Background and Acknowledgement

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Documentation and Accommodation for Students

on the Autism Spectrum

Loring Brinkerhoff, Ph.DLorraine Wolf, Ph.D

Jane Thierfeld Brown, Ed.D


Background and Acknowledgement

• ETS Policy Statement for Documentation of Autism Spectrum Disorders (ASD) in Adolescents and Adults is a work in progress.

• Being developed collaboratively by the College Board and ETS

• Projected publication date: September 1, 2013 • Grateful acknowledgement to Dr. Lorraine Wolf

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What is ASD?

• A neuro-developmental disorder ranging from mild to severe that is characterized by core features of social/communication deficits, repetitive/restrictive behaviors, and a lack of emotional reciprocity

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DSM-5 Changes to ASD

• The four previously separate disorders (e.g, Asperger’s disorder, childhood disintegrative disorder, and PDD- NOS) are now viewed as a single condition with different levels of symptom severity in two core domains:o deficits in social communication and social

interactiono restricted, repetitive behaviors, interests &

activities

4Banerjee and Brinckerhoff, June 2013


College Students With ASD Are on the Rise

• ASD affects 1 to 1.5 million Americans. • The CDC (2013) estimates that 1:88 individuals have ASD. • 3-4 times more prevalent in males• Number of test takers with ASD requesting accommodations

on ETS tests is increasing each year. • A recent study by SRI International (2012) noted that “STEM

related majors were more common among college students with ASD than students with any other type of disability.”

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College

Students with ASDDespite intellectual and academic gifts, persons with AS have a decreased ability to decipher the intentions and actions of others, to integrate multiple streams of incoming information, and to navigate an increasingly complex social world. They may be rigid and perfectionistic and resist changing to meet the demands of their environment.”

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(Wolf, Thierfeld Brown & Bork, 2009)


Why Develop Documentation Guidelines for ASD?

• ETS Policy Statements for LD, ADHD, and Psychiatric don’t fit this population.

• Need to move away from the LD discrepancy model review mindset

• ASD documentation typically does not show test scores with significant deficits in cognitive profiles or in achievement areas.

• The key is an in-depth discussion by the evaluator of symptomatology.

• Documentation may involve multiple professionals.

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Documentation Considerations

• ASD is often picked up at school age and misdiagnosed as ADHD.

• ASD should spill over into two or more settings.• Look for relevant information regarding current

treatment.• Individuals with ASD may experience difficulties

with major life activities such as learning, reading, concentration, and/or thinking.

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Documentation Considerations (cont’d):

• The use of psychotropic drugs is becoming increasingly common, so there may be side effects of medication to consider.

• Both the positive and negative effects of medication should be noted.

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Concerns about AHEAD’s Position Concerns about AHEAD’s Position on Documentationon Documentation

• Medical and scientific evidence is viewed in the Guidance Document as "inappropriate and burdensome"

• Dependence on past history alone, without current documentation can create an unfair advantage



Concerns about AHEAD’s Position Concerns about AHEAD’s Position on Documentationon Documentation

• Testing agencies and many postsecondary institutions depend on normed psychometric and/or medical evidence from a qualified third party for accommodation decisions.

• Assumes that the student is able to articulate his/her needs, discuss functional impact of the disability, recall accommodation history and accurately provide information about the diagnosis



ETS Policy Statement for ETS Policy Statement for Documentation of Autism Documentation of Autism

Spectrum Disorder in Adolescents Spectrum Disorder in Adolescents and Adults (in press), cont.and Adults (in press), cont.

I. A qualified professional must conduct the evaluation: • Licensed psychologist/neuropsychologist • Psychiatrist • Relevantly trained medical doctors, developmental

pediatricians, child neurologists, clinical social workers,• School psychologists, speech and language therapists,

occupational therapists.

Documentation from more than one source, often involving a multi-disciplinary approach.



ETS Policy Statement for ETS Policy Statement for Documentation of ASD, cont.Documentation of ASD, cont.

