Chapter 9 Exceptional Learners

Evidence-Based Specific Practices and Programs for Students with Autism Spectrum Disorders

(1) *evidence-based specific practices*: are video self-modeling and social narratives. (2) *evidence-based programs*: programs that meet the requirements for being evidence-based are Picture Exchange Communication System (PECS), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH), and Pivotal Response Training (PRT). (3) *Service Delivery Models*: In this model, general educators and special educators work together to meet the individual needs of students with autism. However, little research describes how this collaboration should look in the classroom. --> we don't have precise figures on how many students with ASD are in the various educational environments. --> state-of-the-art teaching emphasizes the most natural possible human interactions.

*Social narratives *

are brief stories (which can also contain drawings or pictures) describing social situations (e.g., going to the grocery store, playing during school recess, flying on an airplane) that present possible social interaction challenges while offering examples of appropriate responding.

*autistic regression*

child progressed normally for about the first 2 years and then abruptly began to regress in behavior. - occurs in about 1 out of 3 cases of children with autism

*occipital lobes*

in the back of the brain; which are largely responsible for visual perceptual processing

*Autism spectrum disorders (ASD)*

involve myriad aberrant perceptual, cognitive, linguistic, and social behaviors. - *symptoms vary and the *severity* of the symptoms can be wide ranging.

*Applied behavior analysis (ABA)*

is a highly structured approach that focuses on teaching functional skills and continuous assessment of progress. - is a comprehensive approach that emphasizes positive reinforcement or rewarding of desired behaviors. In its original conceptualization, ABA also meant punishing undesired behaviors.

Picture Exchange Communication System (PECS)

is one augmentative and alternative communication (AAC) system that educators have successfully used to support the communication needs of individuals with autism - It's estimated that one third (1/3/ to 1/2) to one half of children with autism lack functional communication - Using PECS, individuals with no or limited speech can initiate requests and describe observations through the use of pictures. PECS can be used as an alternative communication system (i.e., the primary means of communication) or as an augmentative communication support (i.e., in conjunction with speech or the development of functional language). pg 210

Androgen Theory

it is a hormone that is responsible for controlling the development of male characteristics; high levels in their mothers' amniotic fluid before birth are more likely to exhibit autistic traits as children. - some have come to refer to persons with autism as having an *extreme male brain (EMB)*.

positive behavioral intervention and support (PBIS)

PBIS involves finding ways to support positive behaviors of students rather than punishing negative behaviors. It focuses on the total environment of the student, including instruction.

*Animal Assisted Interventions (AAI)*: What's the Evidence?

Using animals to help treat children with autism spectrum disorders has mushroomed in popularity. At first blush, for the general public, the notion of children with ASD "connecting" with animals when they can't relate to people seems reasonable. At first blush for scientists, however, the notion of dolphins or horses as aid to reduce symptoms of ASD seems far-fetched. Fortunately, researchers have begun to turn their attention to whether AAI has merit. - A systematic review of AAI suggests that AAI has achieved the status of "proof of concept," a term borrowed from the business world, indicating that a new product has enough positive research support to bring it to market. Equine therapy, in particular, has been found by several researchers to benefit persons with ASD. The therapy has involved horseback riding, as well as grooming and stable chores.

Temple Grandin

a high functioning person with ASD; she "thinks" in pictures. - high functioning autism have well-developed visual and spatial processing abilities and poor social skills.

*Theory of Mind (ToM)*

refers to a person's ability to take the perspective of other people. It's the ability to "read" the mind of other people with respect to characteristics such as their intentions, feelings, beliefs, and desires. The reading of social cues is another way of saying that a person can anticipate and understand what another is probably thinking. - *the more severe the ToM impairment, the lower the cognitive abilities and severity of autism symptoms.* - ToM impairment in individuals with ASD can result in problems with social skills

*stereotyped motor or verbal behaviors*

repetitive, ritualistic motor behaviors such as twirling, spinning objects, flapping the hands, and rocking, similar to those that are evident in some people who are blind

What is the "*gold standard*" for diagnosing autism?

the American Psychiatric Associa-tions's Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) • DSM-5 divides them into *two general domains*: *1.* "social communication impairment" and *2.* "repetitive/restricted behaviors." - The DSM-5 no longer recognizes Asperger syndrome as a separate entity; instead, it emphasizes that ASD is an umbrella term.

