Psychometric Assessment of Autism

Psychometric Assessment Autism

Background of Autism

What is autism? Autism is a disease, which poses tons of questions, while providing least of answers. This being said, autism is one of the five diseases coming under Pervasive Developmental Disorder (PDD). It shows in early years of a human and effects the brain's functioning. An autism website states that, 'it's a result of a neurological disorder, which hampers the proper operations of a brain, hindering the social interactions and communications' (Autism Society of America website). Autism asks us millions questions, its origins, its solutions, its causes and symptoms; none of which are answered. The diagnostic and statistical manual of mental disorders (American Psychiatric Association (APA), 2013), states that, autism is basically pervasive developmental disorder otherwise called Autism Spectrum Disorder (ASD). It is described as a condition where the person faces severe problem in social communication, interactions, perception and communication. APA (2013) shows that, autistic people show unwarranted cases of unexpected and unusual interests and activities.

People with autism show different characteristics, they have an intricate personality and unique set of features. This means that some ASD adults have trouble making friends, while some have problem in conversing with others, whereas some have problem communicating.

They have problems listening and talking to people. They are talking to themselves instead of others. For instance, talking about a favourite subject, the ASD adult will keep on talking regardless of someone's interest. The ASD individuals respond to information in different ways. Some inflict damage on others / themselves, while some are violent and show episodes of anger.

Autism is rising day by day as estimates show that 1 person in 150 is autistic (CDC, 2010). So, this means that 1.5 million Americans are suffering from autism. Their form can differ. The mind of an autistic and non-autistic child is different. The doctors are at a loss for an explanation. The researchers have been searching for the last decade for the autism gene, which they haven't found yet. If people look on autistic websites, they can clearly see that which children are autistic and which aren't. Thus, they believe there must be a trigger of some sort which instigates autism. Autism shows up suddenly in a child; in case families of no past record of autism before. The children and adults with ASD have a hard time interacting and communicating with the populace. They can't take part in recreational activities and leisure activities. It affects one portion of the brain, but there aren't any signs of such patterns. It's not a visible disease.

Autism can be checked and verified by the concerned parents. The children with ASD are often acting as deaf and non-respondent because they are trapped in their own mental asylum. Calling them by their name and shouting doesn't work in their case either. They might respond to touch, that could vary from person to person with ASD. Children hate change. While changing schools and homes, children often make commotion. In case of children with ASD, they throw tantrums when things don't go their way. That's a common fact. Often, they like an object which can be given to them to calm them down. Thus, that's one way of calming them down.

It is praiseworthy to note that, according to Piven & Rabins (2011), there is evidence that autism is a permanent condition, not just a childhood disorder. CDC (Center for diseases control and prevention) calculates that autism prevails nearly 1%. Also, there aren't any studies showing the evolution of ASD in an ASD individual's life. But, thousands of ASD adults can give their personal life accounts about ASD on www.autismspeaks.org. They can give great insights and information about their lifelong battles with ASD. The extreme cases of ASD are often suffering from Down syndrome, diabetes and other illnesses. This just complicates matters for ASD adults having complex sensory aberrations (Gense & Gense, 2011).

ASD is being diagnosed on a greater frequency now and is this remains the case then it seems that the adult population is suffering from ASD, which puts the healthcare industry, families and community under strained pressure (Piven & Rabin, 2011). According to Piven and Rabins (2011), more institutions and homes should be equipped to cope with aggressive and violent situations shown by ASD individuals.

Autism is categorized into five different categories. These are namely:

Autistic disorder

Rett's disorder

Childhood disintegrative disorder

Asperger syndrome

Pervasive developmental disorder (PDD)

But, (APA 2013) found out that diagnoses weren't made use of. Thus, they finally decided on diagnosing any one of the five would do the trick for ASD.

The aims and objective of assessing people suffering from autism

A high quality evaluation is necessary for comprehending and helping the kids, adults, teenagers as well as their family-units to support the fight against autism. Assessment means collecting handy data pertaining to an individual to reach a conclusion. In an earlier study Harrison and Oakham (2003) point out that assessment is considered to be broader than testing (this is because tests are included within an assessment) as well as their results are more consequential than the test scores. There happen to be multiple motives for assessing individuals suffering from autism during various stages of their lives (Harrison and Oakham, 2003).

