Education-Based Evaluations for ASD

1. Education-Based Evaluations for ASD http://START Project Education- Based Evaluations for ASD

2. INTRODUCTIONS Working Agreements Welcome

3. Poll Everywhere2 ways to sign in

4. AGENDA • New Reality in ASD Evaluations • Foundations in CET (Centralized Evaluation Team) • MARSE Eligibility Criteria for ASD • Essential Evaluation Components • Differential Eligibility • ASD or ECDD, CI, EI

5. New Reality

6. Michigan Students with an ASD Eligibility

7. New Reality: Players at the Table

8. Individualized Family Service Plan MAASE Document

9. Acronym Deciphering Tool • SE = Special Education • ASD = Autism Spectrum Disorder • MARSE = Michigan Administrative Rules for Special Education • REED = Review of Existing Evaluation Data • MET = Multidisciplinary Evaluation Team • IFSP = Individual Family Service Plan • IEP = Individualized Educational Program • SAS = Supplementary Aids and Services • P&S = Programs & Services • FAPE = Free and Appropriate Public Education • LRE = Least Restrictive Environment • AIB = Autism Insurance Benefit • DSM = Diagnostic and Statistical Manual of Mental Disorders • PDD-NOS = Pervasive Developmental Disorder – Not Otherwise Specified • ADOS = Autism Diagnostic Observation Schedule • ADI = Autism Diagnostic Interview • CMHP = Child Mental Health Professional • PCP = Person-Centered Plan • IPOS = Individual Plan of Service • ABA = Applied Behavioral Analysis • EIBI = Early Intensive Behavioral Intervention • ABI = Applied Behavioral Intervention • ABLLS = Assessment of Basic Language and Learning Skills • VB-MAPP = Verbal Behavioral Milestones Assessment and Placement Program

10. DSM-V Change: ASD Persistent Deficits in Social Communication & Social Interaction SEVERITY RATING LEVELS 1-3: 3 = Requiring very substantial support 1 = Requiring support

11. MARSE ASD Triad

12. New Reality in Evaluations for ASD • Potential increase in referrals • Potential increase in pressure to accept clinical diagnoses • Increased need for collaboration across systems

13. New Reality: More Complexity • Common Comorbid Conditions: • Seizures and epilepsy • Anxiety • Depression • Attention difficulties • Bipolar Disorder • Obsessive Compulsive • Some comorbid conditions are characteristics of ASD; • Some cannot be primary for eligibility under ASD

14. FIRST STEP: Improve OUR Process • All staff need to be competent at ASD screening / evaluation • Current Issues: • Not recognizing there are THREE required eligibility areas • Not recognizing that “educational impact” can be in one of THREE areas (e.g. academic, behavior, social) • Use of tools with no observational data • Not understanding terms: • Pervasive • Marked • Qualitative • Adverse Impact

15. Goals for Evaluation Teams • Confident and Competent • Strength in Process • Defendable • Consistent

16. Autism Council

17. Education-Based Evaluations Autism Council START

18. Foundations in CET VIDEO(Centralized Evaluation Team) • Educational Eligibility vs. Medical Diagnosis • Parent and Family Engagement • Focus on Qualitative using Quadrants • Combined Report Writing • Use of Meeting Mechanics • OBJECTIVE Team

19. Foundations in CET (Centralized Evaluation Team) • Educational Eligibility vs. Medical Diagnosis • Parent and Family Engagement • Focus on Qualitative using Quadrants • Combined Report Writing • Use of Meeting Mechanics • OBJECTIVE Team

20. Eligibility vs Diagnosis (Pg.4)

21. Process & Application (page 4)Bar Talk (Single’s Bar) • 30 Sec Speech “What is the difference between diagnosis and eligibility?” • Share your speech with a partner you don’t know • Let your partner share their speech • Share your PARTNER’s speech back at your home table

22. Foundations in CET (Centralized Evaluation Team) • Educational Eligibility vs. Medical Diagnosis • Parent and Family Engagement • Focus on Qualitative using Quadrants • Combined Report Writing • Use of Meeting Mechanics • OBJECTIVE Team

