School Psychologists' Confidence in Conducting ASD Assessments

Background: With Autism Spectrum Disorder (ASD) in the U.S. reaching prevalence rates of 1 in 68, and an average age of diagnosis well beyond the entry age for special needs preschool (CDC 2010), public schools are increasingly tasked with assessing these students (Christensen et al., 2016; Pettygrove et al., 2013). Furthering the demand on school psychologists, ASD identification rates vary across racial and ethnic groups, with average ages of diagnosis in the school age years in disadvantaged communities (Christensen et al., 2016; Daniels & Mandell, 2014). In addition, girls with ASD may be missed in assessment due to variations in their presentation (Dean et al., 2014; Dworzynski, Ronald, Bolton, & Happe, 2012).

Objectives: To examine school psychologists’ confidence in assessing children with ASD. Specifically, school psychologists’ confidence in assessing various childhood disabilities, including ASD, learning disabilities (LD), and emotional and behavioral disorders (EBD) was compared. Follow-up analyses evaluated confidence in ASD evaluations across gender and bilingual children.

Methods: A team of clinicians and researchers created a survey with Likert-scale (1-5) questions assessing ASD assessment procedures in the school setting. The survey was emailed to 557 valid email addresses. After two reminder emails, a total of 333 surveys were completed. The response rate was 59%. IDEA Section 618 data records indicate that in 2013 there were 720 school psychologists, indicating the respondents represent approximately 46% of school psychologists in state of Georgia.

Results: A repeated measures ANOVA indicated variations in school psychologists’ confidence across ASD assessments (M=4.05; SD: .720), LD assessments (M=4.61; SD: .516), and EBD assessments (M=4.33; SD: .647) were significant (Greenhouse-Geisser correction F(1.748, 499) = 96.58; p<0.001). Effect sizes between ASD and LD assessment confidence were large (r = .617) and moderate for ASD as compared to EBD assessment confidence (r = .34). School psychologists were significantly less confident in assessing ASD than LD or EBD. Paired t-tests revealed significant differences in confidence assessing ASD in boys (M=4.07; SD=.693) versus girls (M=3.99; SD=.729) (t (286)= 4.23; p = 0.001; d= .112). School psychologists’ confidence in assessing ASD overall (M = 4.05; SD = .72) versus assessing ASD in bilingual children (M= 2.54; SD=1.08) was also significantly different (t (286) = 24.16; p <0.001; d = 1.65).

Conclusions: While school psychologists are often called upon to conduct assessments of ASD in the schools, they are much less confident in assessing ASD versus learning disabilities and emotional/behavioral disorders. In particular, school psychologists are reticent about their ability to assess bilingual children for ASD. This likely contributes to the later age of diagnosis and lower prevalence rates of nonwhite, Hispanic children (Locke et al., 2017). School psychologists also indicated lower confidence assessing girls for ASD, although this effect size was relatively small. As research indicates that most school psychologists did not receive specific pre-service training in conducting ASD evaluations, the need for increased pre-service and continuing education for school psychologists is apparent (Aiello, Ruble, & Esler, 2017; Combes, Chang, Austin, & Hayes, 2016).