II. Documentation Necessary Must be Comprehensive: • Specific diagnosis or diagnoses• Description of current symptoms in the testing

environment and across settings • Relevant information regarding the test taker’s prescribed

use of medications and side effects• Relevant information regarding current treatment• A narrative discussion of all relevant information including

results of standardized assessment measures. • Specific recommendations for accommodations




III. Relevant Testing Domains:“ETS acknowledges that a clinical discussion of symptoms may be

more valuable than a standardized score.” • Cognitive • Executive functioning• Expressive and receptive language and communication• Psychiatric, personality, and behavioral • Sensory-motor integration• Attention/Memory/Learning• Visual-perceptual motor skills • Academic achievement




IV. Interpretive Summary “Many of the core features of ASD are not captured in test

scores.”V. Alternative Diagnoses should be ruled outVI. Currency Requirements of the Documentation

“ASD is an enduring disorder that exists across the lifespan. Functional limitations of the disorder, however, may change depending upon the test taker’s age as well as environmental demands.”

Documentation must be from the last 5 years.




VII. Rationale for each requested accommodation must be provided

“A link must be established between the requested accommodations and the manifested symptomatology of the disorder that is pertinent to the anticipated testing situation.”




VIII. Additional sources of information:• IEP, 504, SOP, prior evaluations, evidence of accommodations, a detailed

letter from the college disability provider, vocational rehab counselor, or a human services professional describing current limitations and use of accommodations.

• A personal letter from the test taker in his/her own words• Appendix I- DSM-5• Appendix II- Recommendations for Consumers• Appendix III- Testing instruments• Appendix IV-Social Cognition



A Rationale for Each Requested Accommodation Must Be Provided • Why grant accommodations to ASD students?• Co-occurring disabilities • Perfectionistic tendencies • May fixate on the wording of test questions• May over-analyze content in test questions• Testing environment may warrant modifications.

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Academic Accommodations for AS• There are no clear cut guidelines• Accommodations flow from understanding:

• Nature of student’s functional impairment• Domains where having difficulty • Fundamental requirements

Wolf ETS 2012 do not reproduce


In theory…• Academic difficulties in ASD are directly

related to the student’s core deficits• If we understand why, we can figure out when

and how to best accommodate



For example…•Some are quite common

–Distraction reduction–Extra time–Computer

•Some need considerably more analysis:–Alternate means of demonstrating mastery without compromising

fundamentals–Alternative to essay exams which require taking another perspective–Sensory adjustments–SOCIAL ACCOMMODATIONS?



Exam Accommodations• Papers instead of exams (to be used sparingly)• Stop the clock breaks• Distraction reduced setting• Extended time• Computer (possibly voice input)• No “scantron” forms• Sensory modifications• Clarification of questions or answers (written or oral)• Space apart sections• Oral supplement to essay exams

• Wolf ETS 2012 do not reproduce


Writing• Writing synthetically vs. stating “the obvious”• Plots & character motivation• Compare & contrast• Personal perspectives• Initiate and sustain• Some students excel at writing though• SOCIAL CONTEXT OF STEMS



Math Disability• Analyzing spatial information• Spatial reasoning• Non-quant questions which tap into this• Charts and graphs• Math fluency and computation



Why extra time?• Stickiness• Slow processing • Anxiety• EF dysfunction• Overanalyzing• Overwriting• Figuring out relationships• Context analysis


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A Favorable Prognosis

• The older, the better• The smarter, the better• The less symptomatic, the better• Take home: Young adults with ASD who go

to college and enter the workforce may have the best prognosis

• Can we extrapolate to grad school grads?



Leave with a challenge…

The student is not the only locus of change



New views?• Is ASD a psychiatric diagnostic?• What about DSM-V?• Should ADAAA influence diagnostic practice?• Is ASD a per se diagnoses?• And what about AHEAD?



Concluding Thought• “If you've met one person with ASD, you've met

one person with ASD” • Stephen Shore, Ph.D., professor, author, person with AS


Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.Confidential and Proprietary. Copyright © 2010 Educational Testing Service. All rights reserved.Wolf ETS 2012 do not reproduce

Background and Acknowledgement

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