Research in Autism Spectrum Disorders 5 (2011) 990–1002

Contents lists available at ScienceDirect

Research in Autism Spectrum Disorders

Journal homepage: http://ees.elsevier.com/RASD/default.asp

Review

A review of assessments for determining the content of early intensive

behavioral intervention programs for autism spectrum disorders
Evelyn Gould, Dennis R. Dixon *, Adel C. Najdowski, Marlena N. Smith, Jonathan Tarbox
Center for Autism and Related Disorders, Inc., 19019 Ventura Blvd. #300, Tarzana, CA 91356, United States

A R T I C L E I N F O A B S T R A C T

Article history: A large proportion of national education and treatment centers for persons with autism
Received 14 January 2011 spectrum disorders (ASD), including those providing applied behavior analysis (ABA)-
Accepted 15 January 2011 based services, show a relatively high percentage of agreement among practitioners on the
Available online 22 February 2011 instruments they routinely use for a variety of purposes, including curriculum design and
treatment evaluation. In this paper, several assessments are reviewed and evaluated in
Keywords: terms of their utility for designing comprehensive early intensive behavioral intervention
Autism (EIBI) curriculum programs for children with ASD. The assessments found to be most
Assessment
useful for this purpose are reported. A general critique regarding the available pool of
Curriculum
assessment tools is provided and the need for a comprehensive assessment directly linked
Early intensive behavioral intervention
to curricula is discussed.
ß 2011 Elsevier Ltd. All rights reserved.

Contents

1. Critical components of an assessment for use in EIBI programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 992

2. Direct versus indirect assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 993
3. Description of existing assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 993
3.1. Developmental/educational . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.1.1. Battelle Developmental Inventory-Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.1.2. Bayley Scales of Infant and Toddler Development-Third Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.1.3. Brigance Diagnostic Inventory of Early Development-II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.1.4. Denver II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.1.5. Psychoeducational Profile-Revised . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.2. Social skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.2.1. Social Responsiveness Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994
3.2.2. Social Skills Rating System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
3.3. Motor function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
3.3.1. Beery–Buktenica Developmental Test of Visual–Motor Integration-Fifth Edition. . . . . . . . . . . . . . . . . . . . . 995
3.3.2. Peabody Developmental Motor Scales-Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
3.4. Speech and language/communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
3.4.1. Assessment of Basic Language and Learning Skills-Revised. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
3.4.2. Clinical Evaluation of Language Fundamentals-Fourth Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995
3.4.3. Peabody Picture Vocabulary Test-Fourth Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 995

* Corresponding author. Tel.: +1 818 345 2345.

E-mail address: d.dixon@centerforautism.com (D.R. Dixon).

1750-9467/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.rasd.2011.01.012
 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002 991

3.4.4. Pragmatics Profile of Everyday Communication Skills in Children Revised Edition . . . . . . . . . . . . . . . . . . . 995
3.4.5. Preschool Language Scale-Fourth Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.4.6. Reynell Developmental Language Scales [U.S. Edition] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.4.7. Test of Language Development-Primary: Fourth Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.4.8. Test of Pragmatic Language-Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.4.9. Verbal Behavior Milestones Assessment and Placement Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.5. Daily living skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.5.1. Scales of Independent Behavior-Revised . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.5.2. Vineland Adaptive Behavior Scales-Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 996
3.6. Play skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.6.1. Symbolic Play Test-Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.7. Academics/achievement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.7.1. Brigance Diagnostic Comprehensive Inventory of Basic Skills-Revised . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.7.2. Peabody Individual Achievement Test-Revised . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.7.3. Wide Range Achievement Test Fourth Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.7.4. Woodcock–Johnson III Normative Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.8. Intelligence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.8.1. Wechsler Intelligence Scale for Children-Fourth Edition Integrated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 997
3.8.2. Wechsler Preschool and Primary Scale of Intelligence-Third Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998
4. Critical analysis of existing assessments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998
4.1.1. VB-MAPP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998
4.1.2. Brigance IED-II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998
4.1.3. VABS-II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998
4.1.4. CIBS-R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 999
4.2. Concerns with existing assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 999
5. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 999
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1000

A substantial amount of research supports early intensive behavioral intervention (EIBI) for the treatment of children
with autism spectrum disorders (ASD). Studies examining the outcomes of EIBI have demonstrated significant
improvements in intellectual, language, and adaptive functioning (Cohen, Amerine-Dickens, & Smith, 2006; Eikeseth,
Smith, Jahr, & Eldevik, 2007; Howard, Sparkman, Cohen, Green, & Stanislaw, 2005; Remington et al., 2007), as well as
significant improvement on diagnostic measures of core ASD symptoms (Sallows & Graupner, 2005; Zachor, Ben-Itzchak,
Rabinovich, & Lahat, 2007). The significant body of research on EIBI has resulted in a number of recent reviews and meta-
analyses supporting it (Eldevik et al., 2009; Peters-Scheffer, Didden, Korzilius, & Sturmey, 2011; Reichow & Wolery, 2009;
Rogers & Vismara, 2008).
EIBI programs share several common features. They are initiated as early as possible (typically before the age of 5) and
involve up to 40 h per week of 1:1 intervention provided by trained tutors or therapists for several years (Love, Carr, Almason,
& Petursdottir, 2009). Treatment is often conducted in the home and then generalized into classroom and community
settings with the ultimate goal of intervention being the successful integration of the child into the classroom (Howard et al.,
2005; Sallows & Graupner, 2005). Individualized treatment programs are designed and supervised by individuals with a
master’s degree or PhD, with advanced training in the provision of EIBI to children with ASD. Treatment consists of breaking
down skills into their simplest components and then teaching them hierarchically, to specified mastery criteria, using
behavior analytic techniques. For example, children are given consistent feedback about their performance, reinforcers are
used to motivate the child and to strengthen new skills, and prompts are provided to maximize success and are faded out as
the child demonstrates progress. Good-quality programs include strategies for ensuring that treatment gains maintain and
generalize to all aspects of the child’s daily life. Data are collected to document progress and inform clinical decisions. The
supervisor and team of therapists meet regularly to review data and discuss cases in order to direct the course of each child’s
treatment (Love et al., 2009).
Despite the common features that most EIBI programs share, there is still great variability between EIBI service-delivery
programs (e.g., differences in curricula, treatment format, and program supervision; Love et al., 2009). Further, research
suggests that not all EIBI programs are equally effective (Bibby, Eikeseth, Martin, Mudford, & Reeves, 2002; Eldevik, Eikeseth,
Jahr, & Smith, 2006; Magiati, Charman, & Howlin, 2007), thus highlighting the need to identify effective treatment
parameters and the mechanisms responsible for change (Kazdin & Nock, 2003). Hayward, Gale, and Eikeseth (2009) have
identified four key variables common to the most effective empirically validated intervention programs that have emerged
through recent outcome research. First, the intensity of EIBI is important and research outcomes suggest that a program of 30
or more hours per week of 1:1 intervention is needed for a minimum of 2 years (Eldevik et al., 2006; Lovaas, 1987). Second,
intervention should be based on behavior principles. Third, supervision should be provided by individuals with extensive
training in applied behavior analysis (ABA) and experience applying the principles of ABA across many different types of
children. Finally, in order to achieve maximum gains for every child, behavioral principles (necessary for optimal learning)
must be paired with a unique, comprehensive curriculum that is tailored to each child’s individual needs across all areas of
functioning (American Academy of Child and Adolescent Psychiatry, 1999; Hancock, Cautilli, Rosenwasser, & Clark, 2000;
992 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002

