Observations and Assessments for

Autism
OCT5ECC 2020
Over view of this session – 2.5 hours

• Students will learn about assessments used for Autism

• Sensory processing theory
• Students will explore assessments and assessment manuals that can
be used for sensory issues – Sensory Profile, SP 2, SPM in small
groups

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Living with ASD
What is ASD ?

http://www.youtube.com/watch?v=vIuIwD-fh9M
7.20-8. 30 (A special day out – removing self into another world. )

http://www.youtube.com/watch?v=Z_R_CUxrZ8I
1.30-3.01 hear the references to in the lines need for sameness ritual
3.01 To 3.53 sensory / interactional play social
Living with my autistic son - Description of Hunter and his tantrums / rituals “ lines”
issues with transitions

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 Autism Spectrum Disorder

• ASD has an estimated worldwide prevalence of around 1% to 2%.

• Persistent difficulties in social communication and interaction, alongside
restricted, repetitive behaviour patterns and interests.
• Core symptoms have an early onset in childhood and tend to persist
throughout the lifespan,
• Significant impairments in daily functioning, including school, work, self-care,
social relationships, independent living, and domestic life.

Schiariti, V., Mahdi, S., Bölte, S. (2018). International Classification of Functioning, Disability and Health Core Sets for cerebral palsy, autism spectrum
disorder, and attention-deficit–hyperactivity disorder. Developmental Medicine & Child Neurology, 60, pp. 933-94; doi: 10.1111/dmcn.13922

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ICF and ASD

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Impact of ASD
Impact of ASD
 Executive Function and Self Regulation
• Executive function and self-regulation skills are the
mental processes that enable us to plan, focus attention,
remember instructions, and juggle multiple tasks
successfully.
• These skills are crucial for learning and development.
They also enable positive behaviour and allow us to make
healthy choices for ourselves and our families.
• Executive function and self-regulation skills depend on
three types of brain function:
1. Working memory – retaining and manipulating
information over short periods of time
2. Cognitive flexibility – Sustaining and shifting attention to
different demands
3. Self-control/ Inhibitory control – resisting impulsive
actions

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 Self-Regulation

"Self-regulation is the ability to

attain, change, or maintain
an appropriate level of
alertness for a task or
situation" (Williams &
Shellenberger, 1996).

14 September 2020
Sensory processing – Sensory systems

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 Sound
Too much
noise outside Movement
Tactile/Touch
I need to get
Chair is not up!
comfortable!

Smell
Coffee smells
good
Vision
This is a funny slide

We are receiving a range of input right now….

This is possible due to our Sensory systems
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Sensory Patterns – Winnie Dunn
Need additional input
to respond to stimuli
but take a passive
approach

“I don’t seem to notice

when my face or hands
are dirty”

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Self-Regulation continuum across the sensory processing
model

Self regulation helps people do things in order

to participate and get the amount of
sensory input they need to help
participation.

Going from a passive state, a situation where

a person might let things happen and then
react,
TO
An active state on the other side of that arrow,
where people do things to manage the
amount of sensory input they get.
Neurological threshold continuum – vertically
oriented on the sensory processing model

High Threshold
Holds lots Low threshold
….reaches the Holds less
top after more …reaches the
time top quicker

14 September 2020 (Taken from Pearsons webinar, 2013) 15

Seeking

The first pattern is called seeking.

Seeking is, high thresholds and active self-regulation.
Seekers enjoy sensation, and they really want more sensation
and do things to get more.
These are ways people add more sensation to their everyday
experiences. Seekers love sensation.

Active, busy, visible in

the classroom, problem
behaviours; Can be
successful if channelled
Large cup

14 September 2020
 Avoiding
The second pattern is called avoiding.
Avoiders have low thresholds. They have active self-regulation like
the seekers, but instead of trying to get more sensory input,
avoiders try to get less.
Their brains are geared to detect a lot of input, but they have low
thresholds so every piece of input is potentially seen as harmful
or threatening.
The less unpredictable input they get, the better they feel.

