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Young K, Harris B, Hall-Lande J, Esler A. The Intersection of Systemic, Child, and Evaluation Factors in the Prediction of Autism Special Education Eligibility; Examining the Role of Race and Ethnicity. J Autism Dev Disord 2024; 54:3274-3289. [PMID: 37480439 DOI: 10.1007/s10803-023-06059-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/24/2023]
Abstract
Though there is evidence autism identification has been inequitable for populations who are culturally and linguistically minoritized, there is limited research that explains the issue of disproportionality and factors contributing to its occurrence, especially within an educational setting. To explore contributors to racial/ethnic disparities in autism special education eligibility, the current investigation evaluated child and evaluation characteristics as they relate to the absence of autism eligibility. Data were obtained from the Autism and Developmental Disabilities Monitoring (ADDM) Network Study and included children with behavioral characteristics consistent with autism and educational evaluation records. Despite documented characteristics consistent with autism, only 72% of the sample received educational services under autism eligibility. To characterize children without autism eligibility, hierarchical logistic regression was used to evaluate factors documented in evaluation records predicting the absence of autism eligibility. Factors influencing autism eligibility included behavioral characteristics documented, evaluation components completed, intellectual ability, and clinical diagnoses present. There was no unique contribution of race/ethnicity in predicting the absence of autism eligibility when accounting for these previous predictors, but many of these predictors differed by racial/ethnic group. Disproportionality in autism may be the manifestation of inequitable evaluation experiences, including experiencing less comprehensive evaluations, and not receiving an autism specific assessment. Though race/ethnicity did not uniquely contribute to the absence of autism eligibility above and beyond those combined factors, it is important to evaluate and reduce inequities experienced within the autism identification process for populations who are culturally and linguistically minoritized.
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Affiliation(s)
- Kelsey Young
- Department of Research, Assessment, & Measurement, Curriculum Associates, North Billerica, MA, USA.
| | - Bryn Harris
- School of Education & Human Development, University of Colorado Denver, Denver, CO, USA
| | - Jennifer Hall-Lande
- Institute on Community Integration, University of Minnesota; Twin Cities, Minneapolis, MN, USA
| | - Amy Esler
- Department of Pediatrics, University of Minnesota; Twin Cities, Minneapolis, MN, USA
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2
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Wilson AC. Cognitive Profile in Autism and ADHD: A Meta-Analysis of Performance on the WAIS-IV and WISC-V. Arch Clin Neuropsychol 2024; 39:498-515. [PMID: 37779387 PMCID: PMC11110614 DOI: 10.1093/arclin/acad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE Previous research has suggested that neurodevelopmental conditions may be associated with distinctive cognitive profiles on the Wechsler intelligence tests (of which the most recent editions are the WAIS-IV and WISC-V). However, the extent to which a cognitive profile can be reliably identified for individuals meeting criteria for autism or ADHD remains unclear. The present review investigated this issue. METHOD A search was conducted in PsycInfo, Embase, and Medline in October 2022 for papers reporting the performance of children or adults diagnosed with autism or ADHD on the WAIS-IV or the WISC-V. Test scores were aggregated using meta-analysis. RESULTS Scores were analyzed from over 1,800 neurodivergent people reported across 18 data sources. Autistic children and adults performed in the typical range for verbal and nonverbal reasoning, but scored ~1 SD below the mean for processing speed and had slightly reduced scores on working memory. This provides evidence for a "spiky" cognitive profile in autism. Performance of children and adults with ADHD was mostly at age-expected levels, with slightly reduced scores for working memory. CONCLUSION Although the pattern of performance on the Wechsler tests is not sufficiently sensitive or specific to use for diagnostic purposes, autism appears to be associated with a cognitive profile of relative strengths in verbal and nonverbal reasoning and a weakness in processing speed. Attention deficit hyperactivity disorder appears less associated with a particular cognitive profile. Autistic individuals may especially benefit from a cognitive assessment to identify and support with their strengths and difficulties.
