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Toward the use of a standardized assessment for young children with autism
Current assessment practices in the UK
N E I L T. M A R T I N PETER BIBBY Research, UK University of Kent at Canterbury, UK

autism © 2003 SAGE Publications and The National Autistic Society Vol 7(3) 321–330; 035378 1362-3613(200309)7:3

Autism & Developmental Disorders Education Keele University, UK

OLIVER C. MUDFORD SVEIN EIKESETH

Akershus College, Norway

A B S T R AC T

Little is known about the progress of autistic children following specific interventions in England. Nor do we know how frequently standardized assessments are used to monitor progress or to evaluate specific educational interventions. The reports of 75 children with autism, for whom special educational provision had been determined by a local education authority, were reviewed. Parents were interviewed and educational psychologists were contacted for details of any norm-referenced assessments. Of these children, 39 percent had no standardized assessments before education authorities determined their provision, and only 9 percent had follow-up assessments that could be used to evaluate progress. Children with autism in the UK rarely have sufficient assessments to allow an objective evaluation of their progress. There is currently no standardized assessment protocol to prescribe a specific educational intervention, to evaluate the progress of children or to make comparisons between interventions. We recommend the development of such a protocol.

K E Y WO R D S

assessment protocols; autism; monitoring; statements

ADDRESS Correspondence should be addressed to: D R N E I L M A R T I N , Tizard Centre, University of Kent at Canterbury, Canterbury, Kent CT2 7LZ, UK. e-mail: N.T.Martin@ ukc.ac.uk

Introduction
In England and Wales, selection of the type of educational provision prescribed for young autistic children rests in the hands of local education authorities (LEAs) following an assessment of children’s needs. Having carried out an assessment the LEA must, if necessary, issue a statement of 321

1988). McEachin et al. Lovaas. The literature suggests that different types of educational provision may lead to different outcomes. social and educational services) to evaluate the effects of a specific type of intervention and to make comparisons both between interventions and between different children who share the same or similar educational provision. Studies of other educational approaches seem to indicate less effectiveness. Weiss. This would allow parents to make betterinformed decisions about the type of education that they would like for their child. Given that outcome for autistic children may be dependent on the type of educational provision prescribed.07martin (bc/t) 5/21/03 3:39 pm Page 322 7(3) special educational needs (Education Act 1996). in health. 2000. The focus of this study is on the use of standardized assessments. it would seem imperative that the progress of children is monitored.. Sheinkopf and Siegel. 1998). 1993. Bibby et al. The statement describes the child’s learning difficulties and prescribes the provision that is deemed appropriate to meet the child’s needs. 1993.. On average the remaining 213 children made minimal gains in IQ and regressed on Vineland Adaptive Behaviour Scales composite scores (Lord and Schopler. there are some reports of children making such outstanding progress that they were no longer deemed autistic and/or were functioning normally (Greenspan and Wieder. Birnbrauer and Leach. This would require the use of comparable assessment protocols.. 1999). Some studies report progress by some young children with autism in response to specific intensive behavioural interventions. 1987. Lord and Schopler (1989) reported that of 216 children who had followed TEACCH programmes for at least 2 years. However.g. 1997. 2001). AU T I S M Method Participants The parents of 92 children with a diagnosis of autism were invited to take part in a study that sought to evaluate parent-managed. home-based early 322 . other studies have reported little change following intensive behavioural treatment (Smith et al. It would also allow other professionals working within the field (e. For example. and also to determine whether data continued to be collected in a way that would allow quantifiable assessment of progress. language and adaptive behaviour as a result of intensive programmes (Anderson et al. For example. The aim of this study was to determine the extent to which young autistic children are assessed prior to the commencement of a specific educational intervention. all but three were classified as autistic during the later assessment.. 1987. There are also reports of young children with autism making substantial gains in IQ.

