Vincent Pandolfi

Validity Study of the CBCL 6–18 for the Assessment of Emotional Problems in Youth With ASD

Youth with autism spectrum disorder (ASD) often present with emotional problems such as anxiety and depression (American Psychiatric Association, 2013). A recent study of the Child Behavior Checklist 6-18 (CBCL; Achenbach & Rescorla, 2001) indicated good sensitivity but relatively low specificity for identifying emotional problems in youth with ASD. The current study examined the extent to which variance in the CBCL’s Anxious/Depressed, Withdrawn/Depressed, Internalizing Domain, and Total Problems scales was accounted for by symptoms of emotional problems relative to ASD symptoms. Correlation and multiple regression analyses indicated that these scales measured anxiety and depression but a small statistically significant proportion of variance in Total Problems scores was also accounted for by ASD symptoms. Results contribute to the emerging evidence base for the inclusion of the CBCL in assessment protocols for assessing emotional and behavioral problems in youth with ASD.

Utility of the CBCL DSM-oriented scales in assessing emotional disorders in youth with autism

BACKGROUND Youth with autism spectrum disorder (ASD) are at risk for one or more emotional disorders (ED) including depressive and anxiety conditions. DSM-5 diagnostic guidelines indicate that co-occurring ED must be specified when present (APA, 2013). While ED may be evaluated for during initial diagnostic assessment, routine monitoring and screening is needed to identify emerging ED in later childhood and adolescence, a period of high risk. METHOD Confirmatory factor analysis, convergent and divergent validity analyses, criterion-related validity, and diagnostic accuracy analyses of the CBCLs Affective Problems and Anxiety Problems DSM Oriented Scales was completed on 93 well-characterized youth, ages 6 to 18 years with ASD (6:1 M:F), with and without intellectual impairment. These youth were from predominately white, middle-class backgrounds. RESULTS Each scale measured a single construct reliably (depressive and anxiety disorders), neither scale measured symptoms of ASD, and youth with a depressive disorder had other ED co-morbidities. CONCLUSIONS Findings demonstrate the DSM Oriented Affective and Anxiety Problem Scales can be used to screen for depression and anxiety in youth with ASD. Replication is needed with various subgroups representing gender, age, developmental level, autism, and mental health severity differences, and with groups across a broader set of demographics.

Screening for autism spectrum disorder in children with Down syndrome: An evaluation of the Pervasive Developmental Disorder in Mental Retardation Scale

ABSTRACT Background Children with Down syndrome (DS) are at risk for autism spectrum disorder (ASD). They are often diagnosed later than other children in part due to difficulty differentiating ASD-related impairment from that associated with DS. The psychometric properties of the Pervasive Developmental Disorder in Mental Retardation Scale (PDD-MRS) were examined with the aim of informing ASD screening guidelines for children with DS. Method Analysis of archival data from children aged 3 to 15 years with DS (N = 386) evaluated the reliability and validity of the PDD-MRS. Results Factor analyses yielded 2 factor-based scales: ASD and Emotional and Behavioural Problems. ASD reliably assessed ASD-specific symptoms, correlated with other ASD measures, and demonstrated good diagnostic accuracy. Emotional and Behavioural Problems assessed problems not diagnostic of ASD but may reflect part of the behavioural phenotype of DS and ASD. Conclusion The PDD-MRS appears to have utility in ASD screening for this population.

Case Example: Inclusion Program Development

The case example presented here illustrates how the ASD Program Development and Evaluation Protocol (hereafter, ASD Protocol for brevity) helped a school district develop an ASD Inclusion Program for four elementary students with ASD. The chapter describes the purpose and objectives of the program development initiative and the unique contextual variables that guided the application of the ASD Protocol to inform program planning and decision-making. The chapter concludes with a discussion of how program evaluation data informed future program development activities.

Case Example: Redesigning a Specialized School

The Individuals with Disabilities Education Improvement Act (IDEA, 2004) compels schools to provide a free appropriate public education (FAPE) to students with disabilities in the least restrictive environment (LRE). However, many school districts lack the capacity or resources to provide intensive special education programs to those students with an ASD who present with severe developmental and/or behavior disorders. Although IDEA emphasizes integration with nondisabled peers, it also recognizes that more restrictive or segregated settings represent the LRE for some students. While a segregated setting may be viewed as more therapeutic and supportive of the student’s educational and behavioral needs (e.g., low teacher-student ratio, intensive clinical supports, more specialized staff), it does not guarantee that the program is implementing evidence-based practices and affecting student achievement.

Building Regional Capacity: Select Case Examples

As the number of students diagnosed and/or classified with ASD grows so does the demand for quality educational programs and services that can be delivered within the student’s local community. However, variability is seen within and across communities with respect to the availability and quality of services and educational programs (Montes, Halterman, & Magyar, 2009). Variability is also evident in the extent to which community infrastructure and resources exist to support the development and maintenance of a range of ASD educational programs and services. This chapter describes how outcomes from community needs assessment and collaborative planning led to the author’s development of the ASD Program Development and Evaluation Protocol and its initial application to a wide geographic region in the greater Finger Lakes Region of New York State.