International Meeting for Autism Research: Implementation of the Autism Diagnostic Observation Schedule by School Assessment Professionals

Implementation of the Autism Diagnostic Observation Schedule by School Assessment Professionals

Friday, May 21, 2010: 1:45 PM
Grand Ballroom AB Level 5 (Philadelphia Marriott Downtown)
1:15 PM
N. Akshoomoff , Dept. of Psychiatry, University of California, San Diego, San Diego, CA
C. Corsello , Casrc, Rady Children's Hospital - San Diego, San Diego, CA
L. A. Palinkas , School of Social Work, University of Southern California, Los Angeles, CA
Background: While many children with ASD are identified before entering a school program, a significant number are not identified until they are assessed for special education services. . Often school-based professionals are making a determination regarding eligibility for services under the educational category of autism. School districts often encourage the use of a standardized instrument when evaluating a child for autism but limited information is available about implementation.

Objectives: This exploratory study was designed to identify factors contributing to short-term implementation of the research based diagnostic measure, the Autism Diagnostic Observation Schedule (ADOS) by school assessment professionals. The potential added benefit of individualized feedback following the two-day workshop was also examined.

Methods: Participants were 46 school assessment professionals (30 school psychologists and 16 speech-language pathologists; 89% female) who attended an ADOS two-day workshop and agreed to participate in this follow-up study. A subset (N =15) provided videos of their ADOS testing and attended feedback meetings with the trainers. An average of 5 months later, participants completed a questionnaire about their experience using the ADOS and participated in a small group discussion meeting.

Results: Participants who provided videos of their ADOS administration following a feedback session showed great improvement in administration and coding. Across all participants, the number of assessments conducted with a child with possible or known ASD since the time of the ADOS workshop ranged from 0 to 40 (M = 10.9, SD=9.9) and the total number of ADOS administrations ranged from 0 to 15 (M = 3.3, SD=3.9). In the time following the ADOS workshop participants thus included the ADOS less than half the time they assessed a child for ASD (M = 37.8%). Regarding future use, 47% indicated they would "definitely" use the ADOS and 53% indicated they "may" use the ADOS. Among those who met with a trainer regarding their ADOS administration and coding, 78% indicated they would definitely use the ADOS while only 37% of those who did not meet with a trainer indicated this. Noted barriers to implementation were related to equipment, time, and difficulty with ADOS coding. Participants noted that an advantage of the ADOS was characterizing specific symptoms instead of relying solely on parent report.

Conclusions: ADOS training guidelines indicate practice and support are needed for new users, factors that are often overlooked by school district officials and assessment professionals when considering adoption of the ADOS. The results from this study indicate that without added support, targeted feedback, and opportunities for practice it may be difficult for school teams to effectively implement the ADOS in their autism evaluations.

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