The Significance of an Autistic Psychometric Assessment

Four major aims facilitate assessment of an autistic person. These 4 goals have been mentioned below:

Firstly, autistic psychometric assessment is essential to comprehend and measure an individual. The main clinical ground for doing so is to furnish information relating to individuals, which assists in better understanding and further help professionals in making, planning and designing competent therapeutic and educational intervention. Cohen et al. (2005) in his study points out that it's essential to take into consideration the standard of individualization in planning of autistic therapy programs by taking in consideration the developmental stage of these individuals, his strong points as well as his flaws, diverse mental and physical skill-sets, his personal preferences as well as dislikes, behaviour pattern, competent teaching strategies as well as inspiration mechanism (Cohen et al., 2005). Lord et al. (2012) point out that the therapists can examine the viability of an intervention and lessen the behavioural outbursts which occur within individuals due to his surroundings not synchronizing with them. Apart from that, it's better to retain a benchmark so as to measure the change in a person (cognitive incline or decline for that matter) belonging to diverse age groups (Lord et al., 2012).

Secondly, autistic psychometric assessment is essential in attaining and explaining the very first diagnosis. Alpern (2007) in his study argues that the first diagnosis process is indeed very tough for individuals as well as his family members. Apart from that it's also quite lengthy, confusing and irritating mainly because the individuals as well as the family members are ineffective in dealing with this issue. Also, the professionals in this field don't like breaking the bad news while others think that a particular individual is not suffering from autism (Alpern, 2007). Paul and Wilson (2009) in their study found that the current literature advises on screening process and transfer-programs to ensure that family members are aware of the impending danger whilst the child is sent for proper diagnostic assessments as soon as possible (Paul and Wilson, 2009).

Thirdly, autistic psychometric assessment is essential in documenting diagnostic status. Many times over in an individual's life, diagnostic reassessment will be needed for properly documenting any diagnosis. The ailment could be autism or perhaps another mental disorder in order to determine admission in school and contacting the services for funding and support regarding education, healthcare and social assistance (APA, 2013).

Fourthly, autistic psychometric assessment is essential in attaining pertinent data for attaining various research goals or perhaps therapy program purposes as well. In a number of instances, information is gathered and accumulated in order to keep track of the sufferer's progress. That's done by comparing their progress from regularly and frequently, which helps in making father moves and plans for that specific individual. When more individuals are taken in consideration from a class or perhaps a program, then all this garnered data might be quite handy to assess the program's evaluation. The aim prior was just for clinical reasons. This assists us in deciding if a specific therapy program or an intervention is required or not, who need it best as well as exactly how the features and traits of a client influence its effectiveness apart from multitude of additional elements. In other cases, more assessment has been considered essential for furthering research purposes and objectives (APA, 2013).

Diagnosis and assessing Autism: The concept of best practices

Pandolfi et al. (2010) found that the best practice approach is generally indicates that certain methods and measures are to be used for the most part. The assessment method must be in conjunction with latest literature available on proof based assessment involving procedures and measures. A trend has been ensuring during the last few years, in many fields, including human services as well as human health; a broad variety of multidisciplinary experts review the current academic research studies and after that accumulate all their work experience within a single report, usually a guideline for clinical practice. It is a consensus-based suggestion ((Pandolfi et al., 2010).

Within the field of autism assessment, two documents have revolutionized the criteria for best practices. These 2 documents belong to New York department of health and American Neurology Academy. The New York Health Department (1999) drafted a board to create a guideline for clinical practice related to diagnosis as well as therapy programs aimed at autistic individuals. Similarly, Filipek et al. (1999) belonging to the American Neurology Academy headed a board of experts from different fields of medicine. They passed on their suggestions for not only premature screening but also assessment standards along with extensive therapeutic programs.

Standard Psychometric Assessments for Autism

Pandolfi et al. (2010) in his study point out that DSM-IV criteria are called the gold standard for diagnosing Autistic Disorder within the medical community. They are used systematically. Every criteria is associated to a developmental level, which has its roots from information garnered from parents and teachers, in multiple instances and sessions (both parents combined and alone for kids and adolescents, significant others alone and combined, structured and semi-structured interviews). In low performing people and young kids, some criteria's can't be matched because they exceed their developmental stage hence declining the denominator of the formula for diagnosis. The diagnostic assessment must be having a report by parents or significant others as well as a collection of prior reports and data accumulated. More observation is required in instances of tough diagnoses and making ambiguous observations. Sometimes collegial consultation is required while sometimes extra testing is needed (Pandolfi et al., 2010).

