Uniquely Hari: Screening/Diagnostic Measures

Showing posts with label Screening/Diagnostic Measures. Show all posts

ADOS-2 Training

ADOS-2 Training Certificate

Infantile Autism v Regressive Autism

Did you know?

Infantile Autism vs Regressive Autism

Screening / Diagnostic / Psychological Measures

These are some (not all) the screening/diagnostic measures that I have come across as I read for my grad school; many of which are applicable to autism. Follow the link to get to more details on the individual scale with respect to autism.

Clinical Dx

DSM-V-TR provides dx criteria and guidelines for autism

DSM vs RDoc

DSM vs ICD: DSM is used in the US, ICD is used internationally [more...]

Screening for Autism

IQ Tests

Communication and Behavior

Behavioral /Developmental

ADHD

SWAN - Strengths and Weaknesses of ADHD Symptoms and Normal Behavior

Tests of Empathy

TASIT: The Awareness of Social Inference Test

Sensorimotor Domain

SSTPQ - The Self, Space, and Time Perception Questionnaire

Post is in progress.

DSM v ADOS

DSM-5-TR (latest version of DSM) and ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition) are two distinct tools used in assessment and dx of autism.

DSM-5-TR

Diagnostic manual that outlines the criteria for diagnosing ASD, including the presence of social communication deficits and RRB.
Serves as a reference for clinicians and researchers in making diagnostic decisions and ensures consistency in the diagnosis of ASD.

ADOS-2

standardized observational assessment tool designed to aid in the diagnosis of ASD.
Administered by a trained professional and involves direct interaction with the individual
consists of a series of activities and social scenarios that allow the examiner to observe and evaluate the individual's communication skills, social interaction, play, and RRB.
It helps in determining whether an individual meets the diagnostic criteria for ASD and provides information to inform intervention and treatment planning.

ADOS-2 can be utilized as part of the diagnostic process, providing valuable information to support the dx under DSM-5. Both tools are commonly used together to aid in the assessment and diagnosis of Autism Spectrum Disorder.

WASI-II Wechsler Abbreviated Scale of Intelligence

The WASI-II (Wechsler Abbreviated Scale of Intelligence) is an IQ test for ages 6-90. It is a shorter and simpler measure based on the more comprehensive Wechsler Intelligence Scale for Children (WISC) and the Wechsler Adult Intelligence Scale (WAIS).

WASI-II measures cognitive abilities across a range of domains and provides an estimate of a person's general intellectual ability (or Full Scale IQ - FSIQ). It is often used in research studies, and often used to screen for intellectual disability or giftedness, or to assess cognitive abilities in the context of neuropsychological evaluations or clinical diagnoses.

Uses in autistic population

Assessment of Cognitive Abilities: believed to help identify cognitive strengths and weaknesses in verbal comprehension and perceptual reasoning, which can be informative for planning educational/ behavioral interventions.
Research: frequently used in autism research studies as measure of cognitive ability.
Diagnosis: While the WASI-II itself isn't a dx tool for autism, it can be part of a broader diagnostic assessment as it is believed that understanding an individual's cognitive functioning can perhaps provide context for other symptoms or behaviors.

Mental Age

The concept of "mental age" in assessments has been subject to criticism and limitations. Here are some reasons why

Normative Bias: Mental age is based on comparing an individual's performance to the average performance of a specific age group. However, these age norms may not adequately account for cultural, linguistic, or socioeconomic differences. The concept assumes that all individuals progress at the same rate, which may not be true or fair across diverse populations.
Arbitrary Cutoffs: Mental age relies on the notion of discrete age categories, which can lead to arbitrary cutoffs and potential misclassifications. Development is a continuous process, and individuals may display a range of abilities that do not neatly align with specific age groups.
Lack of Sensitivity: The concept of mental age does not capture the full complexity and multidimensionality of human intelligence. It may oversimplify and overlook individual strengths, weaknesses, and variations in cognitive abilities across different domains.
Limited Predictive Value: Mental age alone may not provide sufficient information about an individual's future development or functional outcomes. It does not account for the dynamic nature of cognitive abilities and the potential for growth and change over time.
Reinforcement of Deficit-Based Approaches: The focus on mental age as a deficit-oriented measure may perpetuate stigmatization and negatively impact individuals' self-perception and opportunities for growth.

