Abstract
This edited edition by Lee A. Wilkinson is, as its title states, a review of evidence-based assessment and interventions for autism within a school setting. It is written primarily for school psychologists, but others who work in the schools (i.e., school counselors, special education teachers, and graduate students in school or educational psychology) should find it useful. The book provides an up-to-date guide to best practices in screening, assessment, and intervention with students on the autism spectrum within the context of the public schools.
The goals of the book are to cover two broad areas of knowledge regarding students with autism. First, the authors attempt to cover the process of screening for autism and assessing the strengths and weaknesses of students with autism using evidence-based assessment tools. The second goal is to provide readers with information on the use of appropriate school-based interventions for students with autism.
Content and Structure
The contributors to this book have attempted to provide the professional reader with all the tools needed for providing services for children with autism spectrum disorder (ASD). Throughout the text, the contributors stress that they have taken a comprehensive approach and have limited the tools (both for assessment and intervention) to those that are supported by research. Those tools that might be useful but are not supported by research have not been included.
The editor has divided the book into two parts made up of 11 chapters. Each chapter is 15 to 20 pages long and is authored by individuals who are knowledgeable in the field. Part One consists of the first 6 chapters and covers evidence-based assessment. Part Two consists of 5 chapters and covers evidence-based interventions (EBIs) for schools. Each chapter ends with a list of the references cited within the chapter.
Chapter 1: Overview of Autism Spectrum Disorder contributed by McCrimmon, Altomare, Smith, Jitlina, Matchullis, and Saklofske, provides a succinct overview of ASD. A brief history of the early work of Bleuler, Kanner, and Asperger with children with autistic symptoms is followed by a discussion of the evolution of diagnostic symptomatology as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) through the years. More attention is given to the changes in autism diagnosis that have occurred with the introduction of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). The rapid increase in the prevalence of individuals with ASD, core symptoms of ASD, and comorbid conditions of ASD are briefly discussed. The authors also touch on symptoms of ASD that are not always covered in a book of this type (i.e., theory of mind, weak central coherence, executive functions) and their impact on the functioning of children with ASD. McCrimmon et al. also give a brief overview of interventions that are known to be effective (i.e., applied behavior analysis [ABA] and social skills training) while acknowledging the use of interventions that have not been shown to be effective, such as facilitated communication, auditory integration therapy, secretin, immunoglobulin injections, and anti-yeast treatments. The authors end the chapter with a brief overview of the outcomes that can be predicted for individuals with ASD. The best predictors of positive outcomes are higher cognitive abilities and development of speech prior to the age of 5. However, even for individuals with these characteristics, many individuals with ASD continue to struggle throughout their lives because they lack independent daily living skills, have significant difficulties forming social relationships, and, as a result, have difficulty living independently and maintaining employment.
Chapter 2: Multitier Screening and Identification is authored by the editor and provides an overview of the basic psychometric principles that practitioners need to know when selecting and interpreting screening tools. There is a brief discussion of diagnostic validity, sensitivity, and specificity and the positive and negative predictive values of screening instruments. The use of several assessment instruments for screening is discussed. Wilkinson also outlines a multitier approach to screening for children who may require a more comprehensive assessment. In Tier 1, he encourages professionals to recognize the risk factors, listen to parent and teacher concerns, and refer the student for screening. In Tier 2, the screening results are shared with parents and teachers and the scores are used to monitor the child’s progress. Tier 3 consists of in-depth assessment and intensive intervention. Limitations of screening methods (e.g., false positives, gender difference, settings in which the tool is used) are discussed.
Chapter 3: Comprehensive Developmental Approach Assessment Model, contributed by Campbell, Ruble, and Hammond, describes the components of an evidence-based assessment battery. It takes into consideration the two classification models used in the schools (i.e., the psychiatric model of DSM-5 and the educational classification of the Individuals with Disabilities Education Act [IDEA]) and the importance of considering educational impact. There is some overlap with Chapter 1 in the discussion of epidemiology and comorbid disorders as well as a brief overview of etiology and treatment. The bulk of the chapter consists of a discussion of the Comprehensive Developmental Approach assessment model by Klin, Saulnier, Tsatsanis, and Volkmar (2005). The model includes assessment of multiple areas of functioning; adoption of a developmental perspective; emphasis on variability of skills, variability across settings, and functional adjustment; and evaluation of delays in development and deviance in development. There is a review of evidence-based assessment including autism-specific measures as well as measures for assessing cognitive functioning, adaptive behavior, language and motor functioning, and academic functioning.
Chapter 4: Cognitive, Neuropsychological, Academic, and Adaptive Functioning by Caterino describes tests for assessing the stated areas of functioning. There are brief reviews of research using the measures with students with ASD. In addition, there are reviews of tests used to assess attention, memory, cognitive flexibility, and planning.
