Saint Paul Public Schools Autism Spectrum Disorders Autism Spectrum Disorders (ASD) refer to a group of related disorders characterized by impaired communication and socialization and by a limited range of interests. Autism Spectrum Disorders develop early in life and have implications for education, social development, and community participation. Autism Spectrum Disorders affect students differently. The cause of Autism Spectrum Disorders is unknown, but most likely results from a variety of factors such as heredity, environment, and brain functioning. Autism Spectrum Disorders are not rare and affect as many as 1 out of 110 children. Autism Spectrum Disorders Include: Autism Asperger’s Disorder Pervasive Developmental Disorder-Not Otherwise Specified Rett’s Syndrome Childhood Disintegrative Disorder. Possible Behaviors Consistent with ASD: Difficulty making friends and understanding social rules Delayed or repetitive language Preoccupied with one or two subjects or activities Lack of imaginative play Under or over sensitivity to stimuli such as noise, light, or unexpected touch Uneven development of cognitive skills Problems reading the emotions of others and taking another’s perspective Problems initiating and maintaining interactions Engaging in repetitive motor movements Difficulty understanding verbal information Difficulty understanding multi-step directions Difficulty screening distractions and multi-tasking Difficulty initiating work activities Problems organizing free time Difficulty being flexible and adjusting to changes in routine Rote memory may be a relative strength Instructional Strategies and Classroom Accommodations: Maintain a consistent classroom routine Foster a structured, predictable, calming environment Avoid long strings of verbal directions Minimize visual and auditory distractions Teach functional learning skills through direct teaching Direct teaching of social skills Encourage areas of talent such as drawing, art, or computers Use student’s topic of interest in content for lessons If student avoids eye contact, allow student to use peripheral vision Foster a climate of understanding in the classroom Intervene early to avoid meltdowns Collaborate with parents and professionals *Adapted from Children’s Mental Health Disorder Fact Sheet for the Classroom from the Minnesota Association for 1 Children’s Mental Health Saint Paul Public Schools 360 Colborne Street St. Paul, MN 55102 Tel: 651-767-8321 Fax: 651-228-3626 Autism Spectrum Disorders Eligibility Checklist Student LEARNER: MARSS ID: District ID: School Gender Grade DOB Home Language: Autism Spectrum Disorders Eligibility Verification Checklist When completing a reevaluation, the Evaluation Team must demonstrate that the student continues to be discrepant from peers based on performance data. This checklist is being used for a(n): __Initial Evaluation __Reevaluation DEFINITION: “Autism spectrum disorders (ASD)” means a range of pervasive developmental disorders, with onset in childhood, that adversely affects a pupil’s functioning and result in the need for special education instruction and related services. ASD is a disability category characterized by an uneven developmental profile and a pattern of qualitative impairments in several areas of development, including social interaction, communication, or the presence of restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. These core features may present themselves in a wide variety of combinations that range from mild to severe, and the number of behavioral indicators present may vary. ASD may include Autistic Disorder, Childhood Autism, Atypical Autism, Pervasive Developmental Disorder not Otherwise Specified, Asperger’s Disorder, or other related pervasive developmental disorders. CRITERIA: A multidisciplinary team shall determine that the pupil is eligible and in need of special education instruction and related services if the pupil meets the criteria in items A and b. A determination of eligibility must be supported by information collected from multiple settings and sources. Item A. An educational evaluation must address all three core features in sub items 1. to 3. The team must document that the pupil demonstrates patterns of behavior described in at least two of these sub items, one of which must be sub item 1. The behavioral indicators demonstrated must be atypical for the pupil’s developmental level. The team shall document behavioral indicators through at least two of these methods: structured interviews with the parents/guardians, autism checklists, communication and developmental rating scales, functional behavior assessments, application of diagnostic criteria from the current diagnostic and Statistical Manual (DSM), informal and standardized evaluation instruments, or intellectual testing. Yes No Sub.1. Qualitative impairment in social interaction, as documented by two or more behavioral indicators, for example: • Limited joint attention and limited use of facial expressions directed toward others • Does not show or bring things to others to indicate an interest in the activity • Demonstrates difficulties in relating to people, objects, and events • A gross impairment in ability to make and keep friends • Significant vulnerability and safety issues due to social naiveté • May appear to prefer isolated or solitary activities • Misinterprets others’ behaviors and social cues 2 • Other Yes No Yes No Sub.2. Qualitative impairment in communication, as documented by one or more behavioral indicators, for example: • Not using finger to point or request • Using others’ hand or body as a tool • Showing lack of spontaneous imitations or lack of varied imaginative play • Absence or delay of spoken language • Limited understanding and use of nonverbal communication skills, such as gestures, facial expressions, or voice tone • Odd production of speech including intonation, volume, rhythm, or rate • Repetitive or idiosyncratic language or inability to initiate or maintain a conversation when speech is present • Other Sub.3. Restricted, repetitive, or stereotyped patterns of behavior, interest, and activities, As documented by one or more