Screening, Assessment, Diagnosis, and Intervention

Autism Spectrum Disorder

1. Impairments in social interactions and communication-sometimes might struggle with pragmatics

   1. Seen through less joint attention

   2. May be less interested in peer and pretend

2. Repetitive/stereotypes patterns of behaviors and interests

   1. Inflexible routines, stimming

3. Language

   1. 25% don’t develop language skills

Causes of autism

1. Biology

2. Prenatal/birth complications

3. Older fathers

4. Prenatal mental health

5. Pollution

California polution study

Polution during pregnancy was associated with higher rates of autism

Steps to diagnosis

1. Developmental Monitoring: seeing if child seems to be meeting typical developpment

2. Developmental Screening: at 18-24 months to see if there is a potential problem

3. Developmental diagnosis: assessment by a trained specialist

In other words, parental monitoring and then screening, assessment, and diagnosis

Screenings

1. Quick, brief, and inexpensive. Usually completed by parents

2. Look to see if development is on target or if child needs early intervention or further evaluation/diagnosis

3. Some are universal, where all kids get them (such as psychosocial assessments at ped appointments) while others are targeted for at-risk populations

PEDS

Parents’ evaluation of developmental status Examines children’s language and motor skills, along with cognition and behavior.

M-CHAT

Modified Checklist for Autism (18 and 24 month versions, assesses up to 30 months). 20 items with yes/no or pass/fail. 

1. 0-1 no’s: low risk

2. 3-7 no’s: Moderate risk. Follow up later. If nothing changes, refer to early intervention and assessment

3. 8-20 no’s: Refer for early intervention and assessment

ASQ-SE-2

Ages and stages questionnaire for socioemotional development

1. Identifies risk for socioemotional difficulties

2. completed by someone who spends 15-20hrs/week with the child

3. Many versions, can be taken from 2-60 months

Edinburgh Postnatal Depression Scale

Used for mothers postpartum. 10 items scored 0-3. If you score a 10+, it is possible that you may have depression

How to share screening results

1. Listen to their feelings and concerns

2. Explain the purpose and meaning of the assessment

3. State the positive first

4. Explain the results of the assessment and what the next steps are

5. Provide resources

Diagnosis

Measured through 3 different things

1. DSM-5 TR

2. ICD-11

3. DC: 0-5

DSM-5TR

The Diagnostic and Statistical Manual of Mental Disorders examines symptoms and disorders. Only used in the U.S.

ICD-11

The International Classification of Diseases and Related Health Problems. It tells you how to globally classify diseases and health-related problems. Helps with insurance. 

DC:0-5

Diagnostic classification (0-5) talks about relationships and stressors and how they impact mental health. Goes beyond symptoms. It looks at physical health considerations, psychological stressors, and developmental competence (are milestones being met?

PPAP

2. Promote Healthy social development

3. Prevent development of IMH problems

4. Refer to professionals when needed

5. Advocate for families

6. Policies that support children

Pyramid model (sometimes called response to intervention. 

1. Universal Interventions: things everyone gets, such as pediatrician screenings

2. Targeted Interventions: For those who ned extra support (e.g., SNAP, head start)

3. Indicated Intervention: For those with severe signs of socioemotional problems (e.g., CPP, PCIT)

Interventions to remember

1. Child Parent Psychotherapy

2. ABC

3. The Circle of Security

Child parent Psychotherapy

Focuses on strengthening the child-parent relationship and creating psychological safety. Is lengthy, and has two phases.

1. Foundational Phase: 6 sessions long. Therapists gets context on the child and parent’s developmental history, mental health, trauma history, and observes interactions between child and parent to develop a treatment phase

2. Play-based. Helps parent to identify angels in the nursery and interpret their children’s behavior more positively (more positive attributions)

Has been shown to increase parents’ positive attributions of their children, attachment security, cognitive functioning, and reduce mental health symptoms. Children were less likely to end up in child welfare.

ABC

Attachment and Biobehavioral Catchup. Developed by Mary Dozier. For children who have experienced adversity. Centered in the home where anyone can join. in the moment feedback/coaching that focuses on strengths. The frequency and quality of comments predict behavior change.

Consists of 10 sessions

1-2 Nuturance

3-5 Following the child’s lead

6 Avoid frightening behavior

4 Identify voices from the past

5 Celebrate gains

Circle of Security

Focuses on enhancing attachment and helping the parent be a safe haven/secure base. Might use videos of dyads to learn. There are two types:

1. Cos-intensive: 20-week program for parents

2. Cos-parenting: Shorter format for parenting groups

There are things that create shark music for parents. The goal is to be aware of your shark music and respond more sensitively. Increases secure attachment in those with disorganized and insecure attachment.