Tight control of what

Lots of order and routine, goes into cup…don’t
No surprises, new, like cup overflowing
unexpected, Bossy, Rigid;
Order jobs, architects
production line

From Winnie Dunn, 2017

https://www.occupationaltherapy.com/articles/sensory-profile-2-what-s-3584
Sensitivity
The third pattern is called sensitivity.
Sensitivity is also a low sensory threshold like avoiding, but it is a passive self-
regulation pattern.
People with sensitivity try to participate, but then they get overwhelmed.
They try to do things to keep it to a minimum, but they are in the game
participating so sometimes they get overwhelmed.
Their brain is trying to take the stuff in, but their low sensory thresholds are
flooding them.
Sometimes people with sensitivity can feel overwhelmed or bossy, because
they are trying to navigate and participate as much as they can.

Anxious, feel Small

bombarded, heightened
cup…
awareness (artists,
creative, detail at work)
Registration/ Bystanders
The fourth pattern is registration.
Registration shares high thresholds with seekers, but they have a
passive self-regulation strategy.
We call them bystanders

Easy going,
passive… Large
universal cup
companions
What sensory pattern are you
 Behaviours of Concern / Challenging Behaviours
in ASD
The challenging behaviour of children and teenagers with ASD often causes
parents and families the most stress.
Children and teenagers with ASD might:
• refuse or ignore requests
• behave in socially inappropriate ways, like taking their clothes
off in public
• Be aggressive or have tantrums
• engage in self-stimulatory behaviours, like rocking or hand-
flicking
• hurt themselves or other children – for example, by head-
banging or biting.
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 Behaviours of Concern – Challenging behaviours

• Children and teenagers with autism spectrum disorder (ASD)

might behave in challenging ways because they:
• have trouble understanding what’s happening around them – for
example, what other people are saying or communicating non-
verbally
• don’t have effective ways of communicating their own wants
and needs, which leads to frustration
• are very anxious.

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 Assessing Behaviour – ABC

Parents are ’Behaviour Detectives’ –

What is the child communicating?
A – Antecedent What usually
happens before the behaviour, and
may set off the behaviour?
B – Behaviour What actually
happens during the behaviour?
C – Consequence What immediate
and delayed reactions follow from
the individual, other people and the
environment?

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 Some common antecedents in children with ASD
include
• Routines and Rituals
• Transitions
• Sensory sensitivities
• Sensory overload
• Unrealistic expectations
• Tiredness
• Discomfort
• Other conditions

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Observations and authentic Assessments – Intake

Authentic assessment includes measures that support our recording of

functional skills – a careful, deliberate and systematic process. Authentic
Assessment includes the following key elements:
▪ Natural observations of ongoing child behaviour and skills in the
environments where the child usually spends time.
▪ Observations of the child within everyday routines and activities.
▪ Observations from the important people in the child’s life including parents,
significant extended family members, care providers and educators.
▪ Monitoring gradual skill development over time (Bagnato et al., 2009).

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 Break Out Rooms
• SP2 -
https://www.brainshark.com/pearsonassessments/
SensoryProfile2/zEsz13FhOz4FEHz0?intk=92912172
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• SPM – 4.58 mins
• https://www.youtube.com/watch?v=NE2-
mCXDROA
• TSFI – Test of Sensory Function for infants – 5mins
• https://www.youtube.com/watch?v=hPb8KmeP1fA
• Miller Fun
• https://www.youtube.com/watch?v=9VJFROTn80A
• From 1.39 min
• ABAS – forms are on LMS
• https://www.youtube.com/watch?v=y0_9wfiAW88
• 1.48 mins

14 September 2020 OCT5ECC 26

Diagnostic Assessments
• ASD detect App; https://asdetect.org
• ADOS – OT’s are doing this, need training through
Monash -
https://en.wikipedia.org/wiki/Autism_Diagnostic_Observation_Schedule

• PEP – 3 http://www4.parinc.com/Products/Product.aspx?ProductID=PEP-3
• Play skills (ChIPPA) - http://www.thetherapystore.com.au/product/chippa-
child-initiated-pretend-play-assessment-kit
• ABAS (II) - https://www.pearsonclinical.com.au/products/view/21
• Vineland – good information on DSM criteria limiting everyday function
http://www.pearsonclinical.com/psychology/products/100000668/vineland-
adaptive-behavior-scales-second-edition-vineland-ii-vineland-ii.html

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 What Assessment can be used for
children with ASD?
BSF
Assessments • Sensory Profile
• SPM
• TSFI
• M-Fun
• Bailey Scales
• Peabody

Activity
• MABC
• BOT-2
• Handwriting Ax
• M-Fun
• VMI Beery
• Learn to Play

Participation
• ABAS
• COPM
References - Evidence supporting the need to look
at sensory processing when working with children
Dean, E. E., Little, L., Tomchek, S., & Dunn, W. (2018). Sensory processing in the general population:
Adaptability, resiliency, and challenging behavior. American Journal of Occupational Therapy, 72,
7201195060. https://doi.org/10.5014/ajot.2018.019919
Foitzik, K., & Brown, T. (2018). Relationship between sensory processing and sleep in typically
developing children. American Journal of Occupational Therapy, 72, 7201195040.
https://doi.org/10.5014/ajot.2018.027524
Pfeiffer, B., May-Benson, T. A., & Bodison, S. C. (2018). Guest Editorial—State of the science of
sensory integration research with children and youth. American Journal of Occupational Therapy,
72, 7201170010. https://doi.org/10.5014/ajot.2018.721003
Reynolds, S., Glennon, T. J., Ausderau, K., Bendixen, R.M., Kuhaneck, H. M., Pfeiffer, B., Watling, R.,Wilkinson, K., &
Bodison, S. C. (2017). The Issue Is—Using a multifaceted approach to working with children who have
differences in sensory processing and integration. American Journal of Occupational Therapy, 71, 7102360010.
https://doi.org/10.5

Roberts, T., Stagnitti, K., Brown, T. & Bhopti, A. (2018). Relationship Between Sensory Processing and Pretend Play
in Typically Developing Children. The American Journal of Occupational Therapy, 72(1), 1-8. doi:
10.5014/ajot.2018.027623014/ajot.2017.019281

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 References - Autism
National Autism Centre (NAC) (2015). Findings and conclusions: National Standards Project, Phase 2.
Retreived from http://www.nationalautismcentre.org/national-standards-project/phase-2/
Roberts, J., Williams, K. (2015). Autism Spectrum Disorder: Evidence-based/evidence informed good
practice for supports provided to preschool children, their families and carers. National Disability
Insurance Agency.
http://www.ndis.gov.au/sites/default/files/Early%20Intervention%20for%20Autism%20research
%20report.pdf
Rodger, S., Ashburner, J., Cartmill, L., & Bourke-Taylor, H. (2010). Helping children with ASD spectrum
disorders and their families: Are we losing our occupation centred focus? Australian
Occupational Therapy Journal, 57(4), 276-280. doi:10.1111/j.1440-1630.2010.00877.x
Schiariti, V., Mahdi, S., Bölte, S. (2018). International Classification of Functioning, Disability and
Health Core Sets for cerebral palsy, autism spectrum disorder, and attention-deficit–hyperactivity
disorder. Developmental Medicine & Child Neurology, 60, pp. 933-94; doi: 10.1111/dmcn.13922
Wong, C., Odom, S. L., Hume, K., Cox, A. W., Fettig, A., Kucharczyk, S., et al. (2014). Evidence-based
practices for children, youth, and young adults with autism spectrum disorder. Chapel Hill: The
University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-
Based Practice Review Group.

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