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3
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Safer-Lichtenstein J, Hamilton J, McIntyre LL. Impact of State-Level Changes to School-Based Autism Identification Criteria. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2023. [DOI: 10.1080/15377903.2023.2182857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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4
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Hirata Y, Ozawa E. Characteristics of students who require elementary school counselors' support owing to developmental disorders. Heliyon 2023; 9:e13791. [PMID: 36873511 PMCID: PMC9982625 DOI: 10.1016/j.heliyon.2023.e13791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
Awareness and support for developmental disorders are increasing in Japan. In the education field, support from school counselors for students with developmental disorders and their roles and responsibilities in elementary schools are on the rise. However, identifying and addressing specific conditions and developmental disorders that require school counselors' attention are not clearly planned. Therefore, this study explored the characteristics of students who require elementary school counselors' support owing to developmental disorders. The participants included 17 school counselors who were experienced in working at elementary schools. Through semi-structured interviews, 30 cases were discussed, examined, and categorized based on "case characteristics," "classification of the main complaint," "basic information on the diagnosis," and "type of support." The analysis included detailed viewpoints of 13 school counselors, a code frequency table, and contrast tables, focusing on the main complaint and diagnosis. Regarding the children whose main complaint was "school refusal," eight out of nine cases were in the fourth grade or above, with several cases of suspected developmental disorders or autism spectrum disorder. The number of children with comorbid attention-deficit hyperactivity disorder, including suspected cases, seemed to be higher, especially in Grades 3-5. The study highlighted the importance of assessing students' developmental characteristics related to the main complaint in the background of a secondary problem. Furthermore, early detection and interventions should be conducted in the first and second grades.
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Affiliation(s)
- Yutaro Hirata
- Faculty of Law, Economics and the Humanities, Kagoshima University, Korimoto, Kagoshima, Japan
- Corresponding author. Kagoshima University, 1-21-30 Korimoto, 890-8580, Kagoshima, Japan.
| | - Eiji Ozawa
- Faculty of Human-Environment Studies, Kyushu University, Motooka, Nishi-ku, Fukuoka, Japan
- Corresponding author. Kyushu University, 744 Nishiku Motooka, 819-0395, Fukuoka, Japan.
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5
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Bray MA, Dale BA. Integrating evaluation data to enhance treatment planning for students with ASD. PSYCHOLOGY IN THE SCHOOLS 2023. [DOI: 10.1002/pits.22813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Melissa A. Bray
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
| | - Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
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6
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Marshall AP, Ding Y, Harris A, Zusho A, Shen Y, Wu Y. Graduate training in school psychology: Applied behavior analysis and autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2023. [DOI: 10.1002/pits.22853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Amanda P. Marshall
- Division of Psychological & Educational Services, Graduate School of Education Fordham University New York New York USA
| | - Yi Ding
- Division of Psychological & Educational Services, Graduate School of Education Fordham University New York New York USA
| | - Abigail Harris
- Division of Psychological & Educational Services, Graduate School of Education Fordham University New York New York USA
| | - Akane Zusho
- Division of Psychological & Educational Services, Graduate School of Education Fordham University New York New York USA
| | - Yangqian Shen
- Division of Psychological & Educational Services, Graduate School of Education Fordham University New York New York USA
| | - Ying Wu
- Division of Psychological & Educational Services, Graduate School of Education Fordham University New York New York USA
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7
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Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, Skowyra C, Fusco A, Baio J, Esler A, Zahorodny W, Hobson N, Mars A, Thurm A, Bishop S, Wiggins LD. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord 2022; 52:5308-5320. [PMID: 34981308 PMCID: PMC9250939 DOI: 10.1007/s10803-021-05377-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.
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Affiliation(s)
- C E Rice
- Emory University, Atlanta, GA, USA.
