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Variables Related to Differences in Standardized Test Outcomes for Children

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Article in Journal of Autism and Developmental Disorders · July 1997

DOI: 10.1023/A:1025894213424 · Source: PubMed

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 Journal of Autism and Developmental Disorders, Vol. 27, No. 3, 1997

Variables Related to Differences in

Standardized Test Outcomes For Children with
Autism1
Lynn Kern Koegel, Robert L. Koegel,2 and Annette Smith
University of California at Santa Barbara

The purpose of this experiment was to assess whether manipulation of variables

related to motivation and attention in children with autism would influence
performance on standardized tests. Two different testing conditions were
compared: One consisted of the usual standardized testing procedures; during
the other, specific variables that were hypothesized to relate to each child's
responsiveness to task stimuli were manipulated. Data were collected in the
context of a repeated reversals experimental design with condition order varied
within and across children. Six children participated in a total of 44 separate
testing sessions, controlled for order of conditions, number of sessions, and
type of test. Results showed consistent differences between the two conditions,
suggesting that improving motivation and attention in children with autism
may considerably influence test performance and interpretation. Findings are
discussed in relation to the difficulty in administering and interpreting changes
in performance on standardized tests with this population.

Standardized testing is frequently a component in interpreting the func-

tioning level and treatment progress for children with autism (Lovaas, 1987;
Lovaas, Koegel, Simmons, & Long, 1973), and current educational practices
often rely heavily on standardized testing in the diagnostic process (cf.
Turnbull, 1993). However, with certain populations, such as those with cul-
1This research was supported in part by U.S. Public Health Service Research Grant MH28210
from the National Institute of Mental Health, and by U.S. Department of Education Grants
G0087C0234 and H023C30070. The authors also acknowledge Mike Furlong and Deborah
Rumore Parks for their assistance.
2Address all correspondence to Robert L. Koegel, Autism Research Center, Graduate School
of Education, University of California-Santa Barbara, Santa Barbara, California 93106-9490.

233
0162-3257/97J0600-0233$12.50/0 © 1997 Plenum Publishing Corporation
234 Koegel, Koegel, and Smith

tural differences or with disabilities, there is much debate over possible

misinterpretation in the use of standardized tests (Berliner, 1988; see dis-
cussion in California Association of School Psychologists, 1987; Lambert,
1981; Rothman & Cohen, 1988; Turnbull, 1993; Williams, 1983; Zigler,
Abelson, Trickett, & Seitz, 1982). Discussions have especially focused on
tests that attempt to measure intelligence, aptitude, or achievement (Wil-
liams, 1983). There also have been related discussions concerning stand-
ardized testing of language (cf. Norris, Juarez, & Perkins, 1989) and reading
skills (Good & Salvia, 1988).
One area lacking in scientific documentation is the use of standardized
tests for children classified as having severe disabilities, such as autism. It has
been suggested that their abilities may be especially difficult to assess because
of deficits in social interaction and associated disruptive behaviors (such as
self-stimulation, task avoidance, and escape behaviors) that may interfere
with testing (R. L. Koegel & Mentis, 1985; Mittler, 1966). An apparent lack
of motivation has also been emphasized as playing a major role in the re-
duced responding of such children. These characteristics demonstrated by
children with autism may be especially evident with an examiner who is un-
familiar with autism, or during initial assessment sessions when even a highly
experienced examiner is unfamiliar with the idiosyncratic characteristics of a
given child (R. L. Koegel & Koegel, 1987; R. L. Koegel, Koegel, & Schreib-
man, 1991; R. L. Koegel, O'Dell, & Dunlap, 1988; R. L. Koegel, O'Dell, &
Koegel, 1987). This may be a serious problem for several reasons. First, a
test result that underestimates the child's functioning level may result in in-
appropriate educational placements and planning. Second, evaluation pro-
grams aimed at assessing treatment gains may be using disproportionately
low pretest scores for comparison with later posttest scores when disruptive
behaviors may have been decreased due to effective treatment programs,
and/or the examiner's increased familiarity with the child (Zigler et al., 1982).
The purpose of the present experiment was to empirically evaluate the
differences that such variables may produce. Two experimental conditions
were implemented. During one condition, the children were tested using
typical standardized test implementation procedures, as described in the
test manuals. In the other condition, specific motivational variables that
were related to the children's attention and responsiveness to task stimuli
were incorporated during testing.