Lovaas, 2003). That is, while the fidelity of teaching procedures is clearly important, the content that is taught is also key to
the success and overall outcomes of intervention. It is this factor that this paper is concerned with.
Despite the need for a comprehensive, individualized treatment program and the importance of program content on
treatment outcome, the current literature neglects to specify what constitutes a comprehensive curriculum and does not
describe how clinicians can best design such a program. Within existing EIBI services, hundreds of different skills are taught
to children, and dozens of curricular programs exist (Love et al., 2009). Love et al. (2009) found that 48% of clinicians were
typically using more than one curriculum manual (e.g., Leaf & McEachin, 1999; Lovaas, 1981; Maurice, Green, & Luce, 1996)
and suggested this indicates that no currently available curriculum meets all program needs.
The challenge then becomes identifying what constitutes a comprehensive program. Given that ASD is pervasive and can
potentially affect all areas of a child’s development, building an effective individualized curriculum should start with a
systematic and comprehensive evaluation of the child’s abilities across all areas of functioning (Hancock et al., 2000). We
have identified eight key areas in which children with ASD are likely to be deficient. In addition to impairment in language
and socialization that are foundational to an ASD diagnosis, children with ASD may also present with deficits in any or all of
the following other areas: motor (Dewey, Cantell, & Crawford, 2007; Dyck, Piek, Hay, & Hallmayer, 2007; Miyahara et al.,
1997; Page & Boucher, 1998), daily living (Carpentieri & Morgan, 1996; Liss et al., 2001; Lord & Schopler, 1989), play (Jarrold,
2003), executive functions (Hill, 2004), social cognition or perspective-taking (Baron-Cohen, Leslie, & Frith, 1985), and
academic skills (Mayes & Calhoun, 2006).
A comprehensive curriculum that targets skill deficits in each of these areas is not enough to ensure quality treatment.
The treatment program must be tailored to the individual child’s needs (Hayward et al., 2009). In other words, simply having
a curriculum available does not ensure that appropriate content will be selected and a unique treatment program formulated
that optimally addresses the needs of each individual child. Comprehensive assessment is needed to meet this requirement.
Assessment results should guide the development of a structured treatment program or curriculum that is hierarchically
organized and developmentally sequenced (Love et al., 2009). Since it is impossible to target every skill deficit, priority
should be given to key skills, behavioral cusps, or pivotal responses that will remain functional for the child across settings
and over time, as well as ‘‘open doors’’ for the child to new and greater learning opportunities (Rosales-Ruiz & Baer, 1997).
Inadequate assessment could result in a number of problems. For example, the child’s curriculum might be lopsided or
unbalanced (i.e., all or most lessons are addressing one area such as academic skills), nonindividualized or in a ‘‘cook-book’’
format (i.e., the user follows the treatment manual in a particular order even though the manual was not designed to be used
that way), and/or heavily focused on unnecessary skills (i.e., skills irrelevant to the child’s life) or inappropriate skills (i.e.,
prerequisite skills have not been taught and/or skills are age-inappropriate). In this paper, we attempt to identify the ideal
characteristics of an assessment tailored to the needs of an EIBI provider. Each of these characteristics is centered on
facilitating treatment and not on establishing diagnosis. From this perspective we have identified five criteria for evaluating
EIBI assessments, each of which is described below.

1. Critical components of an assessment for use in EIBI programs

First, the assessment should be comprehensive. As discussed above, ASD is pervasive and can potentially affect all areas of
a child’s development; therefore, assessment should address all major areas of human functioning (i.e., social, motor,
language, daily living, play, executive functions, social cognition, and academic skills), allowing clinicians to prioritize
treatment goals and develop a balanced, fully individualized curriculum. Human child development is enormously complex
and an assessment that does not address all relevant details may run the risk of allowing clinicians to overlook important
areas of development.
Second, it should target early childhood development. The goal of an EIBI program is to start early (as soon as a diagnosis is
made or a child is identified to be at risk) so that emerging deficits can be remediated through training. Thus, assessments
must be usable for children with ASD starting very early (i.e., 6 months or less), and extending until such time that a child is
able to be fully included in regular education. Thus, the upper limit of the assessment would likely need to equate to first or
second grade (approximately 7 or 8 years old developmentally). Further, items should be age-appropriate for each child
being assessed and should progress by age of typical development of skills. As such, assessments should ideally be age-
normed, or at a minimum provide developmental markers based upon empirical research.
Third, it should consider behavior function, not just behavior topography. Behavior analysts ensure programs are
individualized by taking a functional analytic approach (i.e., interventions are matched to the function of a child’s behavior,
rather than solely to topography; Hancock et al., 2000). There is a small but significant amount of research that has shown
that the many different ways in which a child might use the same behavior may each need to be taught separately (Sundberg
& Michael, 2001). Technically speaking, the effects of training one operant may not generalize to other functions of the same
topography (e.g., training a child to tact blue things may not lead to him manding them). Therefore, EIBI assessments should
result in curricula matched to what is developmentally and functionally relevant to each individual child’s strengths and
needs (e.g., verbal operants associated with language).
Fourth, there should be a direct link from assessment items to specific curricula targets (i.e., items should ask if the child
exhibits specific behaviors under specific conditions). Behavior analytic interventions are built on operationally defined
target behaviors. If assessment items target behaviors or skill areas that are too general, they will not yield sufficient
information to guide the design of individualized EIBI curricula (i.e., further assessment would be needed in order to
 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002 993

determine exactly what to teach and where to start teaching skills). For example, an assessment item asking, ‘‘Does your
child play independently with age appropriate toys?’’ could help identify whether independent play is an important area to
target, but not which particular types of play (e.g., functional pretend play, symbolic play, etc.), or further still, which
particular components of particular types of play (e.g., one-step imitation of play movements, multiple-step play sequences,
constructing play objects, narrating play, etc.). In addition to identifying specific skills that a child does not possess, the
results of the assessment should also identify specific skill strengths that the child possesses within the same skill area. This
information should provide a starting point for clinicians. For example, if it is determined that a child does independently ask
for preferred items using one-word requests, but does not independently ask for preferred items using modifiers (e.g., ‘‘big,’’
‘‘more,’’ etc.), then a logical starting point for expanding the child’s requesting (manding) language might be to start with
adding simple modifiers to one word requests.
Finally, an assessment should be useful for tracking child progress over time. Ongoing measurement and analysis of the
effects of the intervention is a central feature to all EIBI programs, and a comprehensive assessment that is repeatable over
time should contribute to painting a comprehensive picture of changes in child learning. Ideally, such an assessment would
not only yield a reliable and valid picture of each child’s individual skills at any given time, but should also be relatively easy,
cost-effective, and time-efficient for clinicians to administer repeatedly. An assessment that is difficult or cumbersome to
administer, complicated to interpret, or expensive/time-consuming is less likely to be administered on a regular basis and
therefore may be less useful for the purposes of tracking ongoing child progress.

2. Direct versus indirect assessment

Direct observation is generally considered the gold standard for measuring a person’s abilities within ABA programs
(Cooper, Heron, & Heward, 2007). Direct observation has the advantages of providing direct information on the skills that a
child actually displayed, not merely third-person reports of what a child may have done, or worse still, information on a
variable that is assumed to be a proxy for the state of a hypothetical construct. However, direct observation is not without
its limitations. Perhaps the largest limitation of direct observation is that it may simply not be practical within many
treatment settings. Direct observation requires ‘‘trained observers, objectively defined target behaviors, and . . . must be
systematic, repeated at regular intervals, and of sufficient duration to ensure the assessment yields an adequate and
representative (i.e., valid) sample of behavior’’ (Sigafoos, Schlosser, Green, O’Reilly, & Lancioni, 2008, p. 181). Thus, direct
observation of all areas of human functioning between the ages of 0 and 8 years would be time and resource intensive and
therefore unrealistic in most treatment settings. Furthermore, because of the reliance on human observers, only a small
number of the most salient behaviors can be selected for assessment at any one time in order to achieve reliable results
(Matson, 2007). Given all of these reasons, it would be difficult to obtain a comprehensive inventory of deficits and excesses
through observation alone.
Assessment in the form of rating scales (measures of frequency and/or severity of skill deficits and behavioral excesses)
and checklists (recording whether skills are present or absent from the child’s repertoire) generally require less time and
fewer resources to conduct than direct observation methods (Sigafoos et al., 2008). Both ask informants to make judgments
based on their familiarity with the person’s behavior over some time frame (e.g., the last 3–6 months). The resulting
information provides an estimate of a child’s behavioral repertoire, across the time that the informant was present to witness
it, which may mean that data are less influenced by transient environmental variables than data collected through direct
observation. Furthermore, variability is a natural property of behavior, so several direct observations may be required before
an accurate estimate of the overall level of a behavior may be obtained. Therefore, when practical constraints do not allow for
the dozens or even hundreds of hours that may be required to gain a comprehensive estimate of every area of child
functioning through direct observation, results from indirect assessments may be the only reasonably accurate option, even
though data may potentially be biased by the informant’s idiosyncratic interpretation of the meaning of items and ratings
(Sigafoos et al., 2008). Thus, a comprehensive indirect assessment that allows for the integration of direct observation data
(when informants are unsure of the answer to a given item) may be a viable option.

