Assessing Autism Article Critique - Term Paper Example

? Assessing Autism Article Critique The article by Ingram et al. (2007) describes an empirical study of 30 elementary school children using a method called “The Playground Observation Checklist.” It starts out by pointing out that severe social impairment is the most prominent feature of autism, as defined using the DSM criteria. The usual way of measuring behavior such as limited eye contact, lack of reciprocal social interaction, fewer greetings and failure to initiate interactions such as offering comfort to someone who is hurt, for example, is to observe how children react in certain contrived situations. This study hypothesizes that children with autism will behave differently from children with mental retardation and children with typical development during natural situations. It proposes that that a standardized way of observing children in the everyday context of school recess would be a helpful assessment tool. The playground observation checklist is just such an observation tool, and the article describes how it was used and the results it produced. These results were then checked for accuracy against other information obtained by the usual autism assessment methods. There were ten items on the behavior checklist, which is a very small amount, and for each child in the sample of 81 a score of yes/no was recorded against each item during a 15 minute observation period. Two observers recorded the sessions simultaneously, and any instance where a child interacted with an adult during the 15 minutes was discounted, and the observation was repeated until a session with only peer to peer interaction took place. The results showed a 94% success rate in identifying children with autism, and there were clear differences in the scores of the three categories of children. Variables such as age, parent occupation, gender and IQ were recorded, and small effects caused by these variables were noted. The authors conceded that the observers were not blind to the diagnosis of the children observed, and that this raises the possibility of observer bias. The authors conclude that this method is therefore very suitable as an initial assessment tool, to be followed up by more detailed diagnosis later. From the perspective of an educator this is an interesting article which recommends an intervention that is relatively inexpensive, easy to administer and suitable for operation in a school context in a way that does not place any undue pressure on the child. This article was an exploration of the method itself, and more needs to be done on that to ensure that the criteria are worded well, for example avoiding gender bias in the way interactions are described and scored. Assuming these details could be ironed out, this observation checklist does appear to be a good method for making initial assessments to indicate what kind of specialist referral, if any, would be appropriate for a particular child. So long as the observation is conducted by trained observers it could be introduced in an elementary school. There are ethical issues about the method, of course, since parents would need to give permission for such observations to take place, whether for research purposes, or for the benefit of the children themselves. There could be a danger of over-diagnosis, or of inappropriate referrals if too much weight is placed on a single fifteen minute observation, and so any use of this tool would be best placed within a school policy on autism, to be called upon under specific circumstances and regulated by school protocols that protect everyone’s rights. The article by Bradley-Johnson et al. (2008) takes a wider perspective than the article by Ingram et al. (2007) and is aimed at school psychologists, rather than educators. The definition of autism used by Bradley-Johnson et al. (2008) is that of the Disabilities Education Improvement Act (2004) which is broader than the DSM criteria. From the start there is an emphasis on “verifying eligibility for special services for autism” which betrays an interest in the funding and cost allocation regime as well as the purely educational and medical aspects of autism. This is not necessarily a negative feature of the article, and the authors make the valid point that diagnosis of autism carries with it considerable stress and sometimes also stigma for children and their families, so that finding a proper and fair diagnosis and assessment regime is a fundamental duty of the school psychology system. Bradley-Johnson et al. (2008) propose a new model for assessment which has three levels ranging from subjective and general through to objective and specific. The evidence for the study is drawn from a meta-analysis of the research which has already been done on testing for autism. Evidence from interviews and from written school and medical records is categorized as level one, and the authors advise that this may be too general, due to lack of space for recording, and sometimes biased because of the different interests of those involved, but it is nevertheless valuable because it indicates what issues different people think are important, and how likely different people might be to follow recommendations. The authors acknowledge the importance of the knowledge that parents and teachers contribute at this level. Level two of the Bradley-Johnson et al. (2008) model consists of rating scales, and the article mentioned above by Ingram et al. (2007) would fall into this category. Bradley-Johnson et al. (2008) warn against the use of such scales, however accurate they might appear, as an independent measure of autism. The reason for this is that they may be conducted with bias, and they may be too narrow in focus, which means that they might miss other psychological conditions that may co-occur with autism. Several broad and narrow band autism screening instruments are evaluated. The third level of the model involves multiple sessions of both observation in the environment and interaction between the student and the trained examiner, and with the participation of at least one second observer on at least one occasion. Ratings and progress monitoring are needed if interventions are to be successful, and this shows that there is a role both for the professional educational psychologist and the educator in maintaining the best regime for children with autism. In fact the authors advise that a multidisciplinary team involving social workers,teacher consultants and speech and language therapists as well is the best approach. Assessment should start out broadly and become more and more specific, with increasing amounts of monitoring. The Bradley-Johnson (2008) article gives a good overview of the whole national context for the provision of assessment and support for children with autism. It is good to learn about all of the options available, but there may be an over-reliance in this article on applying one over-arching model to all children. Most practising teachers have experience of many different needs in relation to autism and similar conditions, and there is also a great variation in the range of competence and willingness of parents and some teachers to take on a leading role in the care of any particular child. The variables are very great and this would suggest that flexibility should be built in to any large scale system for assessing autism. The main point of this article, however, is very useful: during the course of a child’s educational career there should be an escalation of assessments starting with general and leading to more and more tailored tests as the child’s needs become more apparent. In conclusion, then, it is clear that both articles provide useful information: the Ingram et al. (2007) article shows how new assessment methods are devised and tested, while the Bradley-Johnson (2008) article shows how such new methods fit into the American regime for the assessment of autism and other psychological conditions. References Bradley-Johnson, S., Johonson, C.M. and Vladescu, J.C. (2008) A Comprehensive Model for Assessing the Unique Characteristics of Children With Autism. Journal of Psychoeducational Assessment 26 (4), pp. 325-338. Ingram, D.H., Mayes, S.D., Troxell, L.B. and Calhoun, S.L. (2007) Assessing children with autism, mental retardation, and typical development using the Playground Observation Checklist. Autism 11, pp. 311-319. Read More