parents, make sure you provide ample time to answer their questions.

The Faces of Autism

Parent perspectives reflect the wide range of needs of children

with ASD and highlight the individual nature of autism.

Areas to Assess: Core Deficits

Reflect - what are the core deficits?

Comprehensive evaluations need to include all areas related to a suspected disability

What will most assessment plans need to consider?

Develop assessment plans with parent input.

Team Assessments

Set up stations such as, fine motor, pretend play, academic, sensory

Tag team - take turns observing and evaluating

Tag team - one team member with parent, two with child and then rotate.

Cognitive Assessment

Use good comprehensive tools: DAS-2, WPPSI-2, KABC-2,

Consider using processing tests, ie., WRAML-II for older children,and NEPSY - can use with 2 1/2 year olds, DAS-2

Note the type of support needed to learn a new task -- how many trials does the child need to learn new information?

Note processing profiles, visual memory vs. verbal

Cognitive cont.

With young children between 2 and 5, important to explain validity of results - IQ or cognitive functioning is not yet stable and can change especially following intensive program

Focus on the cognitive functioning and how areas of deficit may impact learning, ie., verbal processing deficits likely to impact ability to take teacher instruction in a large group

Important to let parents know the possibilities, such as mental retardation,processing challenges, while at the same time recognizing that cognition is difficult to determine at a young age, and need to see how child will respond to intervention.

Cognitive cont.

Case Study: Mark

Six year old still in preschool NPA program Transition to school Standardized evaluation difficult Standardized results indicate moderate MR,

however, adaptive skills and academic skills indicate much higher functioning.

Following transition, child is now reading and able to access general education setting.

Adaptive Behavior

Parent and teacher interview are integral to a comprehensive assessment and often lead to specific needs to generate goals and objectives.

Cross reference adaptive behavior with other areas of functioning -- are there discrepancies?

How much support does the student need to perform these tasks?

Use standardized questionnaires, such as Vineland, to establish baseline and to provide objective data on the student’s development.

Fine and Gross Motor

Fine and gross motor deficits are often deficit areas in children with ASD, often requiring direct assessment and intervention.

Occupational Therapists are best equipped to provide a comprehensive assessment of these two areas, in addition to sensory issues.

Observe child’s grasp, use of writing and drawing tools, visual-perceptual issues, motor planning, and ability to keep up with written motor tasks - pace of instruction.

Behavior & ASD Specific Measures: Use of standardized measures:

BASC-2 Achenbach Child Behavior Checklist Childhood Autism Rating Scale - 2 (CARS-2)--very

strong validity Gilliam ARS (moderate validity) Social Responsiveness Scale -ages 4 and up Autism Diagnostic Observation Schedule (ADOS) The Autism Diagnostic Interview-R (ADI-R)--

highest validity

Determine Interfering Behaviors

Observation and data collection: Target behaviors, or interfering behaviors,

level of intensity, frequency, impact on learning

Critical to gather baseline data on target behaviors, determine if a BSP is needed or FAA

Tools Looking at “Autistic Like Behaviors”Solid Psychometric Support

The Autism Diagnostic Interview-R (ADI-R)Social Communication Questionnaire (SCQ)

Sufficient SupportChildhood Autism Rating Scales (CARS)Social Responsiveness Scales (SRS)

Adequate Support Autism Diagnostic Observation Schedule (ADOS)Child Behavior Checklist (CBC)Psycho-educational Profile -R (PEP-R)

Modest SupportAutism Behavior ChecklistGilliam Autism Rating Scales (GARS)Asperger’s Syndrome Diagnostic Interview (ASDI)

A Closer Look at the CARS 2

CARS 2 has high reliability and validity

Utilizes three data points: observation in multiple environments, parent survey/interview/ and teacher survey and interview

Group Think

Sample Reports: Jigsaw in groups of 3 How are ASD

specific issues addressed?

What would you add/change?

Your concerns questions about addressing ASD specific behaviors

Assessment Environment“When clinically indicated, observations of a child in

various settings and at different times increases the validity of information obtained and assists in diagnosis, case management and intervention.”

Looking at the child in multiple environments is beneficial and necessary

Home, preschool, playground, backyard, daycare, school/clinic

Collaborative assessment with other team members allows for better observation/data collection

Autism Spectrum Disorders: Best Practice Guidelines for Screening, Diagnosis and Assessment

California Dept. of Developmental Services 2002

ASSESSMENT TOOLS: Direct/Standardized

1. Preschool Language Scale-4

2. Peabody Picture Vocabulary Test

3. Receptive and Expressive One Word Picture Vocabulary Tests

4. Sequenced Inventory of Communicative Development-Revised(SICD-R)

5. Comprehensive Assessment Comprehensive Assessment of Spoken Language (CASL) of Spoken Language (CASL)

6. Reynell Developmental 6. Reynell Developmental Language ScalesLanguage Scales

7. Goldman Fristoe Test of 7. Goldman Fristoe Test of Articulation-2/KLPA-2Articulation-2/KLPA-2

8. Clinical Assessment of 8. Clinical Assessment of Articulation and Phonology Articulation and Phonology (CAAP)(CAAP)

9. Language Sample9. Language Sample

1.1.Rossetti Infant Toddler Language Scale Rossetti Infant Toddler Language Scale (Linguisystems)(Linguisystems)2.2.Pragmatics Profile of Everyday Communication Skills Pragmatics Profile of Everyday Communication Skills in Preschool Children (Hazel Dewart and Susie in Preschool Children (Hazel Dewart and Susie Summers )Summers )3.3.Pragmatic Communication Skills Protocol (Academic Pragmatic Communication Skills Protocol (Academic Communication Associates)Communication Associates)4.4.Functional communication Profile Revised Functional communication Profile Revised (Linguisystems)(Linguisystems)

