What to Expect from an Autism Assessment

By Rachel Fenning, PhD, assistant clinical professor at The Center for Autism & Neurodevelopmental Disorders

The experience of having a child evaluated for a developmental concern may feel overwhelming, but the assessment process can provide clarity and guidance. If your child does receive a diagnosis of autism spectrum disorder (ASD), the assessment represents a vital first step in securing important treatments for your child.

A diagnosis of ASD is based on direct assessment of the child and clinical information gathered from key individuals in the child’s life. A physician or clinical psychologist typically performs the initial diagnostic evaluation, which may include:

• A complete history, including a detailed interview about your child’s current and past experiences and behaviors.

You will be asked to recall specifics about your child’s history. Many families find it useful to reference their child’s baby book or other notes. For instance, creating a timeline of events, including developmental milestones, behavioral changes, and the emergence of any concerns may be helpful. It is also important to be prepared to talk about family medical history, too.

• Careful observation and interaction with your child during the appointment.

Many professionals use specific tools to evaluate symptoms of ASD. The Autism Diagnostic Observation Schedule-2 (ADOS-2) is among the most widely used and most respected instruments. However, results from any diagnostic tool should  always be used in combination with other information to inform clinical decisions.

Many experts further recommend a multi-disciplinary assessment approach in order to better understand a child’s functioning and to guide recommendations. This may include several visits with different specialists. You should feel comfortable inquiring about the need for any or all the following:

• A thorough medical assessment, including a general physical and neurological exam, hearing and vision testing, and laboratory testing.

• A psychological assessment, including measures of cognitive functioning, social-emotional skills and adaptive behavior, and possibly academic skills.

• A speech and language assessment, including tests of language comprehension, expression, and everyday language use.

• An occupational or physical therapy assessment, including measures of motor functioning and sensory processing.

Depending on the assessment results, your provider may suggest a range of possible interventions, such as intensive behavior intervention (applied behavior analysis), counseling, speech and language therapy, educational interventions, occupational and physical therapy, and related supports. You will have an opportunity to ask questions, and it may help to have a few in mind ahead of time. It is also important to establish ways to follow up with your provider about any future concerns.

Finally, know that by engaging in the assessment process, you are taking an important step toward gaining understanding and support for you and your child.

Learn more about CHOC’s partner, The Center for Autism & Neurodevelopmental Disorders.

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Building Hand Skills in Young Children – Tips from The Center for Autism

By Aparna Guttery, occupational therapist at The Center for Autism & Neurodevelopmental DisordersHand Skills in Young Children

Children learn through physical exploration. Some children, including those with autism, may struggle more with fine motor coordination and the use of their hands for exploration. These kids may benefit from addressing underlying foundations that support hand skill development, such as strength, grasp, and awareness of one’s hand. Here are a few fun everyday activities to support these important areas:

Strong Arms and Hands – Activities for upper body and hand strength. 

  • Encourage your child to climb up, down and over playground equipment. Help your child swing from the monkey bars or hang on one bar for as long as your child can.
  • Try wheelbarrow walking and fun animal walks, such as crab walking or donkey kicks.
  • Show your child how to play, pinch and/or cut play-doh or silly putty.
  • Have your child play with a small size water bottle in the bath tub, or have them help water the plants. This is a great way to strengthen the small muscles of his or her hand.

Grasp and Control – Learning proper placement of hands/fingers on small tools for effective use.

  • With your supervision, have your child use tongs or tweezers to pick up objects (craft pom-poms, cotton balls, scrunched up paper).
  • Choose short and wider coloring and writing tools for smaller hands. This can include jumbo crayons broken in half to support finger positioning.
  • Tape butcher paper to the wall for your child to color, draw and write on. Working on vertical surfaces (easel, wall mounted chalkboard) is beneficial for grasp and building control.
  • Beading activities can be a great way to promote grasp. Try stringing beads onto sturdy pipe cleaners for greater ease.

Touch, Feel and Play – Increase awareness of hands/fingers to help with positioning and movement for use.

  • Have your child try finger painting, or writing in paint, pudding, shaving cream, or anything messy.  If your child has sensitivities to certain textures, find something that might be a better fit.
  • Play in the sand at the park and beach; hide small toys in the sand (buried treasure) and have him or her dig with hands.
  • Create hide and seek bins filled with uncooked rice, beans, or cotton balls, and hide puzzle pieces or small toys for him or her to find. Added challenge: cover bin with a towel and have your child sneak his or her hand in and use only touch cues to find the hidden object.

Try to incorporate these and any hands-on activities on a daily basis.  Have fun, be creative, and try to make the activities interesting and meaningful for your child.

The Center for Autism & Neurodevelopmental Disorders is located at 2500 Red Hill Ave, in Santa Ana. For more information, please visit www.thecenter4autism.org.

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Tips for Being an Active Participant at Your Child’s IEP Team Meeting

By Jeanne Anne Carriere, director of the Chapman Ability Project, a collaboration between Chapman University’s College of Educational Studies and The Center for Autism & Neurodevelopmental Disorders 

An Individualized Education Plan (IEP) may be a critical part of some kids’ educational programs, including those with autism and other disorders. The IEP meeting is a common, multi-discipline team approach for sharing information and decision making.