23. Objective Team

24. Process and Application3Advantages & 1Disadvantage of Objective Team

25. TEAM Process for Evaluation Collaboration One voice One contact One report

26. TEAM CONFIGURATIONS (Pg 30) Which best represents your current configuration? Considerations for Changes?

27. AGENDA • New Reality in ASD Evaluations • Foundations in CET (Centralized Evaluation Team) • MARSE Eligibility Criteria for ASD • Essential Evaluation Components • Differential Eligibility • ASD or ECDD, CI, EI

28. The Three Prongs of Eligibility • CRITERIA • IMPACT • NEED

29. (a) Academic MARSE Criteria Autism Spectrum Disorder (ASD) • Considered a lifelong developmental disability that adversely affects a student’s educational performance in 1 or more of the following areas: (Establishes IMPACT and NEED for SpEd Services) a) Academic (e.g. ability to meaningfully participate and progress in the general curriculum including lack of initiation, impaired quality of participation, low grades, etc.) (b) Behavioral (e.g. disruption, aggression, lack of appropriate engagement, eloping, tantrums, etc.) (c) Social (e.g. ability to develop and maintain relationships/friendships, responses to social situations that alienates others and diminishes acceptance, etc.)

30. Purpose of “LIFELONG” • Definition of ASD • Increases threshold for decisions • Reduces need to re-evaluate for evidence of ASD • Implies lasting impact, not permanent eligibility

31. MARSE Criteria ASDAge of Eligibility Autism spectrum disorder is typically manifested before 36 months of age. A child who first manifests the characteristics after age 3 may also meet criteria. Autism spectrum disorder is characterized by qualitative impairments in reciprocal social interactions, qualitative impairments in communication, and restricted range of interests/repetitive behavior.

32. National Research Council “There is no single behavior that is always typical of Autism and no behavior that would automatically exclude an individual child from a diagnosis of Autism.” National Research Council

33. MARSE Criteria forAutism Spectrum Disorder (ASD) Characterized by : Qualitative Impairment in Reciprocal Social Interactions Qualitative Impairment in Communication Restricted, Repetitive, and Stereotyped Behaviors

34. “Qualitative” • Atypical • Significantly different from other students at the same age and developmental level • Outside the typical sequence of development • Across all environments. • Presence and Absence • Unique to each Student

35. MARSE Definition Reciprocal Social Interaction (a) Qualitative impairments in reciprocalsocial interactions including at least 2 of the following areas: (i) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction. (ii) Failure to develop peer relationships appropriate to developmental level. (iii) Marked impairment in spontaneous seeking to share enjoyment, interests, or achievements with other people, for example, by a lack of showing, bringing, or pointing out objects of interest. (iv) Marked impairment in the areas of social or emotional reciprocity.

36. Reciprocal Social Interaction A mutual exchange (e.g. words, actions, or feelings)

37. Reciprocal Social InteractionAt least 2 of the 4 (i) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction. • Marked = Substantial & Sustained; Clearly Evident; Distinctive and noticeably different from same-aged peers Likert Scale for Marked

38. Reciprocal Social InteractionAt least 2 of the 4 (i) Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction. • Marked = Substantial & Sustained; Clearly Evident; Distinctive and noticeably different from same-aged peers • PURPOSE / FUNCTION of Nonverbal Behavior • EXAMPLES: • Seems to look “through” a person, lacks eye contact to initiate or sustain interaction, has fleeting or inconsistent eye contact • Lacks emotion or appropriate facial affect for the social situation, lacks accurate facial expression to reflect internal feelings, facial expressions seem rehearsed or mechanical • Difficulty maintaining appropriate body space, awkward/stiff response or movement, gait challenges • Lacks understanding of the use of nonverbal cues (e.g. pointing, head nod, waving), does not respond to communication partner signals to start or end a conversation

39. Reciprocal Social InteractionAt least 2 of the 4 (ii) Failure to develop peer relationships appropriate to developmental level. • Impaired perspective taking: viewing situations from another’s point of view / emotional state; predicting other’s behavior (THEORY OF MIND) • Anthropomorphic • Examples: not understanding humor / jokes, disrupting activities (play), rarely initiates or sustains interaction, tolerates peers but not engaged in interaction