Parent Interview and Observation Tools

DIRECT ASSESSMENT MEASURES-LANGUAGE/COMMUNICATION SKILLS

PLS-4 -measures Auditory Comprehension and Expressive Communication for Birth-6-11

PPVT-measures receptive single word vocabulary

ROWPVT/EOWPVT-measures receptive single word/expressive single word vocabulary(2-18)

SICD-R Receptive and Expressive portions(4mos-48 mos)

Direct Assessment cont

CASL-Research-based, theory-driven oral language assessment battery for ages 3-21. Fifteen tests measure language processing skills,comprehension, expression, and retrieval—in four language structure categories:Lexical/Semantic, Syntactic, Supralinguistic, and Pragmatic. Subtests can “stand-alone”.

PRAGMATICS PROFILE OF EVERYDAY COMMUNICATION SKILLS/PRESCHOOL

Interview questionsTypically done in home

with parent/caregiver4 domain areas:

Communicative Function, Response to Communication, Interaction and Conversation, Contextual Variation

Information gathered can be helpful for parents to understand all aspects involved in communication

Information also helpful in identifying specific areas of need, writing goals and planning intervention

Website to download profile: http://wwwedit.wmin.ac.uk/psychology/pp/documents/Pragmatics%20Profile%20Children.pdf

Language Goals

•Important to meet as a team to discuss who will write which goals•Behavior specialists/analysts have expertise in writing ABA type goals•Language goals should not be addressed solely in pull-out therapy –Language opportunities happen all day!!•Important for classroom teachers/aides to be familiar with goals and how to implement them within the classroom.

Pre-Academics and Academic Assessment: Consider using

criterion referenced measures in addition to standardized, ie., Brigance, AEPS, Hawaii

Obtain work samples using age level / adjusted age level curriculum

Note the necessary accommodations needed for learning

Does the child need frequent breaks?

Note level of frustration tolerance.

Observe how well the child generalizes academic information, can they respond to a question in circle time?

Executive Function

Executive function is becoming a prominent area for assessment and intervention for a range of neuro-developmental disorders, in particular, ASD. Difficult to evaluate in children younger than 5.

Areas to assess: planning and organization, anticipating an event and preparing for it, ie.,forming goals, and strategies to reach them, attention, memory processing, cognitive flexibility, cognitive planning.

Assessment of Executive Function Behavioral Rating

Inventory of Executive Function (BRIEF), 5 and up

Conner’s-for Attention issues, ages 3-5

DAS-2 working memory ages 5 and up

NEPSY Developmental Neuropsychological Assessment-Attention/Concentration Scale

Cognitive Assessment System (CAS)-ages 5 and up-Attention Scale

Tower Tasks Wisconsin Card

Sorting Test Reference (Ozonoff

and Schetter)

Sensori-Integration

SI is an important area to assess due to the high probability of SI problems--about 70% or > in ASD population.

SI is related to ability to attend, adapt to new environments, fatigue, and emotional regulation.

Occupational Therapists are the most qualified to assess in this area.

include observing response to various sensory activities, checklists (Sensori-Integration and Praxis Test, Ayers clinic), parent interview, and natural observation.

HFA vs. AS: How do we tell the difference? High functioning autism

requires the same DSMIV conditions as autism, however, high functioning autism is characterized by higher cognitive skills, some in the normal or above average range, often with wide scatter across cognitive domains.

Definitive delay in language acquisition.

Asperger’s is typically not identified until age 7 or 8, and there is no discernable delay in language acquisition, and typically there is average or above average intelligence.

Assessment Tips

Find out best time of day to test (try to eliminate fatigue)

Use approved motivators or reinforcers, ie., favorite food or activity

Give clear directions using abbreviated instructions when possible

Use preferred activities throughout

Include caregiver or individual who is very familiar with the child to participate with you

Assess in teams of two to three

Plan on two to three assessment sessions

Case Study: Conner

2 years 10 months Parent referral Ambivalent about

delays Conflicted about

getting a dx Very young parents,

first child

Team strategies and approach

Four sessions, parent present throughout

Talked with parent prior to IEP

Presented possibilities and concerns for parent to consider

Translating Assessment Information into FAPE

Assessment data needs to be translated into:

1. Identifying Unique needs2. Goals that address all areas of need3. Accommodations/supports for educational

benefit4. Recommendations for

programming/placement, ie., ABA/EIBT instruction

Unique Needs

What does the assessment data indicate are unique needs of the child?