behavioral indicators, for example: • Insistence on following routines or rituals • Demonstrating distress or resistance to changes in activity • Repetitive hand or finger mannerism • Lack of true imaginative play versus reenactment • Overreaction or under-reaction to sensory stimuli • Rigid or rule-bound thinking • An intense, focused preoccupation with a limited range of play, interests, or conversation topics • Other Include at least two of these methods ___Structured Interview with Parents ___Autism Rating Scale or Checklist(s) ___Communication and Developmental Scales ___Functional Behavior Assessment ___ Application of DSM-IV Criteria ___ Informal and Standardized Evaluation Instruments ___Intellectual Testing Item B. The team shall document and summarize in an evaluation report that ASD adversely affects a pupil’s performance and that the pupil is in need of special education instruction and related services. Documentation must include: ___Yes ___No ___Yes ___No ___Yes ___No B.1. An evaluation of the pupil’s present levels of performance and educational needs in each of the core features identified by the team in item A. In addition, the team must consider all other areas of educational concerns related to the suspected disability; B.2. Observations of the pupil in two different settings, on two different days; B.3. A summary of the pupil’s developmental history and behavior patterns. Sub.4. Team Membership: The team determining eligibility and educational programming must include at least one professional with experience and expertise in the area of ASD due to the complexity of this disability and the specialized intervention methods. The team must include a school professional knowledgeable of the range of possible special education eligibility criteria. Sub.5. Implementation: Pupils with various educational profiles and related clinical diagnoses may meet the criteria of ASD. However, a clinical or medical diagnosis is not required for a pupil Yes No Yes No 3 to be eligible for special education services, and even with a clinical or medical diagnosis, a pupil must meet the educational criteria. Saint Paul Public Schools ASD EVALUATION PROCEDURES INITIAL EVALUATION Pre-referral interventions need to be completed & need to address referral concern o Social interaction, social communication, repetitive/restricted behaviors. On-line referral completed, signed by principal, forwarded to child study team. Initial parent interview completed by social worker (or by special ed ELL staff). Child study team meets to discuss child including effectiveness of interventions and any outside testing and/or diagnosis o A DSM-IV diagnosis of Autism Spectrum Disorder is not required nor does it automatically qualify a student for a special education label. Building psychologists will consult with assigned ASD psychologist if needed prior to development of Prior Written Notice/Consent to Evaluate. At least ONE professional with experience in the area of ASD should be on the evaluation team. The team MUST include a school professional knowledgeable of the range of possible special education eligibility criteria. A. SUGGESTED COMPONENTS FOR INITIAL EVALUATION: o o o o o o o o o An instrument specific to evaluating ASD or review of assessment from outside agency Parent Interview specific to ASD that includes developmental history (Appendix A) Teacher Interview specific to ASD (Appendix D-F) Student Interview specific to (Appendix G) Two observations in two different settings on two different days (Appendixes H-J) Communication procedures that address pragmatic and social language often are included A Sensory Motor evaluation upon recommendations from the occupational therapist An Assistive Technology evaluation should be considered Any area of significant concern needs to be included in the evaluation (Intellectual, Academic, Communication, Motor, Sensory, Behavior, Functional, Health, Transition) 4 RE-EVALUATION o Case manager should contact parent, explain process, and complete parent interview to gather required parent information for the re-evaluation. Consider using the “ASD Parent Interview- Reevaluation” (Appendix B) in this guide. **Case manager should summarize parent concerns and be prepared to discuss at child study. o Case manager should review past evaluations and determine if initial criteria was met. Be prepared to discuss why student met criteria (core features) and any other areas of concern at child study. o As a pupil receives specialized intervention over time, you would expect to see gains made. It is not required that a student demonstrate the same level of severity upon reevaluation, however, the report must document what behaviors are present that are associated with ASD. The report also should document the ongoing educational needs for the student, based upon those behaviors that are still present. B. ADDITIONAL DATA NEEDED Consider the following procedures for ASD reevaluation if ADDITIONAL DATA is needed: o Review of Records: review of school history, school cum file information, attendance, discipline record, summary of previous interview information including developmental history o Review of Previous Testing: Summary of ASD rating scales/procedures from initial or subsequent evaluations. Review of any outside evaluations, including outside DSM-IV diagnosis, if available. o Parent and Teacher Interview: Update present level of performance in the three core features of ASD (Social Interaction, Communication, and Restricted Interests and Stereotyped Behaviors). Review behavioral indicators listed under each core feature from state ASD criteria as a guide. o Observations: 2 different settings (structured and unstructured) on two different days. o Procedures in other areas if concerns: Academic, Intellectual, Motor/Sensory, Health, Social/Emotional/Behavioral, FBA, Functional, Transition, Assistive Technology. Communication: new procedures if needed to address language skills / pragmatic language skills, or review of previous assessment and update on IEP goals/objectives. C. NO ADDITIONAL INFORMATION NEEDED: o The purpose of a reevaluation is to demonstrate continued eligibility. Remember, the present levels and progress towards goals should be reflected in the IEP including strengths and weaknesses. o The team needs to verify that the last evaluation included all the required components and additional data is not needed to verify eligibility and document educational needs. o All criteria components need to be addressed in the evaluation report. Assessment/test data that reflects the student’s current level of functioning (intellectual, academic, communication, motor, health, transition, etc.) should be summarized. o The report is written using existing information gathered prior to the consent to evaluate date. NO new evaluation procedures are completed (observations, formal interviews, FBA, informal academics measures, etc.). 