*central coherence *

the natural inclination for most people to bring order and meaning to information in their environment by perceiving it as a meaningful whole rather than as disparate parts. - autistic individuals have weak central coherence.

Autism Savant Syndrome

their autistic symptoms can be severe, with serious developmental delays in overall social and intellectual functioning, they have remarkable skills or talents, which often involve preoccupation with the memorization of facts. - extremely rare classification

*evidence-based programs*:

*PECS* focuses on language, *TEACCH* stresses structure, organization, and use of visual cues, and *PRT* targets pivotal, or key, skills that, once learned, can lead to progress in other skill areas. For students with relatively severe language deficits, the Picture Exchange Communication System (PECS) involves the use of pictures to help students initiate and maintain functional communication. The *TEACCH* (Treatment and Education of Autistic and Related Communication Handicapped Children) approach places heavy emphasis on structure. The physical environment has boundaries for such things as group work, independent work, and play. Activities are structured, using scheduling, organization, and routine, so that children know what they will be doing throughout the day. A key element of the pro-gram is its emphasis on visual cues, such as labeling, color coding, pictures of tasks, and so forth. Pivotal response teaching *(PRT)*: is based on the assumption that some skills are critical, or pivotal, for function in other areas. ---> PRT emphasizes using ABA's structured approach of continuous assessment and reliance on behavioral learning theory to teach pivotal skills. Some of these pivotal areas are motivation, self-management, initiations, and responding to multiple cues—all areas of difficulty for many persons with autism spectrum disorders. ---> Motivation is obviously critical to many areas of learning. PRT fosters motivation by emphasizing natural rewards of the child's own choosing.

Using video modeling and video self-modeling

*What the Research Says* - A growing number of studies have demonstrated the effectiveness of video modeling and video self-modeling for *increasing the functional, vocational, social communication, and behavioral skills of students with autism*. During video modeling (VM) a competent peer or adult demonstrates a behavior or skill that the target student will later perform. Video self-modeling (VSM) involves the student watching a video of himself or herself competently completing a task. Research has shown that viewing video models is a powerful teaching technique. Video modeling, however, has been largely applied to non-academic tasks. With increasing numbers of students with autism being served in general education classrooms, researchers are now exploring the efficacy of VM and VSM for increasing academic skills. *Research Findings* - In both studies, the researchers found that viewing a video self-model on an iPad was an effective instructional approach. Burton et al. found that across all four participants the use of VSM resulted in students successfully learning and applying the new problem-solving skills. Hart and Whalon's study demonstrated that watching the VSM increased the students' accurate, unprompted responding in class.

Genetic basis of ASD

- Studies have shown that when a child is diagnosed with autism, the chances are 15% that his younger sibling will be also be diagnosed with autism. This percentage is 25 to 75 times higher than in the population as a whole - sporadic genetic mutations (spontaneous deletions and/or duplications of genetic material) are involved in some cases.

Intestine-Microflora-brain basis of ASD

- children with autism are more likely than children without autism to exhibit gastrointestinal distress, such as chronic diarrhea and constipation - researchers have found a correlation between the severity of autism symptoms and the level of bacteria in the gut - the levels and types of bacteria differ in persons with autism, with some bacteria elevated and some depressed compared to individuals without autism - Taking it one step further, they "treated" the mice with a probiotic. Not only were there positive changes in their intestines, but the mice displayed fewer "autistic" symptoms—less anxiety, better social behavior, and less repetitive digging.

