IWGA's Review of Research | June 9, 2017
Smiling adolescent banner
Review of Research is a monthly update on current research and study outcomes from an array of professional publications.
If you have any questions regarding this information, please contact:

Melissa H. Bacon, OCALI Program Director – Policy and Interagency Collaboration
470 E. Glenmont Ave. | Columbus, OH 43214 | (614) 578-6630 (mobile)
GET A GOOD START

Rotholz, D. A., Kinsman, A. M., Lacy, K. K., & Charles, J. (2017). Improving early identification and intervention for children at risk for autism spectrum disorder. Pediatrics, e20161061.

Given the increasing prevalence of autism spectrum disorder (ASD), early identification and intervention services for children with ASD are critical to their quality of life. According to Oswald et al. (2015), it takes nearly three years (34 months) from the onset of their initial concerns for families to receive an ASD diagnosis, thereby creating a long and frustrating waiting period during which precious time is lost. To solve this problem, in South Carolina, policy makers statewide collaborated to adopt “Presumptive Eligibility,” a policy that states children under 3 years old may qualify for funding and services without a formal ASD diagnosis if the child is found to be “at risk” for ASD, as determined by two screening tools: Modified Checklist for Autism in Toddlers and the Screening Tool for Autism in Toddlers and Young Children. This two-tier screening process was implemented by BabyNet (South Carolina’s Early Intervention Program) in collaboration with the lead agency for developmental disability services in the state. Presumptive Eligibility has led to a fivefold increase in the number of children eligible for applied behavior analysis (ABA) services without a formal ASD diagnosis and the avoidance of a long wait for a diagnostic evaluation.

STRENGTHENING SUPPORTS ALONG THE WAY

Shawler, P. M., & Sullivan, M. A. (2015). Parental stress, discipline strategies, and child behavior problems in families with young children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 1088357615610114.   

  • Approximately 70% of individuals with ASD have at least one comorbid psychiatric condition, and approximately 40% of individuals with ASD have two or more co-occurring psychiatric conditions.
  • 37% of individuals with ASD report having the comorbid disorder oppositional defiance disorder.
One predictor of high stress levels for parents of children with ASD is the frequent engagement of challenging behavior from their child with ASD. In addition, extended exposure to these stressful situations has been associated with the development of depression in parents. This study demonstrated that parental discipline strategies facilitated the association between parent stress and child disruptive behavior problems. Furthermore, parents who frequently used harsh or punitive discipline strategies reported higher levels of stress and challenging behavior from their child with ASD. Development of parent training programs on the use of evidence-based practice may simultaneously reduce both children’s challenging behavior and parents’ stress.
DEVELOP THE SKILLS TO SUCCEED

Chou, Y. C., Wehmeyer, M. L., Palmer, S. B., & Lee, J. (2016). Comparisons of self-determination among students with autism, intellectual disability, and learning disabilities: A multivariate analysis. Focus on Autism and Other Developmental Disabilities, 1088357615625059.

This study compared levels of self-determination among students with ASD, intellectual disability (ID), and learning disabilities (LD) by specifically assessing autonomy, self-regulation, psychological empowerment, and self-realization. The major results were as follows:

  • Students with ASD had the lowest levels of autonomy when compared to students with ID and LD.
  • Students with ID had significantly lower levels of self-regulation than students with LD, but not considerably different than students with ASD.
  • Levels of psychological empowerment were significantly lower for students with ASD and ID than for students with LD.
  • Levels of self-realization were significantly lower for students with ID when compared to students with LD, but not significantly different than for students with ASD.
 Implications for educators:
  • Consider the student’s level of difficulty with social interactions when developing self-determination interventions.
  • Provide goal-setting, problem-solving, and decision-making interventions with frequent and meaningful opportunities to practice in the general education setting.

Consider teaching self-regulation and student-directed learning skills to students with ASD as a means of increasing their lifelong autonomy.

HELP OTHERS UNDERSTAND

Oswald, D. P., Haworth, S. M., Mackenzie, B. K., & Willis, J. H. (2015). Parental report of the diagnostic process and outcome: ASD compared with other developmental disabilities. Focus on Autism and Other Developmental Disabilities, 1088357615587500.

The following table shows a comparison between the diagnostic process of individuals with ASD vs. individuals with “other developmental disabilities.” 

Experimental Measures Children With ASD Children With
“Other Developmental Disabilities”
Average age of child when parent first had concerns. 28.4 Months 42.4 Months
Average number of concerns from parents during the time of “first concerns” for their child 8.2 5.0
Average age of child when receiving his/her diagnosis 62.8 Months 55.4 Months
Average percent of health professionals who suggested that parents communicate their concerns to their child’s school. 32% 47%
Average percent of health professionals who told parents “nothing was wrong/behavior is normal” 33% 19%
Average percent of health professionals who told parents, “the child might grow out of it” 48% 41%

These data present two majors concerns. First, the discrepancies in time between the initial reporting of parent concerns and the actual age of diagnosis for the individuals with ASD. For the ASD group, this discrepancy was 34.4 months compared to 13 months for individuals with other developmental disabilities. That is, on average, it takes nearly three times longer for a child with ASD to get a diagnosis than for children with other disabilities.
 
Second, the data reflects a need for professional development in the medical field to understand the characteristics of ASD in a young child. 

OBTAIN NEEDED SERVICES

Walsh, C., Jones, B., & Schonwald, A. (2017). Health care transition planning among adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 1-12.

This study examined the national transition core outcomes among youth with ASD. Overall, results suggest a need to for collaboration among professionals across disciplines at various community, state, and national levels to support the health care transition process for individuals with ASD.

Specific Study Results:

  • Less than 10% of youth with ASD met the national transition core outcome.
  • The largest disparities in health care transition planning among youth with ASD were found with African Americans, family incomes below 400% of the federal poverty line, and individuals with severe activity limitations.
  • Non-Hispanic African American individuals with ASD were 90% less likely to meet the national transition core outcome than non-Hispanic Caucasian individuals with ASD. 
  • Approximately 80% of parents reported their child’s doctor had not mentioned that their child will eventually need to see a doctor or healthcare professional who treats adults.
  • Families without care coordination services were 45% less likely to have had conversations with professionals about the health care transition process.

Approximately 53% of families reported their child’s doctor consistently had conversations with the family and child with ASD about the importance of the child learning to take responsibility for his/her health care needs. 

 
Copyright © 2017 Ohio Department of Developmental Disabilities, All rights reserved.