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - L A Carpenter
- Medical University of South Carolina, Charleston, SC, USA
| | | | - C Lord
- University of California Los Angeles, Los Angeles, CA, USA
| | - M DiRienzo
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Boan
- Medical University of South Carolina, Charleston, SC, USA
| | - C Skowyra
- Washington University in St. Louis, St. Louis, MO, USA
| | - A Fusco
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Baio
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Esler
- University of Minnesota, Minneapolis, MN, USA
| | - W Zahorodny
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - N Hobson
- Independent Consultant, Keller, TX, USA
| | - A Mars
- Hunterdon Healthcare System, Flemington, NJ, USA
| | - A Thurm
- National Institute of Mental Health, Bethesda, MD, USA
| | - S Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - L D Wiggins
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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8
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Mathews TL, Daly E, Kunz GM, Lugo AM, McArdle P, Menousek K, Kupzyk K. Addressing the Need for Training More School Psychologists to Serve Toddlers and Preschoolers with Autism Spectrum Disorders. CONTEMPORARY SCHOOL PSYCHOLOGY 2022; 28:1-16. [PMID: 36311282 PMCID: PMC9590395 DOI: 10.1007/s40688-022-00434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
The prevalence of autism spectrum disorder (ASD) has risen significantly in the past two decades. Unfortunately, there is a shortage of mental health providers who have specialized training in delivering evidenced-based services to this population. Early intensive behavioral intervention (EIBI) is an evidenced-based treatment recommended for toddlers with ASD, and school psychologists are uniquely positioned to help children with ASD receive it. However, many school psychologists do not receive adequate training in this subspecialty. This paper makes recommendations to school psychology training programs about how to add or improve training in this subspecialty based on the results of an Office of Special Education Programs grant-funded ASD training program which involved collaboration between a NASP-approved and APA-accredited school psychology training program and a community-based early intensive behavioral intervention (EIBI) clinic. The grant supported development of an interdisciplinary didactic and clinical training program to increase the ASD knowledge, skills, and competencies of school psychology graduate students, with the broader goals of developing a replicable training model and increasing the workforce of trained providers for this underserved population. Fifteen graduate students completed the training program. Outcomes related to trainee knowledge, skills, and competencies, trainee satisfaction, and lessons learned over time analyzed within a logic model that guided the project's development and execution can be informative for other school psychology programs undertaking training in this subspecialty.
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Affiliation(s)
- Therese L. Mathews
- University of Nebraska Medical Center, College of Nursing, Nebraska Medical Center, Omaha, NE 985330 USA
| | - Ed Daly
- Department of Educational Psychology, University of Nebraska– Lincoln, NE Lincoln, USA
| | | | | | - Paige McArdle
- Children’s Mercy Hospital and Clinics, Kansas City, MO USA
| | | | - Kevin Kupzyk
- University of Nebraska Medical Center, College of Nursing, Nebraska Medical Center, Omaha, NE 985330 USA
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9
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Margiano SG, Sassu KA, Dale BA, Caemmerer JM, Bray MA, Peters E. School psychologists and autism identification: Present challenges and potential solutions. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Suzanne G. Margiano
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
| | - Kari A. Sassu
- Department of Counseling & School Psychology Southern Connecticut University New Haven Connecticut USA
| | - Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
| | | | - Melissa A. Bray
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
| | - Emily Peters
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
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10
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Dale BA, Finch WH, Shellabarger KAR, Davis A. Comparison of Verbal Performance of Children with Autism Spectrum Disorder on the WISC-V. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2022. [DOI: 10.1177/07342829221106592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with autism spectrum disorder (ASD) display variable verbal cognitive profiles despite a historical requirement for a language delay in autistic disorder. This study compared the Verbal Comprehension Index (VCI) to the newly created ancillary index score, the Verbal Expanded Crystallized Index (VECI) of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) in a group of children with ASD. Using the ASD sample from the standardization data of the WISC-V, results indicated the VCI and VECI were significantly different for the ASD group but not for the matched controls. Follow up analysis of the ASD group revealed the VCI and VECI were significantly different for those with language impairment but not for those without language impairment. Psychologists should consider administering all verbal subtests of the WISC-V to children with ASD given the VECI may better capture the language impairment seen in this population.