METHOD
Participants
Six pre- and elementary school-aged children, five boys and one girl,
participated in this study. All were diagnosed by an outside agency as hav-
Test Interpretation for Children with Autism 23S

ing autism and referred to our clinic for treatment of autism. An initial
intake interview confirmed the diagnosis of autism according to DSM-IV
criteria (American Psychiatric Association, 1994), including (a) a qualitative
impairment in reciprocal social interaction as manifested by a preference
to be alone; (b) qualitative impairment in verbal and nonverbal communi-
cation (lack of eye contact, expression, gestures, and expressive language);
(c) a markedly restricted repertoire of activities, preferring to engage in
stereotypies, and or persistent preoccupation with specific objects or parts
of objects; and (d) a marked distress over changes in minor aspects of the
environment. Individual child characteristics are described below.
Child 1 was 9 years 6 months old, and was placed in a segregated
special education class for children with communicative disabilities. His be-
havior was marked by verbal stereotypic behavior and obsessions with spe-
cific cartoon characters. He was generally unresponsive and tended to stare
into space when others attempted to interact with him or place demands
on him. He was able to formulate syntactically correct sentences of at least
five words, although they were typically of a self-stimulatory nature and
rarely social or directed at others. Most communicative interactions tended
to be requests or protests.
Child 2 was 5 years 3 months old. He exhibited a number of stereo-
typies, such as spinning toys, rather than appropriate play. He used short
sentences to express his needs, but was not observed to use language for
social communication. He frequently turned away or said "no" upon at-
tempts to engage him in social interaction or presentation of an instruction.
He was permitted to attend a preschool for primarily nondisabled children
three mornings a week, only if an aide (hired by his parents) was with him.
Child 3 was 4 years 1 month old and was placed in a segregated special
education classroom for children with severe disabilities. He was able to
form sentences, but he most frequently exhibited delayed echolalia, and
verbal self-stimulatory behavior at which times he talked incessantly about
a particular topic, such as the military. Although he did interact occasion-
ally with adults, he was not observed to interact with his peers.
Child 4 was 5 years 9 months old and was placed in a segregated class-
room for children with severe disabilities. She exhibited numerous disrup-
tive behaviors including crying, tantruming, and screaming (typically "no"
or "I hate") when given an instruction. She also had a preoccupation with
certain objects, and avoided social contact. Language use consisted primar-
ily of short sentences to meet her needs.
Child 5 was 3 years 4 months old and attended a preschool primarily
for children without disabilities. He had not yet been assessed for public
school placement. He was able to create sentences of at least five words
and could read at approximately a first-grade level with some comprehen-
236 Koegel, Koegel, and Smith

sion. Socially, he responded fairly well to his mother and nanny, but was
not observed to interact with peers at his school or home. He also engaged
in lengthy periods of self-stimulatory behavior, such as lying down and sift-
ing sand through his hands, throughout the day.
Child 6 was 4 years 10 months old. He was nonverbal and frequently
engaged in tantrums and other disruptive behaviors (whining, crying, lying
on the floor, aggression, etc.), although he tended to cease tantruming and
respond appropriately when his mother was present. He had a preoccupa-
tion with small objects (typically cars, which he repeatedly lined up in rows)
and engaged in tantrums when one was taken away or when the order of
the cars was disrupted. The school district recommended that he be placed
in a classroom for children with severe disabilities, but was currently at-
tending a preschool primarily for children without disabilities.

Setting and Examiners

All sessions were conducted in a small testing room that contained a

table and two or three chairs. In addition to the child, the examiner and
one or two data recorders who sat outside of the child's field of vision
were present during the sessions. To increase external validity, a variety of
tests designed to assess different areas of cognitive functioning were em-
ployed. The specific tests used were: Assessment of Children's Language
Comprehension (ACLC; Foster, Giddan, & Stark, 1973); the Peabody Pic-
ture Vocabular Test Revised (PPVT-R; Dunn & Dunn, 1981); the Leiter
International Performance Scale (1979), and the Stanford-Binet Intelli-
gence Test IV (Thorndike, Hagen, & Sattler, 1986). The language and in-
telligence tests were administered by a licensed speech/language pathologist
or psychologist, or by an advanced doctoral student under the supervision
of a speech/language specialist or psychologist.

Design

This experiment employed two different testing conditions (the stand-

ardized condition and a motivation/attention condition; see below) within
the context of a multiple reversal design. To increase the internal validity
of this experiment the number and order of sessions was counterbalanced,
with order of conditions and number of sessions per condition varied both
within and across subjects. Thus, the six children participated in a total of
44 systematically sequenced testing sessions. To control for experimenter
bias, in 9 sessions throughout the experiment (in both conditions) the ex-
perimenter was unaware that another testing condition was being imple-
Test Interpretation for Children with Autism 237

