ABA Assessment Test 3

For learners who are between 9 and 11...

...and who have not achieved beyond the early language learner stage of the ABLLS-R a *shift towards functional skills is appropriate while continuing to work on the basic language skills*

AFLS can be used for...

...learners from approximately 2 through the lifespan

For learners who are 12 and older...

...regardless of skill level, should *prepare for greater independence* through instruction on functional skills

VB-MAPP Transition Assessment

Contains 18 assessment areas to help identify if a child is making progress and if they can move on to a less restrictive educational setting

Developmental Disabilities Include

Intellectual deficits, autism, epilepsy, cerebral palsy, neurological impairment (including learning disabilities)

Z Score

Is interpreted by the number of standard deviations a score varies from the mean (either in the positive or negative direction)

VB-MAPP Barriers Assessment

Provides an assessment of 24 common barriers to learning and language faced by children with autism

Top 2 Intelligence Tests

WISC and Stanford-Binet

Severity Levels of ASD

*Level 3* "Requiring very substantial support" *Level 2* "Requiring substantial support" *Level 1* "Requiring support"

How to decide if the mean or median is more reliable

*Skews* are how you decide if the mean or median is more reliable. If it is a positive or negative skew, you use the median to determine the most reliable score.

Prompting

*Stimulus that ensures correct responding to SD.* Prompt type depends on learner and situation.

Autism Spectrum Disorder Definition

- Developmental disorder characterized by deficits and atypicalities in social communication and behaviors -Previously known as pervasive developmental disorders in DSM-IV - ICD-10 still contains a category for PDD as well as Asperger's syndrome

Correlates of Intelligence

-*High correlations with academic achievement* (.80 with achievement tests and .50 with academic grades). -*High to moderate correlations with job performance*, especially with professional level vocations. -*Positive correlations shown with a wide variety of health related and quality of life issues*

People involved in the AFLS

-*Learner*: person that you're assessing from age 2-lifespan -*Caregiver*: anyone who complete the assessment and who provides for the learner at home, school, or in some setting -Demonstration of what learner "knows" should be observable in some way (either through seeing it or if has been seen by others or through direct assessment)

VB-MAPP Levels

-*Level 1 (orange)*: 9 measures consistent with 0-18 mo. -*Level 2 (green)*: 12 measures consistent with 18-30 mo. -*Level 3 (blue)*: 13 measures consistent with 30-48 mo.

Measures of Variability

-*Range* - distance from the lowest to highest score. -*Standard deviation* - most widely used measure of variability. -*Variance* - the square of the standard deviation

Difference between verbal prompts and discriminative stimuli (concepts needed for scoring)

-*SD*: could be verbal, signals availability of a reinforcer for a response. It does not ensure that response. -*Verbal prompt*: a stimulus that ensures a correct response. Just because you're giving an SD doesn't mean the person isn't doing the response independently. But if the SD is supposed to be nonverbal and you give a verbal SD, it isn't independent.

Autism Prevalence

-1 in 59 -4:1 males:females

Transition Assessment

-18 measurable areas (Table 7-1 page 130) -Helps educators and parents make decisions regarding goals related to placement -*Category 1*:Content related to language, social, behavioral and academic domains -*Category 2*: Information about the child's ability to learn new skills outside of intensive teaching -*Category 3*: Self help, spontaneity and self direction

Dr. Leo Kanner

-1st person to diagnose Autism -1943- "autism" means self because he felt that the kids were different than kids with cognitive impairments or mental illness because they were turned in on themselves -Psychological theory of psychoanalysis takes over as predominant idea after Kanner

Spearman's "g"

-1st person to say that intelligence is one thing, you have a certain amount of "g" (potential) -"s" is error variance, other stuff that affects you. Remove "s" to find out "g"

Barriers Assessment

-24 barriers that may impede a child's learning and language acquisition -Once a specific barrier has been identified a more detailed functional assessment is required -An intervention plan should include both skill acquisition goals and goals addressing the barriers (often the lack of skill and the presence of the barrier is related)-Rate the barriers on the protocol using a likert scale (0-4)