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Affiliation(s)
- Brittany A. Dale
- Department of Special Education, Ball State University, Muncie, IN, USA
| | - W. Holmes Finch
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
| | | | - Andrew Davis
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
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11
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Dale BA, Bray MA. Collaborative approaches to autism spectrum disorder assessment. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
| | - Melissa A. Bray
- Department of Educational Psychology University of Connecticut Storrs Connecticut USA
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12
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Dale BA, Finch WH, Shellabarger KAR. Performance of children with ASD on the WISC‐V ancillary index scales. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
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13
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Schmidt J, Harris B, McClain MB, Benallie KJ. Evaluating psychometric properties of common autism educational identification measures through a culturally and linguistically responsive lens. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Jaime Schmidt
- School of Education and Human Development University of Colorado Denver Denver Colorado USA
| | - Bryn Harris
- School of Education and Human Development University of Colorado Denver Denver Colorado USA
| | | | - Kandice J. Benallie
- Emma Eccles Jones College of Education and Human Services Utah State University Logan Utah USA
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14
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Luallin S, Hulac D, Pratt AA. Standardized administration of the Autism Diagnostic Observation Schedule, Second Edition across treatment settings. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Stephanie Luallin
- Department of School Psychology University of Northern Colorado Greeley Colorado USA
| | - David Hulac
- Department of School Psychology University of Northern Colorado Greeley Colorado USA
| | - April A. Pratt
- Department of School Psychology University of Northern Colorado Greeley Colorado USA
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15
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Christopher K, Lord C. Best practice assessments for autism spectrum disorders in schools. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kourtney Christopher
- Departments of Psychiatry and School of Education University of California Los Angeles California USA
| | - Catherine Lord
- Departments of Psychiatry and School of Education University of California Los Angeles California USA
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16
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Camodeca A. Diagnostic Utility of the Gilliam Autism Rating Scales-3rd Edition Parent Report in Clinically Referred Children. J Autism Dev Disord 2022; 53:2112-2126. [PMID: 35244837 DOI: 10.1007/s10803-022-05483-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Abstract
There is limited research regarding the Gilliam Autism Rating Scales-3rd Edition (GARS-3) despite its extensive use. A comprehensive diagnostic evaluation, including the Autism Diagnostic Observation Schedule-2nd Edition (ADOS-2) was provided to 186 clinically referred children suspected of autism ([Formula: see text] age = 8.98; Autism [AUT] n = 87; Not Autism [NOT] n = 99). Mean difference analyses, Logistic Regressions, and ROC analyses were non-significant for both Autism Index scores. The author-suggested cutoff score of 70 correctly classified approximately 47% of participants, with false positive rates = 82.83-87.88%. ADOS-2 correlations were significantly lower vis-à-vis the standardization sample. The Social Interaction subscale demonstrated weak, marginal results, and sensitivity/specificity could not be optimized. In its current form, the GARS-3 does not demonstrate adequate criterion validity for use in assessment of complex community samples.
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Affiliation(s)
- Amy Camodeca
- Psychology Department, The Pennsylvania State University, 100 University Drive, Monaca, PA, 15061, USA. .,University of Windsor, Windsor, ON, Canada. .,The Pennsylvania State University, Beaver Campus, 100 University Drive, Monaca, PA, 15108, USA.
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17
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Gardner L, Campbell JM, Gilchrest C, McClain MB, Shahidullah JD. Identification of autism spectrum disorder and interprofessional collaboration between school and clinical settings. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Lauren Gardner
- Psychology and Neuropsychology Division Johns Hopkins All Children's Hospital St Petersburg Florida USA
| | - Jonathan M. Campbell
- Department of Psychology Western Carolina University Cullowhee North Carolina USA
| | - Callie Gilchrest
- Psychology and Neuropsychology Division Johns Hopkins All Children's Hospital St Petersburg Florida USA
| | | | - Jeffrey D. Shahidullah
- Department of Psychiatry and Behavioral Sciences The University of Texas at Austin Austin Texas USA
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18
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Duesenberg MD, Burns MK. Autism spectrum disorder identification in schools: Impact of criteria, assessments, and student data for identification decisions. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- McKinzie D. Duesenberg
- Department of Educational, School, & Counseling Psychology University of Missouri Columbia Missouri USA
| | - Matthew K. Burns
- Department of Educational, School, & Counseling Psychology University of Missouri Columbia Missouri USA
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19
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Crepeau-Hobson MF, Leech N, Russell C. CLEAR Autism Diagnostic Evaluation (CADE): Evaluation of Reliability and Validity. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2021; 34:853-869. [PMID: 34873387 PMCID: PMC8636580 DOI: 10.1007/s10882-021-09828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
Recent surveillance efforts indicate that 1 in 54 American children meet the criteria for Autism Spectrum Disorder (ASD), making it the fastest growing neurodevelopmental disorder in the U.S. Despite evidence that ASD can be reliably diagnosed as early as 24 months, the median age at ASD diagnosis in 2016 in the U.S. was 51 months. The CLEAR Autism Diagnostic Evaluation (CADE; Willard & Kroncke, 2019), was developed in response to the need to improve, shorten, and standardize the clinical ASD evaluation process. The CADE is a 33-item rating scale designed to be completed by caregivers and clinicians. The current study was conducted to examine the reliability and validity of the CADE using a sample of 191 individuals who received a private evaluation for ASD. Using the client's evaluation records, clinicians completed the CADE items. The coefficient alpha was .94, which indicates that the items form a scale that has high internal consistency. The CADE total scores were highly correlated with ADOS scores, with r values ranging from .52-.86, and discriminated between those participants with a diagnosis of ASD and those without (p < .001). Receiver operator characteristic (ROC) curve analyses indicated excellent diagnostic accuracy of the CADE total score (ROC area under the curve = .998). Results suggest that the CADE can be used as an efficient and accurate means of evaluating ASD. Limitations and implications for use of the CADE are discussed.