3. Description of existing assessments

In the absence of an assessment scale developed specifically for the creation of EIBI treatment programs that addresses all
major areas of human functioning, clinicians have attempted to adapt a vast number of existing assessments for this purpose.
Essentially, any instrument which yields information regarding social, motor, language, adaptive, play, executive functions,
cognition, or academic skills may be used to guide treatment planning. However, as already discussed, simply because an
instrument provides information regarding a construct does not ensure that the information is useful in teaching particular
skills within that domain of functioning.
A large portion of national education and treatment centers for persons with ASD, including those providing ABA-based
services, show a relatively high percentage of agreement among practitioners on the instruments they routinely use for a
variety of purposes, including curriculum design (Luiselli et al., 2001). For the current review, we began by limiting the
assessments reviewed to those reported as having some daily use within ASD treatment centers by Luiselli et al. (2001), and
which were publicly available for use at the time this review was conducted. Further, to be included in this review, an
994 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002

instrument was minimally required to have published data regarding its reliability and validity. The final list of assessments
reviewed was expanded slightly to include those assessments that are currently in common use in EIBI programs.
Each of the assessments reviewed were evaluated in terms of how well they fit the criteria outlined above. What follows is
first a brief description of each of the assessments reviewed. The brief descriptions outline the domain of functioning
intended to be assessed, how the assessment data are obtained (e.g., administered tests versus questionnaire, etc.), the
intended age range, the approximate length of the assessment (including time needed to administer), and the level of
training required to administer the assessment. Following these brief descriptions, we discuss four assessments that most
closely meet the criteria outlined above.

3.1. Developmental/educational

3.1.1. Battelle Developmental Inventory-Second Edition

The Battelle Developmental Inventory-Second Edition (BDI-2; Newborg, 2005) is an assessment tool designed to evaluate
the development of children ages 0 to 7 years 11 months. The BDI-2 assesses adaptive, personal–social, communication,
motor, and cognitive abilities. The instrument is intended to be administered by qualified professionals (e.g., childhood
teachers, early intervention providers, special educators, psychologists, health professionals, etc.). Furthermore, it takes
approximately 60–90 min to administer the BDI-2 depending on the child’s age (Athanasiou, Barton, & Spiker, 2007).

3.1.2. Bayley Scales of Infant and Toddler Development-Third Edition

The Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III; Bayley, 2006) is an assessment battery
that evaluates the development of children ages 1–42 months. The Bayley-III contains five scales that assess cognitive,
language, motor, social–emotional, and adaptive skills. It takes approximately 50–90 min to complete the entire assessment.
The Bayley-III is intended to be administered by trained and experienced examiners who are familiar with administration
and scoring procedures (Bayley, 2006).

3.1.3. Brigance Diagnostic Inventory of Early Development-II

The Brigance Diagnostic Inventory of Early Development-II (Brigance IED-II; Brigance, 2004) is a comprehensive
assessment that evaluates skills pertinent to developmental ages between 0 and 7 years. The inventory assesses multiple
areas including perambulatory, gross and fine motor skills, self-help skills, speech and language skills, general knowledge
and comprehension, social and emotional development, readiness, basic reading skills, manuscript writing, and basic math
skills. The Brigance IED-II is lengthy and is not intended to be administered in full. Therefore, the administration time is
variable. Examiners do not require specialized training; however, the Brigance IED-II should be administered with
professional supervision (Davis, Finch, Spiker, & Barton, 2007).

3.1.4. Denver II
The Denver II (Frankenburg et al., 1990) is a screening instrument designed to identify developmental deficits in children
ages 0–6 years. The instrument evaluates personal–social, fine motor-adaptive, language, and gross motor abilities. Roughly
20 min are required to administer the Denver II. The Denver II was developed to be used by trained examiners (Hughes &
Mirenda, 1995).

3.1.5. Psychoeducational Profile-Revised

The Psychoeducational Profile-Revised (PEP-R; Schopler, Reichler, Bashford, Lansing, & Marcus, 1990) is an instrument
designed to assess the development of children with ASD and related developmental disorders between the ages 6 months
and 7 years. The PEP-R is made up of two scales. The developmental scale evaluates imitation, perception, fine motor, gross
motor, eye–hand interaction, cognitive performance, and cognitive verbal abilities. Moreover, the behavioral scale assesses
areas including relating and affect, play and interest in materials, sensory responses, and language. The authors recommend
that examiners be familiar with the manual and have some experience administering tests to children. Roughly 45–90 min
are required to administer and score the PEP-R (Schopler et al., 1990). A revision of the PEP-R, the Psychoeducational Profile-
Third Edition (PEP-3; Schopler, Lansing, Reichler, & Marcus, 2005) has also been developed.

3.2. Social skills

3.2.1. Social Responsiveness Scale

The Social Responsiveness Scale (SRS; Constantino & Gruber, 2005) is a questionnaire designed to assess children and
adolescents ages 4–19 years. The SRS evaluates areas concerning interpersonal behavior, communication, and repetitive/
stereotypic behavior. Primarily, the SRS functions as a screener or aid in diagnosing disorders across the autism spectrum.
Five additional treatment subscales are provided to assist program planning and treatment evaluation. These subscales
evaluate areas including social awareness, social cognition, social communication, social motivation, and autistic
mannerisms. The authors recommend that the SRS be administered by professionals with education and training in ASD
treatment and assessment. Approximately 15–20 min are required to complete the SRS, and about 5–10 min are needed to
score the questionnaire (Constantino & Gruber, 2005).
 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002 995

3.2.2. Social Skills Rating System

The Social Skills Rating System (SSRS; Gresham & Elliott, 1990) is a questionnaire used to evaluate social skills from
kindergarten through 12th grade. The SSRS contains three rating forms: teacher, parent, and student. All forms evaluate
social skills, specifically cooperation, assertion, responsibility, empathy, and self-control. The teacher and parent forms
assess problem behavior, in particular externalizing problems, internalizing problems, and hyperactivity. Finally, the teacher
form measures academic competence by evaluating reading skills, math skills, motivation, parental support, and cognitive
functioning. The authors recommend that the SSRS be administered by licensed professionals working in education,
psychology, medicine, social work, or related fields. In addition, examiners should be trained in psychological test
interpretation. The SSRS takes about 25 min to complete and roughly 5 min to score (Gresham & Elliott, 1990). A revision of
the SSRS, the Social Skills Improvement System (SSIS; Gresham & Elliott, 2008), has also been developed.

3.3. Motor function

3.3.1. Beery–Buktenica Developmental Test of Visual–Motor Integration-Fifth Edition

The Beery–Buktenica Developmental Test of Visual–Motor Integration-Fifth Edition (Beery VMI; Beery & Beery, 2004) is
an instrument developed to assess visual–motor skills in persons between the ages 2 and 100 years. The subject’s hand–eye
coordination is evaluated via the ability to copy geometric shapes. Examiners require graduate level training and experience
in assessment administration and interpretation. The Beery VMI takes approximately 10–15 min to administer (Graham,
McKnight, & Chandler, 2007).

