IMPROVING AUTISM ASSESSMENT
SERVICES IN THE SCHOOLS
John Prickett
Donald Oswald
Commonwealth Autism Service
THE PROBLEM
Children with Autism Spectrum Disorders
(ASDs) who receive early diagnosis and
intervention experience better outcomes
(Zwaigenbaum, 2010).
 Interdisciplinary diagnostic assessment is the
accepted state of the art.
 Rural school divisions face particular challenges
in providing interdisciplinary assessment and
intervention.
 Evidence suggests that local teams can be
successfully trained to provide high-quality
assessments of children with ASDs (McClure,
MacKay, Mamdani, & McCaughey, 2010)

OVERCOMING BARRIERS TO EARLY
IDENTIFICATION OF ASDS

Barriers to effective early identification include:
 Long wait time for external evaluations
 External evaluations may not translate easily
into educational plans
 External evaluations may foster an
adversarial relationship between parents and
school personnel
 Single-discipline evaluations fail to capture
the complexity of the child’s ability / disability
profile.
GOAL OF THE PROJECT

To identify students with Autism Spectrum
Disorders (ASDs) at an earlier age via:
A school-based interdisciplinary team trained in goldstandard, autism-specific assessments .
 Generate reliable diagnostic decisions.
 Used by Local Education Agencies (LEAs) for the
purposes of eligibility and IEP development.

COLLABORATORS
Commonwealth Autism Service (CAS)
 Shenandoah Valley Regional Program (SVRP), a
regional special education program consisting of:
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Page County Public Schools
Shenandoah County Public Schools
Rockingham County Public Schools
Augusta County Public Schools
Harrisonburg City Public Schools
Staunton City Public Schools
Virginia Leadership Education in
Neurodevelopmental Disabilities (Va-LEND)
REGIONAL AUTISM ASSESSMENT TEAM
(RAAT)
The Regional Autism Assessment Team (RAAT)
is a school-based interdisciplinary assessment
service serving six rural school divisions.
 The objectives of the collaboration were to train
RAAT members in:

The use of reliable, gold-standard diagnostic
assessment instruments;
 Interdisciplinary team functioning and family
centered practice;
 Integrating multi-disciplinary perspectives and
contributions to the diagnostic assessment process.

RAAT MEMBERSHIP

SVRP school-based interdisciplinary regional
autism assessment team:
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school psychologists
speech and language pathologists
occupational therapists
school social workers
behavior analysts
TRAINING ACTIVITIES

RAAT members receive formal training in:
 Autism Diagnostic Observation Schedule
(ADOS) administration and coding
 Autism Diagnostic Interview – Revised (ADIR) administration and coding
 Interdisciplinary team functioning
 Family-centered practice
 Interdisciplinary assessment: Role of the
occupational therapist
 ADOS - Consensus coding
 Evidence-based interventions
TRAINING ACTIVITIES

Principles of interdisciplinary team assessment:
 Ecological validity of assessments
 Recognizing uncertainty
 Coordination and non-redundant testing
 Dynamic nature of the assessment
 Respect for contributions of other disciplines
 Cultural competence
 Role of the family
 Role of community providers
 Inclusion and support
TRAINING ACTIVITIES (2010)

Previously provided trainings:
December 9th : ADI Training provided to SVRP RAAT
 November 29th & 30th: ADOS Training provided to
SVRP RAAT.
 October 7th : Consensus scoring for the (ADOS).
 February 22: Role of the occupational therapist in
assessing, designing and delivering services to
support learners with ASD.
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School-based assessment team members and
trainees regularly observe evaluations at the
CAS Transdisciplinary Diagnostic Assessment
Clinic.
TRAINING RESULTS
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Trainees achieved the identified objectives and were
satisfied with the training provided.
Survey of Trainees:
• Before-session: Participants indicated they were ‘not
at all ‘ to ‘somewhat’ informed about assessment
issues.
• After-session responses ranged from ‘somewhat’ to
‘well informed’
Participants showed increased knowledge about the
training topics.
Training participants indicated that training was useful
and would change their practice/behavior.
Training participants indicated that they were satisfied
with the overall training and that effective training
tools were used.
RAAT ADMINISTRATIVE PROCESS
SVRP and CAS
staff worked
with local
school division
personnel to
devise an
administrative
process for:
• referral to the
assessment team
• feedback of
assessment
results to the
child’s eligibility
team.
REFERRAL TO THE ASSESSMENT TEAM

Student is identified by the student’s local special
education director with input from:
The school psychologist, social worker, special
education teacher.
 Special Education Director makes a referral, in
writing, to the RAAT Coordinator.
 RAAT Coordinator recruits a trans-disciplinary team
from a pool of 22 various team members.

ASSESSMENT PROCESS
Referral is made by the relevant Special
Education Director
 Team is selected by the RAAT Coordinator
 Classroom Observation is conducted by the
behavior analyst (1.5 to 2 hours)
 The ADOS is administered at the testing center,
typically, the parent is present (2.5 to 3.5 hours)
 The ADI is administered at the student’s home or
at the testing center (2 to 3 hours).
 Review of previous reports (1 to 3 hours)
 Completion of summaries by the represented
disciplines.
 Report completion.
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FEEDBACK TO THE CHILD’S ELIGIBILITY
TEAM.
Team members complete discipline specific
summaries.
 School psychologist combines summaries and
completes report
 Report is submitted by the RAAT coordinator to
the referring special education director.
 Behavior Analyst from the referring district
attends the student’s eligibility meeting.

OVERALL PROJECT RESULTS
A functioning Regional Autism Assessment Team
consisting of 22 members that has over the
period of 14 months, contributed to the eligibility
determination and intervention planning of 15
children.
 Of 12 parents who responded to surveys, 11
stated the assessment team:
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Helped them to feel informed about the assessment
process.
 That they (the parents) were involved in the
assessment process
 That the assessment team made sufficient effort to
get to know their child.
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ENGAGING PRIMARY CARE PROVIDERS
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Primary care providers in screening and
interdisciplinary assessment:
Primary care physicians (PCPs) – a critical link in
the process
 April 14th, 2010: SVRP in conjunction with CAS
hosted a dinner & provided presentations to provide
information about the RAAT, screening & assessment
issues for ASD.
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ADDITIONAL ISSUES

Issues addressed in the implementation of the
project included:
 administrative concerns of participating school
divisions about the quality of the reports from
outside assessments, delays, etc.
 distinguishing a clinical evaluation from an
educational assessment
 advertisement / marketing of the service
 advantages of ongoing contact with the
children and families through school services
 possibility of further comprehensive singlediscipline evaluations (e.g., in-depth OT and
Speech/ Language evaluations if needed).
REFERENCES
Guralnick, M.J. (2000). Interdisciplinary clinical
assessment of young children with developmental
disabilities. Baltimore MD: Paul H. Brookes
Publishing Co.
 McClure, I., MacKay, T., Mamdani, H., &
McCaughey, R. (2010). A comparison of a
specialist autism spectrum disorder assessment
team with local assessment teams. Autism, 14, 1–
15.
 Zwaigenbaum, L. (2010). Advances in the early
detection of autism. Current Opinion in
Neurology, 23, 97-102.
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CONTACT US

John Prickett, MA, BCBA
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jprickett@autismva.org
Donald Oswald, PhD
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doswald@autismva.org
QUESTIONS / COMMENTS