Announcement: Carol Fiorile has a new website!

After months in development, I am ecstatic to finally announce the launch of my new website athttp://www.carolfiorile.com, which is offered as a resource for you. I have created this website, which will be a work in progress, in order to educate parents and educators. I hope my new website enables you to learn more about my work with children with special needs, and to offer any assistance. It is my hope that you enjoy exploring this new website.

Contact me at carol@carolfiorile.com .

What types of evaluation and assessment tools are used for children suspected of having learning problems?

A major problem in the evaluation and/or assessment of children diagnosed with autism is the deficit areas, particularly that of language, that are targeted on most norm-referenced evaluations. Therefore, scores yielded as a result of standardized testing MUST BE interpreted with caution when determining cognitive and language skills, in particular, for children with autism.  There are other types of assessments that are often conducted, which fall into the category of criterion-referenced tests. The distinctions between these tools follow:

What is a norm-referenced test?

 This is a type of test that bases the outcomes on comparisons among the target population. Based on the standard bell curve, individuals receive percentile rankings which place him or her in a position relative to the other test takers within the specified population. A norm-referenced test provides information relative to others within that population, and usually assesses more general information. 

What is a criterion-referenced test?

This is a type of test that provides information related to whether or not the individual has learned the material. A criterion-referenced test allows the examiner to make statements about the specific behaviors of the individual being evaluated relative to specific subject matter.  A good example of a criterion-referenced test is an end of chapter review for American History, or a math test at the end of the unit. 

The Importance of Early Treatment

Why is early intensive treatment so important? Just as an early diagnosis and treatment for cancer, for example, is so important in the individual patient’s prognosis for recovery, so too is an early diagnosis and treatment for autism. Early treatment recommendations called for 40 hours of instruction weekly for 12 months, as recommended by Dr. Ivar Lovaas.  Current treatment recommendations are usually based on the severity of the symptoms and are made on an individual basis.  These treatment recommendations often include not less than 30 hours per week of intensive instruction, speech/language therapy, occupational therapy, and parent training. Children who are treated early are less likely to establish behavior patterns that are increasingly more difficult to change after several years. Therefore, the earlier therapy can begin, the less likely it is that rigid patters of behavior will be ‘cemented’ into the child’s repertoire and the more likely it is that treatment will result in the optimum result for the individual child. Subsequent chapters will focus on the myriad of treatment options, and will provide a clearer understanding of which options may be most useful for your child.

What are Autistic Spectrum Disorders?

Autism

Autism may become apparent in infancy, although the usual timeline for diagnosis is between 18 and 36 months. Some of the early signs include a lack of eye contact, lack of babbling, no single words by 16 months of age, and often a regression in skills becomes apparent sometime during the child’s second year of life. There is a higher incidence of diagnosis among boys. The primary aspects of autism include deficits in the areas of socialization, reciprocity, understanding and production of language, non-verbal imitation capabilities, and severe limitation of the child’s interests and activities. Many children with autism develop language, which may be marked by literal, repetitive, and non-communicative language, often what is termed ‘echolalia.’  There are two types of echolalia. A common echolalic response is  characterized by a repetition of the words spoken by another person which are immediately repeated by the child with autism. A second type of echolalic response is commonly referred to as ‘scripting,’  or delayed echolalia . This type of language response is characterized by the child repeating words (i.e., over-learned scripts) that he or she heard previously, often from a favorite TV show or DVD.  It is important that these behaviors be specifically addressed in the child’s intervention program. For example, a poorly implemented program will employ instructors who overuse verbal prompts with your child, leading to an increase rather than a decrease in echolalia. Of course that is the result, because your child is being taught how to be echolalic! Without specific prompt-fading strategies in place via a systematic plan to fade out those prompts, you can expect that your child will continue to be echolalic and may even become increasingly unable to respond to any questions at all.

Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS)

PDD-NOS is a sub-condition on the autism spectrum in which some, but not all, of the features of autism are present. PDD-NOS is often incorrectly referred to as PDD. However, PDD is the umbrella term for the Autism Spectrum of disorders and is not a specific diagnosis. PDD-NOS is a diagnosis in which social skills appear to be less impacted than for children diagnosed with classical autism. For this group of children, intellectual deficits are less common and they may be diagnosed later than children with classical autism. 

Asperger’s Syndrome

Individuals with Asperger’s Syndrome often have traits that include an intense and limited interest. These individuals may be compulsive and rigid, and appear to be socially awkward or timid. Some individuals with Asperger’s Syndrome may have no early indication of a developmental delay and may in fact be intelligent and continue developmentally in a relatively typical manner. Individuals with Asperger’s Syndrome are often described as ‘loners’ or ‘nerds,’ although they are interested in generating friendships but, due to awkward approaches and insensitivities, their efforts are unsuccessful. The symptoms of Asperger’s can be changed over time but are not usually completely overcome. One of my students diagnosed with Asperger’s is so interesting. If you tell him the date you were born, including the year, within a few seconds he can tell you the day of the week you were born on. Amazing! And he’s always correct!!