Chapter 3 Flashcards
SLPs are a valuable resource on teams diagnosing ASD
Extensive knowledge of ____ ____ skills
Building ____ profile
Identifying areas of ____
SLPs are a valuable resource on teams diagnosing ASD
Extensive knowledge of social communication skills
Building communicative profile
Identifying areas of concern
Early intervention for autism is ideal
More about early intervention in Week ____
Developmental surveillance recommended for well-child visits through ____ -months
Recommended that children be screened for autism at ____ and ____ months
Early intervention for autism is ideal
More about early intervention in Week 5
Developmental surveillance recommended for well-child visits through 30-months
Recommended that children be screened for autism at 18 and 24 months
Further developmental evaluation is required when a child ____ to meet any of the following milestones
____ by 12 months
____ by 12 months
____ words by 16 months
____ -____ spontaneous (not just echolalic) phrases by 24 months
Loss of any ____ or ____ skills at any ____
Further developmental evaluation is required when a child fails to meet any of the following milestones
Babbling by 12 months
Gesturing by 12 months
Single words by 16 months
Two-word spontaneous (not just echolalic) phrases by 24 months
Loss of any language or social skills at any age
Further developmental evaluation is required when a child fails to meet any of the following milestones
Babbling by ____ months
Gesturing by ____ months
Single words by ____ months
Two-word spontaneous (not just echolalic) phrases by ____ months
Loss of any language or social skills at any age
Further developmental evaluation is required when a child fails to meet any of the following milestones
Babbling by 12 months
Gesturing by 12 months
Single words by 16 months
Two-word spontaneous (not just echolalic) phrases by 24 months
Loss of any language or social skills at any age
Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (Wetherby & Prizant, 2002)
Screening tool for communication delays in children 6-24 mos.
Modified Checklist for Autism in Toddlers (Robbins et al., 1999) and Screening Tool for Autism in Two-Year-Olds (Stone & Ousley, 2004)
Specific screeners for autism in young children
Social Communication Questionnaire (Rutter et al., 2003) and Autism Spectrum Screening Questionnaire (Ehlers et al., 1999)
Screeners for older children or children who are on mild end of spectrum
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Early parental concerns
Child’s decreased ____ or ____ communication
Difficulty in ____ interaction
Problem ____ (often related to communication difficulties)
Case study: “Mom has anxiety about her child when he’s at school, since he cannot communicate”
Early parental concerns
Child’s decreased nonverbal or verbal communication
Difficulty in peer interaction
Problem behaviors (often related to communication difficulties)
Case study: “Mom has anxiety about her child when he’s at school, since he cannot communicate”
Multidisciplinary nature of diagnosis SLPs can diagnose autism if they have significant \_\_\_\_ working with ASD population However, is more generally a team diagnosis \_\_\_\_ \_\_\_\_ Clinical or school \_\_\_\_ \_\_\_\_ \_\_\_\_ \_\_\_\_ \_\_\_\_
Multidisciplinary nature of diagnosis SLPs can diagnose autism if they have significant experience working with ASD population However, is more generally a team diagnosis SLP Physician Clinical or school psychologist Educator OT PT RN
No medical ____ , ____ , etc. that can diagnose ASD
Diagnosed through direct ____ and ____ collected from people who know the child
No medical test, bloodwork, etc. that can diagnose ASD
Diagnosed through direct observation and information collected from people who know the child
SLP can administer these ____ standard measures if they receive proper training to do so
Autism Diagnostic Observation Schedule-2nd Ed. (Lord et al., 2012)
Autism Diagnostic Interview-R (Rutter et al., 2003)
SLP can administer these common measures, although they are more likely to be done by a ____ or ____
Childhood Autism Rating Scale- 2nd Ed. (Schopler et al., 2010)
Gilliam Autism Rating Scale- 2nd Ed. (Gilliam, 2006)
Note: It is not imperative for SLP to know how to ____ these tests, but they must ____ results and how they relate to ____ needs
SLP can administer these gold standard measures if they receive proper training to do so
Autism Diagnostic Observation Schedule-2nd Ed. (Lord et al., 2012)
Autism Diagnostic Interview-R (Rutter et al., 2003)
SLP can administer these common measures, although they are more likely to be done by a physician or psychologist
Childhood Autism Rating Scale- 2nd Ed. (Schopler et al., 2010)
Gilliam Autism Rating Scale- 2nd Ed. (Gilliam, 2006)
Note: It is not imperative for SLP to know how to administer these tests, but they must understand results and how they relate to intervention needs
Assessment of ASD must stay away from averaging across abilities/deficits to come to one “____ ”
____
____ skills
Examples?