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Affiliation(s)
| | - Nancy Leech
- School of Education and Human Development, University of Colorado Denver, Denver, CO USA
| | - Courtney Russell
- School of Education and Human Development, University of Colorado Denver, Denver, CO USA
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20
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Fennell LCP, Johnson SA. Examination of professional biases about autism: how can we do better? Clin Neuropsychol 2021; 36:1094-1115. [PMID: 34369298 DOI: 10.1080/13854046.2021.1958922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This paper lends a critical eye to six common assumptions/biases about autism that may influence neuropsychologists in their clinical work. These biases are based on research as well as the historical roots of the study of autism. Our goal is to encourage curiosity and reflection on these biases in order to improve neuropsychological service delivery for people on the autism spectrum. Methods: We argue that psychologists should strive to understand the function of behaviours observed with autism in order to offer helpful supports. We explore the assertions that autism is not a dichotomous or linear construct and that the use of high and low functioning descriptors are not useful nor appreciated by the autism community. We discuss the widely held beliefs that individuals on the autism spectrum lack theory of mind, empathy and social motivation. Importantly, people on the autism spectrum are telling us that the dialogue about them around theory of mind and empathy is a human rights issue. Finally, we discuss the role of standardized testing. Conclusions: Through an exploration of research literature, the writings of scholars and advocates on the autism spectrum, and personal, clinical and research experience we encourage our profession to take a leadership role in examining biases and changing the clinical and research landscape so that it better reflects respectful discourse for individuals on the autism spectrum. This is critical to reduce the stigma that continues to be associated with autism and has a negative affect on mental health and quality of life.
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Affiliation(s)
- Louise C P Fennell
- Department of Psychology, University of Victoria, Victoria, Canada.,Private Practice of Psychologist Louise Fennell, Victoria, Canada
| | - Shannon A Johnson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
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21
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R Bradbury K, Duvall SW, Armstrong K, Hall TA. Survey of training experiences and clinical practice in assessment for autism spectrum disorder by neuropsychologists. Clin Neuropsychol 2021; 36:856-873. [PMID: 34308763 DOI: 10.1080/13854046.2021.1948610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The primary purpose of this study is to better understand current practices in the assessment of autism spectrum disorder (ASD) by neuropsychologists. METHODS A 21-item survey regarding ASD assessment beliefs and practices was sent via email through neuropsychology listservs. The survey was accessed by 445 licensed psychologists who identified as neuropsychologists. A total of 367 surveys were deemed usable for data analysis. Descriptive statistics were used to characterize the full sample. Exploratory analyses were conducted between groups of interest, including primary population served (pediatric, adult, or lifespan), primary practice setting (medical center vs. private practice) and years in practice (< 5 years, 5 to 14 years, or 15+ years). RESULTS Respondents were well-distributed across age range, years in practice, primary practice setting, and primary practice location. Almost all respondents (most of whom self-identified as pediatric-focused clinicians) believe that neuropsychologists should be able to competently rule in or out ASD and most received training in ASD assessment. Approximately 40% of respondents endorsed wanting more training in ASD assessment to increase their competence and confidence in making this differential diagnosis. Minimal differences in ASD beliefs and assessment practices were seen across years of practice or primary practice setting. Pediatric and lifespan clinicians had similar experience with ASD assessment practices, and both generally differed from adult clinicians. CONCLUSIONS Our findings suggest many respondents desire further specialty ASD training for neuropsychologists. Additionally, the large majority of respondents indicated that future neuropsychologists should receive training in ASD assessment during graduate school, internship and/or post-doctoral fellowship.