Adaptive Behavior

-Adaptive behavior refers to a *set of skills that enable people to function effectively in their everyday lives*. Adaptive behavior is typically divided into three basic skill sets: 1) *conceptual skills*; e.g., fundamental reading skills, concepts of numbers and money, concepts of time, and written, verbal, and non-verbal communication skills; 2) *social skills*; e.g., interpersonal and relational skills, understanding and following social rules and customs, obeying laws, recognizing and detecting the motivations of others to avoid victimization and deception and, 3) *practical life skills*; e.g., activities of daily living (feeding, bathing, dressing), occupational skills, navigational skills, (such as using public transportation), and the ability to use communication devices such as telephones, etc.

Developmental Norms

-Age or grade equivalent --Average of kids by age or grade

Standard Scores

-All intelligence, academic achievement, social living skills, etc. -Renumber the raw scores to use the same test for different age groups -Calculate age and mean score and standard deviations for each age group --Ex. 5 becomes 100 for a 5 year old, based on a sample age group. 100 is the average and based on that. -Not interpretable by the average person

ADI-R

-Autism Diagnostic Interview - Revised -Same people who made the ADOS -To support the results of the ADOS -Takes about 1.5-2 hours to administer -Tends to have a bunch of false positives -Under-diagnoses very verbal individuals with Autism

Autism Spectrum Disorder

-Autism is considered a *developmental disability that is diagnosed within the framework of a mental disorder* -A developmental disability is a mental or physical impairment that is *manifested before the age of 2*, is *likely to persist indefinitely* and results in *substantial functional limitations* in at least three of the following areas: *Self care, language, mobility, self direction, independent living, economic self sufficiency*

What is the VB-MAPP based on?

-Based on Skinner's analysis of verbal behavior (1957) -Influenced by Dr. Joseph Spradlin's work applying Skinner's VB theories to individuals with developmental disabilities and his Parsons Language Sample (1963)

Level 1 Operant Level

-Beginning learner -Focus should be on establishing the six primary language skills (mand, tact, listener behavior, motor imitation, echoics and visual perception and matching) -Also some focus on social and play skills -Requires an intensive teaching format with a high number of trials and carefully arranged contingencies

Psycho-dynamic Theory of Autism

-Bruno Bettelheim -Refrigerator mother syndrome- maternal rejection causes Autism - child reverts into self -Very popular theory -Treatment: 1) play therapy, 2) institutionalization, 3) long term psychotherapy for mother

Administering AFLS

-Can be completed by a caregiver, parent, educator, behavior analyst, psychologist, speech and language therapist or other professional who has: --thoroughly studied the guide and protocols --frequent contact with the learner --knowledge of assessment procedures and interpretation of results

Hierarchical Models

-Compromise between Spearman and Thurstone -Educationally accepted, psychologically not as accepted -Not a usable model -Not a usable model -Not an adequate substitute for intelligence

How to Give the VB-MAPP

-Correct responses should be reinforced -Approximations may be scored as correct -Can be conducted in home, classroom or community -Administration time depends on child's age, cooperation and functioning level -Assessment of barriers occurs simultaneously with assessment of milestones

VB-MAPP Scoring

-Each milestone receives a score of 0, .5 or 1 according to the scoring criteria outlined in the guide -Some skills can be assessed informally through observation or through reliable others and some require formal testing. The method of measurement is noted for each milestone (O) Observation (T) Formal testing (E) Either observation or formal testing (TO) Timed observation

EESA

-Early Echoic Skills Assessment (Barbara Esch) -Included in the Level 1 and 2 Milestones Assessment -Evaluates a child's ability to repeat a speech model as compared to children birth - 30 mo. -100 total points divided between 5 groups -Optimal results may be obtained via a speech pathologist