Variety of multiple assessments should be administered
Dependent upon ____ and ____ of assessment
Assessment of ASD must stay away from averaging across abilities/deficits to come to one “score”
Misrepresentation
Splinter skills
Examples?
Variety of multiple assessments should be administered
Dependent upon child and goals of assessment
Types of measures used in assessment with children with ASD
____ -____ measures- ____ to compare an individual’s ____ to that of a ____ , normative group
Preferred by ____ companies and ____ districts because of standardized results
However, often hard to administer due to deficits in ASD
____ assessment tools may not ____ detect ____ language and ____ deficits in ASD, thus skewing evaluation
Types of measures used in assessment with children with ASD
Norm-referenced measures- standardized to compare an individual’s performance to that of a larger, normative group
Preferred by insurance companies and school districts because of standardized results
However, often hard to administer due to deficits in ASD
Formal assessment tools may not accurately detect social language and communication deficits in ASD, thus skewing evaluation
Types of measures continued
____ -referenced measures- provide a comparison of individual ____ to a set expected ____ of performance; level of ____ , not ____ to other ____ ’s performance levels
Can be ____ or ____
High level of ____ and are also accepted for ____ or ____ purposes
Similar to norm-referenced measures, does not allow for individualization of administration
Not as desirable as Norm-Referenced measures
Types of measures continued
Criterion-referenced measures- provide a comparison of individual performance to a set expected level of performance; level of skill, not compared to other children’s performance levels
Can be standardized or nonstandardized
High level of objectivity and are also accepted for school or insurance purposes
Similar to norm-referenced measures, does not allow for individualization of administration
Not as desirable as Norm-Referenced measures
Types of measures continued
____ assessments, including ____ and ____ checklists- provide information about what an individual does or does not do in ____ -____ situations
____ -structured
____ sampling, ____ sampling, ____ , teacher, and caregiver ____ , ____ analysis
Allows for greatest amount of ____ and individualization
Provides information that might otherwise be difficult to attain
Requires more specialized skill from clinician, ____ planning time
____ preferred by schools and insurance companies
Provides information that might otherwise be difficult to obtain – esp. those communication aspects.
Types of measures continued
Authentic assessments, including observational and caregiver checklists- provide information about what an individual does or does not do in real-life situations
Semi-structured
Language sampling, speech sampling, developmental, teacher, and caregiver checklists, play analysis
Allows for greatest amount of flexibility and individualization
Provides information that might otherwise be difficult to attain
Requires more specialized skill from clinician, increased planning time
Not preferred by schools and insurance companies
Provides information that might otherwise be difficult to obtain – esp. those communication aspects.
Preparing for an assessment that may result in ASD diagnosis
- Talk with ____ , ____ , or other ____
- Review any previous ____ from medical or educational professionals for insight into the child’s individual ____ and/or ____ profile
- ____ parents, teachers, or other communicative partners to ____ and ____ in the assessment session
- Consider the ____ of ____ sessions
- Set up the testing ____ to ____ the child’s ____
Preparing for an assessment that may result in ASD diagnosis
- Talk with parents, teachers, or other caregivers
- Review any previous evaluations from medical or educational professionals for insight into the child’s individual medical and/or learning profile
- Schedule parents, teachers, or other communicative partners to observe and participate in the assessment session
- Consider the length of testing sessions
- Set up the testing environment to maximize the child’s performance
Preparing for an assessment that may result in ASD diagnosis continued
- Prepare ____ supports for use ____ to and ____ the evaluation to explain ____ and ____ to the child
- Give the child an ____ to meet you ____ to the evaluation
- Carefully plan the ____ of ____ activities to alternate ____ and more ____ , as well as ____ versus ____ -____ tasks
- Prepare ____ ____
- Plan to ____ performance in ____ ways
Preparing for an assessment that may result in ASD diagnosis continued
- Prepare visual supports for use prior to and during the evaluation to explain changes and expectations to the child
- Give the child an opportunity to meet you prior to the evaluation
- Carefully plan the order of assessment activities to alternate easier and more challenging, as well as preferred versus non-preferred tasks
- Prepare communicative temptations
- Plan to observe performance in multiple ways
During the evaluation
- Allow the child to ___ the ____ before testing begins
- Provide a ____ schedule and a ____ schedule that individualized to the child
- Allow the child to be actively involved in ____ task completion
- Begin assessment with items the child can feel ____ with and present a broad range of tasks
- Do not ____ directions too many times or too loudly