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Affiliation(s)
- Kathryn R Bradbury
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA.,Children's Neuropsychological Services, Andover, MA, USA
| | - Susanne W Duvall
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
| | | | - Trevor A Hall
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA.,Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR, USA
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22
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Nathanson EW, Rispoli KM. School Psychologists’ Assessment Practices for Students with Co-Occurring Anxiety and Autism Spectrum Disorder. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2021. [DOI: 10.1080/15377903.2021.1941468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Emma W. Nathanson
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, Michigan, USA
| | - Kristin M. Rispoli
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, Michigan, USA
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23
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Dale BA, Finch WH, Shellabarger KAR, Davis A. Wechsler Intelligence Scale for Children, Fifth Edition Profiles of Children With Autism Spectrum Disorder Using a Classification and Regression Trees Analysis. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2021. [DOI: 10.1177/07342829211025924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Wechsler Intelligence Scales for Children (WISC) are the most widely used instrument in assessing cognitive ability, especially with children with autism spectrum disorder (ASD). Previous literature on the WISC has demonstrated a divergent pattern of performance on the WISC for children ASD compared to their typically developing peers; however, there is a lack of research concerning the most recent iteration, the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). Due to the distinctive changes made to the WISC-V, we sought to identify the pattern of performance of children with ASD on the WISC-V using a classification and regression (CART) analysis. The current study used the standardization sample data of the WISC-V obtained from NCS Pearson, Inc. Sixty-two children diagnosed with ASD, along with their demographically matched controls, comprised the sample. Results revealed the Comprehension and Letter-Number Sequencing subtests were the most important factors in predicting group membership for children with ASD with an accompanying language impairment. Children with ASD without an accompanying language impairment, however, were difficult to distinguish from matched controls through the CART analysis. Results suggest school psychologists and other clinicians should administer all primary and supplemental subtests of the WISC-V as part of a comprehensive assessment of ASD.
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Affiliation(s)
- Brittany A. Dale
- Department of Special Education, Ball State University, Muncie, IN, USA
| | - W. Holmes Finch
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
| | | | - Andrew Davis
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
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Stichter J, Stormont M, Buranova N, Herzog M, O'Donnell R. Educational and Diagnostic Classification of Autism Spectrum Disorder and Associated Characteristics. J Autism Dev Disord 2021; 51:4033-4042. [PMID: 33439435 DOI: 10.1007/s10803-020-04867-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2020] [Indexed: 11/26/2022]
Abstract
Research continues to highlight discrepancies between clinical diagnoses of Autism Spectrum Disorder (ASD) and determination of special education eligibility for services within school settings. However, limited research has been conducted on the impact of those discrepancies for the identification of appropriate services within schools. The aim of the current study is to examine students' characteristics (e.g., language, social emotional) associated with educational eligibility and clinical diagnoses. More specifically, the study examines characteristics differentially associated with ASD diagnoses to inform targeted evidence-based interventions. The study accessed data from a four-year cluster-randomized trial of 283 students with and without reported ASD diagnosis. The results of the study demonstrate that the educational eligibility of Autism did not differentiate between students with and without autism on any of the measured characteristics including language, peer and social competence, academics, and aggressive behaviors. However, the Autism Diagnostic Observation Schedule, second edition (ADOS-2; Lord et al. in Autism diagnostic observation schedule. Western Psychological Services, Torrance, CA, 2012) classification was a more sensitive diagnostic measure for characteristics associated with autism. Implications for research, practitioners, and schools are discussed.
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25
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Hooks E, Dale BA, Hernandez Finch ME. Profile analysis of the Personality Assessment Inventory‐Adolescent (PAI‐A) for individuals with autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elizabeth Hooks
- Critical Care Unit for Behavioral Supports Behavioral Dimensions, Inc. Minnesota USA
| | - Brittany A. Dale
- Department of Special Education Ball State University Muncie Indiana USA
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26
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Safer-Lichtenstein J, Reardon K, McIntyre LL. Does Location Matter? A Single-State Case Study Examining Geographic Differences in School-Based ASD Identification Practices. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2020. [DOI: 10.1080/15377903.2020.1821270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Kyle Reardon
- Special Education and Clinical Sciences, University of Oregon College of Education, Eugene, Oregon, USA
| | - Laura Lee McIntyre
- Special Education and Clinical Sciences, University of Oregon College of Education, Eugene, Oregon, USA
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27
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School-Based Autism Rates by State: An Analysis of Demographics, Political Leanings, and Differential Identification. J Autism Dev Disord 2020; 51:2271-2283. [PMID: 32926306 DOI: 10.1007/s10803-020-04700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We reviewed federal special education data to determine school-identified prevalence of Autism Spectrum Disorder (ASD) and other disability categories by U.S. state. We also examined whether state-level policies, demographic factors, and rates of other eligibility categories are predictive of these state ASD rates. Results indicate that overall, 1 of 81 school-aged children are served under an ASD special education eligibility. State-level demographic factors, such as socioeconomic status and political leanings were highly predictive of rates of ASD. States with higher rates of ASD had lower rates of intellectual and learning disabilities, but higher rates of Other Health Impairment (OHI).