3.3.2. Peabody Developmental Motor Scales-Second Edition

The Peabody Developmental Motor Scales-Second Edition (PDMS-2; Folio & Fewell, 2000) is an assessment tool designed
to evaluate fine and gross motor skills in children ages 0–6 years. The PDMS-2 assesses various motor functions including
reflexes, stationary, locomotion, object manipulation, grasping, and visual–motor integration. It takes roughly 45–60 min to
administer the PDMS-2. Moreover, the instrument was developed to be administered by occupational and physical
therapists, diagnosticians, early intervention providers, adapted physical educators, special educators, and other related
professionals. Examiners do not require specialized training to administer the PDMS-2 (Bunker, Kellers, & Stovall, 2003).

3.4. Speech and language/communication

3.4.1. Assessment of Basic Language and Learning Skills-Revised

The Assessment of Basic Language and Learning Skills-Revised (ABLLS-R; Partington, 2008) is an instrument developed to
evaluate children with language delays. The ABLLS-R assesses various areas including language, social, play, academic, self-
help, and motor skills. The instrument should be administered by an individual who is familiar with the subject (e.g., a
caregiver, teacher, behavior analyst, psychologist, or speech and language therapist) and preferably is the subject’s program
planner. Furthermore, the user should be familiar with the ABLLS-R protocol and have experience administering and
interpreting assessments (Partington, 2008). The ABLLS-R manual does not specify the assessment’s intended age range, nor
the length of time it takes to administer it.

3.4.2. Clinical Evaluation of Language Fundamentals-Fourth Edition

The Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4; Semel, Wiig, & Secord, 2003) is an assessment
that evaluates language and communication development in persons ages 5–21 years. The authors recommend that the
CELF-4 be administered by trained professionals (e.g., speech–language pathologists, school psychologists, special educators,
and diagnosticians) who are experienced in administration and scoring procedures. The assessment is broken down into four
levels designed to identify if a language disorder is present, reveal features of the disorder, assess underlying clinical
behaviors, and assess language and communication in context. It takes approximately 30–45 min to complete the four
subtests that make up the first level. The remaining subtests have varied administration times due to a number of factors
including the subject’s age, language ability, and motivation (Semel et al., 2003).

3.4.3. Peabody Picture Vocabulary Test-Fourth Edition

The Peabody Picture Vocabulary Test-Fourth Edition (PPVT-4; Dunn & Dunn, 2007) is an assessment tool developed to
evaluate receptive language skills across a wide age range (2 years 6 months to 90+ years). Receptive language skills are
assessed via the subject’s ability to identify pictures that correlate with words spoken by the examiner. The PPVT-4 takes
approximately 10–15 min to administer. Examiners require training in administration and scoring procedures (Kush & Shaw,
2010).

3.4.4. Pragmatics Profile of Everyday Communication Skills in Children Revised Edition

The Pragmatics Profile of Everyday Communication Skills in Children Revised Edition (Dewart & Summers, 1995) is a
language assessment that appears in two versions. The preschool version was designed to evaluate children ages 0–4 years,
and the school-aged version was developed to assess children ages 5–10 years. Both versions cover areas including
communication functions, response to communication, interaction and conversation, and contextual variation. Examiners
996 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002

should be familiar with the administration procedures. Furthermore, the profile was designed to be used by professionals in
fields pertaining to language and communication development (e.g., speech and language therapists, educational and
clinical psychologists, health visitors, child development teams, teachers, and researchers). Both versions of the profile can
be completed in roughly 30 min (Dewart & Summers, 1995).

3.4.5. Preschool Language Scale-Fourth Edition

The Preschool Language Scale-Fourth Edition (PLS-4; Zimmerman, Steiner, & Pond, 2002) is an instrument designed to
evaluate language skills in children ages 0 to 6 years 11 months. The PLS-4 assesses areas including language precursors,
semantics, structure, integrative language skills, and phonological awareness. The authors recommend that the instrument
be administered by trained professionals with experience in assessment (e.g., speech–language pathologists, early childhood
specialists, pediatricians, psychologists, and diagnosticians). The PLS-4 takes roughly 20–45 min to administer, depending on
the subject’s age and cooperation (Zimmerman & Castilleja, 2005).

3.4.6. Reynell Developmental Language Scales [U.S. Edition]

The Reynell Developmental Language Scales [U.S. Edition] (RDLS; Reynell & Gruber, 1990) is a tool developed to evaluate
language skills in children between the ages 1 year and 6 years 11 months. The RDLS consists of two scales that evaluate
verbal comprehension and expressive language. The authors recommend that the RDLS be completed by examiners trained
to administer clinical tools. The RDLS can generally be administered in less than 30 min (Berry, Bridges, & Zaslow, 2004).

3.4.7. Test of Language Development-Primary: Fourth Edition

The Test of Language Development-Primary: Fourth Edition (TOLD-P:4; Newcomer & Hammill, 2008) is an assessment tool
designed to evaluate spoken language skills in children ages 4 years to 8 years 11 months. The TOLD-P:4 is made up of six core
subtests, which evaluate grammar and semantics, and three supplemental subtests, which assess phonology. The authors
recommend that the TOLD-P:4 be used by professionals with training in administering assessments and evaluating language
skills. Examiners should also be familiar with administration and scoring procedures. It takes approximately 35–50 min to
administer the core subtests and about 30 min to administer the supplemental subtests (Newcomer & Hammill, 2008).

3.4.8. Test of Pragmatic Language-Second Edition

The Test of Pragmatic Language-Second Edition (TOPL-2; Phelps-Terasaki & Phelps-Gunn, 2007) is an assessment that
evaluates pragmatic language skills in children and adolescents ages 6–18 years. The TOPL-2 assesses skill areas including
physical context, audience, topic, purpose, visual and gestural cues, abstractions, and pragmatic evaluation. The authors
recommend that the TOPL-2 be conducted by individuals with training in standardized test administration. Furthermore,
roughly 60–90 min are required to administer and score the TOPL-2 (Phelps-Terasaki & Phelps-Gunn, 2007).

3.4.9. Verbal Behavior Milestones Assessment and Placement Program

The Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP; Sundberg, 2008) is an assessment tool,
based on Skinner’s analysis of verbal behavior (1957), developed to evaluate verbal skills in individuals with language delay.
The VB-MAPP consists of five components. First, the Milestones Assessment evaluates learning and language milestones for
three developmental age levels: 0–18 months, 18–30 months, and 30–48 months. Next, the Barriers Assessment evaluates
behaviors that commonly inhibit learning and language acquisition in children with ASD and other developmental
disabilities. The remaining components of the VB-MAPP include the Transition Assessment, the Task Analysis and Skills
Tracking, and the Placement and IEP Goals. Although the VB-MAPP is primarily intended for children with ASD and other
developmental disabilities, the tool can be adapted for individuals of all ages with various types of language delay. The
author recommends that examiners be familiar with Skinner (1957), linguistic structure, and types of prompting. In addition,
examiners should be knowledgeable about grammar and sentence structure. Administration time is variable and contingent
on multiple factors including the subject’s performance level and cooperation (Sundberg, 2008).

3.5. Daily living skills

3.5.1. Scales of Independent Behavior-Revised

The Scales of Independent Behavior-Revised (SIB-R; Bruininks, Woodcock, Weatherman, & Hill, 1996) is an assessment
tool developed to evaluate adaptive and problem behaviors across a wide age range (infancy to 80+ years). Areas assessed by
the SIB-R include motor skills, social interaction and communication skills, personal living skills, community living skills, and
problem behavior. In addition to the Full Scale, the SIB-R contains a Short Form, an Early Development Form, and Individual
Plan Recommendations forms. The SIB-R can be completed in two ways, via a structured interview or a checklist. Examiners
using the SIB-R do not require extensive training in interview or checklist administration. The SIB-R can typically be
completed in less than 60 min (Bruininks et al., 1996).