mented. Also, in both conditions the examiners verbally encouraged the

children and provided verbal and edible rewards contingent upon appro-
priate test-taking behavior. The differences between the conditions are de-
scribed below.
Standardized Testing Condition. During this condition, the standardized
language and intelligence tests were administered as instructed by the test
manuals by professionals who were familiar with the testing procedures and
who had no particular bias with respect to the outcome of this study. Spe-
cifically, test materials were set up at a small table with a chair on each
side. Each child was asked to sit at the table and the preliminary trial items
were presented. The children were prompted to respond to the examiner's
instructions and were rewarded (with verbal praise and candy treats) for
appropriate sitting, and for appropriate test-taking behavior.
Motivation/Attention Condition. This condition differed from the Stand-
ardized Testing Condition in that motivational and/or attentional variables
were identified individually for each child (Table I). That is, prior to begin-
ning the tests, each child was observed and each child's parents were inter-
viewed with respect to behaviors that were likely to interfere with the testing
situation. The behaviors hypothesized as likely to interfere with test respond-
ing for each child are listed in the left-hand column of Table I. Motiva-
tional/attentional variables related to these behaviors were then defined for
each child, and the standardized test sessions were then modified in relation
to each child's presenting problem. These modifications are listed in the
right-hand column of Table I. For example, consider Child 1. The left-hand
column of Table I shows parental interviews and observations indicated that
he engaged in obsessive verbal self-stimulatory behavior, incessantly talking
in a "cartoon-like" voice. It was hypothesized that his behavior would inter-
fere with testing. Therefore, the right-hand column of Table I shows that dur-
ing the motivation/attention condition Child 1 was permitted to engage in
the obsessive cartoon talking, but only contingent upon on-task responding
to the test stimuli. In this same manner, specific behaviors hypothesized to
be problematic in testing, and the respective modifications for each child in
the experiment are listed in Table I.

Reliability

Reliability of the item scoring was assessed by having a second observer

independently record answers on a separate test protocol. To control for ob-
server drift, reliability observers were selected randomly from a pool of four
observers. Data were compared on a test item by test item basis during 36.4%
of the total sessions using the formula agreements divided by agreements plus
disagreements x 100 to yield a percentage. Reliability percentage agreements
238 Koegel, Koegel, and Smith

Table I. Behaviors Hypothesized to Interfere with Responding, and the Motivation/Atten-

tion Technique Used to Improve the Likelihood of Responding to Test Stimuli for Each
Child
Behavior hypothesized to interfere
Child with responding
1 Incessant talking in cartoon character
voice
2 Failing to orient to test stimuli. Lack
of attention to the test instructions
(e.g., failing to respond at all or
naming test items other than those
in the instruction)
3 Incessant perseverative stereotypic self-
talking
4 Screaming when asked to sit at test
table
5 Failure to respond to test stimuli due
to repetitively leafing through
favored books that he carried with
him and tantruming when favored
books were removed
6 High levels of crying, tantruming,
biting, pinching, and kicking in
the absence of his mother
Motivation/attention technique used to
improve the likelihood of responding to
test stimuli
Provided predictable breaks for "cartoon
character talking" contingent upon on-
task responding to test stimuli
Required to repeat back each
instruction prior to responding
Permitted repetitive self-talking during
breaks, contingent upon on-task
responding
Presented test stimuli at a different
location, such as when seated on the
floor
Permitted repetitive leafing through
books during breaks contingent upon
on-task responding
Test administered in the presence of
child's mother

averaged 98.6%, with a range of 94 to 100% across test sessions. These results
suggest a high degree of reliability in the data recording.

RESULTS

The results for this experiment are shown in Figure 1. A total of 44

test sessions were conducted using the procedures described above. Four
separate tests were incorporated in order to assess external validity of the
results across tests. Each light bar represents test performance for an in-
dividual test session using the standardized testing procedures. Similarly,
each dark bar represents an individual test result obtained during the mo-
tivation/attention sessions.
The upper left portion of Figure 1 shows the results of 14 test sessions
with 5 different children. These data reflect the performance of the children
during the two testing conditions when the ACLC multiple components
language assessments were analyzed. These results demonstrate that re-
gardless of condition order, all of the children showed higher test scores
Test Interpretation for Children with Autism 239
240 Koegel, Koegel, and Smith

