#108: Autism Assessment: Step one of the Turn Autism Around Approach

autism assessment

Nearly every question I receive from parents or professionals boils down to one of two questions:

  1. How can I get my child or client to stop ______?
  2. How can I teach my child or client to ______?

Whether it’s getting a child to stop hitting, biting, or stimming, or it’s teaching a child to get dressed, sleep in their own bed, or eat properly, parents and professionals wrestle with these two questions daily.  The answers to these questions will always start with an autism assessment.

Before you can begin to address these concerns, you need to understand where the child is at developmentally. That’s why I provide a full chapter on autism assessment in my newest book Turn Autism Around: An Action Guide for Parents of Young Children with Early Signs of Autism. I know that it can be discouraging to see where a child is at and to realize that they’re behind.

Children who struggle to speak will have other problems, and the questions are designed to uncover the variety of problems a child may have so that parents and professionals can move forward with a solid understanding of how to help a child learn.

The first two pieces in an autism assessment are the child’s age and the child’s general ability level. Once you know that, you can move onto the 4 parts of the Turn Autism Around Approach which are:

  • Assess
  • Plan
  • Teach or intervene
  • Evaluate

The plan for a ten-year-old child with the ability of a two-year-old will look very different from a three-year-old with the general ability level of a one-year-old, so understanding where the child is at can help you see where to go next. This step-by-step autism assessment sets out a clear and concise path for parents and professionals to see where progress can be made, and it also gives them the opportunity to recognize where a child is succeeding or even thriving.

My newest book is full of techniques, strategies, and assessments that can help parents who are waiting for an autism diagnosis, or are waiting for therapy services and are ready to start helping their child today. Pre-order your copy today and receive exclusive access to a video interview with Dr. Temple Grandin, as well as a free workshop for parents of children with autism.

YOU’LL LEARN

  • Why it’s important to start with an assessment, and how often you should update that assessment.
  • Some examples of the types of questions in my one-page assessment.
  • Resources, including a self-care checklist, to help you get a quick snapshot of a child’s abilities.
Want to get started on the right path and start making a difference for your child or client with autism?
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Transcript for Podcast Episode: 108
Autism Assessment: Step One of the Turn Autism Around Approach
Hosted by: Dr. Mary Barbera

You're listening to the Turn Autism Around podcast, I'm your host, Dr. Mary Barbera, and today we are talking about the first step of the Turn Autism Around approach, which is assessment. And that's important to assess every child in every situation where you want to decrease some probable behavior and or increase a prosocial or quote-unquote, good behavior. So let's get to this important episode on assessment.

Welcome back to another episode of the TurnAutism Around podcast, you can and should preorder my new book, Turn Autism Around: An action guide for Parents of Young Children with Early Signs of Autism. And you can get all the details at TurnAutismAround.com. If you preorder, you'll get all the preorder bonus videos and get a sneak peek at the book too.

This episode I'm going to dedicate to assessment in the Turn Autism Around Approach book. There is a whole chapter on assessment. So I'm going to pull out some of the key things in that chapter to give you a glimpse. I've talked about assessments before. I've done a video blog or two on assessments. We can link those in the show notes, but there are four steps to the Turn Autism Around approach and assessment is the very first step. So before we start with assessment and where you start, I do think it's important to kind of go backwards and say basically every question I get can be categorized in two different categories.

So question number one category I get from members of my online community podcast listeners questions we get over email. So the number one question we get is how can I get my child clients student to stop blank so you could fill in the blanks with any kind of problem behaviors like crying, biting, hitting, lining things up. So how do I get my child to stop biting? How do I get my child to stop hitting? Those sorts of things. How do I get my child to stop scripting from movies throughout the day constantly? So that's the first category of questions I get.

And the second category of questions I get is how can I teach my child, client, student to blank? And you can fill in the blanks with how do I teach my child to talk? How do I teach my child to brush your teeth, to get dressed, to walk to the playground, to potty train, to sleep in their own bed through the night.So as I said, one of the chapters in the Autism Round book is all about assessment. And we discuss assessment throughout the book and a lot of chapters.

When we talk about talking, we talk about an assessment. When we talk about potty training, there's a special assessment on that. When we talk about eating, we do our food, kind of a three-day food journal as an assessment. We also do a food, easy, medium, difficult food sheet. Those are all assessments. We're not going to talk about every assessment that I would recommend every assessment in the book.

But we're going to talk today about the four easy assessments that you can start literally today, even if your child already goes to an ABA clinic, even if you just had reams of assessments done, I'm going to tell you the four easy assessments you can and should do right now so that you can get a very good snapshot of your child or clients. As I said, assessment is step one of the Turn Autism Around approach. But let me tell you what the other steps are. It's basically the scientific method. When we look at a problem, we assess a step one of the Turn Autism Around approach we plan, which is step two. We teach or intervene in some way. That's step three. And number four is we evaluate with easy data and we kind of start over.