3.5.2. Vineland Adaptive Behavior Scales-Second Edition

The Vineland Adaptive Behavior Scales-Second Edition (VABS-II; Sparrow, Cicchetti, & Balla, 2005) is an assessment that
evaluates adaptive behaviors in individuals between the ages 0 and 90 years. Multiple versions of the VABS-II have been
 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002 997

developed including two survey forms (the Survey Interview Form and the Parent/Caregiver Rating Form), the Expanded
Interview Form, and the Teacher Rating Form. The Survey forms assess areas including communication, daily living skills,
socialization, motor skills, and maladaptive behavior. It takes approximately 20–60 min to complete a survey form and an
additional 15–30 min to score it. The authors recommend that examiners, administering the Survey Interview Form, have a
detailed understanding of the items and previous experience performing semi-structured interviews (Sparrow et al., 2005).

3.6. Play skills

3.6.1. Symbolic Play Test-Second Edition

The Symbolic Play Test-Second Edition (SPT; Lowe & Costello, 1988) is an assessment tool designed to evaluate children
between the ages 1 and 3 years. The SPT assesses language potential via direct observation of the subject’s nonverbal play.
Roughly 10–15 min are required to administer the instrument. The SPT is intended to be used by qualified professionals (e.g.,
speech and language therapists, and psychologists; Paolitto & Switzky, 1995).

3.7. Academics/achievement

3.7.1. Brigance Diagnostic Comprehensive Inventory of Basic Skills-Revised

The Brigance Diagnostic Comprehensive Inventory of Basic Skills-Revised (CIBS-R; Brigance, 1999) is a tool developed to
evaluate skill performance in elementary and middle school students. The CIBS-R assesses areas including readiness, speech,
listening, reading, spelling, writing, study skills, and math. The CIBS-R contains 154 assessments and is not intended to be
administered in full. The examiner must use personal judgment to choose assessment areas and skill levels that are
pertinent. For this reason, the administration time varies. While training is not required to administer the instrument, the
author recommends that the CIBS-R be used by supervised paraprofessionals (Brigance, 1999). A revision of the CIBS-R, the
Brigance Comprehensive Inventory of Basic Skills II (CIBS II; Brigance, 2010), has also been developed.

3.7.2. Peabody Individual Achievement Test-Revised

The Peabody Individual Achievement Test-Revised (PIAT-R; Markwardt, 1998) is an assessment tool developed to evaluate
achievement from kindergarten through 12th grade. The PIAT-R contains six subtests and assesses areas including general
information, reading recognition, reading comprehension, mathematics, spelling, and written expression. The PIAT-R should be
conducted by individuals who are familiar with the administration procedures. In addition, the author recommends that the
instrument be interpreted by professionals with experience in psychology (e.g., psychologists, teachers, learning specialists,
counselors, and social workers). It takes approximately 60 min to complete all six subtests (Berry et al., 2004).

3.7.3. Wide Range Achievement Test Fourth Edition

The Wide Range Achievement Test Fourth Edition (WRAT4; Wilkinson & Robertson, 2006) is an assessment tool designed
to evaluate academic skills in persons between the ages 5 and 94 years. The WRAT4 consists of four subtests that assess areas
including math computation, word reading, spelling, and sentence comprehension. It takes approximately 15–45 min to
administer the instrument depending on the subject’s age. The WRAT4 was designed to be administered by trained
paraprofessionals (Hoff, Swerdlik, Sabers, & Olson, 2010). The Wide Range Achievement Test Fourth Edition Progress
Monitoring Version (WRAT4-PMV; Roid & Ledbetter, 2006) has also been developed to track academic improvement over
time (Schafer & Venn, 2010).

3.7.4. Woodcock–Johnson III Normative Update

The Woodcock–Johnson III Normative Update (WJ III NU; McGrew, Schrank, & Woodcock, 2007) is a revision of the
Woodcock–Johnson III (WJ III; Woodcock, McGrew, & Mather, 2001) and features adjusted normative data derived from the
2005 U.S. Census. The WJ III NU contains two assessment batteries, the Tests of Cognitive Abilities and the Tests of
Achievement. The cognitive tests assess areas including verbal ability, thinking ability, and cognitive efficiency. Moreover,
the achievement tests evaluate areas including reading, oral language, math, writing, and academic knowledge. The WJ III NU
is designed to assess persons ages 2–90+ years. It takes about 35–45 min to administer the 7 standard cognitive tests and
approximately 55–65 min to complete the 11 standard achievement tests. The WJ III NU is intended to be administered by
professionals who are familiar with administration and scoring procedures. Furthermore, the authors recommend that
examiners have graduate-level training (McGrew et al., 2007).

3.8. Intelligence

3.8.1. Wechsler Intelligence Scale for Children-Fourth Edition Integrated

The Wechsler Intelligence Scale for Children-Fourth Edition Integrated (WISC-IV Integrated; Wechsler et al., 2004) is an
assessment tool developed to evaluate cognitive functioning in children and adolescents ages 6 years to 16 years 11 months.
The WISC-IV Integrated assesses four cognitive areas including verbal comprehension, perceptual reasoning, working
memory, and processing speed. Roughly 65–80 min are required to administer the 10 core subtests. Examiners should be
trained and experienced in psychological assessment administration and interpretation (Wechsler et al., 2004).
998 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002

3.8.2. Wechsler Preschool and Primary Scale of Intelligence-Third Edition

The Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III; Wechsler, 2002) is an instrument
designed to evaluate intellectual functioning in children ages 2 years 6 months to 7 years 3 months. The WPPSI-III measures
verbal intelligence quotient (IQ), performance IQ, full scale IQ, processing speed quotient, and general language composite
scores. Examiners should have training and experience in psychological assessment administration and interpretation.
Furthermore, approximately 30–50 min are required to administer the core subtests depending on the subject’s age
(Wechsler, 2002).

4. Critical analysis of existing assessments

After reviewing the assessments described above, four meet our original five criteria most closely: the VB-MAPP, Brigance
IED-II, VABS-II, and CIBS-R. We now turn to a description of how these four can be used for designing EIBI programs, as well as
a critical analysis of the strengths and limitations of each for this purpose.

4.1.1. VB-MAPP

The VB-MAPP was designed for and is used by providers for designing EIBI programs. It addresses five of the
identified skill areas (social, motor, language, play, and academic skills) for children between the ages of 0 and 4 years.
The items within the assessment progress by age of typical development of skills. The items are not only operationally
defined but they also consider function (and not just topography) of behavior. Specifically, there are questions to assess
whether the child uses his or her language skills under all relevant conditions (i.e., assesses verbal operants associated
with language such as echoics, mands, tacts, and intraverbals). The greatest limitation to the VB-MAPP is the lack of
psychometric evaluation. Sufficient reliability and validity of assessments is not a default assumption, but rather, a
consideration that requires empirical investigation. Another potential limitation of the VB-MAPP is that administration
can be lengthy because it requires the assessor to test the child on each item, although the manual states that caregivers
can be interviewed in lieu of direct administration if the report of the caregivers is deemed likely to be accurate. Once
the items are administered though, results of the assessment are easily obtained and interpreted. The assessor is
presented with a list of skills that need to be taught and some direction in terms of the order in which to teach the skills;
however, there is no clear presentation of what the prerequisites are for each item. While the items are not directly
linked to curricula, the items are meant to guide curriculum design. If the supervisor of the child’s EIBI program has
expertise in translating specific skill deficits into lessons to teach the skills, then the results of the VB-MAPP should
significantly aid in curriculum design. The assessment also comes with tracking charts that allow the user to see skill
strengths and to measure progress over time.