40. Reciprocal Social Interaction Reciprocal Social InteractionAt least 2 of the 4 (iii) Marked impairment in spontaneous(i.e. without prompting) seeking to share enjoyment, interests, or achievements with other people, for example, by a lack of showing, bringing, or pointing out objects of interest. (i.e. Joint / Shared Attention) • Examples: • Deficits in the use of pointing to orient another to an object or event • Bringing objects or items to others for the purposes of getting needs met, but not for a shared experience • Shifting conversations to one’s own interest rather than responding to the interests of others

41. Reciprocal Social InteractionAt least 2 of the 4 Reciprocal social Interaction (iv) Marked impairment in the areas of social or emotional reciprocity (i.e. Identifying and responding appropriately to other’s emotional states) • EXAMPLES: • Lack of social smiling; Lack of interest in the ideas of others • Aloofness and indifference toward others • Seemingly rude statements to others without filter or negative intent Difficulty explaining their own behaviors in context of impact on others • Difficulty predicting how others feel or think • Problems inferring the intentions or feelings of others • Failure to understand how their behavior impacts how others think or feel • Problems with social conventions (e.g. turn-taking / personal space) • Lack of appropriate responding to someone else’s pain or distress • Creating arbitrary social rules to make sense of ambiguous social norms

42. Developmental Trajectories Theories

43. Shape Shifter 3 Key Points What’s still circling in your mind? What squared away with what you already knew? • Part 1: • Draw each shape on a sheet of paper • Reflect on Day 1 content for each shape • Part 2: • Start with ____, clockwise, share your reflections • Identify themes in each shape • Part 3: Report Out

44. MARSE Criteria: Communication (b) Qualitative impairments in communication including at least 1 of the following: (i) Delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime. (ii) Marked impairment in pragmatics or in the ability to initiate, sustain, or engage in reciprocal conversation with others. (iii) Stereotyped and repetitive use of language or idiosyncratic language. (iv) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

45. MARSE Criteria: CommunicationAt least 1 of the following 4 (i) Delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate • Failure to understand that words have communicative intent • Some students with an ASD do not talk at all; • Some students with ASD have words at 12 to 18 months of age and then lose them; • Some students with ASD speak, but sometimes not until later in childhood and/or use non-functional / atypical speech. Autism Spectrum Disorder CDC

46. Communication (ii) Impairment in Pragmatics: The ability to initiate, sustain, or engage in reciprocal conversation with others • Using language for varying purposes (e.g. greeting, informing, promising, requesting, etc.) • Changing language according to the needs of the listener or situation (e.g., giving background information to an unfamiliar listener, speaking differently in a classroom than on a playground) • Following rules of conversations and storytelling (e.g., taking turns in conversation, staying on topic, rephrasing when misunderstood, proximity, use of eye contact • EXAMPLES: • Difficulty with the social aspects of language (e.g. understanding non-literal language used in conversation) • Issues with prosody (e.g. flat and emotionless or high and pitchy with atypical rhythm or rate) • Difficulty initiating, sustaining, or ending conversations with others • Difficulty using repair strategies when communication breaks down • Talking for extended periods of time about a subject of the student’s liking, regardless of the listener’s interest • Talking at someone in a monologue rather than conversing

47. RECEPTIVE & EXPRESSIVE LANGUAGE are not equal • Ididn’t say she stole my money. • I didn’t say she stole my money. • I didn’t say she stole my money. • I didn’t say she stole my money. • I didn’t say she stole my money. • I didn’t say she stole my money. • I didn’t say she stole my money.

48. Literal Language Interpretation “We’re gonna make a day of it!” “Put your shoes and socks on.” “Say these numbers backward.”

49. Communication (iii) Stereotyped / repetitive use of language / idiosyncratic • Idiosyncratic = contextually irrelevant or not understandable to the listener; may have private meaning / be understood by the speaker or to those familiar to the situation (e.g. movie lines) • Can include: • Echolalia • Repeat videos / scripts • Nonsense language • Verbal Fascinations

50. (iv) Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level. • Compared to Developmental Level (Pg 26) • Play Scheme vs. Directive • Repetitive Play