Deficit areas/weaknessesAreas directly related to educational

benefit, ie., those skills needed to benefit from education

Needs related to learning, accessing curriculum and instruction, accessing their environment

Goals - The Hallmark of a Good IEPGood goals indicate a quality

assessment and knowledgeable teamGoals are the driving force behind

rationale for services, accommodations and supports

ASD goals need to be comprehensive, intensive, and designed with a developmentally sequenced curriculum

Refer to Curriculum Assessment Sheet developed by Patty Schetter, ABTA

Goal activity

Refer to Sample Goals Look at a set of unique

needs and determine what type of goals will effectively address the needs

Goals set a trajectory for progress

How can we make goals meaningful?

Rationale for Services/Supports

General education opportunities Specialized Academic Instruction Individual Instruction, IA support Need for intensity, ratio of adult to child Need for ABA approach or other DIS services - is the model collaborative,

individual, both?

Rationale and LRE

Critical to know what empirically based practices (EPBs) are and provide clear direction for how these can be delivered, and in what setting they can most be effective in.

Does the child’s needs require a degree of intensity such as one to one and small group with highly controlled environment?

Or is the child able to observe and attend to small and large group instruction and generalize skills in group settings?

Accommodations and Supports

Small group Instructional Assitant Verbal cues Visual supports Sensory breaks BSP/BIP? Visual schedule Clear routine Alternative communication-PECS

FAPE Considerations:

Data needs to back up recommendations and provide rationale for placement considerations

Need to consider a full range of continuum of options

Tie goals to services - ie., functional communication needs/goals require …

FAPE considerations cont.

Tie unique needs to program components-what is a good fit or match to these needs?

Have clear descriptions of supports/accommodations program can provide, ie., good ratios, 1:1, developmentally sequenced curriculum, systematic instruction,etc.

National Autism CenterResources: Educator’s Manual

Evidenced Based Practices, National Standards Project

Established Treatments from National Standards Project:◖◖ Antecedent Package◖◖ Behavioral Package◖◖ Comprehensive Behavioral Treatment for Young Children◖◖ Joint Attention Intervention◖◖ Modeling◖◖ Naturalistic Teaching Strategies◖◖ Peer Training Package◖◖ Pivotal Response Treatment◖◖ Schedules◖◖ Self-management◖◖ Story-based Intervention Package

National Professional Development Center On Autism Spectrum Disorders

What are Evidence-Based Practices (EBP)?While many interventions for autism exist, only some have been shown to be effective through scientific research. Interventions that researchers have shown to be effective are called evidence-based practices. The NPDC has identified 24 evidence-based practices.

View NPDC Website

http://autismpdc.fpg.unc.edu

The Report

Consider team report-pros & cons

Reports need to provide specificity, be comprehensive yet readable for parent

Clear headings, meaningful sequence

Clear summary and conclusions

Clear recommendations for IEP team to use in determining FAPE

Journey of Hope:Parent Interview

Listen to the core message of this parent and reflect on your practice of working

with parents.

Parent Collaboration

Establish a positive rapport at the earliest point possible in the referral process

Explain the roles of each examiner, and explain what the assessment process will look like and the IEP process

Find out what the parent’s interests are

Parent Input

Find out their long term goals areEstablish shared interests based on the

child’s needsEstablish common goalsRefrain from making assumptionsProvide frequent follow-up and an

established routine of communication

Parent Collaboration cont.:

Provide regularly scheduled communications, such as quarterly review dates, monthly phone call, weekly note home.

When things get diverted, bracket knee jerk reactions, and redirect the discussion to the child’s needs and goals.

Parent Input cont.

Acknowledge parent concerns and needs -- communicate that you want to understand their perspective so that you can work jointly on behalf of their child.

Emphasize areas in which there is agreement and areas of common interest.

Parent Perspective

Important to convey to a parent that their input is valued-How do we do this?

This is their child for the rest of their lives - the issues for them are truly intense

Parents feel an urgency - they are in a crisis For a parent, trust is the most critical aspect,

with trust you can move forward Building relationships is critical to any

successful team - even when there is disagreement

When there is disagreement Remember, there is no “winner” in an

argument Goal is to maintain a positive relationship Shift from a framework that is argumentative

to one that is trying to gain common understanding of the child

Look for opportunities to build agreement Recognize when there is not agreement and

provide an environment where this is okay Recognize when mediation will be helpful

Parent shoes

Put yourself in the parent’s shoes - relate to having a child with an ASD like you would having a child or spouse with a life threatening disease or illness -- what are your likely emotions, actions, and needs?

Teaming: What does it mean?

Define “team” Reflect on positive

team experiences: what were the core elements of that experience? What are effective “team” behaviors?

What are the key characteristics of a strong team?

Your Team: Next Steps

Identify three goals in the next three weeks

What are potential barriers or road blocks?

What strengths do you bring to your team? -- dyad exercise

It’s the Journey not the Destination

The assessment process is like a journey, discovering unique needs, learning about families, and continuous new challenges as well as successes.