Autism Spectrum Disorder (ASD) Evaluation

Autism Spectrum Disorder (ASD) Evaluation

Dr. Andersen has extensive experience evaluating students on the autism spectrum ranging from high functioning individuals (i.e., Asperger’s type) to nonverbal children with an accompanying intellectual impairment.  In fact, Dr. Andersen currently also works in a school that has a self-contained Level C program (i.e., inside the regular education class <40% of the day).

Definition & Prevalence of Autism

According to Autism Speaks.org, Autism Spectrum disorder (ASD) refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.  According to the Centers for Disease Control and Prevention, Autism affects approximately 1 in 54 children in the United States today.  ASD is more than 4 times more common in boys than girls, and occurs in all racial, ethnic, and socioeconomic groups.  Moreover, in a study between 2009-2017 approximately 1 in 6 (17%) of children ages 3-17 years old were diagnosed with a developmental disability.

The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) sets forth the diagnoses and criteria that the majority of psychologists used to identify various conditions.  In the previous version of the manual (i.e., the DSM-IV-TR), autism fell under the umbrella of Pervasive Developmental Disorders and the following conditions included Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) in addition to Rett’s Disorder and Childhood Disintegrative Disorder.  However, in the current version of the manual (i.e., the DSM-5), autism falls under the broad category of Neurodevelopmental Disorders and the term Autistic Disorder, Asperger’s Disorder, and PDD-NOS are no longer used.  In fact, according to the DSM-5, even individuals with well established DSM-IV-TR diagnoses of Autistic Disorder, Asperger’s Disorder, and PDD-NOS should be give the diagnosis of Autism Spectrum Disorder (ASD).  Moreover individuals who have marked deficits in social communication, but do not meet full criteria for ASD should be evaluated for a social (pragmatic) communication disorder.

Division of Developmental Disabilities

Autism is also one of four qualifying diagnosis for Division of Developmental Disability (DDD) benefits (the other three diagnoses are cognitive/intellectual disability, cerebral palsy, and epilepsy).  In addition, individuals can also have two or more qualifying diagnoses (e.g., Autism and C/ID).  According to the Division’s eligibility requirements, the child must have a comprehensive evaluation by a licensed psychologist (such as Dr. Andersen; or a psychiatrist, child neurologist, or developmental pediatrician with expertise in autism).  It is important to note a school based psychoeducational evaluation (MET) conducted by a non-licensed psychologist is not sufficient documentation for DDD eligibility.  And the large majority of school psychologists are master’s level practitioners.

However, similar to C/ID, the qualifying diagnosis itself is not sufficient for DDD eligibility.  Rather, there must be evidence of at least 3 of 7 substantial functional limitations (SFLs).  Therefore, individuals with a Level 1 diagnosis of ASD likely would not be eligible for DDD benefits.  This is particularly important to note for the receptive and expressive language SFL.  As stated in this document (see page 6 of 9), this SFL is essentially reserved for individuals that cannot communicate with others without the aid of a third person, a person without skills, or without a mechanical device.  As such, individuals with this level of communication impairment will likely have an Individualized Education Program (IEP) in school and receive assistive technology (i.e., an augmentative communication device).

What Do You Receive with an Autism Spectrum Disorder (ASD) Evaluation?

Assessment

  • Interview with the parent(s)/guardian(s) (~ 2 hours)
  • Direct Autism testing (e.g., ADOS-2; ~ 1 hour) *Note: during the COVID-19 pandemic, the test publisher and author stance is the ADOS-2 cannot be administered in a valid manner with PPE.  That said, Dr. Andersen will still used various ADOS-2 activities (e.g., interview questions) for qualitative purposes.
  • Communication testing (~30 minutes)
  • Executive Function testing (~30 minutes)
  • Social/Emotional testing with the child & Behavioral Questionnaires (completed by the parent[s]/guardian[s])
  • Adaptive testing (questionnaires completed by the parent[s]/guardian[s])

Results

  • Verbal Feedback (~1 hour)
  • Written Report (~10 pages) with diagnostic impressions and practical recommendations

This evaluation is typically conducted over three sessions.  The first session is for the initial interview.  The second session is for the direct testing with you or your child.  And the last (third) session is provide you with verbal feedback with practical recommendations, at which time you will receive a written report.

Sources:

What Is Autism? | Autism Speaks

Data & Statistics on Autism Spectrum Disorder | CDC