Level 2 Operant Level

-Early learner -Focus on the core language program --expanding mand, tact and listener repertoires --Developing sentences --Beginning listener responding with form, function and class --Beginning intraverbal training --Developing social and verbal interactions with peers --Developing group and classroom skills --Learning in less restrictive settings -Requires intensive teaching with behavioral procedures with a gradual increase of teaching in the natural environment

Strengths and Weaknesses of Percentile Ranks

-Easy to calculate -Until you understand them, people confuse them with percent correct -Don't easily distribute- you can go from 50th-60th percentile rank with only 1 question right, but to go from 95th-96th percentile rank is a lot more questions right

Interpreting VB-MAPP Results

-First step is to determine a general level of the child (1, 2 or 3) -Even if a child obtains points in multiple levels, what is the general level? -Then you analyze scores within each relevant domain

Basic Structure of VB-MAPP

-Five Components to the Assessment: 1) VB-MAPP Milestones Assessment 2) VB-MAPP Barriers Assessment 3) VB-MAPP Transition Assessment 4) VB-MAPP Task Analysis and Supporting Skills 5) VB-MAPP Placement and IEP Goals

AFLS Behavioral Cusps Necessary for Independence

-Flexibility -Following directions -Compliance with spoken directions -Unspoken directions in context -Staying with a caregiver or in a designated area -Positive social interactions -Walking and traveling with caregivers -Appropriate behavior in a vehicle -Fundamental self help skills -Health and grooming -Decreasing unusual reactions to sights and sounds -Leisure activities -Following routines -Generalized use of existing skills

Developmental History

-Focuses on milestone at 15, 18, and 24 months

SRS-2

-For high functioning kids with Autism (also for kids without Autism, but with social issues) -Great for developing social goals

When can functional skills be taught?

-Functional skills *can be taught at a very young age* -Skill such as self help, hygiene, and social interactions should be *taught simultaneously with intensive early language development* -The AFLS was therefore created to compliment the ABLLS-R

Teaching through task analyses

-Functional skills are best taught by *breaking complex tasks into smaller teachable skills* (task analyses) and then using prompts and prompt fading to teach the required chain of skills (shaping and chaining) -Flow charts are great for general education learners for decision making -Taught with prompting, reinforcement, repetition trials

Teaching in real life

-Functional skills can be taught in analog conditions, however it is *best that they are taught in naturalistic conditions under real life contingencies* - this builds in generalization. -Remember that professionals have been trained in goal writing and effective teaching procedures -Caregivers in naturalistic conditions are not behavior analysts or teachers, you need to train them how to teach. Train them how to teach.

Normed Scores

-Gives meaning to raw scores -Could be: --Percentile ranks --Standard scores --Developmental norms

Strengths of Developmental Norms

-Have a naturalness to their meaning -Progresses over time

Variability

-How the scores *vary around the measures of central tendency* (specifically how they vary around the mean). -How *far apart* the scores are -How *messy* the scores are -How *widespread* the scores are -How *different* the scores are -How *scattered* the scores are -How *distributed* the scores are -How *close together* the scores are -How *compact* the scores are -How *centralized* the scores are around something -*The entire basis of interpreting a norm referenced assessment.*

Common Characteristics of Intelligence Tests

-Individually administered -Administration requires advanced training -Tests usually cover a wide range of age and ability -The examiner must first establish rapport with the examinee -Typically require immediate scoring of individual items -Administration usually requires about 1-2 hours -Allows opportunity for observation apart from the formal test

Skills Tracking System

-Initial assessment can be conducted over a period of several weeks -Results are displayed on the skills tracking display grid -Can be updated 4 times using one protocol

AFLS

-It is impossible to include all needed skills in one assessment -Criterion referenced -The AFLS is broken down into 6 different assessment modules -Each assessment module can be given in isolation or the modules can be given together as a full assessment of functioning across environments and situations -Each module tests out the basic skills necessary to be independent in that environment/setting -See the protocols for skills assessed

Prompt Fading

-It is necessary for the prompt to be faded and eliminated as quickly as possible -Failure to fade a prompt can result in prompt dependency -Prompt dependency can be highly difficult to eliminate once established

Scoring the Protocol

-Just like the ABLLS-R -Do not overestimate competence -Score a 0 if the person is unable to do it (except for the NA options) --Do a complete interview -> observe in natural condition -> test out

For learners under 5 years of age...

