Sunday, September 25, 2022

Standardized Assessments For Autism In Adults

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Comprehensive Developmental Evaluation of Assessment of Autism Spectrum Disorder (ASD)

As the authors of one case study stated, we should make the least dangerous assumption, which suggests that when there is no absolute evidence , it is essential to make the safest and most respectful assumption that would be least dangerous to the individual if proven to be false.

Soma Mukhopadhyah, the inventor of RPM, did just that with Tito, her nonverbal son. She taught him a lot, either by reading extensively to him, talking directly to him, or exposing him to interesting places. She assumed he was smart, and she was right Tito is now a published writer.

And that kind of treatment is what those like Reyes probably want, too. As he succinctly wrote in another article: To help me best, please see me as an equal human being as you. That means treat me the way you want to be treated.

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Assessing Repetitive And Restricted Behaviors

Repetitive and restricted behaviors include such habits and routines as lining up objects or arranging them in patterns, fiddling obsessively with objects or insisting that aspects of a daily routine remain exactly the same. The RBQ-2 test is designed to indicate when such behaviors are unusually frequent or severe.

To determine the tests reliability, autism experts at Cardiff University and La Trobe University, in Melbourne, asked 311 British and Australian adults to complete the test. Around half had already been diagnosed with autism. The other half were not.

Though some adults without autism showed a high tendency for repetitive behaviors, those with an autism diagnosis scored significantly higher on the test.

How Adults Discover They May Be On The Autism Spectrum

A recent CDC study reported that 2.2% of American adults are on the autism spectrum. This information was based on projections of how many children had been diagnosed with autism or a related condition that the DSM-5 now considers autism.

There may be more adults with autism who are diagnosed much later in life. However, there are few screening tools that are designed specifically for adults, so many medical professionals rely on talking about childhood experiences or on information their client gathered while self-diagnosing, which the medical professional can expand on.

If you are an adult with autism, you might have:

  • Been diagnosed with a mental or behavioral health disorder, or an intellectual disability, as a child but now understand those symptoms as closer to autism.
  • Felt socially isolated, different, or alone without understanding how to solve the problem.
  • Read about autism and recognized symptoms in yourself or feel acutely that your experience is being described.
  • A child in your family who has been diagnosed with autism, and you recognize the symptoms in yourself based on their diagnosis.

While you may suspect you have autism, you cant officially diagnose yourself. You need a doctor to assess you and make an official diagnosis.

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Assessment Of Social And Communication Skills For Individuals With Autism Spectrum Disorders

The Assessment of Social and Communication Skills for Individuals with Autism Spectrum Disorder, Revised was previously the Social Skills Checklist. It was designed to assess skills, prioritize needs, target goals, and plan intervention. The ASCS-2 includes three components that help to create childrens social and communication behavior profile, identify social learning obstacles, and assess social and communication skills. The tools may be used individually or together.

Limitations And Future Directions

Autism Assessment Tests

Third, we only investigated the 3Di-Adults psychometric properties in people without an intellectual disability. Given that between a third and half of people on the autism spectrum have an intellectual disability , and that it is likely that a substantial number autistic individuals with intellectual disability have reached adulthood without an ASC diagnosis , it will be important to investigate the reliability and validity of the 3Di-Adult in this group. Fourth, researchers were not blind to group which could have biased findings in favour of the 3Di-Adult. Mitigating against this, the second rater for the inter-rater reliability investigation was fully blinded, and registered a very high level of agreement with the original interviewers. Fifth, there were a higher proportion of males in the ASC group than in the control groups. However this is unlikely to have substantially confounded our findings of strong criterion validity, as the group differences we observed were very large, and we found no significant effects of gender on 3Di-Adult scores. Fourth, we did not have sufficient numbers to investigate whether the method of administration or who acted as the informant influenced the results. These are important concerns relevant to the efficient design of clinical services and research studies. Future work is required with large samples to compare the 3Di-Adults performance for different administration media and informants .

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Work With A Professional

Several websites offer self-diagnosis tests or quizzes for autism, but these are not definitive or even approved by medical practitioners who understand autism spectrum disorder. Reading information about autism, and the experiences of people who were diagnosed as adults, can be more helpful. This information can guide you into a discussion with your doctor, so you can get therapeutic support.

Restrictive And Repetitive Behaviors

  • You have trouble regulating your emotions and your responses to them.
  • Changes in routines and expectations cause strong feelings that may include outbursts or meltdowns.
  • When something unexpected happens, you respond with an emotional meltdown.
  • You get upset when your things are moved or rearranged.
  • You have rigid routines, schedules, and daily patterns that must be maintained no matter what.
  • You have repetitive behaviors and rituals.

