Barry M. Prizant

The Screening and Diagnosis of Autistic Spectrum Disorders

The Child Neurology Society and American Academy of Neurology recently proposed to formulate Practice Parameters for the Diagnosis and Evaluation of Autism for their memberships. This endeavor was expanded to include representatives from nine professional organizations and four parent organizations, with liaisons from the National Institutes of Health. This document was written by this multidisciplinary Consensus Panel after systematic analysis of over 2,500 relevant scientific articles in the literature. The Panel concluded that appropriate diagnosis of autism requires a dual-level approach: (a) routine developmental surveillance, and (b) diagnosis and evaluation of autism. Specific detailed recommendations for each level have been established in this document, which are intended to improve the rate of early suspicion and diagnosis of, and therefore early intervention for, autism.

Practice parameter: Screening and diagnosis of autism Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society

Article abstract Autism is a common disorder of childhood, affecting 1 in 500 children. Yet, it often remains unrecognized and undiagnosed until or after late preschool age because appropriate tools for routine developmental screening and screening specifically for autism have not been available. Early identification of children with autism and intensive, early intervention during the toddler and preschool years improves outcome for most young children with autism. This practice parameter reviews the available empirical evidence and gives specific recommendations for the identification of children with autism. This approach requires a dual process: 1) routine developmental surveillance and screening specifically for autism to be performed on all children to first identify those at risk for any type of atypical development, and to identify those specifically at risk for autism; and 2) to diagnose and evaluate autism, to differentiate autism from other developmental disorders.

The SCERTS Model A Transactional, Family-Centered Approach to Enhancing Communication and Socioemotional Abilities of Children With Autism Spectrum Disorder

A range of educational/treatment approaches is currently available for young children with autism spectrum disorders (ASD). A recent comprehensive review by an expert panel on ASD (National Research Council, 2001) concluded that a number of approaches have demonstrated positive outcomes, but nonetheless, not all children benefit equally from any one approach. Efforts to increase communicative and socioemotional abilities are widely regarded as among the most critical priorities, and growth in these areas is closely related to prognosis and long-term positive outcomes. However, some widely disseminated approaches are not based on the most contemporary developmental research on social and communication development in children with and without disabilities, nor do they draw from current understanding of the learning style of children with ASD. This article describes the SCERTS Model, which prioritizes Social Communication, Emotional Regulation, and Transactional Support as the primary developmental dimensions that must be addressed in a comprehensive program designed to support the development of young children with ASD and their families. The SCERTS Model has been derived from a theoretical as well as empirically based foundation and addresses core challenges of children with ASD as they relate to social communication, emotional regulation, and transactional support. The SCERTS Model also is consistent with empirically supported interventions and it reflects current and emerging “recommended practices” (National Research Council, 2001).

Communication and language assessment for young children

Early childhood professionals need to be familiar with current approaches to communication and language assessment because of the high prevalence of communication difficulties In young children and the significant impact that such problems may have on other aspects of a childs development and on the family. Principles of early communication and language assessment are discussed, and domains that should be addressed in a comprehensive assessment are delineated. Particular emphasis is placed on the use of various assessment strategies in a cooperative effort between families and professionals.

Social Communication, Emotional Regulation, and Transactional Support (SCERTS)

Educational programming for individuals with Autism Spectrum Disorders (ASD) can be described at two different levels: focused approaches and comprehensive approaches. Focused approaches utilize evidence-based strategies directed at particular symptoms. These evidence-based strategies are indeed essential for supporting individuals with ASD in relation to particular areas of need. In contrast, a comprehensive approach provides a framework that is broad in scope and is designed to improve overall functioning and to produce positive long-term outcomes in adulthood. The SCERTS® Model is a comprehensive, multidisciplinary educational approach that was developed to maximize long-term positive outcomes for individuals with ASD and their families while embracing a wide range of more focused evidence-based interventions (Prizant et al. 2006 ).

Supporting Parents to Promote Emotion Regulation Abilities in Young Children with Autism Spectrum Disorders: A SCERTS Model Perspective

Emotional regulation is a key developmental capacity concerned with the regulation of physiological arousal, emotion, and attention. Effective emotional regulation is associated with social success, academic readiness, and pro-social behaviors. Young children with autism spectrum disorder (ASD) have documented emotional regulatory challenges. These difficulties include challenges in managing emotions, focusing attention, inhibiting reactions, delaying gratification, and seeking comfort in conventional ways. Some of these difficulties are associated with neurological differences and cognitive learning style differences, which are associated with an ASD diagnosis. Other challenges may be associated with ASD-related social learning differences, which impact the nature and effectiveness of parent/child interactions that are geared toward expanding a young child’s emotional regulatory abilities. An emotional regulation approach to intervention represents a relatively new focus in intervention for young children diagnosed with ASD and holds the promise of supporting active engagement in everyday activities resulting in more emotionally satisfying social interactions between children and their caregivers. A brief framework for assessment of young children’s emotional regulatory abilities and selection of developmentally appropriate emotional regulatory objectives utilizing the SCERTS® Model is presented. Parent coaching, embedding teaching opportunities within natural routines, and modeling are discussed as developmentally appropriate intervention techniques for young children at presymbolic and symbolic levels of communication.