- Consider the ____ level of the child when choosing materials
- Be cautious with introduction of highly ____ materials during the assessment
- Have materials to prepare quick ____ supports
- Further probe skills from ____ tests to dynamically assess if the child is more successful with alternative prompts, formats, or cues
- Provide ____ breaks as needed
- End the session on a ____ note
During the evaluation
- Allow the child to explore the environment before testing begins
- Provide a visual schedule and a reinforcement schedule that individualized to the child
- Allow the child to be actively involved in monitoring task completion
- Begin assessment with items the child can feel successful with and present a broad range of tasks
- Do not repeat directions too many times or too loudly
- Consider the age level of the child when choosing materials
- Be cautious with introduction of highly preferred materials during the assessment
- Have materials to prepare quick visual supports
- Further probe skills from standardized tests to dynamically assess if the child is more successful with alternative prompts, formats, or cues
- Provide sensorimotor breaks as needed
- End the session on a positive note
Comprehensive social communication assessment
____ communication- achievement of communicative competence through communicating and playing with others in everyday activities and sharing joy and pleasure in social relationships
Two components
Capacity for ____ ____
Capacity for ____ ____
Comprehensive social communication assessment
Social communication- achievement of communicative competence through communicating and playing with others in everyday activities and sharing joy and pleasure in social relationships
Two components
Capacity for joint attention
Capacity for symbol use
____ ____
Capacity to attend to and respond to social overtures of others
Occurs through sharing of ____, ____, and ____
Foundation for reciprocal communication
Crucial ____ skill
Basis for early language learning
Joint attention
Capacity to attend to and respond to social overtures of others
Occurs through sharing of attention, emotion, and intentions
Foundation for reciprocal communication
Crucial prelinguistic skill
Basis for early language learning
Joint attention in children with ASD
Difficulty ___ into and ___ others’ attention and interests to objects in their shared world
Leads to ____ language learning
____ of autism
Joint attention in children with ASD
Difficulty following into and directing others’ attention and interests to objects in their shared world
Leads to decreased language learning
Hallmark of autism
Characteristics of joint attention in children with ASD
Difficulty ____ to speech sounds in infancy
Reduced ____ looking
Decreased _____ and ____
Difficulty _____ others’ ____ focus
Reduced ____ ____
Decreased use of _____ _____ and _____ focus for intended communicative partner
In ____ children, difficulty following and using ____ ____ during ____; difficulty _____-____, especially in _____
Characteristics of joint attention in children with ASD
Difficulty orienting to speech sounds in infancy
Reduced referential looking
Decreased pointing and showing
Difficulty following others’ attentional focus
Reduced social referencing
Decreased use of gestures paired and attentional focus for intended communicative partner
In verbal children, difficulty following and using eye gaze during conversation; difficulty turn-taking, especially in groups
Symbol use
Governs language, both verbal and nonverbal aspects
Semantics, syntax, and morphology usage
Reduced ____ use in children with ASD
____ use of ____ gestures (e.g., using caregiver’s hand as tool by placing person’s hand on desired item)
May use problem behaviors to communicate
Symbol use
Governs language, both verbal and nonverbal aspects
Semantics, syntax, and morphology usage
Reduced gesture use in children with ASD
Extended use of presymbolic gestures (e.g., using caregiver’s hand as tool by placing person’s hand on desired item)
May use problem behaviors to communicate
Relationships between cognitive, linguistic, and external factors in symbolic language
External influences \_\_\_\_ \_\_\_\_ knowledge Exposure to \_\_\_\_ Instruction
Cognitive components \_\_\_\_ \_\_\_\_ \_\_\_\_ taking \_\_\_\_ \_\_\_\_ \_\_\_\_ \_\_\_\_ \_\_\_\_\_ \_\_\_\_
Linguistic components \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_
Relationships between cognitive, linguistic, and external factors in symbolic language
External influences Experiences Background knowledge Exposure to print Instruction
Cognitive components Executive function Perspective taking Central coherence Motivation Joint attention Memory
Linguistic components Pragmatics Phonology Syntax Morphology Semantics
Cognitively and linguistically, children with ASD are ____ learners v. _____ learners
Do not move through developmental _____ of _____ acquisition (e.g., single words, two-word utterances)
Immediate and delayed ____ reflects this ____ style
____ can be utilized to benefit helping _____ functions
Cognitively and linguistically, children with ASD are gestalt learners v. analytical learners
Do not move through developmental hierarchy of language acquisition (e.g., single words, two-word utterances)
Immediate and delayed echolalia reflects this processing style
Echolalia can be utilized to benefit helping communicative functions
Gestalt – whole is greater than the sum of its parts.