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28
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Clements CC, Sparding T, Schultz RT, Yerys BE, Watkins MW. DAS-II Cognitive Profiles Are Not Diagnostically Meaningful For Autism: A ROC Analysis. Autism Res 2020; 13:2143-2154. [PMID: 32696622 DOI: 10.1002/aur.2336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/08/2020] [Accepted: 05/24/2020] [Indexed: 01/01/2023]
Abstract
Intelligence assessment is an integral part of a comprehensive autism evaluation. Many past studies have described a cognitive profile of autistic individuals characterized by higher nonverbal than verbal IQ scores. The diagnostic utility of this profile, however, remains unknown. We leveraged receiver operating characteristic methods to determine the sensitivity, specificity, and area under the curve (AUC) of three different IQ profiles in a large sample of children who have an autism spectrum disorder diagnosis (N = 1,228, Simons Simplex Collection) who completed the Differential Ability Scales-Second Edition (DAS-II), School Age compared to the normative sample provided by the DAS-II publisher (N = 2,200). The frequently discussed nonverbal > verbal IQ profile performed near chance at distinguishing ASD from normative individuals (AUC: 0.54, 95% CI [0.52-0.56]), and performed significantly worse for females than males (AUC: females: 0.46 [0.41-0.52]; males: 0.55 [0.53-0.58]). All cognitive profiles showed AUC < 0.56. We conclude that while significant differences between verbal and nonverbal IQ scores exist at the group level, these differences are small in an absolute sense and not meaningful at an individual level. We do not recommend using cognitive profiles to aid in autism diagnostic decision-making. LAY SUMMARY: Some researchers and clinicians have reported an "autistic cognitive profile" of higher nonverbal intelligence than verbal intelligence. In an analysis of over 1,000 autistic children, we found that the group's average nonverbal intelligence is usually higher than their verbal intelligence. However, this pattern should not be used by clinicians to make an individual diagnosis of autism because our results show it is not helpful nor accurate.
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Affiliation(s)
- Caitlin C Clements
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Psychology Department, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Timea Sparding
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Robert T Schultz
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Benjamin E Yerys
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marley W Watkins
- Department of Educational Psychology, Baylor University, Waco, Texas, USA
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30
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Camodeca A, Todd KQ, Croyle J. Utility of the Asperger Syndrome Diagnostic Scale in the Assessment of Autism Spectrum Disorders. J Autism Dev Disord 2020; 50:513-523. [DOI: 10.1007/s10803-019-04272-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Maddox BB, Rump KM, Stahmer AC, Suhrheinrich J, Rieth SR, Nahmias AS, Nuske HJ, Reisinger EM, Crabbe SR, Bronstein B, Mandell DS. Concordance between a U.S. Educational Autism Classification and the Autism Diagnostic Observation Schedule. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:469-475. [PMID: 30892948 PMCID: PMC6754325 DOI: 10.1080/15374416.2019.1567345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
States in the United States differ in how they determine special education eligibility for autism services. Few states include an autism-specific diagnostic tool in their evaluation. In research, the Autism Diagnostic Observation Schedule (ADOS for first edition, ADOS-2 for second edition) is considered the gold-standard autism assessment. The purpose of this study was to estimate the proportion of children with an educational classification of autism who exceed the ADOS/ADOS-2 threshold for autism spectrum (concordance rate). Data were drawn from 4 school-based studies across 2 sites (Philadelphia, Pennsylvania, and San Diego, California). Participants comprised 627 children (2-12 years of age; 83% male) with an autism educational classification. Analyses included (a) calculating the concordance rate between educational and ADOS/ADOS-2 classifications and (b) estimating the associations between concordance and child's cognitive ability, study site, and ADOS/ADOS-2 administration year using logistic regression. More San Diego participants (97.5%, all assessed with the ADOS-2) met ADOS/ADOS-2 classification than did Philadelphia participants assessed with the ADOS-2 (92.2%) or ADOS (82.9%). Children assessed more recently were assessed with the ADOS-2; this group was more likely to meet ADOS/ADOS-2 classification than the group assessed longer ago with the ADOS. Children with higher IQ were less likely to meet ADOS/ADOS-2 classification. Most children with an educational classification of autism meet ADOS/ADOS-2 criteria, but results differ by site and by ADOS version and/or recency of assessment. Educational classification may be a reasonable but imperfect measure to include children in community-based trials.