Autism and the brain

- the brains and heads of young children with autism tend to grow suddenly and excessively starting perhaps as early as the first year of life. - This is then followed by a *deceleration*, such that they are about normal in size by adolescence. - The significance of abnormally high rates of brain growth in the first 2 years is underscored by the fact that this is a *time of critical importance* to brain organization.

functional behavioral assessment (FBA)

FBA involves determining the consequences, antecedents, and setting events that maintain such behaviors - *Consequences*: refer to the purpose the behavior serves for the person. - *Antecedents*: refer to things that trigger the behavior. - *Setting events*: take into account the contextual factors in which the behavior occurs.

Kanner's Paper

Found *major characteristics* such as: • An inability to relate to others in an ordinary manner • An extreme autistic aloneness that seemingly isolated the child from the outside world • An apparent resistance to being picked up or held by the parents • Deficits in language including . . . echolalia. . . . • Extreme fear reactions to loud noises • Obsessive desire for repetition and maintenance of sameness • Few spontaneous activities such as typical play behavior • Bizarre and repetitive physical movement such as spinning or perpetual rocking (Scheuermann & Weber, 2002, p. *major conclusion* - these children could be distinguished from children who had schizophrenia in at least three ways: *1.* The children with schizophrenia tended to withdraw from the world, whereas the children with autism *never seemed to have made any social connections to begin with*. *2.* The children with autism *exhibited some unique language patterns*, such as pronoun reversals (e.g., I for it, he for she) and echolalia, the repetition of words or phrases. *3.* The children with autism *did not appear to deteriorate in their functioning over time*, as did some children with schizophrenia.

What does *spectrum* emphasize?

Spectrum emphasizes that the disabilities associated with ASD fall on a *continuum* from relatively mild to severe.

Students with ASD in the General Education Classroom

Successful Strategies for Collaboration -> One such model is the *Autism Spectrum Disorder Inclusion Collaboration model* which "emphasizes shared responsibility and shared decision making among general educators, special educators, and support personnel. The model also permits consideration of both learner behaviors and instructional factors" (p. 117). --> The model includes *five main components*: (1) environmental and curricular modifications, general education classroom support, and instructional methods; (2) attitudinal and social support; (3) coordinated team commitment; (4) recurrent evaluation of inclusion procedures; and (5) home-school collaboration. The model isn't prescriptive in its recommendations for how collaboration should look in the classroom, but it does list *specific items that should be in place in each component in order for collaboration to work*. These items include: *Environmental and Curricular Modifications*: • Availability of appropriately trained support personnel • In-service training • Implementation of appropriate instructional methods • Availability of paraeducators • Adequate teacher planning time • Reduced class size *Attitudinal and Social Support* • School administration has positive attitude toward inclusion • Administrative support for those working to include students with autism spectrum disorders • Dissemination of information about autism spectrum disorders • Use of curricula and experiences to facilitate understanding and sensitivity toward students with autism spectrum disorders • Social interaction training for students with autism spectrum disorders *Coordinated Team Commitment* • Clear definition of roles for service delivery personnel • Effective communication • Shared decision making *Recurrent Evaluation of Inclusion Practices* • Evaluating appropriate supplemental aides and services • Evidence of benefit from participation and education • Student demonstration of appropriate participation *Home-School Collaboration* • Meaningful participation • Suitable administrative supports • School's willingness to listen

Asperger's Paper

The 6 children he observed had similar characteristics to Kanner's cases with 2 notable exceptions: *1.* they had average intelligence, although they seemed to channel their intellectual pursuits into obsessive preoccupation in narrow areas, such as machinery or mathematical calculations. *2.* their language was perceived as normal.

When does autism become evident?

deficits *begin in early childhood*, even though they might not become evident until later, often when the child's poor communication skills become apparent

*Synaesthesia*

occurs when the stimulation of one sensory or cognitive system results in the stimulation of another sensory or cognitive system. - people with autism experience a neurological mixing of the senses, or synaesthesia. - extraordinary capabilities in such things as playing music, drawing, or mathematical calculations.

Autism and air pollution:

one can't rule out the possibility of some as yet undetected factor(s), such as *toxins*, contributing to the increase - For example, some preliminary evidence suggests a *relationship between the amount of air pollution and the prevalence of autism*.

