“Assessment is the estimation or
evaluation of the nature, quality, or
ability of someone or something. It is a
systematic process of information
gathering about some phenomenon,
conducted in a reliable manner. It's
completion then allows one to make a
judgment about something.”
Assessment is a CRUCIAL Leadership Skill
and Tool
Standardized Assessment and
Individuals with
Neurodevelopmental Disorders
The first of five sessions over the LEND experience aimed
at targeting Leadership/Interdisciplinary Teamwork with
this service area.
Dr. Richard Kiefer-O’Donnell
Oct 24th, 2014
Agenda for today
 Results of Skills Analysis
 Discussion on Sally Ozonoff’s overview,
assessment questions and impact on you as
LEND Fellows
 Overview of the 5 Assessment-related
sessions and goals relative to LEND
 ASD Assessment and new DSM 5 diagnostic
criteria
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Survey findings (8 of 11 Fellows)
1.
Academic training experience
 Employing tools: distributed
 Planning/use of findings: slightly skewed to having had coursework
coverage
2. Employment or family training experience
 Employing tools: skewed – at least workshop but often more intense
 Planning/use of findings: skewed to having had workshop and
beyond. Everyone has had some exposure
3. Current role/responsibility
 Screening: distributed but intermittent role or less
 Diagnosis: Rare, but a couple have implementation and leadership
role
 Admin/intervention: distributed but most have at least some role;
again, a couple have regular if not team leadership role
Converting % to actual number of respondents
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1 = 12.5% 2 = 25% 3 = 37.5%
4 = 50% 5 = 67.5%
Ozonoff’s Reasons for Engaging in
Assessment
1.
2.
Feedback on streamed video?
National role of MIND
Institute
3. Levels and AAP
4. Tools anchored in DSM-IV TR
5. Differential diagnosis versus
co-morbidity
6. HFA versus Asperger’s
7. Assessment function
represented in “questions”
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associated with referral
Ozonoff’s Reasons for Engaging in
Assessment
6
Assessment and LEND
Assessment Concern
1.
Diagnosis of young
children who
potentially
experience a
neurodevelopmental
disorder
2.
Determine eligibility
for services
3.
Annual client
evaluation of
progress
4.
Target intervention
5.
Program evaluation
Interdisciplinary
teaming
role
Leadership role
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Family
support
role
Cultural
competence role
Overview of five sessions
LEND, Leadership/
Teaming and
Assessment - from the
20,000 foot level; DSM 5
Criteria.
Partial Demonstration of
Interdisciplinary
Assessment
ADOS-2
Autism Diagnostic
Observation
Schedule, Second
Edition
Ideal
Criterion-referenced
Assessment
And Program
Planning
Real
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Where were we with DSM-IV? – Incidence rate across these 3
most common groups
Approximate Ratio of Primary
Categories
15%
9%
Autistic Disorder
Aspergers
PDD-NOS
76%
(Suggested from several sources)
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CDC Prevalence (8 year olds)
1 in 68 children
State reported Incidence:
6 in 1000 students nationally
DSM-IV TR: Diagnostic Criteria for Autistic Disorder
A.
B.
C.
Six or more items from A (1), (2), and (3), with at least two from A1, and one each from
A2 and A3.

qualitative impairment in social interaction – a) marked impairment in the use
of multiple nonverbal behaviors , b) failure to develop peer relationships, c) a lack
of spontaneous seeking to share enjoyment/interests, and d) lack of social or
emotional reciprocity

qualitative impairments in communication – a) delay in, or total lack of, the
development of spoken language, b) marked impairment in the ability to initiate or
sustain a conversation, c) stereotyped and repetitive use of language and d) lack
of varied, spontaneous make-believe play

restricted repetitive and stereotyped patterns of behavior, interests, and
activities – a) preoccupation with one or more stereotyped and restricted patterns
of interest, b) inflexible adherence to specific, nonfunctional routines or rituals, c)
repetitive motor manners, and d) persistent preoccupation with parts of objects
Delays or abnormal functioning in at least one of the following areas, with onset prior to
age 3 years: (1) social interaction, (2) language as used in social communication, or (3)
symbolic or imaginative play
The disturbance is not better accounted for by Rett’s Disorder or Childhood
Disintegrative Disorder
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DSM-IV TR: Diagnostic Criteria for Asperger's
A.




B.




Qualitative impairment in social interaction, as manifested by at least two of
the following:
Marked impairment in the use of multiple nonverbal behaviors such as eye-toeye gaze, facial expression, body postures, and gestures to regulate social
interaction
Failure to develop peer relationships appropriate to developmental level
A lack of spontaneous seeking to share enjoyment, interests, or achievements
with other people (e.g., by a lack of showing, bringing, or pointing out objects of
interest to other people)
Lack of social or emotional reciprocity
Restricted repetitive and stereotyped patterns of behavior, interests, and
activities, as manifested by at least one of the following:
Encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal either in intensity or focus
Apparently inflexible adherence to specific, non-functional routines or rituals
Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or
twisting, or complex whole-body movements)
Persistent preoccupation with parts of objects
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DSM-IV TR: Diagnostic Criteria for Asperger's
C. The disturbance causes clinically significant
impairment in social, occupational, or other important
areas of functioning.
D. There is no clinically significant general delay in
language (e.g., single words used by age 2 years,
communicative phrases used by age 3 years)
E. There is no clinically significant delay in cognitive
development or in the development of age-appropriate
self-help skills, adaptive behavior (other than in social
interaction), and curiosity about the environment in
childhood.
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DSM-5: Diagnostic Criteria for Autism
Spectrum Disorder
The individual must meet all four of the following criteria.
1.
Persistent deficits in social communication and social interaction
across contexts, not accounted for by general developmental
delays, and manifest by all 3 of the following:
a) Deficits in social-emotional reciprocity; ranging from abnormal social
approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation
of social interaction.
b) Deficits in nonverbal communicative behaviors used for social interaction;
ranging from poorly integrated- verbal and nonverbal communication, through
abnormalities in eye contact and body-language, or deficits in understanding and
use of nonverbal communication, to total lack of facial expression or gestures.
c) Deficits in developing and maintaining relationships, appropriate to
developmental level (beyond those with caregivers); ranging from difficulties
adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in
people.
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DSM-5: Diagnostic Criteria for Autism
Spectrum Disorder
The individual must meet all four of the following criteria.
2. Restricted, repetitive patterns of behavior, interests, or
activities as manifested by at least two of the following:
a) Stereotyped or repetitive speech, motor movements, or use of
objects; (such as simple motor stereotypes, echolalia, repetitive use of
objects, or idiosyncratic phrases).
b) Excessive adherence to routines, ritualized patterns of verbal or
nonverbal behavior, or excessive resistance to change; (such as
motoric rituals, insistence on same route or food, repetitive questioning
or extreme distress at small changes).
c) Highly restricted, fixated interests that are abnormal in intensity or
focus; (such as strong attachment to or preoccupation with unusual
objects, excessively circumscribed or perseverative interests).
d) Hyper-or hypo-reactivity to sensory input or unusual interest in
sensory aspects of environment; (such as apparent indifference to
pain/heat/cold, adverse response to specific sounds or textures, excessive
smelling or touching of objects, fascination with lights or spinning
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objects).
DSM-5: Diagnostic Criteria for Autism
Spectrum Disorder
The individual must meet all four of the following criteria.
C. Symptoms must be present in early childhood (but may not
become fully manifest until social demands exceed limited
capacities)
D. Symptoms together limit and impair everyday functioning
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