Speech Pathology Australia
Autism Spectrum Disorder Independent Study Resource
Self Assessment Task 1
In order to complete this self assessment task, the following resources are recommended:
a) Module 1 Screening, Assessment & Differential Diagnosis
Module 2 Intervention Models & Evidence Based Practice
Module 3 Working With Families
Module 6 Autistic Disorder; Using Augmentative Strategies
b) Register on the Positive Partnerships Website autismtraining.com.au to access the on line learning
modules and fact sheets.
c) Speech Pathology Association Evidence Based Speech Pathology Practice for Individuals with Autism
Spectrum Disorder Position Paper available on www.speechpathologyaustralia.org.au
d) Roberts, J. M. A., & Prior, M. (2006). A review of the research to identify the most effective models of
practice in early intervention of children with autism spectrum disorders. Australian Government
Department of Health and Ageing, Australia
Case History 1
Young child with Autistic disorder
Jessie attends your clinic with her mother for an initial contact appointment. Jessie is 18mths old
and during the initial interview, her mother reports:
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Jessie lives at home with her English speaking parents and 5 year old brother and 3 year old
sister.
She had been diagnosed by her paediatrician with global developmental delay.
She was slow with all her fine and gross motor development.
Jessie was described as “too content” as a baby.
Jessie was slow to babble; although she did start to babble, she then stopped.
The mother recognized hunger, thirst and tiredness from grizzles.
The mother said Jessie didn’t let her know what she wanted. (ie. no leading, pointing)
Jessie does say ‘mumu’ 2 to 3 times when upset but has no other words
Auditory Brainstem Response showed Jessie’s hearing mildly impaired
It is really hard to establish eye contact with Jessie.
Jessie likes to bang most toys.
It took a long time to transition to finger foods because Jessie doesn’t like new things in her
hand.
Jessie shows a strong gag and has just introduced chunky bits in mashed foods.
Jessie is slow to eat, looks at the ‘little bits’ in her food.
Jessie likes bright light and always notices the ceiling fans.
She loves bouncing on Mum’s knee with music and being rocked over Mum’s shoulder.
1. During this initial contact, the mother reports she has spent a lot of time on the internet, has googled
autism amongst many other things and although her daughter has not been diagnosed with autism,
she has some questions.
How would you answer the mother’s questions as follows:
a) If Jessie does have autism, what caused it, did she cause it?
Type answer here
b) She’s confused by the terminology on different websites. Are there different types of autism?
Type answer here
c) How common is autism in Australia (ie what is the incidence rate)?
Type answer here
d) What is the average age of diagnosis?
Type answer here
2. Which of the following are differentially diagnostic for autistic disorder compared to global
developmental delay at this age?
a)
Diagnosed by paediatrician with global developmental delay
b)
Slow with all fine and gross motor development
c)
The mother described her as a baby as “too content”
d)
Slow to babble, did start to babble then stopped
e)
The mother said Jessie didn’t let her know what she wanted (ie. no leading, pointing)
f)
Says ‘mumu’ 2 to 3 times when upset
g)
Really hard to get eye contact.
h)
Bangs most toys
3. What would be the main components of an initial assessment for Jessie?
Type answer here
You complete an initial screening assessment at 20 months of age (using a parent questionnaire)
and observation.
Results indicate restricted development for age of emotion and eye gaze, communication,
gestures, sounds, words, understanding and object use.
In addition, you make the following clinical observations: Lack of joint attention, a delayed smile at
presentation of a new toy but to no-one in particular; banging toys, using peripheral vision to look
at desirable toy; trying to chew the door stop.
At this stage you recommend another paediatrician assessment.
4. What types of support might you provide for the family during this pre-diagnosis phase?
Type answer here
Second paediatrician assessment occurred at 2 years 7 months of age.
The paediatrician conducted;
1) The Griffith’s Developmental Test. Child was assessed as functioning at approximately 13 to
14 months of age.
2) The Autism Diagnostic Observation Schedule. Jessie’s total score was well within the range
for an autism diagnosis and was subsequently diagnosed as having Autistic Disorder with a
co-existing intellectual disability.
Jessie is now 3 yrs old and has returned to your clinic. At this time you complete a thorough
assessment.
Results from your speech pathology assessment and information gained from other professionals,
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reveal:
 Impaired auditory comprehension (at approx 18mth)
 Severely limited verbal expression (5 words). Vocalises but largely unintelligible (more
vocalisations when angry or distressed). Does not gesture.
 Social communication – only occasionally points or takes adult to an object the child wants.
Does not greet or acknowledge others when they enter the room. Little/no eye contact.
 Play – severely delayed. No symbolic play evident. Continues to enjoy banging toys or
repetitively getting them out and packing them away. Does not attempt to interact with peers.
Parents report Jessie is obsessed with The Wiggles.
You liaise with the family and other professionals involved and based upon your findings and
collaboration, commence an evidence based intervention program you believe to be appropriate
for Jessie and her family.
5. The family ask if this intervention program you’ve devised is the gold standard/best treatment for
autism. How would you respond?
Type answer here
6. As part of the intervention program, you decide to introduce an AAC system.
Outline how you would present this option to the family to allay their fears that AAC will inhibit Jessie’s
speech development.
Type answer here
7. As part of the AAC system you introduce simple visual aids such as:
 Activity sequence cards (eg. Have breakfast, go to playgroup, visit Nana)
 ‘finished’/ ‘it’s OK’ cards (particularly to stick on TV)
 First-then schedule (first lunch, then Wiggles)
 Simple ‘on the go’ book (pack bag, in car, shopping, in car, Wiggles)
The family are concerned you are including Jessie’s obsession (The Wiggles) in AAC systems and
fear focusing on The Wiggles will further make their child less “like other kids”.
How could you respond?
Type answer here
8. As part of your service provision, you’re able to provide intervention within Jessie’s home.
a) List some of the benefits of this type of service delivery.
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b) What are some of the challenges in providing intervention within the home?
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9. The family plan to commence a Gluten Free-Casien Free diet as they’ve heard another parent at early
intervention playgroup talking up the benefits and ask your opinion. What would you tell them?
Type answer here
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10. After 6 months of therapy, Jessie is showing some measurable signs of responding well to your
intervention program. The family inform you they plan to continue with your service but also enrol in a
new expensive program they saw promoted on TV. What information would you give the family to help
them evaluate the new program?
Type answer here
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