Theory of Mind: The Sally and Anne Experiment

researchers investigated whether children with autism ages 6 to 16 years could recognize that others can have false beliefs that affect their judgment - Using two dolls (Sally and Anne), an investigator played out a scenario to three groups of children (ASD, Down syndrome, no disabilities). *The scenario was designed to determine how capable the children were in understanding what the thinking of another child would be*. Each child was tested individually, with the following steps: 1. The child is introduced to two dolls—Sally, who has a basket and Anne, who has a box. 2. Sally puts a marble into her basket and covers it up. 3. Sally leaves the room. 4. Anne takes the marble from Sally's basket and hides it her own box. 5. Sally comes back into the room. 6. The experimenter asks the child, "Where do you think Sally will look for the marble?" If the child says that Sally will look in her own basket for the marble (not in Anne's box), the conclusion is that he or she is able to recognize Sally's perspective, which reflects having a "theory of mind". The vast majority of the children without disabilities and even the children with Down syndrome answered correctly. - However, only a few of the children with autism spectrum disorder gave the correct response. They were unable to understand that Sally had no way of knowing that the item had been switched—that to her way of thinking, the marble was where she had left it.

*behavior management*

severe levels of autism, sometimes display highly inappropriate behaviors, such as biting, hitting, or screaming. - authorities recommend that a combination of functional behavioral assessment (FBA) and positive behavioral intervention and support (PBIS) can help reduce or eliminate these behaviors.

*person-centered planning*

whereby the person with the disability is encouraged to make her own decisions as much as possible.

*frontal lobes*

which are largely responsible for executive functioning

How do professionals *define* autism spectrum disorders*= (ASD)?

• *Autism spectrum disorders (ASD)* is characterized by clinically significant deficits in social communication and by restricted, repetitive patterns of behavior, interests, and activities. • People who have Asperger syndrome have higher cognitive and language skills than those with classic autism, but they have problems in other areas, especially social interaction.

What causes autism spectrum disorders?

• *Early causal theories* were influenced by psychoanalytic thinking and blamed parents, often mothers, for causing autism by being too cold and unresponsive. ➞ Hans Asperger had conjectured that there was a biological and hereditary basis for autism ➞ Kanner also speculated that the cause of autism was biological, but he noted that the parents of these children were not "warmhearted." ➞ psychoanalytic: Bruno Bettelheim (1967) conceived a theory that cold and unresponsive mothers caused autism. The term *refrigerator moms* (once used to refer to mothers of children with autism) is trace dback to Bruno. • *Today's causal theories* point to a neurological and genetic basis for autism. ➞ neurological—not interpersonal—factors are involved. Strong evidence that genetics, neurological factors, and environmental contributions interact to result in autism in many cases. ➞ Genetics can contribute to poor neuronal connections related to neurological anatomy and weakened synaptic strength that can result in vulnerability to environmental factors (e.g., toxic chemicals, maternal health issues, and early social deprivation) that results in symptoms of ASD ➞ given the range of symptoms and levels of severity of ASD, it's a reasonable guess that *no single neurological or genetic cause exists*. ➞ autism is better conceived as a *disorder of neural networks* rather than as being due to an abnormality in one particular part of the brain. ➞ *Neuronal underconnectivity*: the brain cells of individuals with autism exhibit deficient connectivity which disrupts the cells' ability to communicate with each other; between the frontal lobes and the occipital lobes of the brain is a likely cause of autism spectrum disorder. This underconnectivity in infants as young as *6 months* of age. ➞ Evidence indicates that *heredity as well as spontaneous genetic mutations* are involved in causing autism. ➞ Evidence indicates that *no single gene results in autism*. ➞ The best scientific evidence indicates that the measles, mumps, rubella *(MMR) vaccinations do not cause ASD*.

effective preschool programs for children with autism spectrum disorders:

