loring c. brinckerhoff dir, office of disability policy educational testing service

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Unraveling the Complexities of Autism Spectrum Disorders (ASD)

for Testing Accommodations

Presented to Building Bridges

Stockholm, SwedenMay 2014

Loring C. BrinckerhoffDir, Office of Disability PolicyEducational Testing Service

[email protected]


What is ASD?

A neuro-developmental disorder ranging from mild to severe that is characterized by core features of social/communication deficits, repetitive/restrictive behaviors, and a lack of emotional reciprocity

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DSM-5 Changes to ASD

• The four previously separate disorders (e.g, Asperger’s disorder, childhood disintegrative disorder, and PDD- NOS) are now viewed as a single condition with different levels of symptom severity in two core domains:o deficits in social communication and social

interactiono restricted, repetitive behaviors, interests &

activities

4Banerjee and Brinckerhoff, June 2013


College Students with ASD are on the Rise

• ASD affects 1 to 1.5 million Americans. • The CDC (2013) estimates that 1:88 individuals have ASD. • 3-4 times more prevalent in males• Number of test takers with ASD requesting

accommodations on ETS tests is increasing each year. • A recent study by SRI International (2012) noted that

“STEM related majors were more common among college students with ASD than students with any other type of disability.”

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College

Students with Asperger’sDespite intellectual and academic gifts, persons with AS have a decreased ability to decipher the intentions and actions of others, to integrate multiple streams of incoming information, and to navigate an increasingly complex social world. They may be rigid and perfectionistic and resist changing to meet the demands of their environment.”

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(Wolf, Thierfeld Brown & Bork, 2009)


Why Develop Documentation Guidelines for ASD?

• ETS Policy Statements for LD, ADHD, and Psychiatric don’t fit this population.

• Need to move away from the LD discrepancy model review mindset

• ASD documentation typically does not show test scores with significant deficits in cognitive profiles or in achievement areas.

• The key is an in-depth discussion by the evaluator of symptomatology.

• Documentation may involve multiple professionals.

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Documentation Considerations

• ASD is often picked up at school age and misdiagnosed as ADHD.

• ASD should spill over into two or more settings.• Look for relevant information regarding current

treatment.• Individuals with ASD may experience difficulties

with major life activities such as learning, reading, concentration, and/or thinking.

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Documentation Considerations (cont’d):

• The use of psychotropic drugs is becoming increasingly common, so there may be side effects of medication to consider.

• Both the positive and negative effects of medication should be noted.

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ETS Policy Statement for Documentation of Autism

Spectrum Disorder in Adolescents and Adults, 2013

I. A qualified professional must conduct the evaluation: • Licensed psychologist/neuropsychologist • Psychiatrist • Relevantly trained medical doctors, developmental

pediatricians, child neurologists, clinical social workers,• School psychologists, speech and language therapists,

occupational therapists.

Documentation from more than one source, often involving a multi-disciplinary approach.



ETS Policy Statement for Documentation of ASD (cont’d)

II. Documentation Necessary Must be Comprehensive: • Specific diagnosis or diagnoses• Description of current symptoms in the testing

environment and across settings • Relevant information regarding the test taker’s prescribed

use of medications and side effects• Relevant information regarding current treatment• A narrative discussion of all relevant information including

results of standardized assessment measures. • Specific recommendations for accommodations




III. Relevant Testing Domains:“ETS acknowledges that a clinical discussion of symptoms may be

more valuable than a standardized score.” • Cognitive • Executive functioning• Expressive and receptive language and communication• Psychiatric, personality, and behavioral • Sensory-motor integration• Attention/Memory/Learning• Visual-perceptual motor skills • Academic achievement




IV. Interpretive Summary “Many of the core features of ASD are not captured in test

scores.”V. Alternative Diagnoses should be ruled outVI. Currency Requirements of the Documentation

“ASD is an enduring disorder that exists across the lifespan. Functional limitations of the disorder, however, may change depending upon the test taker’s age as well as environmental demands.”

Documentation must be from the last 5 years.




VII. Rationale for each requested accommodation must be provided

“A link must be established between the requested accommodations and the manifested symptomatology of the disorder that is pertinent to the anticipated testing situation.”




VIII. Additional sources of information:• IEP, 504, SOP, prior evaluations, evidence of accommodations, a detailed

letter from the college disability provider, vocational rehab counselor, or a human services professional describing current limitations and use of accommodations.

• A personal letter from the test taker in his/her own words• Appendix I- DSM-5• Appendix II- Recommendations for Consumers• Appendix III- Testing instruments• Appendix IV-Social Cognition



Why grant accommodations to ASD students?

• Co-occurring disabilities • Perfectionist tendencies • May fixate on the wording of test questions• May over-analyze content in test questions• Testing environment may warrant

modifications.

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Case Study: “Craig”

Profile: 29 year old marriage and family therapist who is seeking to take the GRE. He is requesting the following testing accommodations:– extended time (time and one-half)– calculator– paper-based test


“Craig”, cont’d

• His documentation is limited. It does not include cognitive or achievement testing, but it does have a very compelling description of what ASD is in adults, and how it specifically manifests in Craig’s diagnostic profile.– work history– current medications– diagnostic measure (RAADS-R)– functional limitations

What would you do?

What would you do?


Thank you

Q & A

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