It is essential to approach assessments and diagnostic criteria with a comprehensive and nuanced perspective, considering multiple factors beyond a single measure like mental age to ensure a holistic understanding of an individual's abilities and needs.

IQ Testing

IQ is a measure designed to assess an individual's cognitive abilities and intellectual functioning; specifically it aims to assess various aspects of intelligence, including verbal comprehension, perceptual reasoning, working memory, processing speed, and problem-solving abilities. These tests typically cover domains such as language, math, spatial reasoning, and logical thinking.

IQ scores are derived by comparing an individual's performance on the test to a representative sample of the population. The scores are standardized and follow a bell curve distribution, with the average score set at 100. Scores above 100 indicate above-average intelligence, while scores below 100 indicate below-average intelligence. The standard deviation is typically 15 points, meaning that about 68% of the population falls within the range of 85-115.

Commonly used IQ tests in Autism

WAIS: Wechsler Adult Intelligence Scale (ages 16-90)
WISC-V: Wechsler Intelligence Scale for Children (ages 6-16)
KABC-II: Kaufman Assessment Battery for Children (ages 3-18)
MSEL: The Mullen Scales of Early Learning (ages birth - 5)
DAS: The Differential Ability Scales (ages 2-17)
Leiter-R (ages 2-20+)
RIAS (ages 3-94)
CAS Cognitive Assessment System (ages 5-17)

See Post: Why is IQ Testing especially problematic in the Autistic Population

Other general problems and limitations of IQ Testing:

Narrow Assessment: IQ tests primarily measure cognitive abilities related to academic success and may not capture the full range of human intelligence, such as creativity, emotional intelligence, or practical skills.
Cultural Bias: IQ tests have been criticized for potential cultural bias, as they may reflect the experiences, values, and knowledge of specific cultural or socioeconomic groups. Some questions or tasks may be more familiar or relevant to individuals from certain backgrounds, leading to potential disparities in scores.
Limited Contextualization: IQ tests provide a snapshot of an individual's abilities at a specific point in time and may not account for the influence of environmental or socio-economic factors, educational opportunities, or individual motivation on test performance.
Interpretation Challenges: IQ scores are often misinterpreted or used as a sole indicator of an individual's worth or potential, neglecting the complexity of human intelligence and the importance of other factors such as motivation, personality traits, or social and emotional skills.

History: The concept of IQ testing dates back to the early 20th century. Alfred Binet and Theodore Simon developed the first modern intelligence test in 1905. Over time, numerous IQ tests have been developed, revised, and standardized.

Why IQ Testing is Problematic in Autistics

Some reasons why IQ Testing is Problematic in Autistics.[What is IQ Testing]

Communication, Language and Social Challenges: Many IQ tests heavily rely on verbal and social interaction (including comprehension, vocabulary, & verbal reasoning), which can be challenging for autistics who may experience difficulties with language, communication, (eg: difficulties with expressive and receptive language, pragmatics, and understanding abstract or ambiguous language) and social skills. This can lead to misinterpretations of their abilities.

ADOS - Autism Diagnostic Observation Schedule

The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured assessment for diagnosing autism. It consists of various social and play-based activities designed to observe behaviors related to autism. [See posts on other Screening/Diagnostic Measures]

Limitations of ADOS as a dx tool

Not a Standalone Diagnostic Tool: It is intended to be part of a comprehensive evaluation, which should also include other assessments and detailed developmental history.
Snapshot in Time: ADOS provides a snapshot of an individual's behavior during the time of the assessment, which may not capture the full range of behavior or abilities.
Limited Scope: It primarily focuses on two areas: social interaction and communication, and restricted/repetitive behaviors. Other aspects of autism, such as sensory issues or co-occurring conditions, are not part of the primary scoring system.
Language and Age Constraints: While ADOS offers different modules for different developmental stages and language abilities, it may not be entirely suitable for all individuals, particularly those with complex profiles or co-occurring conditions.
Requires Specialized Training: to ensure accurate administration and interpretation of the results. This requirement can limit its accessibility and use.
Culture and Context: The ADOS was developed in English-speaking countries and may not fully account for cultural differences in behavior and communication. Translated versions are available, but they may not capture all nuances.
Reliability of Diagnosis over Time: Some studies have questioned the reliability of the ADOS over time, especially in younger children, where symptoms and behaviors can change significantly as the child grows and develops.