Children with ASD don’t show that linear hierarchy of language. Explains echolalia?
Full assessment of both ____ and structural _____ skills
Need to get a clear picture of _____, as distribution of skills can be ____
Full assessment of both conversational and structural language skills
Need to get a clear picture of abilities, as distribution of skills can be skewed
Communication behaviors often seen in chidlren with ASD \_\_\_\_ (immediate, delayed, mitigated) Misuse of \_\_\_\_ or \_\_\_\_ \_\_\_\_ \_\_\_\_ language \_\_\_\_ routines Decreased \_\_\_\_ language Decreased \_\_\_\_ to \_\_\_\_
Immediate – traditional echolalia. ____ repeat what was just said.
Delayed – ____ repeat ____ utterances heard previously.
Mitigated – ____ on the _____ of repeated language.
Verbal routines – “What do you do when you meet someone for the first time?”
Communication behaviors often seen in chidlren with ASD
Echolalia (immediate, delayed, mitigated)
Misuse of pronouns or pronoun reversals
Idiosyncratic language
Verbal routines
Decreased pragmatic language
Decreased responsiveness to speech
Immediate – traditional echolalia. Immediately repeat what was just said.
Delayed – later repeat multiword utterances heard previously.
Mitigated – variation on the chunk of repeated language.
Verbal routines – “What do you do when you meet someone for the first time?”
Areas of social communication assessment differ depending on level of verbal communication
_____ model
_____ _____ of _____ ____
____
____ verbal
____ verbal
Two of the theoretical basis for social communication. Levels of social communication.
Areas of social communication assessment differ depending on level of verbal communication
SCERTS model
McDonald progression of social communication
Preverbal
Emerging verbal
Fluently verbal
Two of the theoretical basis for social communication. Levels of social communication.
Assessing the ____ act
Definition: “____ behavior that consists of a _____, ____, or ____ that is ____ toward another ____ and that serves a ____ function” (Shumway & Wetherby, 2009)
Assessing the communicative act
Definition: “interactive behavior that consists of a gesture, vocalization, or verbalization that is directed toward another person and that serves a communicative function” (Shumway & Wetherby, 2009)
Developmental progression of communicative functions
____ regulation
____ interaction
____ attention
Children with ASD
Behavior regulation (primarily ____ or _____)
SLP must assess degree to which child with ASD goes beyond this basic level of ____ function
Developmental progression of communicative functions
Behavior regulation
Social interaction
Joint attention
Children with ASD
Behavior regulation (primarily request or protest)
SLP must assess degree to which child with ASD goes beyond this basic level of communicative function
Conversational/pragmatic language assessments
Pragmatic Protocol (Prutting & Kirschner, 1987)
Systematic Observation of Communicative Interaction (Damico et al., 1999)
Communication and Symbolic Behavior Scales (Wetherby & Prizant, 1993)
Standardized, structured format to elicit communication and play
Communication and Symbolic Behavior Scales is geared towards autism specifically
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Play assessment \_\_\_\_ development mirrors \_\_\_\_\_ achievements, typically \_\_\_\_ understanding/symbol systems Shared \_\_\_\_ on objects \_\_\_\_ routines Dimensions of play to consider Level of \_\_\_\_ demonstrated How the play involves others \_\_\_\_
Play assessment Play development mirrors language achievements, typically Symbolic understanding/symbol systems Shared attention on objects Social routines Dimensions of play to consider Level of symbolism demonstrated How the play involves others socially
In children with ASD
Decreased ____ imitation skills due to decreased ____ ____
Leads to difficulty integrating into ____ ____ and _____
In children with ASD
Decreased spontaneous imitation skills due to decreased joint attention
Leads to difficulty integrating into peer groups and relationships
Children with ASD
____ play extends for ____ time period; more ____ and _____
____ sensorimotor exploration due to _____ ____ differences
____ exploratory play
____ and/or ____ play schemas
___ or ____ functional and ____ play
Less ____ functional play
Pretend play may surround stereotypical interests or be comprised of scripts from TV, etc.