The assessment instruments used are listed in Table 2. directly comparable between different children and different types of educational provision) were surveyed.. The third method was for a research assistant to visit each of the families to ask about any assessments that had been carried out on their children. Procedure Three different methods were used to examine the extent to which children had been assessed before and after commencing educational programmes. The first method was to survey the files that had been collated by the family’s legal representative. The results from this study have been published separately (Bibby et al. These parents had independently approached one of the authors for legal assistance in seeking a statement of special educational needs that prescribed an EIBI programme (based on those described by Lovaas. These were completed between August 1995 and February 1999. They all had statements of special educational needs prescribing educational intervention in response to their autism. Results The mean age of the children at completion of their statements was 52 months. Partially completed assessments were not included.6 months (SD 14. These included all the assessments that formed part of the children’s statements of special educational needs. 2001. therefore. 2000).07martin (bc/t) 5/21/03 3:39 pm Page 323 M A RT I N E T A L . : S TA N DA R D I Z E D A S S E S S M E N T intensive behavioural intervention (EIBI). The 75 remaining children were distributed across 42 different LEAs in England (representing approximately 30 percent of the total number of LEAs in England) and were born between 1989 and 1995. One family subsequently withdrew and contact with two further children was lost. assessments had to be complete in that all the elements had been administered or that the assessor had halted the assessment and recorded that the child was untestable. They had a mean age of 53. Mudford et al.. The second method was to write to the psychologist who had provided advice to the LEA in the preparation of the child’s statement. Seventy-eight parents responded to our request for participation. Only assessments that were standardized or norm-referenced (and were.6) and 61 (81 percent) were boys. Almost half (48 percent) had norm-referenced assessments carried out by either the LEA or the health authority before the child’s statement had been completed (see Table 1). These visits took place after completion of the children’s statements. Furthermore. The most commonly used assessments prior to the issue of a statement were the Griffiths Mental Development Scales (Griffiths. 1987). 323 .

1984) and the Reynell Developmental Language Scales (Edwards et al. Nearly half of the sample (49 percent) had no further assessments. After the children’s statements had been issued.. The three most commonly used assessment tools following statementing AU T I S M Table 1 Numbers and percentages of children assessed before the issue of a statement of special educational needs (total N = 75) Children who had: No norm-referenced assessment Only privately arranged assessments Assessments conducted by LEA and/or health authority Assessments conducted by LEA Assessments conducted by health authority N 29 10 36 20 28 % of sample 39 13 48 27 37 Table 2 Numbers of children for whom each different assessment tool was used before the issue of a statement of special educational needs Assessment instrument Private LEA Health authority 47 20 1 6 4 2 1 5 3 4 1 0 All Totals Griffiths Mental Development Scales Vineland Adaptive Behavior Scales Reynell Developmental Language Scales Bayley Scales of Infant Development Leiter International Performance Scale Wechsler Preschool and Primary Scale of Intelligence MacArthur Communicative Developmental Inventory Merrill–Palmer Scale of Mental Tests Symbolic Play Test CELF Pre Sschool Language Scales British Ability Scales 30 0 17 3 0 3 2 0 1 1 2 1 18 6 2 1 3 2 3 0 1 0 0 0 95 26 20 10 7 7 6 5 5 5 3 1 324 . the Vineland Adaptive Behavior Scales (Sparrow et al.07martin (bc/t) 5/21/03 3:39 pm Page 324 7(3) 1996).. 37 percent of the sample had norm-referenced assessments carried out by either an LEA or a health authority (see Table 3) and a further 13 percent had privately arranged assessments carried out. 1997).

1989) (see Table 4). The use of the same instrument for test–retests is not always Table 3 Numbers and percentages of children assessed after the issue of a statement of special educational needs (total N = 75) Children who had: No norm-referenced assessment Only privately arranged assessments Assessments conducted by LEA and/or health authority Assessments conducted by LEA Assessments conducted by health authority N 37 10 28 17 17 % of sample 49 13 37 23 23 Table 4 Numbers of children for whom each different assessment tool was used after the issue of a statement of special educational needs Assessment instrument Private LEA Health authority 22 3 10 1 0 1 1 3 1 1 0 1 0 All Totals Vineland Adaptive Behavior Scales Reynell Developmental Language Scales Wechsler Preschool and Primary Scale of Intelligence Bayley Scales of Infant Development British Ability Scales Merrill–Palmer Scales of Infant Development Griffiths Mental Development Scale British Picture Vocabulary Scales Leiter International Performance Scale CELF Pre Sschool Language Scales Symbolic Play Test MacArthur Communicative Developmental Inventory 51 20 6 6 4 2 6 0 2 2 2 0 1 23 3 0 7 4 5 1 2 0 0 0 1 0 96 26 16 14 8 8 8 5 3 3 2 2 1 325 . The final stage of this survey was to examine the extent to which the subsequent assessments could be related to earlier assessments in order to measure progress. : S TA N DA R D I Z E D A S S E S S M E N T were the Vineland Adaptive Behavior Scales. the Reynell Developmental Language Scales and the Wechsler Preschool and Primary Scale of Intelligence–Revised (Wechsler. This requires test–retest using the same or comparable instruments.07martin (bc/t) 5/21/03 3:39 pm Page 325 M A RT I N E T A L .