So within each child, though, we might be assessing or reassessing and the feeding area we may be planning because we're right before an IEP meeting, but we can't just jump into the planning step without assessing or reassessing. So they all have to go. It's almost like a circular motion as opposed to like a straight line because you're constantly assessing, planning, intervening and evaluating. And it's almost like loops throughout the day in every area we can. We use the scientific method to solve any problems. We will use the four steps of the autism around approach to solve problems as well. And we will use those that approach, my approach, the Turn Autism Around approach to answer those two categories of questions. How do I stop blank? How do I teach my child blank?

One thing I want to make clear is that assessment and the other three steps of the Turn Autism Around approach is not just for professionals, parents can and should learn how to do the assessment to improve their lives, their child's life, and even your typically developing kids, it's the same process you think your older child might have a learning disability. The first step is assessment and go on from there. So the other thing I want to make clear, it's not just for professionals, also for parents. And number two is that assessment is not a once a done thing. You'll need to regularly assess your child or clients. And this is important so that you can continuously plan, intervene and make day to day based decisions to make sure that you're making the most out of your child's time.

So back to our top two categories of questions. How do I stop blank? How do I teach my child blank? But before I can even begin to answer, I need to know at least two things. When a member of my online community asks me a question, I always ask for these two pieces of information, which are first two pieces of assessment: the child's age and the child's general ability level in terms of talking tantrums and self-help abilities. So age and ability level are your two first pieces of assessment, because the reason I asked for age and ability level, if you have a question about potty training, but you have a four year old who is almost conversational and flops to the ground and hits others twice a week, and you have a question about potty training or if you have a five or 10 year old child or client who is speaking in one word utterances, aggressive ten times per day and not potty trained, my answer to your potty training questions will be different.

Sure, it's very important that a five- or ten-year-old become potty trained, but if they are aggressive ten times per day and refuses to sit on the toilet, we have to start there. So the other thing, when people ask questions and they go into these two categories, you know, it's not always like you want to tackle the teaching question if they're having major problem behaviors.

And especially as the child gets older, their hits or their flops to the ground become less safe as the child grows bigger. So the key here is to complete the four easy assessments, which I outline in the chapter of the Turn Autism Around book. As I said, there are a few assessments like the sleep and the eating, medium, easy, medium, difficult assessments that we're not going to talk about. But you should definitely preorder the book, TurnAutismAround.com and you'll be able to get the book resources, including samples of the easy, medium, difficult Cheat's and all those kinds of things. But I don't want to overwhelm you with every assessment under the sun.

We're going to talk about the easy, four easy assessments that I would recommend for all of you listening. And these are going to be detailed in the show notes as well, and available for as a book resource. So the first assessment that I would recommend is an assessment I created. It's only a one-page assessment. So everything is really tight and very much like a snapshot. The one page will only take you as a parent or a professional to interview the parent about 10 minutes to complete. There is some if you're not sure if the child can say star when you say Twinkle, twinkle little. If you don't know that, then there's some testing to be done with writing down the answers on the one-page assessment.

This is really important to do this one-page assessment. Like I said in the beginning of this podcast, even if you have reams of data, even if your child was just assessed by a professional, getting this snapshot in all areas is super important. There's three columns of this one page assessment. And on the first column we'll talk about, you know, does your child or client have a diagnosis? Do they have allergies? Do they how do they sleep, potty train, eat? Are they do they use a pacifier or a bottle? And these are really important because some parents, if you don't ask the question about pacifiers or bottles, won't bring it up. They don't know that that's part of an assessment that is going to probably be impacting quite a bit of talking. Children with no ability to speak will probably have issues with eating a variety of foods, pacifier addiction, drinking from straws and open cups. These are all might be part of the issue. The kids without any language also will probably have social skills, deficits and problem behaviors due to a lack of communication.

So getting all of this on one sheet, quickly, assessing and taking a snapshot that can be redone every three months, every six months, every 12 months. And that is the one big assessment that I would recommend for all of you. And if your child is especially if they're under the age of five, you will also want to review typical milestones so you can compare your child's ability with what's expected. And I talk about that in the book as well. You might think like I don't want to, you know, find out that my four-year-old is speaking like a nine-month-old or I don't want to know that he should be drinking out of an open cup and a straw. And he's at 18 months of age and he's now five and not doing that.

You might think like it's depressing to find out, but you have to see where your child or client is at developmentally and meet them. They're working with their strengths and trying to catch up their deficits as much as possible. So you have to assess to get your starting point and you have to start where our child is at developmentally, not what their chronological or real age is. And so I think knowledge is power. And I think you looking into developmental milestones is important. As I said, we have a lots of things on this one page assessment, not just allergies and diagnosis and self-care, but all that language broken down into the different verbal operations, whether our child imitates, whether they have matching and puzzle skills, what their social skill deficits are like, and finally problem behaviors.

And we take all of this together to really begin to see where we're going with the plan. OK, so the first assessment is the one-page assessment, the second assessment that I encourage all my online participants to do. I'm going to encourage you to do it. I encourage it in the book is to complete the four-partself-care checklist developed by Dr. Mark Sunberg. He was gracious enough to allow me to republish parts of the self-care checklist within the term autism around book. And Dr. Sunberg created this self-care checklist when he published the VB-MAPP assessment.

So, Dr. Sunberg, how he created these self-care checklists was he looked at all these developmental milestones and saw when typically developing kids are supposed to drink out of an open cup or when kids are supposed to use a knife and fork, or when kids are supposed to bathe themselves or wash their hands independently or brush their teeth. And so there are four chunks of the self-care checklist. Again, not to depress you. And if you have a nine-year-old or a 12-year-old, it doesn't matter. Look at those developmental checklists and see, because I did an independent evaluation, I think my last independent evaluation ever was a 17-year-old and he took a bottle of water and he drank.

And when he drank, he didn't move his lips to cover the hole so he would get water all over himself. And he also was minimally verbal and vocal. So I asked his staff, I'm like, can he drink out of a straw? And they said, I don't know. And so they brought in a straw. And sure enough, he could drink out of a straw. And so drinking out of a straw is an 18 month old skill, even though this young man was 17 years old. And drinking out of a straw will help oral motor. It'll help hygiene, keep him cleaner. It's just better all around. So doing this, even if you have an older child, is important.

OK, so first assessment is the one-page assessment. Second assessment is self-care checklist, all four parts. The third assessment, which I would recommend you do is to take two different one-minute videos, one minute of your child or client, if it's a client, you're going to have to get permission to take videos. These aren't videos you send in. And even if you're a part of my online course and community, we don't collect them. We don't look at them. You don't post them one minute of your child alone doing something and then a minute. Or you could do two minutes of you trying to engage your child or client in an activity.

And this is used as a baseline information so that as you implement the term autism around approach, you'll be able to see pre and post. Just like if you're trying to lose weight or make improvements in some area, you might weigh yourself, you might take a picture of yourself and before and after, and you might also weigh yourself before and after. And these are two great pieces of information that can really help you and the team see the improvements. OK, and the very last assessment, which you can decide if it's going to be 10 minutes, 15 minutes, 30 minutes, 60 Minutes, set a timer and you do a baseline language sample where you're going to want to write down your location and then you're going to pay attention.

So if you can't sit with your child or clients and you don't have 60 Minutes, set your timer for 10 minutes and write down your location. Try to get your child to talk and write down every sound or word or word approximation. If you have zero words, zero sounds, that's fine. You just write that down. Again, this is like weighing yourself before and after, because hopefully the strategies that you will learn in my new Turn Autism Around book in my online courses will help you make progress. So that some people take baseline language samples every day, every week, every month, every three months. It's up to you. But again, the more information we have, the better we can help our children and clients.

So, as I said, there are also other assessments throughout the book for behavior reduction. ABC forms, calendar data system. You know, just a lot of assessment tools on feeding, sleeping, potty training. But for now, I would focus on these four assessments. The one-page assessment, the four-part part, Mark Sunbergself-care checklist, the two very short videos. Just take your phone and take some videos. One child alone don't even make a big deal up that you're videotaping. You really want to get them doing whatever they're doing alone and then one minute with you engaging them. In summary, the first step to reducing problem behaviors or teaching any new skill to a child with autism or signs of autism needs to start with an assessment age and ability level at the very minimum, even to answer any questions.

But in general, to get the ability level you're going to need to do those four assessments to get a really good sample. And the whole thing together should only take about an hour. If you are going to do a 10- or 15-minute language sample, you can get all four assessments done within an hour Max. So I would, if I were a professional, I would work with the parent to direct them. Maybe they could take the videos and keep the videos.

It's also super motivating if you can really see a lot of gains and if you're not seeing a lot of gains, then something is wrong and we need to dig deeper. Not to say, well, the child just has intellectual disability and they're not able to learn. Every child can learn and make progress and we need to figure out how to best help them make the fastest progress in the least amount of time. OK, so I hope you enjoyed this podcast episode all about assessment. And I hope you professionals out there will start to think more about when you get those categories of questions either how do I stop? How do I teach a child any skill and hope that these four easy assessments you'll try out today or make a plan to try them out this week?

Don't forget to preorder the Turn Autism Around book at TurnAutismAround.com. We are going to have lots of bonuses there. So check it out and sign up today. Get your book. And I look forward to seeing you or you hearing me next week on another podcast episode next Tuesday. Have a good one.