• *Entry* into intervention programs *as soon as an autism spectrum diagnosis* is seriously considered • Active engagement in intensive instructional programming for a minimum of the equivalent of a full school day, 5 days (at least 25 hours) a week, with full-year programming varied according to the child's chronological age and developmental level • Repeated, planned teaching opportunities generally organized around relatively brief periods of time for the youngest children (e.g., 15-to 20-minute intervals), including sufficient amounts of adult attention in one-to-one and very small group instruction to meet individualized goals • Inclusion of a family component, including parent training • Low student-teacher ratios (no more than two young children with autistic spectrum disorders per adult in the classroom) 2:1 ratio • Mechanisms for ongoing program evaluation and assessments of individual children's progress, with results translated into adjustments in programming.

Autism in IDEA

• Autism has been a *separate category* under the Individuals With Disabilities Education Act (IDEA) since 1990, it and other similar disorders are now typically collected under a broader term: autism spectrum disorders (ASD).

What methods are used to *identify* individuals with autism spectrum disorders?

• For autism, the psychiatrist uses DSM-5 criteria that focus on communication skills, social interactions, and repetitive and stereotyped patterns of behavior. ➞ DSM-5 considers ASD symptoms to fall under two general categories: social communication impairment and repetitive/restricted behaviors, ➞ DSM-5 *doesn't recognize Asperger* syndrome as a distinct category within ASD. ➞ Uses observation and behavior checklist parents/teachers fill out • Clinicians often use two instruments that are considered the *"gold standards"* for diagnosing ASD: *(1)* the Autism Diagnostic Observation Scale (ADOS) and *(2)* the Autism Diagnostic Interview-Revised (ADI-R). ➞ *ADOS*: involves observing the child in several semi-structured play activities ➞ *ADI-R*: is used to interview caregivers about the child's functioning in language/communication, reciprocal social interaction, and restricted, repetitive, and stereotyped behaviors. • Some *early signs of autism* are a lack of the following: no babbling or pointing by age 1, no single words by 16 months or two-word phrases by age 2, no response to name, loss of language or social skills, poor eye contact, excessive lining up of toys or objects, no smiling or social responsiveness.

What is the *history* behind autism spectrum disorders?

• In 1943, Leo *Kanner* reported on cases of children, whom he labeled as "autistic," who had major problems in communication and social interactions, as well as bizarre repetitive movements and an obsessive dislike of change. • In 1944, Hans *Asperger* reported on cases of children, whom he referred to as having "autistic psychopathy," whom he thought had normal intelligence and language but who were socially isolated and had obsessive interests in extraordinarily narrow areas • (Bleuler, 1916/1951) coined Autism was a label that had been coined earlier in the 20th century and was used to refer to individuals who had an extremely narrow range of personal relationships and restricted interactions with their environment: "a withdrawal from the fabric of social life into the self. - 'autistic' and 'autism' from the Greek word *autos meaning 'self'"*

What are some important considerations with respect to *transition to adulthood* for learners with autism spectrum disorders?

• In general, regardless of symptom severity, *fewer than 1/2 half of young adults with ASD are employed*, which is even less than young adults with intellectual disabilities • the majority of adults with autism *don't live independently* • For those with *more severe ASD*, the emphasis is on *person-centered planning*, with living arrangements in *community residential facilities or supported living settings* and placement in *competitive employment or supported competitive employment* situations. • For those with *less severe ASD*, such as Asperger syndrome, the focus is often on improving social interactions both in employment and in postsecondary settings (college). --> research shows social interaction issues tend to increase as they reach adolescence and adulthood. --> when people with Asperger syndrome do experience job difficulties, the cause is usually *inappropriate social interactions* rather than job performance.