Johnson and Myers (2007) in their study found that conventional Autism therapy guidlines propose the usage of standard autism assessment measures. For children the most popular and widely used ones are Autism-Rating-Scale-For-Children and the most popular ones for adults is Autism-Diagnostic-Observation-Program. Another standard psychometric autism scale is CARS, which consists of key basic observations as well as prearranged interaction series (to evaluate both verbal and nonverbal communication skills) and collecting information from teachers/staff / parents (Johnson and Myers, 2007).

Ozonoff et al. (2005) found that the results in case of CARS were amazing in terms of both reliability as well as validity (consistency, mutual consent as well as reliability of tests and retests; along with synchronization with clinical analysis) of the not only the adults but also children suffering from autism. In case of CARS, now therapists have their very own training manual with concrete standards for basing reliability, but it ought to be noted that therapists and psychologists don't usually like CARS that much and therefore don't use if very often. Apart from that, there happen to be many parental surveys as well as questionnaires aimed to attain different objectives with differing psychometric assessment functions used frequently by therapist and psychologists (Ozonoff et al.,2005).

Standard Psychometric Assessment Limitations for Autism

There are an assortment of myths and popular beliefs which we have been mentioned below:

If Autism has been diagnosed then intelligence levels carry little relevance

Mental capacity can't be estimated in autistic

People suffering from autism less interested in tests and assessments; however, their intelligence and motivation levels may be higher in normal circumstances.

The autism afflicted people are tough to test in standard tests. To use verbal-based tests for autistic individuals is unfair as one cannot distinguish their intellectual capacity accurately and precisely (Norris et al., 2010).

Sattler (2002) found that the limitations of psychometric assessment shown above are bit wayward, baseless and quite bluntly speaking, do not corroborate the results found in clinical trials. Most of the people suffering from autism (approximately eighty percent) fit the levels fixed for Mental Retardation (MR). The ratio is higher for the adult population suffering from autism in treatment facilities. The learning issues as well as behavioural problems are additionally observed within people suffering from developmental disabilities (from herein referred to as DD) and can be connected to an individual's learning curve instead of autism. Hence it has been considered necessary for people to be examined by means of the guidelines related to DD field to gain an insight into adaptive functioning and mental functioning.

Sattler (2002) additionally argue that clinical guidelines dictate using reliable, standardized and appropriate written and oral and intellectual operations suitable for the sufferer's intellect-level as well as age. The tests must be from recent peer-reviewed journals so as to gurantee not only their validity and reliability but also suitable psychometric functions. Sometimes it's important to make use of assessments, which are suitable for younger kids. This implies that conventional rating systems can't be taken for this child as he is either above the age-group or perhaps he has reduced brain functioning level when compared with his age group. Hence sometimes, therapists make way for age-parallel (for instance Peter attained a score at 5-year on an 10-month level); or ranges (Jill's skill ranges from 2-3-year level) or perhaps descriptive statistics (Paul successfully solved inset puzzles however failed at making geometric designs). These kind of tasks, therapists perform with most children they come in contact with. In such instances, it is necessary to have some set of items within the child's mental range irrespective of their physical age; at least more than three test items should be available.

In the absence of verbal responses, the rating score and items shouldn't be impeded, particularly in area of expressive and responsive communication. This is because they form a constituent of the intelligence part therapists intend to measure in the first place. Hence they shouldn't be any less than other sufferers they examine. Even though, isolated scores in both vocal and non-vocal fields are useful clinically, but in situations where high level vocal communication retardation is found, more non-vocal assessment tools are employed (it occurs quite less on a positive note). A pattern of definite cognitive strong-points and cognitive flaws are found in individuals who are capable in finishing the WISC -- III (or comparable assessments) as they are mentally capable enough. Their strength lies in:

Rote learning

Good hand eye connection

Spatial visualization capabilities

Their flaws are found in:

Social understanding

Language understanding

Expressing self-emotions and thoughts

Reasoning and rationalizing properly

For an individual who possesses an intense pattern of strong points, flaws and vocal communication flaws; The scale with complete range and items is usually not taken in consideration. Therapists also cannot oversimplify a strong point centered on one particular skill alone (for example, having great memory of movies he has seen). Sattler (2002) argues that this doesn't mean he was born intelligent as that's rarely the case (Sattler, 2002). Therapists and Psychologists make use of different tests that comprise the following: