Unraveling the Complexities of
Autism Spectrum Disorders (ASD)
for Testing Accommodations
Presented to
Building Bridges
Stockholm, Sweden
May 2014
Loring C. Brinckerhoff
Dir, Office of Disability Policy
Educational Testing Service
[email protected]
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
What is ASD?
A neuro-developmental disorder ranging from
mild to severe that is characterized by core
features of social/communication deficits,
repetitive/restrictive behaviors, and a lack of
emotional reciprocity
3
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
DSM-5 Changes to ASD
• The four previously separate disorders (e.g,
Asperger’s disorder, childhood disintegrative
disorder, and PDD- NOS) are now viewed as a
single condition with different levels of symptom
severity in two core domains:
o deficits in social communication and social
interaction
o restricted, repetitive behaviors, interests &
activities
Banerjee and Brinckerhoff, June 2013
4
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
College Students with ASD are on
the Rise
• ASD affects 1 to 1.5 million Americans.
• The CDC (2013) estimates that 1:88 individuals
have ASD.
• 3-4 times more prevalent in males
• Number of test takers with ASD requesting
accommodations on ETS tests is increasing each
year.
• A recent study by SRI International (2012) noted
that “STEM related majors were more common
among college students with ASD than students
with any other type of disability.”
5
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
College Students with Asperger’s
Despite intellectual and academic gifts, persons
with AS have a decreased ability to decipher the
intentions and actions of others, to integrate
multiple streams of incoming information, and to
navigate an increasingly complex social world.
They may be rigid and perfectionistic and resist
changing to meet the demands of their
environment.”
(Wolf, Thierfeld Brown & Bork,
2009)
6
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Why Develop Documentation
Guidelines for ASD?
7
• ETS Policy Statements for LD, ADHD, and
Psychiatric don’t fit this population.
• Need to move away from the LD discrepancy
model review mindset
• ASD documentation typically does not show test
scores with significant deficits in cognitive profiles
or in achievement areas.
• The key is an in-depth discussion by the
evaluator of symptomatology.
• Documentation may involve multiple
professionals.
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Documentation Considerations
• ASD is often picked up at school age and
misdiagnosed as ADHD.
• ASD should spill over into two or more settings.
• Look for relevant information regarding current
treatment.
• Individuals with ASD may experience difficulties
with major life activities such as learning,
reading, concentration, and/or thinking.
8
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Documentation Considerations
(cont’d):
• The use of psychotropic drugs is becoming
increasingly common, so there may be side
effects of medication to consider.
• Both the positive and negative effects of
medication should be noted.
9
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
ETS Policy Statement for
Documentation of Autism
Spectrum Disorder in Adolescents
and Adults, 2013
I. A qualified professional must conduct the evaluation:
•
•
•
•
Licensed psychologist/neuropsychologist
Psychiatrist
Relevantly trained medical doctors, developmental
pediatricians, child neurologists, clinical social workers,
School psychologists, speech and language therapists,
occupational therapists.
Documentation from more than one source, often
involving a multi-disciplinary approach.
Banerjee and Brinckerhoff, June 2013
10
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
ETS Policy Statement for
Documentation of ASD (cont’d)
II. Documentation Necessary Must be Comprehensive:
• Specific diagnosis or diagnoses
• Description of current symptoms in the testing
environment and across settings
• Relevant information regarding the test taker’s prescribed
use of medications and side effects
• Relevant information regarding current treatment
• A narrative discussion of all relevant information including
results of standardized assessment measures.
• Specific recommendations for accommodations
Banerjee and Brinckerhoff, June 2013
11
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
ETS Policy Statement for
Documentation of ASD (cont’d)
III. Relevant Testing Domains:
“ETS acknowledges that a clinical discussion of symptoms
may be more valuable than a standardized score.”
• Cognitive
• Executive functioning
• Expressive and receptive language and communication
• Psychiatric, personality, and behavioral
• Sensory-motor integration
• Attention/Memory/Learning
• Visual-perceptual motor skills
• Academic achievement
Banerjee and Brinckerhoff, June 2013
12
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
ETS Policy Statement for
Documentation of ASD (cont’d)
IV. Interpretive Summary
“Many of the core features of ASD are not captured in test
scores.”
V. Alternative Diagnoses should be ruled out
VI. Currency Requirements of the Documentation
“ASD is an enduring disorder that exists across the lifespan.
Functional limitations of the disorder, however, may
change depending upon the test taker’s age as well as
environmental demands.”
Documentation must be from the last 5 years.
Banerjee and Brinckerhoff, June 2013
13
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
ETS Policy Statement for
Documentation of ASD (cont’d)
VII. Rationale for each requested accommodation must
be provided
“A link must be established between the
requested accommodations and the manifested
symptomatology of the disorder that is pertinent
to the anticipated testing situation.”
Banerjee and Brinckerhoff, June 2013
14
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
ETS Policy Statement for
Documentation of ASD (cont’d)
VIII. Additional sources of information:
• IEP, 504, SOP, prior evaluations, evidence of
accommodations, a detailed letter from the college
disability provider, vocational rehab counselor, or a human
services professional describing current limitations and use
of accommodations.
• A personal letter from the test taker in his/her own words
• Appendix I- DSM-5
• Appendix II- Recommendations for Consumers
• Appendix III- Testing instruments
• Appendix IV-Social Cognition
Banerjee and Brinckerhoff, June 2013
15
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Why grant accommodations to
ASD students?
•
•
•
•
•
16
Co-occurring disabilities
Perfectionist tendencies
May fixate on the wording of test questions
May over-analyze content in test questions
Testing environment may warrant
modifications.
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Case Study: “Craig”
Profile: 29 year old marriage and family therapist
who is seeking to take the GRE. He is requesting
the following testing accommodations:
– extended time (time and one-half)
– calculator
– paper-based test
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
“Craig”, cont’d
• His documentation is limited. It does not include
cognitive or achievement testing, but it does
have a very compelling description of what ASD
is in adults, and how it specifically manifests in
Craig’s diagnostic profile.
– work history
– current medications
– diagnostic measure (RAADS-R)
– functional limitations
What would
would you
you do?
do?
What
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.
Thank you
Q&A
Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.