4.1.2. Brigance IED-II

The Brigance IED-II also suffers from the limitation that its psychometric properties have not been evaluated in published
research. However, in addition to covering the five areas addressed by the VB-MAPP, this assessment also covers adaptive
skills. Furthermore, it extends the population of children who can be assessed up through the age of 7 years. And, because the
VB-MAPP is primarily a language assessment, the pool of test items within the Brigance IED-II is more comprehensive in the
areas of motor and academic skills. The assessment questions progress by age of typical development of skills and are well-
defined. A benefit of the Brigance IED-II is that there is reportedly no specialized training needed by persons who administer
it. The method used for assessment is flexible. Assessors can either obtain information by interviewing caregivers, testing the
child, or gathering data from school records. If direct observation is a chosen method, there are few materials needed for this
assessment. The results are easily interpreted in that the assessor is provided with a list of skills that the child needs to be
taught; however, interpreting what to do with this list is not as clear. The assessment does not link to curricula/lesson plans,
nor provide any indication of prerequisites for deficient skills. On the other hand, the way in which the testing booklet is
scored provides a visual depiction of the child’s strengths within various skill domains and also allows the assessor to see the
child making progress over time.

4.1.3. VABS-II

The VABS-II not only has impressive psychometrics (Beail, 2003) but is also by far the most popular assessment and is
among the most widely used scales (Balboni, Pedrabissi, Molteni, & Villa, 2001; Dixon, 2007). This assessment addresses five
of the eight skill areas (social, motor, language, daily living, and play skills) and includes skills relevant from birth through 90
years. The items within the assessment progress by age of typical development of skills and are well-defined. This
assessment does not require direct observation and can be filled out in an interview format leading to a great deal of
information being obtained in a relatively short period of time with no materials needed other than a scoring booklet and
pencil. Information is easily obtained and scored, and the assessor is provided with a graphical depiction of the child’s
strengths by domain (e.g., within the daily living skills section, the assessor obtains information as to how the child is doing
with personal, domestic, and community skills). However, interpretation of the results in order to use the information for
 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002 999

curriculum design is difficult because each of the items scored as deficient would need to be compiled into a list and
compared with one another to determine which should be targeted within a child’s curriculum. There is no indication of how
skills relate to one another in terms of knowing if any are prerequisites for others or the order in which to teach skills. In
addition, although the VABS-II covers a broad range of skill areas, it lacks detailed information on specific skills within those
areas. Therefore, much more detailed information would be needed in order to develop targeted lesson plans that teach
particular component skills that are needed.

4.1.4. CIBS-R

The CIBS-R is an assessment designed for the purpose of assessing academic skills from kindergarten through 9th grade.
The items within this assessment progress by academic grade of typical development of skills and are well-defined. Like the
Brigance IED-II the testing methods are flexible and the assessment does not require an assessor with specialized training.
Also like the Brigance IED-II, few materials are needed should direct observation be the chosen method of assessment. The
results are easily obtained in that the assessor is provided with a list of skills that the child needs to be taught; however,
interpreting what to do with this list is not as clear. The assessment does not link to curricula/lesson plans, nor provide any
indication of prerequisites for deficient skills. However, given that the test items pertain specifically to academics, there are
likely other academic curricula from which teachers can pull. The way in which the testing booklet is scored provides a
visual depiction of the child’s strengths within various skill domains and also allows the assessor to see the child making
progress over time.

4.2. Concerns with existing assessments

Of all the assessments reviewed in this paper, four were identified as best meeting the criteria we suggested are important
for their use in designing EIBI programs. Despite the strengths of these assessments, some concerns warrant discussion. For
one, there is no single assessment that is comprehensive enough to be used for developing a fully comprehensive EIBI
curriculum for a child who has deficits across all developmental domains. Assessments used for the purpose of intervention
planning must ‘‘identify specific skills that are either present or absent from the person’s repertoire, appropriate or
inappropriate, and effective or ineffective’’ across all skill domains (Sigafoos et al., 2008, pp. 169–170). However, within the
history of assessment development for this population, assessments have been designed by individuals from differing
perspectives with an emphasis on specific features of ASD; thus a comprehensive assessment designed to measure all areas
of human functioning has not been established (Richdale & Schreck, 2008).
Between these four assessments, the following five of the eight skill areas are addressed: social, motor, language,
adaptive, play, and academic skills. With respect to evaluating executive functioning skills, only one of the reviewed
assessments measures this repertoire (WISC-IV); however, the results are not useful in aiding clinicians to design targets to
teach children with ASD executive functions. With respect to evaluating social cognition, none of the assessments reviewed
have a section designed to test this repertoire; however, there are a few items on the VABS-II that address it (albeit not
thoroughly).
Guidelines regarding the assessment of children with ASD still generally focus almost exclusively on differential
diagnosis (American Academy of Child and Adolescent Psychiatry, 1999). Scales designed for treatment planning require
greater emphasis on an in-depth measurement of skill domains than those designed for diagnostic purposes (i.e., focus on
areas of intervention, not symptoms indicative of ASD). Thus, assessments that identify specific deficits and/or excesses are
likely to be the most relevant for selecting treatment targets. Although commonly used screening and diagnostic tools
provide data on some aspects of each domain, they contain too few items on specific skills to be used to identify and prioritize
treatment targets. Further, while domain-specific instruments may provide a more detailed picture regarding skills, they
often cover too generalized a behavior repertoire to be considered useful for curriculum development. Operationally defined
target behaviors are the ‘‘hallmark of behaviorally-based treatment programs’’ (Matson, 2007, p. 212). EIBI programs rely on
operational definitions of specific component and composite skills. However, assessments are generally not designed to
measure changes in specific behaviors and instead measure change in overall functioning, or changes in variables assumed to
be proxies for hypothetical constructs. All too often, poor performance within a specific domain is indicative that the child
needs further evaluation in that domain in order to then identify specific targets for intervention/specific skill deficits (e.g.,
Bayley-III).
Perhaps the most concerning feature of all the assessments reviewed here is that none of them are linked directly to
established curricula/lesson plans with outlined prerequisites. Assessment items linked to established EIBI curricula would
remove some of the guessing that likely currently determines what lesson plans are targeted.

5. Conclusion

There is a general dissatisfaction, particularly among ABA treatment providers, with existing assessments that are used
within EIBI programs. Without appropriate assessment tools, clinicians are left to assess as they see fit and to choose
programs as best they can. They are left to employ a battery of tests and assessment techniques for identifying a child’s skills
and deficits in order to determine where to begin intervention. ‘‘In most cases, the assessment will involve a combination of
1000 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002

approaches and procedures, including interview, behavioral observation, and administration of standardized rating scales or
checklists’’ (Sigafoos et al., 2008, p. 177). Not only is it time-consuming and expensive to become trained to administer a
variety of assessments, but test selection is also arbitrary and dependent on the clinician’s personal preferences, training
(different assessments require different training/expertise), and experience, as well as on the availability of tests, time, and
settings. Therefore, program content may be based more on clinician expertise, experience, and tradition, rather than on a
detailed and accurate assessment of child functioning. Such a state of affairs likely contributes to the wide variation in
quality, which is common today across EIBI programs.
The assessments reviewed and critiqued in this paper revealed that the VB-MAPP benefits from including information on
very specific skills and is based on a functional approach to language. However, it suffers from a lack of data on
psychometrics, extends only to age 4, and is not as comprehensive as may be desired, with respect to including skills from all
developmental domains. Others may be more comprehensive (e.g., Brigance IED-II) or have excellent psychometrics (e.g.,
VABS-II), but do not provide sufficient information to identify specific behavioral targets for treatment. Most concerning,
none of the assessments reviewed here are linked directly to a comprehensive curriculum.
The diverse expression and complexities across and within individuals with ASD over the course of development present
significant challenges for clinicians involved in assessment and treatment (American Academy of Child and Adolescent
Psychiatry, 1999). Curriculum content is crucial to intervention success and thus a comprehensive assessment capable of
determining curriculum content is important. Currently available assessments, such as those reviewed in this paper,
represent a good start. However, much future work is needed to develop an assessment that is comprehensive enough to
address all developmental domains while also being precise enough to determine specific targets for intervention. Such an
assessment will likely aid clinicians in reliably developing treatment programs that are more comprehensive and
individualized than the programs commonly found in applied settings today.