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Sensory And Behavioral Symptoms

Many of these are common in all people with ASD, but may not be as obvious in those with mild autism. They may seem more like quirks than symptoms of autism.

  • You’re very sensitive to light, sound, smell, touch, and taste and do not like being touched or hugged.
  • You may need physical pressure to feel calm. You may hug yourself tight if you’re upset, for example.
  • You move in strange ways or make odd sounds. This is a form of self-calming called stimming. Examples include pacing, rocking, hair-twirling, and humming. If you’re in public, people may stare at you, but you can’t stop the behavior.
  • You have “autistic meltdowns.” You get very frustrated and upset, find it impossible to control your words and actions, and may even frighten other people.

How Will They Determine That I Am Autistic

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The characteristics of autism vary from one person to another, but in order for a diagnosis to be made, you will usually be assessed as having had persistent difficulties with social communication and social interaction and restricted and repetitive patterns of behaviours, activities or interests . These difficulties will have been present since early childhood and will have affected your everyday life.

There are several diagnostic tools available, and diagnosticians aren’t obliged to use a specific tool. The tool is likely to involve a series of questions about your developmental history from when you were a young child (for example, about language and play.

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Ages & Stages Questionnaires

The Ages & Stages Questionnaire, Third Edition is a standardized, parent-completed screening instrument useful for documenting developmental progress in communication, gross and fine motor, problem solving, and personal-social areas for children between 1 month and 5 years, 6 months.

Transition and Vocational Assessments

My Child Has Been Diagnosed With Autism What Happens Next

If your child has received a diagnosis of autism, we will, with your consent, inform the Autism SA My Pathways Team. A Pathways Consultant will then make contact with you directly in order to arrange a Newly Diagnosed Support meeting , where your ongoing needs and options in terms of next steps, support, available programs, NDIS funding, etc., will all be discussed.

This meeting will give you an opportunity to discuss your specific circumstances and needs, and the ways in which Autism SA can support you on your autism journey.

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What Is Autism Screening

Autism screening is usually administered by a pediatrician during a routine well-child checkup. The doctor may observe the child or ask you questions about his or her behaviors at home and while interacting with other children on the playground. The purpose of an autism screening is to identify common early signs of autism. The following are early signs of autism, however, they do not necessarily need to be present.

  • Delays in communicating with others including speech and gestures
  • Not responding to ones own name
  • Getting upset over minor changes in routine
  • Avoiding many, if not most, forms of physical contact
  • Showing little interest in objects or people

The American Academy of Pediatrics suggests that autism screenings should be part of standard 18 and 24-month well-child checkups, whereas the National Center on Birth Defects and Developmental Disabilities recommends that all children be screened at 9, 18, and 24 or 30 months.

Screenings administered during well-child checkups are only designed to indicate whether a child may be showing some early signs of autism. These screenings identify areas requiring further assessment and do not replace a formal diagnosis. Although many doctors follow the AAP and NCBDD guidelines, parents should also be proactive. If you suspect your child may have autism, please ask your childs pediatrician to administer screening or request a referral to a qualified specialist.

Ongoing Assessment For Autism

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Your childs school district and/or clinician may perform a Functional Behavioral Assessment. This evaluation seeks to determine causes for specific, often challenging, behaviors. Based primarily on observations in various settings, strategic intervention are developed to address these behaviors. Other assessments may include interviews with parents and teachers and completing behavioral and sensory rating scales.

It is recommended that families, educators, and pediatricians track their childs progress over time. Regular assessments help guide treatment choices throughout the entire lifetime. The Autism Treatment Evaluation Checklist , a frequently used, no-cost, online tool developed to monitor symptoms and behaviors and assess the effectiveness of various treatments over time.

The following webinar is the first in a two-part series about the importance of ongoing assessment and evaluation for children with symptoms of autism. It is presented by Claire Schute, Psy.D.

Watch to learn:

  • What assessment and evaluation are
  • The benefits of assessment and evaluation
  • About different types of assessments and evaluations
  • How to prepare for the assessment process

Families can also use the CDCs developmental milestone tracker to monitor child development and to help them decide whether its time to share their concerns with a physician.

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Support For Adults With Autism

Adults arent generally given the same support as children with ASD. Sometimes adults with ASD may be treated with cognitive, verbal, and applied behavioral therapy.

Note that certain therapies such as applied behavioral analysis are controversial in autistic communities. Some advocacy groups such as the Autistic Self-Advocacy Network do not support the use of ABA.

In general, youll want to seek out specific support based on the impacts youre experiencing. This might include anxiety, social isolation, relationship problems, or job difficulties.