Sensorimotor play extends for a longer time period
The reason is because of the sensory processing differences.
Children with ASD
Manipulation play extends for longer time period; more repetitive and restricted
Increased sensorimotor exploration due to sensory processing differences
Ritualized exploratory play
Inflexible and/or stereotypical play schemas
Decreased or absent functional and pretend play
Less diverse functional play
Pretend play may surround stereotypical interests or be comprised of scripts from TV, etc.
Sensorimotor play extends for a longer time period
The reason is because of the sensory processing differences.
Observation of ____ play skills
Observe in multiple _____
Observe in multiple ____ of ____
Observe multiple ____ of ____ activities with different materials
Keep in mind that different scenarios elicit different play skills
Observation of symbolic play skills
Observe in multiple contexts
Observe in multiple levels of structure
Observe multiple types of play activities with different materials
Keep in mind that different scenarios elicit different play skills
Children with ASD
Levels of social play skills vary greatly between children
Difficulty ____ to ____’ play attempts
Difficulty ____ play with peers
Difficulty playing ____ with peers
____ and _____ play may show skill discrepancy
“How does the child play with people?”
Children with ASD
Levels of social play skills vary greatly between children
Difficulty responding to peers’ play attempts
Difficulty initiating play with peers
Difficulty playing appropriately with peers
Symbolic and social play may show skill discrepancy
“How does the child play with people?”
Assessment of speech Children with ASD Increased \_\_\_\_ of \_\_\_\_ \_\_\_\_ \_\_\_\_ (SSD) Increased difficulty in \_\_\_\_ skills development (e.g., apraxia) \_\_\_\_ \_\_\_\_ of \_\_\_\_ is a possible reason as to why some children with ASD remain \_\_\_\_\_ Difficulty with \_\_\_\_, \_\_\_\_\_, \_\_\_\_, \_\_\_\_\_ Increased \_\_\_\_\_/\_\_\_\_ Increased \_\_\_\_ Higher \_\_\_\_\_
Assessment of speech
Children with ASD
Increased rates of speech sound disorders (SSD)
Increased difficulty in motor skills development (e.g., apraxia)
Childhood apraxia of speech is a possible reason as to why some children with ASD remain nonverbal
Difficulty with prosody, pitch, duration, intensity
Increased intensity/loudness
Increased repetitions
Higher pitch
Interrelationships between language processes
Difficulty with ____ is expected in children with ASD
No one profile of literacy associated with ASD
Possible to ____ literacy despite significant ____ ____ delay, even in _____ children with ASD
Interrelationships between language processes
Difficulty with literacy is expected in children with ASD
No one profile of literacy associated with ASD
Possible to acquire literacy despite significant oral language delay, even in nonverbal children with ASD
____- superior word _____ skills despite ____ _____ difficulties that lead to poor _____ comprehension
In ASD, may result from ____ with reading
Hyperlexia- superior word recognition skills despite cognitive linguistic difficulties that lead to poor reading comprehension
In ASD, may result from preoccupation with reading
SLP should look for abilities and areas of difficulty for: \_\_\_\_ language skills \_\_\_\_\_ literacy skills \_\_\_\_\_ awareness \_\_\_\_-word \_\_\_\_ and \_\_\_\_\_ skills \_\_\_\_\_ reading skills (reading accuracy, fluency) \_\_\_\_\_ comprehension \_\_\_\_\_ composition
SLP should look for abilities and areas of difficulty for: Oral language skills Emergent literacy skills Phonemic awareness Single-word reading and spelling skills Connected reading skills (reading accuracy, fluency) Reading comprehension Writing composition
Assessments listed on pgs. 70-71 of textbook by skill topic
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