References

American Academy of Child and Adolescent Psychiatry. (1999). Practice parameters for the assessment and treatment of children, adolescents, and adults with
autism and other pervasive developmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 32S–54S.
Athanasiou, M., Barton, L. R., & Spiker, D. (2007). Test review of the Battelle Developmental Inventory (2nd ed.). In K. F. Geisinger, R. A. Spies, J. F. Carlson, & B. S.
Plake (Eds.), The seventeenth mental measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Balboni, G., Pedrabissi, L., Molteni, M., & Villa, S. (2001). Discriminant validity of the Vineland scales: Score profiles of individuals with mental retardation and a
specific disorder. American Journal on Mental Retardation, 106, 162–172.
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a ‘‘theory of mind’’? Cognition, 21, 37–46.
Bayley, N. (2006). Bayley Scales of Infant and Toddler Development (3rd ed.) administration manual. San Antonio, TX: PsychCorp.
Beail, N. (2003). What works for people with mental retardation? Critical commentary on cognitive-behavioral and psychodynamic psychotherapy research.
Mental Retardation, 41, 468–472.
Beery, K. E., & Beery, N. A. (2004). The Beery–Buktenica Developmental Test of Visual-Motor Integration (5th ed.). Bloomington, MN: Pearson.
Berry, D. J., Bridges, L. J., & Zaslow, M. J. (2004). Early childhood measures profiles. Washington, DC: Child Trends.
Bibby, P., Eikeseth, S., Martin, N. T., Mudford, O. C., & Reeves, D. (2002). Progress and outcomes for children with autism receiving parent-managed intensive
interventions. Research in Developmental Disabilities, 23, 81–104.
Brigance, A. H. (1999). Brigance Diagnostic Comprehensive Inventory of Basic Skills Revised. North Billerica, MA: Curriculum Associates.
Brigance, A. H. (2004). Brigance Diagnostic Inventory of Early Development-II. North Billerica, MA: Curriculum Associates.
Brigance, A. H. (2010). Brigance Comprehensive Inventory of Basic Skills II. North Billerica, MA: Curriculum Associates.
Bruininks, R. H., Woodcock, R. W., Weatherman, R. F., & Hill, B. K. (1996). Scales of Independent Behavior-Revised comprehensive manual. Itasca, IL: Riverside
Publishing.
Bunker, L. K., Kellers, P., & Stovall, D. L. (2003). Test review of the Peabody Developmental Motor Scales (2nd ed.). In B. S. Plake, J. C. Impara, & R. A. Spies (Eds.), The
fifteenth mental measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Carpentieri, S., & Morgan, S. B. (1996). Adaptive and intellectual functioning in autistic and nonautistic retarded children. Journal of Autism and Developmental
Disorders, 26, 611–620.
Cohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: Replication of the UCLA model in a community setting. Developmental
and Behavioral Pediatrics, 27, 145–155.
Constantino, J. N., & Gruber, C. P. (2005). Social Responsiveness Scale (SRS) manual. Los Angeles, CA: Western Psychological Services.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Upper Saddle River, NJ: Merrill/Prentice Hall.
Davis, A. S., Finch, W. H., Spiker, D., & Barton, L. R. (2007). Test review of the Brigance Diagnostic Inventory of Early Development-II. In K. F. Geisinger, R. A. Spies, J. F.
Carlson, & B. S. Plake (Eds.), The seventeenth mental measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Dewart, H., & Summers, S. (1995). The Pragmatics Profile of Everyday Communication Skills in Children (Rev. ed.) manual. Windsor, England: NFER-Nelson.
Dewey, D., Cantell, M., & Crawford, S. G. (2007). Motor and gestural performance in children with autism spectrum disorders, developmental coordination
disorder, and/or attention deficit hyperactivity disorder. Journal of the International Neuropsychological Society, 13, 246–256.
Dixon, D. R. (2007). Adaptive behavior scales. International Review of Research in Mental Retardation, 34, 99–140.
Dunn, L. M., & Dunn, D. M. (2007). Peabody Picture Vocabulary Test (4th ed.). Bloomington, MN: Pearson.
Dyck, M. J., Piek, J. P., Hay, D. A., & Hallmayer, J. F. (2007). The relationship between symptoms and abilities in autism. Journal of Developmental and Physical
Disabilities, 19, 251–261.
Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: A
comparison controlled study. Behavior Modification, 31, 264–278.
Eldevik, S., Eikeseth, S., Jahr, E., & Smith, T. (2006). Effects of low-intensive behavioral treatment for children with autism and mental retardation. Journal of Autism
and Developmental Disorders, 36, 211–224.
Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism.
Journal of Clinical Child & Adolescent Psychology, 38, 439–450.
Folio, M. R., & Fewell, R. R. (2000). Peabody Developmental Motor Scales (2nd ed.). Austin, TX: Pro-Ed.
Frankenburg, W. K., Dodds, J., Archer, P., Bresnick, B., Maschka, P., Edelman, N., et al. (1990). Denver II. Denver, CO: Denver Developmental Materials.
Graham, T., McKnight, T., & Chandler, T. (2007). Test review of the Beery–Buktenica Developmental Test of Visual-Motor Integration (5th ed.). In K. F. Geisinger, R.
A. Spies, J. F. Carlson, & B. S. Plake (Eds.), The seventeenth mental measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Gresham, F. M., & Elliott, S. N. (1990). Social Skills Rating System manual. Circle Pines, MN: American Guidance Service.
Gresham, F. M., & Elliott, S. N. (2008). Social Skills Improvement System rating scales manual. Minneapolis, MN: Pearson.
 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002 1001