...and who have mastered the ABLLS-R curriculum, the next move would be to a *focus on typical academics as well as functional skills*

Diagnostic Red Flags

-Lack of appropriate gaze -Lack of warm, joyful expressions with gaze -Lack of sharing enjoyment of interest -Lack of response to name -Lack of coordination of gaze, facial expression, gesture and sound -Lack of showing -Unusual prosody (intonation and tone) -Repetitive movements or posturing of body, arms, hands or fingers -Repetitive movements with objects -Lack of response to contextual cues -Lack of pointing -Lack of vocalizations with consonants -Lack of playing with a variety of toys conventionally

Diagnostic Process

-Made by a professional licensed to make it -Psychologist, neurologist, pediatrician (usually) -Made based on a combination of screening tools, behavioral rating scales, developmental history, parent interview, and direct observation -Diagnosis can be made with an interdisciplinary approach including speech, occupational and physical therapists as well as other related professionals -*Formal diagnosis can only be made through the DSM-5 criteria* (also the only legal way to diagnose Autism)

15 Month Milestones for ASD

-Makes eye contact when spoken to -Reaches to anticipate being picked up -Shows joint attention (shared interest) -Displays social imitation -Waves "bye-bye" -Responds to spoken name consistently -Responds to simple verbal request -Says "mama" or "dada"

Measures of Central Tendency

-Measures of central tendency tell us around which scores the data tend to cluster. -*Mean* - arithmetic average -*Median* - middle score when arranged from lowest to highest -*Mode* - most frequently occurring score

Administration of VB-MAPP

-Milestones mark a significant point along the way to a greater destination -Goal is to *achieve a level of linguistic competence similar to typically developing peers* -Identifying milestones in different areas provides for more focused intervention

Selecting goals for teaching from AFLS

-Most of goals should come from items in the Basic Living Skills protocol -Address issues as low as possible on the scoring grid before addressing higher level skills -Always consider the behavioral cusps necessary for independence

What are the purpose of norms?

-Norms and normed scores *make test results interpretable*. -The *score obtained on a test cannot be interpreted unless it can be compared to scores of other individuals*. These individuals are referred to as the Norm Group. -*Your performance is judged based on how other people do. Scores on a norm referenced test have comparative meaning.* -Normed scores can also be called *derived scores or scaled scores.*

Limitations of AFLS

-Not an exhaustive list of skills -Does not identify steps in the teaching process that are necessary to teach the skills -Does not provide age norms -Does not compare performance to a peer norm group (it is criterion referenced skills assessment)

PDDBI

-Objective -Detailed -Sticks to behavior of Autism -Normed on kids with a diagnosis of Autism -Diagnosible range is an averaged score

Percentile Ranks

-One of the most misinterpreted scores out there -The 50th percentile is right where you should be -The percentile rank tells the percentage of cases in the norm group falling below a given raw score. -Must be stated in a clinically meaningful way --Ex. 80% of peers scored higher (will get your services) --Ex. Just as well or better than 90% of people in a standardized class

Determining the Operant Level for VB-MAPP

-Operant level refers to the *baseline level of a skill* or what the child currently knows -The VB-MAPP Milestones Assessment determines operant level across various skills -Items can be completed with or without formal testing -Items well below the operant level can be quickly scores as 0 -If 3 milestones in a row received a score of 0 a ceiling has been hit and that section can be stopped

18 Month Milestones for ASD

-Points to body parts -Speaks some words -Has pretend play -Points out objects -Responds when examiner points out object

