School Psychologist Utilization of Evidence-Based Practice for Assessment of Autism Spectrum Disorder

Background: Although there are many global similarities between children with ASD, the population is extremely heterogeneous. Evaluating a child for ASD is often complicated, as practitioners must evaluate a wide range of behavior to determine where a child falls on the autism spectrum. The recent reported increase in the prevalence of ASD has created a growing demand for cutting-edge research examining how evidence-based practices (EBPs) developed for children with ASD can be effectively disseminated into community practice to improve diagnostic accuracy. Although consistency and reliability for ASD assessment practice has been established in the research community, it is unclear how ASDs are being assessed in community settings such as schools.

Objectives: This study assessed the benefits of training school psychologists to use evidence-based practices (EBPs) for ASD evaluations in school settings.

Methods: A single-subject, multiple-baseline design across participants was implemented with six school psychologists who collectively assessed 78 children for ASD over the course of the study. After a baseline phase where usual care for assessment of children with ASD was monitored, school psychologists were trained to utilize two standardized ASD assessments considered EBP for ASD evaluation in research settings: the Autism Diagnostic Observation Schedule (ADOS) and the Social Communication Questionnaire (SCQ). Throughout the study, ASD evaluations performed by participating school psychologists were videotaped and their subsequent child evaluation reports were collected in order to assess any effects of ADOS or SCQ training on school psychologist practice.

Results: Results indicate that school psychologists utilize a wide variety of practices when assessing children for ASD in the school setting but do not often use EBPs. School psychologists were not performing ADOS-related tasks during their usual care ASD assessment practice and many ASD-specific symptoms were not mentioned in subsequent child evaluation reports. After a 2-day ADOS Clinical Training, school psychologists administered the ADOS with good fidelity of implementation. Coding of individual ADOS items was challenging for the school psychologists, although overall ADOS classification determinations were typically accurate. Use of the SCQ was somewhat limited after training. Examination of child evaluation reports indicated that the school psychologists captured more ASD-specific behaviors after ADOS and SCQ training. 

Conclusions: School psychologists can and will utilize the ADOS, and to a lesser extent the SCQ, to evaluate children for ASD in the school setting with minimal training. Challenges to and advantages of school psychologist use of EBPs such as the ADOS and SCQ for ASD assessment will be discussed.