ASQ: Ages and Stages Questionnaires

The Ages and Stages Questionnaires (ASQ) is a developmental screening tool designed to assess the developmental progress of children from birth to 5 years of age.

The ASQ is a parent-reported questionnaire that assesses various domains of child development, including communication, fine and gross motor skills, problem-solving, personal-social skills, and adaptive behaviors. It is used to identify potential developmental delays or concerns and determine the need for further evaluation or intervention.

Limitations of the ASQ include the reliance on parent-reported information, which may be subject to biases or inaccuracies.

Scoring and Interpretation:
The ASQ uses a scoring system based on the number and nature of items that the child has achieved. Each item is scored as "yes," "sometimes," or "not yet." The scores are used to identify potential developmental concerns or delays. There are established cutoff scores for each age-specific questionnaire that help determine if further evaluation or intervention is needed.

The ASQ was developed by Jane Squires and Diane Bricker in the 1990s.

Citation:
Squires, J., & Bricker, D. (2009). Ages & Stages Questionnaires®, Third Edition (ASQ-3™). Baltimore, MD: Brookes Publishing.

STAT: Screening Tool for Autism in Toddlers and Young Children

The Screening Tool for Autism in Toddlers and Young Children (STAT) is a play-based screening measure designed to identify early signs of autism in toddlers and young children. It t assesses social communication and play behaviors associated with ASD in children between 24 and 36 months of age.

Limitations

The STAT is a screening tool and not a diagnostic instrument. A comprehensive evaluation by a qualified professional is necessary for a definitive autism diagnosis.

Scoring and Interpretation
The STAT includes a series of play-based activities and social interactions between the child and the examiner. The examiner observes and scores the child's behaviors in different domains, such as joint attention, pretend play, and social responsiveness.

The STAT scoring involves rating specific behaviors observed during the play-based interactions. The scoring criteria may vary depending on the specific version or adaptation of the STAT being used. There are established cutoff scores that help identify children who may be at risk for ASD and require further evaluation by a qualified professional.

History and Revisions:
The STAT was developed by Wendy Stone, Barry L. Prizant, and Samuel P. Openden in 2008.

Citation:
Stone, W. L., Prizant, B. M., & Openden, S. (2008). The Screening Tool for Autism in Toddlers and Young Children (STAT). Retrieved from https://www.researchgate.net/publication/228625486_STAT_Screening_Tool_for_Autism_in_Toddlers_and_Young_Children

See posts on Screening/Diagnostic Measures

SCQ - Social Communication Questionnaire

The Social Communication Questionnaire (SCQ) is a caregiver-reported questionnaire that evaluates social communication and interaction patterns in individuals suspected of being autistic. It was derived from the Autism Diagnostic Interview-Revised (ADI-R). It is designed for use with children and adults who have a mental age [see post on why "mental age" is problematic] of at least 2 years and 6 months. It is often used as a screening tool in clinical and research settings. [See posts on other Screening/Diagnostic Measures].

Limitations:

The SCQ is a screening tool and should not be used as a standalone diagnostic instrument. A comprehensive evaluation by a trained clinician using multiple assessment methods is necessary for a formal autism diagnosis.
Co-occurring Conditions: Many individuals with ASD may have co-occurring conditions such as intellectual disabilities, language impairments, ADHD, anxiety, or sensory processing difficulties. The SCQ focuses specifically on social communication and interaction and may not fully capture the range of challenges associated with co-occurring conditions such as language challenges, ADHD, anxiety or sensory processing.
Caregiver reports are subject to biases and inaccuracies, as they rely on the caregiver's observations and interpretations of the individual's behaviors.
Caregivers' ability to accurately report on specific social communication behaviors and experiences of nonspeaking autistics may be limited.
The SCQ is not designed to assess other developmental disabilities apart from ASD.