Autism and vaccinations:

• In the late 1990 early 2000s, a controversy raged about whether the measles, mumps, rubella (MMR) vaccine can cause autism. • Scientific community believes the debate should be extinguished for *lack of evidence*. • 1998, Andrew Wakefield & 12 others published a paper that reported two major findings pertinent to the issue of autism. *1.* They asserted that nine of the children were determined to be autistic. *2.* Parents or physicians of eight of the children attributed the onset of autistic symptoms to MMR vaccination; that is, the symptoms suddenly appeared a short time (48 hours to 2 weeks) after vaccination. • Measles outbreaks occurred in England and the United States as a result of belief in Wakefield's study. • In 2009, 1 in 5 parents in the United States believed that vaccines could cause autism • 10 of the 13 authors of the Wakefield paper offered a retraction; in 2010 the Lancet published a retraction of the Wakefield et al. study. • The Institute of Medicine of the National Academies commissioned a review of the available evidence. They concluded that there was no evidence that vaccines cause autism. • Wakefield had failed to disclose a potential conflict of interest—his name was on a patent for a new medicine designed to prevent measles, and he and one of his colleagues had not selected the participants for the study in an unbiased manner. • the time the vaccination is administered coin-cides with the age when children start displaying signs of ASD

What are some important considerations with respect to *early intervention* for learners with autism spectrum disorders?

• Most early intervention programming focuses on children with relatively severe degrees of ASD rather than those with milder issues because the severe issues are more likely to be diagnosed earlier. • To be *most effective*, education and related interventions for students with autism must be early, intensive, and highly structured and should involve families (*family intervention is essential*. • Research reveals that the vast majority of children diagnosed as having ASD at an early age (about 2 1⁄2 years old) do not improve when tested again at 5 1⁄2 years of age • The most effective early intervention programs are intensive, use principles of applied behavior analysis (ABA), are highly structured, and involve families. One such program that has been effective for some but not all children is the *Early Intensive Behavioral Interventions (EIBI)* program. --> (EIBI) program requires considerable time commitments from therapists and parents in implementing very structured training on discrete skills, starting when children are about 2 to 3 years old. Some professionals therefore have been cautious in recommending it. --> is more effective when implemented before 2 years of age • Early intervention programs often use natural interactions to teach students in natural environments, including general education classrooms to the extent possible.

What are some of the *psychological and behavioral characteristics* of learners with autism spectrum disorders?

• People with ASD have deficits in social interaction, communication, and cognition; they also have *repetitive and stereotyped patterns of behavior*, and some have abnormal sensory perceptions. • Impaired social communication in communicative intent, joint attention, and pragmatics. ➞ Most lack *communicative intent*, the desire to communicate for social purposes. Many infants and young children with autism display a lack of *joint attention*, the process of one person alerting another to a stimulus via nonverbal means, such as gazing or pointing. --↳ Some have severe language impairments and some can be *mute*; they use no, or almost no, language. Their speech sounds "robotic," or they might exhibit echolalia, parroting what they hear. --↳ typically show abnormalities in intonation, rate, volume, and content of their oral language. ➞ They have cognitive deficits similar to those of people with intellectual disabilities; some have additional peculiarities, such as processing things visually and spatially rather than conceptually or linguistically. ➞ Some, who are referred to as having autism savant syndrome, have extraordinary specialized skills. ➞ Examples of abnormal sensory perceptions are being hyperresponsive, hyporesponsive, or having synaesthesia (a mixing of sensory information). • Compared to people with more severe ASD, those with Asperger syndrome often display a milder degree of *impairments or abnormalities in social interaction*, communication, repetitive and stereotyped patterns of behavior, cognitive processing, and sensory perceptions. ➞ People with Asperger syndrome often have difficulties with social interactions, understanding the *hidden curriculum* (the dos and don'ts of everyday living that most learn from little instruction), and taking things too literally. ➞ Another communication challenge in Asperger syndrome is in *pragmatics*, the social uses of verbal and nonverbal communication skills. ➞ ASD individuals have *trouble reading social cues*; deficits in recognizing emotions, facial expressions, and vocal intonation • The abnormal sensory perceptions of people with ASD can sometimes be manifested by being *hyperresponsive or hyporesponsive* to particular stimuli in their environment • *Three theories* have been proposed to account for the many deficits in autism spectrum disorders. No single one explains all the deficits of all the disorders, but together they begin to build a composite picture. ➞ (1) Problems with *executive functions*, including working memory, self-regulation of emotions, and the ability to plan ahead. ➞ (2) Problems with *weak central coherence* involve paying too much attention to details or parts in cognitive processing, thereby leading to impairments in conceptualizing coherent wholes. ➞ (3) Problems with a *theory of mind* lead to impairments in taking another person's perspective, or being able to "read" what others might be thinking.