Unfortunately, for many families, the IEP process can sometimes be emotionally overwhelming and confusing.  For IEP collaboration to be successful, parents need to feel like valued, respected, and equal members of the team. One way for parents of children with autism and other disorders to become more engaged in this process, is to understand the Who, What, How and Why of their child’s IEP meeting.

Who? Ask who will be at the meeting. The meeting usually consists of a parent, general education teacher, special education teacher, and an administrator, unless you have given permission for them to be absent. If assessments were conducted, someone who can explain the assessments should be present, such as the school psychologist. Your child’s service provider/s should also be present, such as the speech and language therapist or occupational therapist. Make sure the participants you would like to be at the meeting have been invited and confirm their attendance before the meeting.

What? Clarify the purpose of the meeting. What information will be presented or reviewed? If evaluations were conducted, ask for reports in advance of the meeting. This will give you time to read the reports and ask questions if needed. Understanding the evaluation results before the meeting can reduce some of the emotional intensity of the IEP meeting.

How? Request a meeting agenda so all members will know how the meeting will proceed.  Plan, review, and agree upon an agenda as the first step in the meeting. This will help the team make good use of time and remain focused on the purpose of the meeting: to create a good educational program for your child.

Why? Ask questions to understand why certain goals, services or placement have been recommended. Do you see the link between your child’s strengths and needs and the goals that have been written? Do you think your child will achieve his goals with this level of service? If not, share your suggestions with the team. Ask for other team members’ opinions and for them to share the information they used to make their recommendations. Feel free to re-ask for clarification if you did not understand an answer or the plan moving forward.

For more information, please visit The Center for Autism & Neurodevelopmental Disorders, a CHOC Children’s partner, at www.thecenter4autism.org.

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The Best Tech for Children with Autism

By Gillian Hayes, director of technology research at The Center for Autism & Neurodevelopmental Disorders and associate professor of informatics at UC Irvine

In the past few years, technology has been a big breakthrough in helping kids with autism learn and helping parents improve care for their children. I’ve witnessed this first hand through my work my work with the Social and Technological Action Research Group, wherein I help create, review and test new autism technologies.Mobile_Tech_Autism

Technology allows us to teach students in a personalized and customized way, despite limited human resources. When you add into the equation that so many kids find computers, smart phones, tablets and so on just inherently appealing, you have the ability to draw them in, retain their attention, and provide customized educational content all in one nice little package.

While people have been using computers for kids with autism for decades, the advent of simple, mobile apps has enhanced and widened our ability to reach children with autism through technology.

There are several apps in particular that I recommend for parents and guardians of children with autism:

The Autism Tracker Pro can help parents see the patterns in their kids’ behavior, as well as empower them to make their own decisions about treatments.

For non-verbal children, the app Proloquo2Go allows children to tap out what they want to say with the help of symbols. This app is expensive, but it’s less costly than the specialized hardware platforms that it replaces.

Finally, check out i.AM Search. This app helps parents find other apps that will help children with autism and their families.

Outside of apps, software that was developed for other settings has helped autism education as well. For example, shared calendaring, which is present on nearly all laptops and smart phones, is transformative for older students with barriers to employment and independent living.

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The Importance of Play

By Michelle L Wahlquist, M.S., CCC-SLP, The Center for Autism & Neurodevelopmental Disorders

If you’ve ever watched a speech therapy session, you probaimportance_of_playbly noticed a lot of play taking place. Well, there is a reason for that.

Play is the foundation to learning how to communicate and interact with others. From the moment an infant first discovers a rattle to when a child builds a fort and pretends to camp under the stars, they are developing their language, social and learning skills.

Through play, children learn new vocabulary and begin to understand new concepts. During play with adults, children learn to follow rules, negotiate, take turns, cooperate, solve problems and tell stories. Playing with toys allows children to develop their imaginations and to recognize and use symbols. Play is a powerful tool to support a child’s development.

What to play with kids

As a parent, sometimes the hardest part about playing with your child is figuring out what to play. Here are a few ideas to get started:

  • Observe – What are they playing with? How are they using toys? Knowing what your child enjoys is key.
  • Join– Sit down and follow their lead. Make comments about what you or your child is doing. For example, “My car is going to get gas” or “My dog is thirsty. He is drinking water.” Try not to ask too many questions like, “What are you doing?,” as it can interrupt the flow of the play.
  • Use books – Try recreating a story that you have read with your child. Take on the roles of characters or can use toys to become the characters.

Finding time for play

Parents have busy schedules and finding time to play can be challenging. Luckily, play can be done anywhere.

  • Play during routine activities – While folding laundry, have your child pretend the laundry basket is a delivery truck and send them on a mission. Give directions using words like first, after and then (e.g., “First deliver the towels, then deliver the pants.”). While cooking, have your child use the vegetable scraps to pretend they are “making soup.”  During bath time, place a rubber container in the bath and pretend it is an island. Have a toy fish dive under, jump on or swim around the island.
  • Car games – These are a fun way to develop a child’s language skills. Some games include 20 Questions, I Spy, riddles, rhyming games and sound games (e.g., “Tell me all the animals you can think of that start with the letter ‘S.’”).

Most importantly, remember that play should be an enjoyable experience for both children and parents. We learn best when we are relaxed and having fun!

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