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Introduction Introduction to Autism Spectrum Disorder ... · PDF file Spectrum Disorder Understanding the ASD criteria Autism Spectrum Disorder •Autism is a developmental brain-based

May 23, 2020




  • 2/16/18


    Introduction to Autism Spectrum

    Disorder & Services for

    Nebraska Children

    Johanna Taylor, PhD, BCBA University of Nebraska-Lincoln

    Presentation for:

    February 27, 2018

    Introduction • Assistant Professor of Practice in Online Early Childhood

    Special Education Program at UNL in the Department of Special Education and Communication Disorders.

    • Master’s and doctoral degrees in Early Intervention with a Specialization in Autism Spectrum Disorder.

    • Board Certified Behavior Analyst (BCBA) since 2007.

    • In the field of autism and disabilities for about 15 years. Most recently was in Hawai’i as a Program Manager for an Early Intervention agency (children 0 – 3 years with disabilities) and BCBA.


    • The information presented today on the resources and support in Nebraska was identified solely by the speaker. It is possible that there are other resources available to help support individuals with autism in Nebraska.

    Objectives • Participants will learn about the diagnostic criteria

    for autism spectrum disorder (ASD).

    • Participants will learn steps for accessing a diagnosis and support for a child with autism.

    • Participants will be provided with a brief overview of evidence-based interventions for autism.

    Autism Spectrum Disorder

    Understanding the ASD criteria

    Autism Spectrum Disorder • Autism is a developmental brain-based disorder.

    • Autism can be diagnosed before two years of age through behavioral observation (Lord, et al., 2006).

    • Estimated prevalence of autism in the U.S. is 1 in 68 children (CDC, 2016).

    • Individuals with autism fall somewhere along a:



    (APA, 2013)

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    There has been an increase. Why?

    • Greater awareness. • Changes to diagnostic criteria and special education. • Availability of services. • We are better at diagnosing.

    (Fombonne, 2009)

    DSM-V Criteria for ASD

    Social- Communication/



    Restricted Repetitive Behaviors

    (APA, 2013)

    DSM-V Criteria for ASD • Symptoms must be present in the early

    development but possible that may not be seen until social demands in school occur.

    • Severity ratings are assigned when diagnosed:

    Level 1 Requires support

    Level 2 Requires

    substantial support

    Level 3 Requires very

    substantial support

    (APA, 2013)

    Social-Communication Criteria To qualify for ASD, must meet all three social- communication criteria. Deficits in:

    Social- emotional reciprocity

    Non-verbal communication

    Developing, maintaining,

    and understanding relationships

    and/or adjusting to

    social context (APA, 2013)

    Early Developmental Differences

    • Child is not using 1 word by 16 months of age.

    • Child is not combining two words by 2 years of age.

    • Child does not respond to his name.

    • Child does not use index-finger to point to objects to show.

    • Child pulls you to items he wants.

    • Child rarely smiles and has limited or no eye contact.

    • Child has motor delays and/or falls often.

    Early Developmental Differences

    • Child does not seem to know how to play with toys:

    • Does the same thing over and over with toys

    • Does not play with toys in a meaningful way

    • Child does not have imitation skills.

    • Child is attached to one particular toy or object • Has to take object with him everywhere

    • Carries object throughout the house

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    Restricted Repetitive Patterns of Behavior Criteria

    To qualify for ASD, must meet two out of four criteria:

    Stereotyped or repetitive motor

    movements, use of objects or speech

    Insistence on sameness, inflexible

    adherence to routines, or

    ritualized patterns or verbal nonverbal


    Hyper- or hyporeactivity to sensory input or unusual interest in

    sensory aspects of the environment

    Highly restricted, fixated interests that

    are abnormal in intensity or focus

    (APA, 2013)

    Early Developmental Differences

    • Child demonstrates odd speech, language, or behavior. • Child demonstrates a regression in overall behavior:

    communication, play, and social skills. • Child experiences tantrums that are out of control and

    last for long periods of time. • May occur with transitions. • When he cannot have something he wants. • May occur when changes are made to schedule without


    DSM-V Criteria for ASD

    Social- Communication/



    Restricted Repetitive Behaviors

    (APA, 2013)

    Signs/Symptoms Resources autism/learn-signs

    Autism Screening & Evaluation

    What is the process used to diagnose autism?

    ASD Screening & Evaluation Process for a Clinical Diagnosis





    No diagnosis provided, continue monitoring/ other recommendations


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    ASD Screening • Anyone can learn to screen for ASD. • Pediatricians are the most common people who

    screen for ASD. • Others can learn including: parents, relatives,

    child care providers, nurses, therapists, etc. • Details on screening process: screening.html


    ASD Screening Tools • M-CHAT (16 – 30 months)

    • Social Communication Questionnaire ( older than 4 yrs)


    ASD Evaluation Who Diagnoses Autism?

    • Pediatricians • Psychologists • Pediatric Neurologist • Psychiatrists well-trained in ASD • Other well-trained professionals may participate

    in a team w/ one of the above professionals.


    Note: School psychologists can provide an ASD educational verification but not a clinical diagnosis.

    ASD Evaluation: Best practice evaluations

    1. Parent/caregiver interview – Autism Diagnostic Interview-Revised (gold-standard).

    2. Review of relevant medical, psychological and/or school records. 3. Cognitive/developmental assessment. 4. Direct play observation – Autism Diagnostic Observation Schedule (ADOS; gold-standard)

    5. Measurement of adaptive functioning. 6. Comprehensive medical exam.


    Referral Process for


    What is the referral process if you suspect a child may have autism?

    ASD Referral Process Clinical Diagnosis of


    Referral made to diagnosing professional

    Access to ABA and other autism-specific treatments

    Education/family support for children with autism

    Referral made to NE Department of Education

    Access to early intervention/

    educational support in classroom

    Do both, but if you’re going to

    start somewhere,_Ph.D._files/M-CHAT.pdf,70432&_dad=portal&_schema=PORTAL

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    ASD Referral Process Referral made to Nebraska Department of Education

    Early Intervention Services (0 – 3 years) 1-888-806-6287 • Service coordinator • Speech language pathologist • Occupational therapist • Early intervention teacher • Physical therapist • Hearing specialist • Vision specialist

    ASD Referral Process Referral made to Nebraska Department of Education

    School-age Special Education Services (0 - 21 years) Contact educational service unit to have a child evaluated for special education services.

    Parent Resources:

    ASD Referral Process Funded through Department of Education • Early intervention (0 – 3 years) • School-based support in classroom Funded through private insurance/Medicaid • Outside therapy services (SLP, OT, PT, Psych) • Applied Behavior Analysis treatment Funded through Division of Developmental Disabilities (if meet eligibility criteria) • Respite • Community-based services

    Autism Support

    • Build and enhance the capacity of NE schools and families in supporting children with autism.

    • Provide training and technical assistance to NE educators supporting students with autism.

    NE Autism Spectrum Disorders Network

    Overview of Autism


    What interventions do we know are effective for autism?

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    Optimal Outcomes • We know that there are factors that

    contribute to individuals with autism having a better outcome in life. – Higher intelligence, joint attention/imitation, early

    intervention, behavioral treatment (Schreibman, 2011) – Strong language skills (Huckabee, 2003) – Personal factors (Fien et al., 2013) – Adaptive factors (Sutera et al., 2007)

    Evidence-based Practices for Autism

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