the Griffiths Mental Development Scales (test–retest. n = 2). Jordan et al. These were the Bayley Scales of Infant Development and the British Ability Scales (n = 1). Only seven children (9 percent of the sample) had test–retests using comparable instruments. 1998). 1998.07martin (bc/t) 5/21/03 3:39 pm Page 326 7(3) possible because the age range of the standardization of the tests varies. 1993) are only standardized up to age 31⁄2. and older children would be expected to progress to a standard IQ test such as the Wechsler Preschool and Primary Scale of Intelligence. for example. generate developmental age scores that may be converted to a ratio quotient (RQ) which can then be compared with a subsequent IQ test. the Merrill–Palmer Scale of Mental Tests 326 . Despite the fact that it is important that the progress made by young children with autism following different programmes can be compared across large numbers of children (Connor. such data are important in light of the increasing numbers of parents who are opting for home-based behavioural programmes (Lovaas. the Griffiths Mental Development Scales and the Wechsler Preschool and Primary Scale of Intelligence (n = 3). 1987) rather than accepting ‘standard’ educational provision. the Bayley Scales of Infant Development covers the age range 1 to 42 months. There are a variety of assessment instruments available but these have all been standardized for typically developing children. n = 1). Markedly different scores may be obtained according to the test used. the Bayley Scales of Infant Development (Bayley. 1998. the Wechsler Preschool and Primary Scale of Intelligence covers the age range 3 years to 7 years 3 months. For example.and post-intervention assessments are crucial for assessing progress made by children with autism placed in special educational provision. Several large surveys (Carter et al.. However. the appropriate test is determined by the chronological age of the child rather than by existing cognitive/developmental ability. and the Reynell Developmental Language Scales (test–retest. provided that the same or comparable assessment instruments are used. Moreover. Some of the assessments. For example. Lord and Schopler.. These studies provide a basis against which outcomes for any particular programme may be compared. the use of the same or comparable assessment instruments is not widespread in England. AU T I S M Discussion Standardized and objective pre. such as the Griffiths Mental Development Scales. 1989) provide normative data for children with autism following traditional programmes in the USA. Nor is choice of provision based on any objective measures of progress. Our findings suggest that LEAs do not systematically assess the outcomes of children placed in different kinds of provision.. 1988.

2000). p < 0.. We would recommend that a standardized assessment of young autistic children include an assessment of adaptive behaviour as a minimum requirement. Magiati and Howlin. 2001). poor linguistic skills and attention problems (Sattler. 1992). although the Griffiths Mental Development Scales covers the age range 0 to 8 years (and is currently being restandardized). Moss and Hogg.2 months. The development of a range of measures that address different areas of impairment is important for the future and may include non-standardized direct 327 . The VABS developmental age score (mean 19 months. it is clear that such assessments are not without their limitations and they may be relatively insensitive to the social and communicative difficulties that are the key deficits in autism. The correlation between Bayley developmental age equivalents and Vineland Adaptive Behaviour (composite) age equivalents for the children in this study (n = 51) yielded a high correlation (r = 0. 2001. SD 8..7) and the Bayley score (mean 20. This study has focused on the use of comparable standardized normreferenced assessments as a simple means of evaluating educational provision for children with autism.8 months.001). may not easily be captured by assessments of cognitive ability or adaptive behaviour. 1997. We would recommend the use of such a test.78. 1993. SD 6. improvements in stereotypic or problematic behaviours. Some researchers have argued that measures of adaptive behaviour could be used in situations where cognitive assessments may prove difficult to administer or may be unreliable because of the degree of intellectual disability (Meins and Süßmann.. Perry and Factor. Freeman et al. It is important that a standardized measure be used that allows evaluations both within and across different interventions.87.. 1988. p < 0. Mudford et al.001). 2001. 1987). The correlation between adaptive behaviour and cognitive ability in individuals with autism appears to be consistently high (Carpentieri and Morgan.2) who had not started any particular type of educational provision and who had also been tested by the same assessors used for the primary study (cf. 1996.07martin (bc/t) 5/21/03 3:39 pm Page 327 M A RT I N E T A L . These data suggest that.1) were also highly correlated for this group of children (r = 0. For example. 1989). However.. The assessment of young autistic children can also present problems that are not ordinarily associated with assessing typical children. SD 17. for example. Bibby et al. : S TA N DA R D I Z E D A S S E S S M E N T (Stutsman. Few tests cover the age range of preschool to later childhood. 1991. 1948) yields consistently higher scores than tests such as the Bayley Scales of Infant Development (Bibby et al. Volkmar et al. in the absence of any other appropriate psychometric assessment. themselves legitimate targets of good educational provision. This finding was replicated for a further 36 children (mean age 48. an assessment of adaptive behaviour (specifically the Vineland Adaptive Behaviour Scales) could be used as a good estimate of cognitive ability.

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