Some possibilities include:

Importance Of Observation Skills In This Test

Question No. 01: I tend to notice, and may get disturbed by, small sounds that others may not notice or care about.

Explanation: You might often be unintentionally disturbed by small sounds. Although being occasionally disturbed should not be construed as a definitive sign of autism, if you find yourself to be constantly worrying about small noises and end up being disturbed, it may be a factor. That said, lower your probability of getting disturbed by smaller sounds or signals and you will lessen the symptoms of autism. Examples of small sounds: humming, phone vibrations, etc.

Question No. 02: I get fixated by tiny pieces of information.

Explanation: Have you often wondered why you get fixated by minute pieces of information when some of your colleagues or friends do not seem to be bothered by them? Although it is usually good practice to keep an eye on the details, being so concerned about smaller pieces of information that it ends up disturbing your normal life, could be a sign of autism.

Your propensity to keep a keen eye on minute pieces of information should be balanced. Extremities on either side of the scale should always be taken care of.

Question No. 03: I like to engage in activities or games with kids that involve pretending or make-believe.

Question No. 04: Even if I am reading a best-seller, often I dont understand what the characters are up to or what their intentions might be.

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Do I Need An Autism Diagnosis

Some adults may question whether they need a diagnosis later in life. Some people self-identify as autistic without receiving an official diagnosis. Its a personal decision. What can be helpful in receiving the label is access to supports and services that may not be available without a diagnosis, i.e. an income support program that provides additional income if mental health issues prevent being able to work full time. Maybe you need a job coach, a support person to look in on you a couple of times a week, specialized mental health services, or supports in the workplace. A diagnosis can also provide peace of mind and validation that indeed, you do have ASD.

Self-diagnosis in the adult autism community is widely accepted. You can join a support group or get together with other ASD adults without a formal diagnosis. Pursuing a diagnosis can be expensive as most health plans wont cover the cost and it can be difficult to find a professional who is adept at providing an adult diagnosis.

What Is A Psychological Evaluation

Autism Diagnostic Evaluation Process

Psychological evaluations take place in school and in outpatient medical settings such as hospitals and private behavioral health practices. The process is often similar across these settings, but will serve a different purpose. Outpatient evaluations result in medical diagnoses while educational evaluations determine eligibility for special education services.

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Assessment Criteria For A Child To Receive An Autism Diagnosis

The interactions and observations made during the assessment, developmental history, plus information gathered during the referral process, are then considered by the Diagnostic Team in light of the criteria for diagnosing autism as set out in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders more commonly referred to as DSM-5.

In DSM-5, there are two domains necessary for a diagnosis of autism to be made:

  • Social communication and social interaction, and
  • Repetitive or restricted behaviour, interests or activities.

Based on all the information we have gathered from others and our own observations, we assess whether any combination of signs and characteristics of autism displayed by your child in these two domains are causing significant challenges in their social, personal, family or educational lives.

If so, it is likely that they will be diagnosed as being on the autism spectrum.

Arguments For A Standard Assessment Battery

Researchers and clinicians do not always rely on the same set of assessments when evaluating study participants or patients. In fact, their selection of assessments varies considerably and may depend on cost as well as the amount of time required and the ease of administering them. However, one cannot assume that all assessments are equally sensitive when measuring the same SBC.

I believe that it is time for us to actively make comparisons between assessments. This will allow us to weed out assessments that may be less useful, and to rely only on the most accurate as well as the most valid and reliable tests.

Narrowing down the current number of assessments to a standardized battery will admittedly be a challenging job. However, the results will benefit all professionals working with individuals with ASD.

With respect to research, for instance, it is preferable to compare findings using the same assessment measures, especially when researchers are attempting to replicate previous findings. As researchers as well as critics often comment, the autism field is replete with mixed findings. Although the heterogeneity of the spectrum is one reason for such discrepancies, the use of different assessment measures is another significant factor.

A standard battery of assessments is the first step needed to develop an evidence-based standard of care for those on the autism spectrum. Now is the time for those of us in the autism field to take this step.

Stephen M. Edelson, Ph.D.

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Effect Of Cannabis Treatment On Additional Behavioral Domains

We also examined changes in adaptive behaviors and cognitive abilities, two behavioral domains that have not been examined to date in Cannabis treatment studies. The results revealed a significant improvement in adaptive behaviors as measured by the Vineland. This overall improvement was primarily driven by improvements in social, communication, and daily living sub-scale scores that were all significant. In contrast, cognitive assessments did not reveal any changes following treatment. These results demonstrate that CBD-rich cannabis treatment at least does not seem to have detrimental effects on cognitive function.

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