An Examination of School Psychologists’ Confidence in Conducting Evaluations for Autism Spectrum Disorder

Background: Recent estimates from the CDC suggest approximately 1 in 68 individuals are diagnosed with autism spectrum disorder (ASD) in the United States (Christensen et al., 2016). Within this group, boys are approximately 4.5 times more likely to be diagnosed than girls, which may reflect a difference in symptom presentations between boys and girls (“Facts About ASDs,” 2016; Rynkiewicz et al., 2016). The median age of initial ASD diagnosis ranges between 3 years, 10 months and 6 years, 2 months. Further, as many as 24% of children are first evaluated for ASD while enrolled in public schools. These figures suggest school psychologists must possess both competence and confidence when conducting ASD evaluations that lead to appropriate educational placement and services (Shriver, Allen, & Mathews, 1999). While little research has been conducted in this area, initial findings suggest a relationship between confidence and accuracy with school-based providers when identifying individuals with ASD (Hedley and colleagues, 2016).

Objectives: The current study examined confidence levels reported by school psychologists working for public school districts in Georgia. Specifically, we explored confidence levels related to the assessment of ASD with consideration for both students’ gender and age. We also examined predictive factors associated with higher levels of confidence including a) the average number of initial ASD evaluations conducted each year, b) years of experience as a school psychologist, and c) level of education.

 Methods: A 28-question, electronic survey was completed by 300 school psychologists who currently work in Georgia public schools. Based on IDEA section 618 data (U.S. Department of Education, 2016), the respondents represented approximately 42% of school psychologists in the state. Sample representativeness was deemed sufficient through a comparison of the respondents’ reported geographic region and the student populations for the 12 regions in the state. Chi-square tests of independence and binary logistic regression were employed to gauge statistical relationships.

Results: Results revealed no difference in school psychologists’ confidence when assessing ASD in male versus female students (p = 0.114). High versus Low Confidence levels were evaluated across age levels served, including preschool (2:10 – 4 years), elementary school (5 – 10 years), and middle/high school (11 – 18 years) aged children. High Confidence ratings for preschool-aged children were significantly lower than High Confidence ratings for elementary and middle/high school-aged children (33.3% versus 80.4% and 83.3%; p < 0.001). Univariate logistic models, considering school psychologists’ High Confidence in assessing ASD, found the highest confidence levels in practitioners with a doctoral degree (p = 0.090) and those who conducted more than ten initial ASD evaluations (p = 0.020) each year.

Conclusions: School psychologists reported similar levels of confidence in evaluating children across gender. Our findings support that greater educational training and clinical practice is predictive of higher confidence, which is consistent with results from the literature (Rasmussen, 2009). Further, school psychologists reported less confidence when assessing preschool children, a critical point given the current focus on early identification.