Essentials of Autism Spectrum Disorders Evaluation and Assessment

CELINE A. SAULNIER, PhD, worked in the Yale Child Study Center’s Autism Program for nearly a decade. Then, she joined the faculty at Emory University’s School of Medicine and the Marcus Autism Center. Currently, she owns her own company, Neurodevelopmental Assessment & Consulting Services. PAMELA E. VENTOLA, PhD, is an Associate Professor in the Yale Child Study Center and leads the Rare Disease and Pediatric Center of Excellence at Cogstate, supporting industry-sponsored clinical trials. She also has extensive clinical and research experience with diagnostic, developmental, and neuropsychological assessments with individuals with ASD across the life span.

About the Authors x

Series Preface xi

Preface xiii

Acknowledgments xiv

One Overview 1

Diagnostic Criteria 1

References 7

Two Assessment of Developmental and Cognitive Skills 9

Selecting Instruments 10

Developmental and Early Cognitive Measures 12

Measures of Cognition and Intelligence in School-Age

Individuals and Adults 16

Measures of Nonverbal Intelligence 19

Neuropsychological Assessments 20

Qualitative Observations 22

Summary 23

References 24

Test Yourself 26

Answers 27

Three Speech, Language, and Communication Assessment 28

Receptive Language 31

Expressive Language 32

Pragmatic Language/Social Communication 34

Stages of Language Development 36

Formulation of Findings 38

Summary 38

References 42

Test Yourself 43

Answers 43

Four Assessment of Adaptive Behavior, Executive Functioning, and

Behavioral Regulation Skills 45

Assessment of Adaptive Behavior 45

Assessment of Executive Functioning 52

Assessment of Behavioral Regulation Skills 53

Summary 56

References 56

Test Yourself 58

Answers 59

Five Developmental History and Record Review 60

Clinical Interview 61

Methods of Collecting Information on Current and

Historical Presentation 70

Summary 74

References 75

Test Yourself 75

Answers 76

Six Direct Diagnostic Assessment 77

Screening Measures for Risk of ASD 77

Diagnostic Rating Scales 79

Direct Diagnostic Assessment 81

Considerations for First-Time Diagnostic Evaluations with Adolescents and Adults 94

Direct Measures of Autism Symptomatology 96

Options for Remote/Telehealth Diagnostic Assessments for ASD 99

Summary 100

References 101

Test Yourself 103

Answers 104

Seven Diagnostic Differentials and Co-Occurring Conditions 105

Intellectual Disability 106

Communication Disorders 110

Learning Disabilities 111

Attention Deficit/Hyperactivity Disorder 114

Anxiety Disorders 115

Depression and Mood Disorders 116

Obsessive-Compulsive Disorder (OCD) 118

TIC Disorders and Tourette’s Disorder 119

Psychiatric Conditions in Adulthood 120

Summary 122

References 123

Test Yourself 125

Answers 127

Eight Catching the Misdiagnosed, Late Diagnosed, and Missed for Diagnosis 128

Factors Related to Racial, Ethnic, Socioeconomic, and Geographical Disparities 129

Factors Related to Sex Differences in ASD Symptomatology 130

Factors Related to Gender and Sexual Identity Development 133

Factors Related to Subtle or Complex Symptom Expression 134

References 136

Test Yourself 137

Answers 138

Nine Preparing for Transition to Adulthood 139

Idea and Transition Planning 139

Assessments Supporting the Transition Plan Process 140

Needs to Consider for Adulthood 146

Job Coaching and Vocational Training 148

Academic Accommodations and Modifications 149

Life Skills and Life Coaching/Mentoring 151

Transitional and College-Preparation Programs 153

References 156

Test Yourself 159

Answers 160

Ten Diagnostic Formulations and Case Conceptualizations 161

Providing Feedback of Results 161

The Written Report 162

Case Samples 163

Case Sample 1: Initial Diagnosis—Toddler 164

Case Sample 2: Re-Evaluation—School-Aged Child with Complex Presentation 175

Case Sample 3: Initial Diagnosis: Adult Female 191

Chapter Summary 205

Author Index 206

Subject Index 000