VB-MAPP Task Analysis and Supporting Skills

-Provides a more complete and ongoing breakdown of the skills in the Milestones Assessment -750 skills representing prerequisite skills and future skills

VB-MAPP Milestones Assessment

-Provides a sample of a child's existing verbal and related skills 170 measurable learning and language milestones -Three developmental levels (0-18 mo., 18-30 mo., and 30-48 mo.) -Includes the Early Echoic Skills Assessment (EESA)

Weaknesses of Developmental Norms

-Psycho-metrically poor - a lot is assumed -Don't test every grade -Completely misinterpreted -Reading 6th grade material as an average 11th grader would read it - you're reading your grade level really well

Early Diagnosis of ASD

-Research continues to indicate that *behavioral intervention provided before are 3.5 has greater impact than that after age 5.* -Because there are no genetic or neurological markers for ASD, screening and *diagnosis must be based solely on behavioral features*. -Despite greater awareness of the disorder, the *mean age for diagnosis in the US is between 3 and 5 years of age*. Diagnosis is often made when the child enters school. -Although diagnosis is often made after 3, *most parents of children with ASD recall having concerns about their child's development in the first 2 years.* -Concerns, often brought to the awareness of the child's pediatrician, were ignored or redirected.

Behavioral Perspective

-Skinner -Lovaas- '60s-'80s, focuses on changing behavioral characteristics with ABA -No known cause of Autism, biological predisposition with environmental findings

Level 3 Operant Level

-Solid foundation of skills -Developmental equivalent of about 30 months -IEP goals will depend on a careful analysis of the child's VB-MAPP scores across domains including addressing barriers -Expansion of all skills using the Scoring Form and the Supporting Skills Form

Task Analysis and Supporting Skills

-Task analysis skills refer to earlier skills that should be prerequisites to the milestone -Supporting skills supplement the milestone -Not to be used as an assessment

Stanford-Binet

-The original -France wanted to find a way to get rid of the kids who "couldn't" learn -Came to the US in 1916

Diagnostic, Rating, and Screening Instruments

-The process of evaluating autism spectrum disorder is complex and cannot be reduced to a single score from a single test -Rating scales cannot be used in isolation to make a diagnosis -They can be useful to a clinician as one source of qualitative information within a more comprehensive assessment -The only way to formally diagnose an individual on the autism spectrum is to rely on DSM-5 characteristics

Raw Scores

-The raw score is the immediate result of testing. -Raw scores are meaningless without a reference point. -Need to be a standardized score or percentile rank to matter -Raw scores must be interpreted

Negative Skew

-The skier is skiing in the direction you're going to call it (towards the negative numbers) -Numbers are actually high -*Mean will always be lower than a majority of people did on the test* -Median is a better number to use

Positive Skew

-The skier is skiing in the direction you're going to call it (towards the positive numbers) -Numbers are actually low -Some *people did so well that it drags the mean higher* than the majority of people performed at

Shifting from Academics to Functional Skills

-There is a point in a learner's life where *conceptual and academic learning needs to be replaced with specific practical skills required to improve independence.* Determined by the student's age and ability. -If a skill does not in some way make the learner less dependent on others, it is not a functional skill.

Definition of Intelligence

-There is no universally agreed upon definition of intelligence. -Psychologists who regularly study in this area agree that intelligence involves: *Thinking abstractly, solving problems, identifying relationships, learning quickly, memory, speed of mental processing, learning from experience, effective planning and dealing effectively with symbols*

Thurstone's primarily mental abilities

-Things don't sum together into a "g" -Isn't Spearman's "g" of adding up of Spearman's concepts?

24 Month Milestones for ASD

-Uses two-word phrases -Imitates household work -Shows interest in other children

Age and Diagnosis for VB-MAPP

-VB-MAPP can be conducted with any language delayed individual, regardless of age of specific diagnosis -Typically for younger children, however materials can be individualized in order to take age appropriateness into account with older learners

Types of Prompts

-Verbal -Gestural -Model (imitative) -Physical -Partial physical -Positional -Intra-stimulus -Etc.