Hancock, M. A., Cautilli, J. D., Rosenwasser, B., & Clark, K. (2000). Four tactics for improving behavior analytic services. The Behavior Analyst Today, 1,
35–38.
Hayward, D. W., Gale, C. M., & Eikeseth, S. (2009). Intensive behavioural intervention for young children with autism: A research-based service model. Research in
Autism Spectrum Disorders, 3, 571–580.
Hill, E. L. (2004). Evaluating the theory of executive dysfunction in autism. Developmental Review, 24, 189–233.
Hoff, K. E., Swerdlik, M. E., Sabers, D. L., & Olson, A. M. (2010). Test review of the Wide Range Achievement Test (4th ed.). In R. A. Spies, J. F. Carlson, & K. F. Geisinger
(Eds.), The eighteenth mental measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G., & Stanislaw, H. (2005). A comparison of intensive behavior analytic and eclectic treatments for young
children with autism. Research in Developmental Disabilities, 26, 359–383.
Hughes, S., & Mirenda, P. (1995). Test review of the Denver II. In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements yearbook Retrieved from the
Mental Measurements Yearbook database.
Jarrold, C. (2003). A review of research into pretend play in autism. Autism, 7, 379–390.
Kazdin, A. E., & Nock, M. K. (2003). Delineating mechanisms of change in child and adolescent therapy: Methodological issues and research recommendations.
Journal of Child Psychology and Psychiatry, 44, 1116–1129.
Kush, J. C., & Shaw, S. R. (2010). Test review of the Peabody Picture Vocabulary Test (4th ed.). In R. A. Spies, J. F. Carlson, & K. F. Geisinger (Eds.), The eighteenth mental
measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Leaf, R., & McEachin, J. (1999). A work in progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York, NY: DRL
Books.
Liss, M., Harel, B., Fein, D., Allen, D., Dunn, M., Feinstein, C., et al. (2001). Predictors and correlates of adaptive functioning in children with developmental
disorders. Journal of Autism and Developmental Disorders, 31, 219–230.
Lord, C., & Schopler, E. (1989). Stability of assessment results of autistic and non-autistic language-impaired children from preschool years to early school age.
Journal of Child Psychology and Psychiatry, 30, 575–590.
Lovaas, O. I. (1981). Teaching developmentally disabled children: The me book. Austin, TX: Pro-Ed.
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical
Psychology, 55, 3–9.
Lovaas, O. I. (2003). Teaching individuals with developmental delays: Basic intervention techniques. Austin, TX: Pro-Ed.
Love, J. R., Carr, J. E., Almason, S. M., & Petursdottir, A. I. (2009). Early and intensive behavioral intervention for autism: A survey of clinical practices. Research in
Autism Spectrum Disorders, 3, 421–428.
Lowe, M., & Costello, A. J. (1988). Symbolic Play Test (2nd ed.). Windsor, England: NFER-Nelson.
Luiselli, J. K., Campbell, S., Cannon, B., DiPietro, E., Ellis, J. T., Taras, M., et al. (2001). Assessment instruments used in the education and treatment of persons with
autism: Brief report of a survey of national service centers. Research in Developmental Disabilities, 22, 389–398.
Magiati, I., Charman, T., & Howlin, P. (2007). A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist
nursery provision for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 48, 803–812.
Markwardt, F. C. (1998). Peabody Individual Achievement Test-Revised/Normative Update manual. Circle Pines, MN: American Guidance Service.
Matson, J. L. (2007). Determining treatment outcome in early intervention programs for autism spectrum disorders: A critical analysis of measurement issues in
learning based interventions. Research in Developmental Disabilities, 28, 207–218.
Maurice, C., Green, G., & Luce, S. C. (1996). Behavioral intervention for young children with autism: A manual for parents and professionals. Austin, TX: Pro-Ed.
Mayes, S. D., & Calhoun, S. L. (2006). Frequency of reading, math, and writing disabilities in children with clinical disorders. Learning and Individual Differences, 16,
145–157.
McGrew, K. S., Schrank, F. A., & Woodcock, R. W. (2007). Woodcock-Johnson III Normative Update technical manual. Rolling Meadows, IL: Riverside Publishing.
Miyahara, M., Tsujii, M., Hori, M., Nakanishi, K., Kageyama, H., & Sugiyama, T. (1997). Brief report: Motor incoordination in children with Asperger syndrome and
learning disabilities. Journal of Autism and Developmental Disorders, 27, 595–603.
Newborg, J. (2005). Battelle Developmental Inventory (2nd ed.). Rolling Meadows, IL: Riverside Publishing.
Newcomer, P. L., & Hammill, D. D. (2008). Test of Language Development Primary (4th ed.) examiner’s manual. Austin, TX: Pro-Ed.
Page, J., & Boucher, J. (1998). Motor impairments in children with autistic disorder. Child Language Teaching & Therapy, 14, 233–259.
Paolitto, A. W., & Switzky, H. N. (1995). Test review of the Symbolic Play Test (2nd ed.). In J. C. Conoley & J. C. Impara (Eds.), The twelfth mental measurements
yearbook Retrieved from the Mental Measurements Yearbook database.
Partington, J. W. (2008). The Assessment of Basics Language and Learning Skills-Revised: Scoring instructions and IEP development guide. Pleasant Hill, CA: Behavior
Analysts.
Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention
programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 60–69.
Phelps-Terasaki, D., & Phelps-Gunn, T. (2007). Test of Pragmatic Language (2nd ed.) examiner’s manual. Austin, TX: Pro-Ed.
Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young
autism project model. Journal of Autism and Developmental Disorders, 39, 23–41.
Remington, B., Hastings, R. P., Kovshoff, H., degli Espinosa, F., Jahr, E., Brown, T., et al. (2007). Early intensive behavioral intervention: Outcomes for children with
autism and their parents after two years. American Journal on Mental Retardation, 112, 418–438.
Reynell, J., & Gruber, C. P. (1990). Reynell Developmental Language Scales (U.S. ed.). Los Angeles, CA: Western Psychological Services.
Richdale, A. L., & Schreck, K. A. (2008). Assessment and intervention in autism: An historical perspective. In J. L. Matson (Ed.), Clinical assessment and intervention for
autism spectrum disorders (pp. 3–32). Burlington, MA: Academic Press.
Rogers, S. J., & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37, 8–38.
Roid, G. H., & Ledbetter, M. F. (2006). Wide Range Achievement Test (4th ed.) Progress Monitoring Version. Lutz, FL: Psychological Assessment Resources.
Rosales-Ruiz, J., & Baer, D. M. (1997). Behavioral cusps: A developmental and pragmatic concept for behavior analysis. Journal of Applied Behavior Analysis, 30, 533–
544.
Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental
Retardation, 110, 417–438.
Schafer, W. D., & Venn, J. J. (2010). Test review of the Wide Range Achievement Test (4th ed.) Progress Monitoring Version. In R. A. Spies, J. F. Carlson, & K. F.
Geisinger (Eds.), The eighteenth mental measurements yearbook Retrieved from the Mental Measurements Yearbook database.
Schopler, E., Lansing, M. D., Reichler, R. J., & Marcus, L. M. (2005). Psychoeducational profile: TEACCH individualized psychoeducational assessment for children with
autism spectrum disorders (3rd ed.). Austin, TX: Pro-Ed.
Schopler, E., Reichler, R. J., Bashford, A., Lansing, M. D., & Marcus, L. M. (1990). Individualized assessment and treatment for autistic and developmentally disabled
children: Vol. 1. Psychoeducational Profile-Revised (PEP-R). Austin, TX: Pro-Ed.
Semel, E., Wiig, E. H., & Secord, W. A. (2003). Clinical evaluation of language fundamentals (4th ed.). San Antonio, TX: PsychCorp.
Sigafoos, J., Schlosser, R. W., Green, V. A., O’Reilly, M., & Lancioni, G. E. (2008). Communication and social skills assessment. In J. L. Matson (Ed.), Clinical assessment
and intervention for autism spectrum disorders (pp. 165–192). Burlington, MA: Academic Press.
Skinner, B. F. (1957). Verbal behavior. Acton, MA: Copley.
Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2005). Vineland Adaptive Behavior Scales (2nd ed.) survey forms manual. Circle Pines, MN: American Guidance Service.
Sundberg, M. L. (2008). Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). Concord, CA: AVB Press.
Sundberg, M. L., & Michael, J. (2001). The benefits of Skinner’s analysis of verbal behavior for children with autism. Behavior Modification, 25, 698–724.
Wechsler, D. (2002). WPPSI-III administration and scoring manual. San Antonio, TX: PsychCorp.
1002 E. Gould et al. / Research in Autism Spectrum Disorders 5 (2011) 990–1002

Wechsler, D., Kaplan, E., Fein, D., Kramer, J., Morris, R., Delis, D., et al. (2004). Wechsler Intelligence Scale for Children (4th ed.)-Integrated administration and scoring
manual. San Antonio, TX: PsychCorp.
Wilkinson, G. S., & Robertson, G. J. (2006). Wide Range Achievement Test (4th ed.). Lutz, FL: Psychological Assessment Resources.
Woodcock, R. W., McGrew, K. S., & Mather, N. (2001). Woodcock-Johnson III. Rolling Meadows, IL: Riverside Publishing.
Zachor, D. A., Ben-Itzchak, E., Rabinovich, A. L., & Lahat, E. (2007). Change in autism core symptoms with intervention. Research in Autism Spectrum Disorders, 1,
304–317.
Zimmerman, I. L., & Castilleja, N. F. (2005). The role of a language scale for infant and preschool assessment. Mental Retardation and Developmental Disabilities
Research Reviews, 11, 238–246.
Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (2002). Preschool Language Scale (4th ed.). San Antonio, TX: PsychCorp.