Question
I am a first year speech pathologist in the school system. I have a caseload of about 55 and am the only SLP in the district. The student that I am concerned about is an eighth grader who is autistic but also has a mild-moderate mental handicap. He has
Answer
The questions you pose are complex and multifaceted due to the scenario you provide. Unfortunately, there is not a quick and easy method to assess individuals who have autism.
First, I recommend you locate a local mentor who is well-versed in your state and school district policies and procedures, specifically in assessment and reassessment issues. It is my understanding that once an individual is placed in a diagnostic category reclassification is not the objective, unless a significant change in the individual is noted. The objective of the reassessment is to determine the continued need for services and to systematically review the status of the individual from all perspectives.
Regardless of age, a standardized test to assess language disorders in an individual with autism does not exist. However, there are tests that systematically look at verbal/nonverbal language communication scales. One of my favorites is the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 1993). I would also refer you to an article written by Hungerford (2004).
Research (Wetherby & Prizant, 2000) has indicated that language deficits in autism are typically manifested in the social or pragmatic areas. This explains why standardized tests are not readily available. In a standardized test, the clinician requires the individual to cooperate and rely on decontextualized items. Thus, the majority of informal assessments require interviewing and observation as the best choice as informal assessments allow the clinician to gather information in a context that is meaningful. In other words, can the individual use communication to relay basic information in order to have his or her needs met? If they can or can not, systematic observation allows the clinician to determine where the breakdown occurs for the individual.
I would also approach this assessment as "What can_____do with communication? Instead of focusing on deficits, explain what he or she is successfully communicating as it may be obvious to everyone what he or she can't communicate. Then step back and ask yourself why the individual is successful in some situations and unsuccessful in others? This may give you some clues as to why the challenging behaviors exist.
In conclusion, your scenario is one clinicians struggle with on a daily basis. However, the time invested in assessment will provide you with the information that will allow you to plan the best intervention.
References/Suggested Readings:
Hungerford, S. (2004, January). Assessing Autistic Children. Speech Pathology Online, Inc.
Johnston, S. & Reichle, J. (1993). Designing and Implementing Interventions to decrease challenging behavior. Language, Speech, and Hearing in Schools, (24), 225-235.
Wetherby, A. & Prizant, B. (1993). Communication and Symbolic Behavior Scales-Normed Edition. Baltimore, MD: Paul H. Brookes Publishing Co.
Wetherby, A. & Prizant, B. (Vol. Eds.) (2000). Autism Spectrum Disorders. Baltimore, MD: Paul H. Brookes Publishing Co.
Kerrilyn R. Phillips, SLP.D., CCC-CLP has been a speech-language pathologist for over 20 years. She is an Assistant Professor at Louisiana Tech University in Ruston, LA. Teaching and research areas are in early intervention, advanced diagnostics, child language, medically fragile, and professional issues. She has presented at local, state, and national conferences and meetings. She is the current Chair of the licensure board in Louisiana and serves on the Board of Directors for the Louisiana Speech, Language, and Hearing Association.