Chapter 5: Language and Social Communication was written by speech language pathologists Twachtman-Cullen and Twachtman-Bassett. It describes the process for social-language learning, as well as joint attention, theory of mind, and nonverbal aspects of language. The authors emphasize the pragmatic, social-communicative functions of language, including quantity, quality, relevance, and clarity of language. There is a discussion of assessments used to identify pragmatic language deficits and the use of the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) to assess communicative functions and to assess progress in specific skill areas over time. A vignette is provided to illustrate the process. The chapter concludes with guidelines for interventions.
Part One concludes with Chapter 6: Co-Occurring Emotional and Behavior Problems by Doepke, Banks, Mays, Toby, and Landau. The contributors report estimates that 70% to 84% of children with ASD have co-occurring psychiatric conditions that can affect daily functioning and complicate intervention and 30% to 40% of those have two disorders (Leyfer et al., 2006; Simonoff et al., 2008). Doepke et al. describe the importance of determining whether a child’s behaviors are solely the result of their ASD diagnosis or whether the child has a comorbid disorder. Failing to sort this out can result in the child not receiving the proper treatment. Diagnosing co-occurring disorders can be difficult for a variety of reasons, and professionals are encouraged to focus on symptoms and their effect on functioning rather than on taxonomy. Assessment instruments, including the Autism Comorbidity Interview—Present and Lifetime, are discussed. There is a brief discussion of interventions for children with ASD and attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders, and internalizing symptoms.
Part Two focuses on intervention beginning with Chapter 7: Evidence-Based Interventions in the Classroom by Suhrheinrich, Hall, Reed, Stahmer, and Schreibman. The contributors begin this chapter with a discussion of the rapid rise in the number of children receiving special education services under the autism label and the expense involved in educating students with ASD compared with students in regular and special education. The authors advocate adapting established EBIs for ASD in the classroom. As stated,
the dramatic rise in the number of children with ASD, combined with the high cost of their care and families’ increased advocacy for services, makes it critical to identify cost-effective, EBIs that are acceptable to families, effective for students and feasible to implement in most school districts.” (Suhrheinrich, Hall, Reed, Stahmer, & Schreibman, 2014, p. 152)
The authors also discuss the wide range of services that students with ASD are receiving in the schools and the need to close the research to practice gap in special education.
Chapter 8: Continuum of Services and Individualized Education Plan Process by Wagner details the Individualized Education Program (IEP) process for students with ASD, identifies appropriate public school special education services, and outlines the major requirements of the IDEA. The author focuses on the continuum of special education services and placement options, individual education planning, curriculum and classroom structure, and instructional support strategies. A vignette is included to clearly explain the IEP process.
Chapter 9: Curriculum and Program Structure by Kabot and Reeve describes a systematic process that can be used for designing structured educational environments for students with ASD. The process involves collaborating with parents and other professionals, developing a program that provides structure and routines, adapting the curriculum to meet the student’s learning needs, and ensuring the curriculum is implemented with fidelity. Two case vignettes are incorporated to illustrate the process.
Chapter 10: Collaboration Between Families and Schools by Barnhill provides techniques and strategies to enhance the home–school partnership. The author discusses the best way to offer support to families of children with ASD and provides direction on how to involve parents as active partners in making decisions about their child’s education.
Part Two concludes with Chapter 11: Legal Issues Under IDEA by Zirkel. It offers a discussion of IDEA and Section 504 and a brief review of legal cases involving the education of students with ASD. The author also discusses relationships between special education law, provision of services, and placement decisions.
Critique
Wilkinson has put together a book that is quite readable and interesting. Difficult concepts are explained clearly but concisely. The style and quality of writing is consistently good across chapters. The authors cover a broad range of information on screening and assessment with less emphasis on school-based interventions. Numerous research articles are cited in each chapter, and references are provided to foster additional research by the reader.
A strength of this book is the breadth of coverage. The authors meet the goal of providing professionals with information on ASD, screening, assessment, and interventions for the classroom. The chapter on collaborating with parents and fostering the home–school connection is especially helpful.
The strength of this book, its broad coverage, leads to its relative weakness—lack of depth on some topics. Although the chapters are packed with material, by necessity there is not as much depth as might be desired. The editor and contributors have attempted to cover a very broad, complex topic in less than 300 pages; as a result, the chapters are brief, and many important topics are only lightly touched upon. This weakness might have been ameliorated, however, if some of the overlap among chapters could have been eliminated. Although cross-references have been used to direct the reader to related topics across chapters, several topics (e.g., the symptoms of ASD, prevalence rates) are repeated in a number of chapters. It also would have been helpful to confine information on intervention to Part Two rather than interspersing it within chapters in Part One.
Many books have been written about children with autism in the past 10 years, and this book is similar to Clinical Assessment and Intervention for Autism Spectrum Disorders edited by Johnny Matson and published by Academic Press in 2008 (Matson, 2008). However, its emphasis on the school setting makes the Wilkinson text quite valuable to school personnel. School psychologists could use this as a reference and will be able to follow up on the many studies cited in the book when they need greater depth of knowledge.