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Affiliation(s)
- Brenna B. Maddox
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Keiran M. Rump
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Aubyn C. Stahmer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Davis, CA,Child and Adolescent Services Research Center, San Diego, CA
| | - Jessica Suhrheinrich
- Child and Adolescent Services Research Center, San Diego, CA,San Diego State University, San Diego, CA
| | - Sarah R. Rieth
- Child and Adolescent Services Research Center, San Diego, CA,San Diego State University, San Diego, CA
| | - Allison S. Nahmias
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Davis, CA
| | - Heather J. Nuske
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Erica M. Reisinger
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Samantha R. Crabbe
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - Briana Bronstein
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
| | - David S. Mandell
- Penn Center for Mental Health, University of Pennsylvania, Philadelphia, PA
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Sullivan AL, Sadeh S, Houri AK. Are school psychologists' special education eligibility decisions reliable and unbiased?: A multi-study experimental investigation. J Sch Psychol 2019; 77:90-109. [PMID: 31837731 DOI: 10.1016/j.jsp.2019.10.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 06/20/2019] [Accepted: 10/31/2019] [Indexed: 11/26/2022]
Abstract
Nearly 50 years of research show persistent racial disproportionality in the identification of special education disabilities, but the underlying mechanisms for these disparities remain largely unexplored. Because ambiguous regulations defining disabilities may allow subjectivity and unlawful differential treatment (i.e., racial bias or discrimination) in the special education eligibility process, an important target of study is disparate treatment of students by race in evaluations required to determine eligibility. School psychologists have long been recognized as highly influential in this process and in schools' resultant decisions. We used a 3 × 2 mixed factorial experimental design in three studies with simulated case report data to measure the influence of race and assessment data on school psychologists' perceptions of students' eligibility for special education in cases centering on emotional disturbance, intellectual disability, or autism, respectively. Participants included 302 practicing school psychologists in three states across the three experiments. There was little evidence of racial disparity, but participants tended to render decisions unsupported by, and even contrary to, evaluation data. Implications for research, practice, and professional development are discussed.
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Affiliation(s)
- Amanda L Sullivan
- Department of Educational Psychology, College of Education & Human Development, University of Minnesota, USA.
| | - Shanna Sadeh
- Department of Educational Psychology, College of Education & Human Development, University of Minnesota, USA
| | - Alaa K Houri
- Department of Educational Psychology, College of Education & Human Development, University of Minnesota, USA
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33
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Dale BA, Neild R. The assessment needs of families with children who are deaf and hard of hearing referred for an autism spectrum disorder evaluation. PSYCHOLOGY IN THE SCHOOLS 2019. [DOI: 10.1002/pits.22328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Brittany A. Dale
- Department of Special EducationBall State UniversityMuncie Indiana
| | - Raschelle Neild
- Department of Special EducationBall State UniversityMuncie Indiana
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34
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McClain MB, Harris B, Schwartz SE, Golson ME. Evaluation of the Autism Spectrum Rating Scales in a Diverse, Nonclinical Sample. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2019. [DOI: 10.1177/0734282919880051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite the changing racial/ethnic demographics in the United States, few studies exist that evaluate autism spectrum disorder (ASD) screening and diagnostic assessment measures for their cultural and linguistic responsiveness. The purpose of this study was to evaluate the structure of the Autism Spectrum Rating Scales (ASRS) in a diverse sample of parents with children (nonclinical sample) between the ages of 6 and 18 years ( N = 405). Confirmatory factor analyses, factor correlations, and the evaluation of item loadings were used to examine the structure of the ASRS across cultural groups. Results yielded cross-cultural differences. Implications and directions for future research are discussed.
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35
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McClain MB, Otero TL, Haverkamp CR, Molsberry F. Autism spectrum disorder assessment and evaluation research in 10 school psychology journals from 2007 to 2017. PSYCHOLOGY IN THE SCHOOLS 2018. [DOI: 10.1002/pits.22133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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