5 Saint Paul Public Schools ASD Interviews and Observations Guidelines A developmental history/parent interview is required as part of criteria for Autism Spectrum Disorder (ASD). The developmental history is used to support formal testing, informal measures, observations, and other information. The purpose of a developmental history is to identify an early pattern of atypical socialization, social communication, and repetitive behavior patterns. Samples of some red flags to consider include: *No warm, joyful engagement by 5 months. *No two-way back and forth gesturing by 9 months *No babbling by 12 months *No pointing or other gestures by 12 months *No single words by 16 months *No two word, non-echolalic phrases by 14 months *Any loss of language/babbling at ANY age. For students with Asperger’s Disorder, early language delay is not always present. However, early concerns are often reported regarding difficulty with social interaction and repetitive interests. Some information may be available within the cumulative file, in outside reports, or other evaluation reports. **Always review file prior to evaluation plan and parent interview to avoid redundancy and to get a better idea about what areas need more information from parents. INITIAL EVALUATIONS: *The parent interview and developmental history will most often be completed by school social workers. Use the ASD Parent Interview/Developmental History form (Appendix A). RE-EVALUATIONS: * The Child Study/ IEP team will determine who reviews and updates the parent interview and developmental history. Use the ASD Developmental History/Parent Interview form or the ASD Parent Interview-Reevaluation form (Appendix A or B). OTHER FACTORS TO CONSIDER: REMINDER: If parents DO NOT report significant behavioral concerns it will be difficult to meet eligibility for ASD and/or EBD. CO-EXISTING EVALUATIONS WITH EMOTIONAL BEHAVIORAL DISABILITIES (EBD): *Familiarize yourself with both parent interview tools for ASD and EBD, so that you do not duplicate questions. Write the Developmental History/Parent Interview as one interview addressing all parts needed for both criteria for EBD and ASD. For example, address social interaction, communication, behaviors within the home, mental health issues, and restricted and stereotyped behaviors in the context of past and current functioning. ELL CONSIDERATIONS: *Take into account language issues, home and outside community experiences, and what is considered acceptable behaviors within the home. Cultural differences may occur, but are not limited to, the following areas: eye contact, response to touch, social games, play routines, responses to an interpreter, and reactions to new situations. 6 Teacher Interview: An interview with the classroom teacher focuses on behavioral indicators of autism spectrum disorders (social interaction, communication, restricted behaviors). The interview can be completed by the school psychologist, special education teacher, or social worker, depending factors such as ASD knowledge, knowledge of the student and additional interview components to consider another disability criteria. For example, if the team is also completing components for an EBD evaluation, integrate these questions into one teacher interview. If you are completing a Functional Behavior Assessment (FBA) as part of the evaluation, include questions regarding frequency of target behaviors, antecedents and settings that predict target behaviors, effective and ineffective strategies, and a hypothesis statement. Consider using Appendix D,E or F Student Interview: An interview with the student is not required for ASD criteria, but for higher functioning, more verbal students, it can provide additional information that address the core features of an autism spectrum disorder, such as providing information on how the student communicates and interacts in a social situation with an adult, their understanding of friendships, etc. If you are considering criteria for EBD, integrating these questions into the student interview would be helpful. Keep in mind that for more verbal students, if the ADOS is on the evaluation plan, these student interview questions are typically included in this procedure. Consider using Appendix G Observations: Two observations are required based on Minnesota criteria. These observations must be completed in two different settings on two different days. Complete one observation in a structured classroom setting and one observation in an unstructured setting, such as lunch or recess. Teams should determine who will complete the observations at the planning meeting. Focus on behavioral indictors of autism spectrum disorders (social interaction, communication, restricted behaviors) If an evaluation is being completed to address EBD components, combine observations to address behaviors of concern and issues related to possible ASD. Consider using Appendixes H, I or J or a data collection sheet such as the OHD Systematic Observation Form. ADDITIONAL RESOURCES Minnesota Low Incidence Projects: Autism Spectrum Disorders http://www.mnlowincidenceprojects.org/asdresources.html Minnesota Department of Education http://education.state.mn.us/mde/Learning_Support/Special_Education/Categorical_Disability_Information/Autism _Spectrum_Disorders/index.html Minnesota Criteria: Autism Spectrum Disorders 7 https://www.revisor.mn.gov/rules/?id=3525.1325 8