Vineland Adaptive Behavior Scales

-Vineland, NJ -Edgar Doll -Interview between a psychologist and a caregiver -Anyone can give a Vineland with basic training -You don't ask the questions, you ask the person to explain things the kid does -Free flowing interview -Mean of 100 with standard deviation of 15 -Shows deficits in daily living -Not objective - easily faked

Typical Items in Individual Intelligence Tests (except nonverbal scales)

-Vocabulary -Verbal relations -Information -Meaning, comprehension -Arithmetic -Short-term memory -Form patterns -Psychomotor -Matrices

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history:

1) *Deficits in social-emotional reciprocity*, ranging, for example, from abnormal social approach and failure of normal back and forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. 2) *Deficits in nonverbal communicative behaviors used for social interaction*, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. 3) *Deficits in developing, maintaining, and understanding relationships*, ranging , for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interests in peers. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life). 4) Symptoms cause *clinically significant impairment in social, occupational, or other important areas of current functioning*. 5) These disturbances are *not better explained by intellectual disability or global developmental delay.* Intellectual disability and ASD frequently co-occur; to make comorbid diagnoses of ASD and IDD, social communication should be below that expected for general developmental level.

Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:

1) *Stereotyped or repetitive motor movements, use of objects, or speech* (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2) *Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior* (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day). 3) *Highly restricted, fixated interests that are abnormal in intensity or focus* (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4) *Hyper or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment* (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

AFLS is broken down into 6 different assessment modules

1) Basic Living Skills 2) Home Skills 3) Community Participation Skills 4) School Skills 5) Independent Living Skills 6) Vocational Skills

Developing the Task Analysis

1) Make a list of all steps necessary 2) Identify decisions needed to be made for each step 3) Determine criteria for completion of each step

Formal Criteria for ASD Diagnosis

1) Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history: 2) Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history:

Sources of Information for AFLS

1) The majority of information will be obtained from parents, educators and other caregivers who have regular contact with the learner 2) Some information will come from direct observation in natural conditions 3) Some information will come from formal presentation of tasks to the learner

Examiner Requirements for VB-MAPP

1. Basic understanding of Skinner's analysis of verbal behavior 2. Knowledge of basic behavior analysis 3. Familiarity with basic language structure 4. Familiarity with linguistic development of typically developing children 5. Understanding of autism and other developmental disabilities 6. Must read the manual and practice administration

IQ Score for IDD

Below 70

CARS 2

Childhood Autism Rating Scale -Most popular (Dr. Cicero doesn't like it thought) -Built on DSM-III criteria, not DSM-V

Scale of Intellectual Disabilities

Mild Moderate Severe Profound

M-CHAT

Modified Checklist for Autism in Toddlers -Tends to overidentify

DSM-5 Intellectual Disability Criteria

Must meet the following three criteria: 1) *Deficits in intellectual functions*, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning and learning from experience, and practical understanding confirmed by both clinical assessment and individualized, standardized intelligence testing. 2) *Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence* and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, and across multiple environments, such as home, school, work, and recreation. 3) *Onset of intellectual and adaptive deficits during the developmental period*

Heredity and Environment

Nature vs Nurture -Heritability is .5 -It is a misconception that hereditary influences are permanent and unchangeable, whereas environmental influences are impermanent and changeable.

VB-MAPP Placement and IEP Goals

Provides instructional directions, general IEP suggestions and placement guide

Narrative Reports

Ranges based on standard deviations

Functional Skills

Skills that have an *immediate benefit and use for the learner*. If the learner is unable to do the skill for himself, then someone else will have to help or do them for him. Skills *can be functional for one individual and not for another, depends on what that individual needs to do.* Skills that we use every day and needed for independence.

A Z score of 1 means...

The score falls one standard deviation above the mean.

A Z score of -2 means...

The score falls two standard deviations below the mean.