What is the *prevalence* of autism spectrum disorders?

• Prevalence figures have *risen dramatically in the past 30 to 40 years*, with the U.S. Centers for Disease Control and Prevention (CDCP) now estimating that *1 out of 68 persons has ASD*. • *Males outnumber females 5:1* in ASD. ➞ reasons for this disparity vary from *males being biologically more susceptible* to neurological dysfunction to professionals having a *biased tendency to refer* and/or diagnose males. • ASD occurs in all socioeconomic, ethnic, and racial groups. ➞ Lower rates in latino children. • From 2005 to 2011, the prevalence of students ages 6 to 21 who were identified as having ASD doubled, with the most recent rate being 0.59%. • The prevalence rate is just as high, if not higher for countries in Europe and Asia. • Prevalence reasons: Most authorities maintain that the increase in autism is due to: 1. widening of the criteria for ASD, 2. a greater awareness of autism spectrum disorders, 3. diagnostic substitution (e.g., persons now identified as having an autism spectrum disorder previously might have been identified as having intellectual disabilities). ➞ the prevalence of students identified as having intellectual disabilities fell by 22%.

What are some *educational considerations* for learners with autism spectrum disorders?

• children with *severe* symptoms are unlikely to recover completely, although they might make substantial progress. Those on the *mild* end of the spectrum, however, can make enough progress that they can lead happy, productive lives, being employed and living independently. • *Educational programming* for students with autism spectrum disorder includes direct instruction of skills, including applied behavior analysis (ABA); instruction in natural settings; and behavior management, when needed, using functional assessment and positive behavioral intervention and support (PBIS). - educational programming for students with autism spectrum disorders should include *(1)* direct instruction of skills; ABA *(2)* instruction in natural settings, and *(3)* behavior management, when needed, using functional assessment and positive behavioral intervention and support. • Examples of approaches for students with autism spectrum disorder include the Picture Exchange Communication System (PECS), TEACCH, and pivotal response teaching (PRT).

How do professionals *assess the progress* of students with autism spectrum disorders?

• two critical areas of assessment: (1) Progress in language development and (2) social/adaptive behavior can be monitored using one or more scales designed for such purposes. - (1) Ongoing progress monitoring of language development can help the teacher or therapist determine if an intervention is meeting the needs of the student. --> The CELF-5 measures receptive, expressive, grammatical, and semantic skills for individuals ages 5 to 21. - (2) monitoring progress in social/adaptive behavior --> Taking only 5 to 10 minutes to administer, the *PDD Behavior InventoryTM Screening Version (PDDBITM-SV)* is designed to monitor progress in social/adaptive behavior of students 18 months to 121⁄2 years old. --> The *Social Responsiveness Scale (SRS)* is a parent/ teacher scale that may be used to monitor progress in social/adaptive behavior (social awareness, social information processing, reciprocal social communication, social anxiety, and avoidance). The SRS evaluates the severity of social impairment of individuals with autism spectrum disorders between the ages of 4 and 18. --> The *Autism Social Skills Profile (ASSP)* is a standardized outcome measure that examines social skills of children and adolescents with autism spectrum disorder. The ASSP is completed by teachers or parents and includes three subscales: (1) Social Reciprocity, (2) Social Participation/Avoidance, and (3) Detrimental Social Behaviors. --> The *Childhood Autism Rating Scale 2nd Edition (Cars2)* is frequently used for screening and diagnostic purposes and can also be used to evaluate the effectiveness of interventions. CARS focuses on behaviors that deviate from those of typically developing children and is appropriate for children over 2 years old.