Neuropsychological evaluations of children with autism: From recommendations to practical implementation.
Posted Oct 20 2008 8:05am
A review of:Stephen M. Kanne, Jena K. Randolph, Janet E. Farmer (2008). Diagnostic and Assessment Findings: A Bridge to Academic Planning for Children with Autism Spectrum Disorders Neuropsychology Review DOI: 10.1007/s11065-008-9072-z
While working at a pediatric neuropsychology division of a large urban hospital in Michigan, I conducted weekly neuropsychological evaluations of children with Autism Spectrum Disorders. Most often, the main purpose of these evaluations was to confirm the diagnosis and to provide a picture of neurocognitive strengths and weaknesses that would guide and facilitate the implementation of educational services. By “Neurocognitive” functions we refer to cognitive processes that are linked to neurological functioning, such as attention, memory, language, visual-motor coordination, auditory processing, etc. I always wondered, however, whether my recommendations were truly reviewed by the child’s educational planning team, and whether they were implemented by the child’s teachers and therapists.
In this very insightful and needed review, the authors present a model that would facilitate the implementation of recommendations resulting from neuropsychological evaluations. The authors indicate that one of the biggest obstacles preventing the proper implementation of these recommendations is the tendency by educators to see the neuropsychological evaluation as, primarily, a diagnostic procedure; one that is only useful to guide decisions regarding eligibility for special education services. However, good neuropsychological evaluations (and reports) provide very detailed information that addresses all 6 areas outlined by the National Research Council as the key areas of focus for IEP committees.
These 6 areas include: 1. Cognitive and Functional Academics 2. Self-Management 3. Communication: Verbal and Non-Verbal 4. Motor Skills 5. Daily Living Skills 6. Social Functioning (including play)
These 6 areas are then integrated into 3 target domains: Environment, Instruction, and Behavior. That is, EIPs should discuss how each of the 6 areas above will be addressed in regards to environmental modifications, specific instruction, and targeted behaviors.
The authors argue that neuropsychologists should complement their reports with a ‘bridge document” which would provide very specific recommendations regarding environmental changes, instructional changes, and targeted behaviors for all six areas of functioning used by the IEP committee.
I recommend to parents who will be obtaining a pediatric neuropsychology evaluation for their children to discuss with their neuropsychologist whether they will include a “bridge document” that could be used during the IEP meeting. This will significantly maximize the utility of neuropsychological evaluation reports.