in the motivation/attention condition. This was true regardless of the test

order or number of test sessions.
The lower left portion of Figure 1 shows similar results for the vo-
cabulary testing section of the ACLC. Four of the five children (Children
1, 2, 3, and 4) always scored higher during the motivation/attention condi-
tion; and Child 5 (who showed the smallest differences on the ACLC mul-
tiple components tests) showed a ceiling effect on the vocabulary test, with
high scores in both conditions. Overall, during 12 of the 14 vocabulary test
sessions, clear differences were observed between the two conditions, with
higher scores obtained during the motivation/attention condition.
The upper right portion of the figure shows the results of the two
testing conditions on the PPVT Similar to the other tests, the results are
replicated, showing that when the motivation/attention procedures were im-
plemented, the children's test scores were always higher than in the stand-
ardized testing condition. Again, this is true regardless of condition order
or number of test sessions.
Finally, the lower right portion of Figure 1 shows the results of the
two testing conditions using IQ tests. As can be seen, all of the children
always demonstrated improved scores during the motivation/attention con-
dition. This was true regardless of the type of IQ test or the order of the
testing conditions.
In summary, the overall pattern of results described above was repli-
cated with different tests as shown in the four portions of Figure 1. With
only one exception, the test scores for the 44 separate testing sessions were
always higher in the motivation/attention condition. The higher test scores
under the motivation/attention condition were evident for receptive vocabu-
lary tests, receptive language tests, verbal intelligence tests, and nonverbal
intelligence tests. Three of the children who were unable to reach a meas-
urable standard score under the standardized test conditions, were some-
times able to score in the normal range when the motivation/attention
techniques were implemented. The other children typically showed smaller
but also improved scores under the motivation/attention condition.

DISCUSSION

The results of this study suggest that the interpretation of test results
needs to take into consideration variables affecting groups of individuals
who may have different experiences and whose behaviors may influence
test performance. A child with autism, for example, may lack necessary
attention to the task, motivation to succeed, and/or present significant dis-
ruptive behaviors which would put him/her at a disadvantage in a stand-
Test Interpretation for Children with Autism 241

ardized testing situation. Functionally then, the test session becomes one
of assessing motivation, attention, or compliance more than of assessing
language or intelligence (L. K. Koegel & Koegel, 1995; Zigler et al., 1982).
The underlying assumption of standardized testing is that individuals
must attain and demonstrate certain competencies deemed essential for ef-
fective functioning as members of society (Williams, 1983). Such testing is
often used to assess gains in treatment programs, research studies, school
programs, individual interventions, and so forth. Testing these competencies
is also used in the identification and evaluation of children with disabilities
in order to plan, program, and appropriate services for their education
(Farb, Cottrell, Montague, & Throne, 1977; Fuchs, 1993; Throne & Farb;
1977; Turnbull, 1993). If standardized testing presents a problem for an
individual child, the type of gains the child makes during intervention may
be misinterpreted. As suggested in this study, standardized testing may be
measuring the child's test-taking disability rather than intellectual or verbal
ability. In contrast, defining and eliminating variables that may interfere
with verbal and intellectual performance provide researchers, school per-
sonnel, and specialists with different but possibly more beneficial target
goals for individualized intervention plans. This is consistent with other lit-
erature demonstrating that these variables can affect performance in other
populations as well, including underachievers (Carr, Borkowski, & Maxwell,
1991) and those labeled as having learning disabilities (Ryan, Short, &
Weed, 1986; Torgesen & Licht, 1983).
One reason that could account for the differences in the two conditions
implemented in this experiment relates to the fact that a standardized test,
by nature of the task itself, does not provide contingent consequences for
correct performance on test items. This could easily set up a situation that
would result in low motivation in students with autism, who appear to be
especially sensitive to such conditions. That is, when responses and conse-
quences are not associated, individuals, such as children with autism, may
exhibit particularly poor performance (L. K. Koegel, Valdez-Menchaca, &
Koegel, 1993; R. L. Koegel & Mentis, 1985; Seligman, Klein, & Miller,
1976). This phenomenon may occur when the children exhibit inappropriate
behaviors as an attempt to avoid or escape the test situation (Carr &
Durand, 1985; Horner, Dunlap, & Koegel, 1988). While the motivation/at-
tention condition also did not offer contingent consequences for correct
responses to test items, it did allow for powerful idiosyncratic reinforcement
tailored to the child's needs, for appropriate on-task responding to test
items. This may have overshadowed the lack of a contingency for correct
responding to test stimuli.
In summary, this experiment illustrates numerous important motiva-
tional and attentional variables that may be problematic during the stand-
242 Koegel, Koegel, and Smith

ardized testing of children with autism, and further emphasizes the neces-
sary caution that may be employed pertaining to the utilization and inter-
pretation of standardized tests. The results of the present study describe
important circumstances correlated with variability in test results for chil-
dren with autism. Factors, such as inadequate attention, lack of motivation
to respond to the test items, or attempts to avoid and escape a demanding
test situation, should be taken into consideration when interpreting test
scores, evaluating intervention program outcomes, and planning educa-
tional experiences and intervention programs for children with autism. The
wide variability in the test scores in the two conditions in the present study
emphasizes the importance of incorporating multiple measures in order to
systematically and accurately evaluate the specific variables associated with
positive outcomes of intervention programs.

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