Autism Spectrum Disorder: Evidence-Based Screening and Assessment

By Lee A. Wilkinson, EdD, PhD, NCSP

Autism Spectrum Disorder: Evidence-Based Screening and AssessmentMore children and youth are being diagnosed with autism spectrum disorder (ASD) than ever before. Epidemiological research indicates a progressively rising prevalence trend for ASD over the past decade. Autism is much more prevalent than previously thought, especially when viewed as a spectrum condition with varying levels of symptom severity. Surveys focusing on this broader definition of autism indicate that ASD is one of the fastest growing disability categories in the world. Recent findings of the Centers for Disease Control and Prevention (CDC) Autism and Developmental Disabilities Monitoring Network ADDM (2012) indicate that one in every 88 school-age children in the United States has an autism spectrum disorder (ASD). This represents an estimated increase of 78% in the prevalence of ASD when compared with the data for earlier surveillance years. Autism is now considered the second most serious developmental disability after intellectual disability and more prevalent among children than cancer, diabetes, and Down syndrome.

Autism Spectrum Disorder: Evidence-Based Screening and Assessment is a new 3-hour online continuing education (CE/CEU) course that identifies DSM-5 diagnostic changes in the ASD diagnostic criteria, summarizes the empirically-based screening and assessment methodology in ASD, and describes a comprehensive developmental approach for assessing students with ASD.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists; by the National Board of Certified Counselors (NBCC) to offer home study continuing education for NCCs (#5590); the Association of Social Work Boards (ASWB #1046, ACE Program); the California Board of Behavioral Sciences (#PCE1625); the Florida Boards of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling (#BAP346) and Psychology & School Psychology (#50-1635); the Illinois DPR for Social Work (#159-00531); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).

This online course provides instant access to the course materials (PDF download) and CE test. Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion. You can print the test (download test from My Courses tab of your account after purchasing) and mark your answers on while reading the course document. Then submit online when ready to receive credit.

Lee A. Wilkinson, EdD, PhD, NCSP, is an author, applied researcher, and practitioner. He is a nationally certified school psychologist, registered psychologist, chartered scientist, and certified cognitive-behavioral therapist. Dr. Wilkinson is currently a school psychologist in the Florida public school system where he provides diagnostic and consultation services for children with autism spectrum disorders and their families. He is also a university educator and teaches graduate courses in psychological assessment, clinical intervention, and child and adolescent psychopathology. His research and professional writing has focused on behavioral consultation and therapy, and children and adults with Asperger syndrome and high-functioning autism spectrum disorders. He has published numerous journal articles on these topics both in the United States and the United Kingdom. Dr. Wilkinson can be reached at

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Young Children With Autism Benefit Regardless of Treatment Model

Researchers at the University of North Carolina at Chapel Hill have found that preschoolers with Autism Spectrum Disorder (ASD) who receive high-quality early intervention benefit developmentally regardless of the treatment model used — a surprising result that may have important implications for special-education programs and school classrooms across the country.

autism-treatment“This is the first study designed to compare long-standing comprehensive treatment models for young children with ASD,” said Brian Boyd, a fellow at UNC’s Frank Porter Graham Child Development Institute (FPG) and one of the study’s co-principal investigators. Boyd also is an assistant professor in occupational science and occupational therapy in UNC’s School of Medicine.

“We know that more children are being diagnosed with ASD each year, and that it can cost an estimated $3.2 million to treat each child over a lifetime. Understanding that a child can benefit from a high-quality program, rather than a specialized program, may help reduce those costs by decreasing the need for teachers and other school practitioners to be trained to deliver multiple specialized services,” Boyd said. He stressed it remains important to ensure educators are trained to provide high-quality programs that meet the special behavioral, communication and other needs of children with ASD.

Previous research has shown that when children with ASD have access to early intervention via treatment programs, they improve developmentally. Until now, however, debate has persisted over which approach to use, said Boyd. The study appeared in the June issue of Journal of Autism and Developmental Disorders.

Two frequently used comprehensive treatment models have a long history: LEAP (Learning Experiences and Alternative Program for Preschoolers and their Parents) and TEACCH (now known only by its acronym).

FPG’s study examined the relative effects of the LEAP and TEACCH school-based comprehensive treatment models when compared to each other and to special-education programs that do not use a specific model. The multisite study took place only in high-quality classrooms and enrolled 74 teachers and 198 3- to 5-year-olds in public school districts.

The study found that children made gains over the school year regardless of the classroom’s use of LEAP, TEACCH or no specific comprehensive treatment model. “Each group of children showed significant positive change in autism severity, communication and fine- motor skills,” said Kara Hume, FPG scientist and co-author. “No statistically significant differences were found among models, which challenged our initial expectations — and likely the field’s.”

“This study may shift the field’s thinking about comprehensive treatment models designed for young children with ASD,” said co-author Samuel L. Odom, FPG’s director and the study’s principal investigator. “Perhaps it’s not the unique features of the models that most contribute to child gains but the common features of the models that most influence child growth.”

Researchers from East Tennessee State University, the University of Miami, Florida International University, University of Minnesota and Griffith University also participated in the study.




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Decreased Autism Rates Found with Healthy Fats During Pregnancy

By Chris Weller

Consuming various healthy fats during pregnancy may reduce a woman’s risk of having a child with autism, new research finds.

Published in the Journal of American Epidemiology by the Harvard School for Public Health, the study examined maternal intake of certain fatty acids across mothers whose children have autism and those whose do not. The study found that women who consumed linoleic acid — a type of omega-6 acid found in vegetable oils, nuts, and seeds — were 34 percent less likely to birth a child with autism, while women who consumed low levels of omega-3 fatty acids — those found in fish — were more 53 percent more likely.

“Our results provide preliminary evidence that increased maternal intake of omega-6 fatty acids could reduce risk of offspring [autism spectrum disorder],” the researchers wrote, “and that very low intakes of omega-3 fatty acids and linoleic acid could increase risk.”

The researchers point to the fatty acids’ importance in the fetus’ brain development, coupled with the mother’s stores of fatty acid toward the end of the pregnancy, as contributing to the decreased risks. However, they could only draw associative links, no causal claims, between the two behavior patterns.

The study included 317 mothers whose children have autism spectrum disorder and 17,728 mothers whose children do not. The mothers all completed surveys about their diets during pregnancy, with some filling out the information while pregnant and others completing it one year after birth.

One standout figure from the research was that women who consumed more omega-3 fatty acids than other women did not necessarily reduce their child’s risk for autism. At a certain point, the benefits reached a threshold.

This suggests that although getting too little omega-3 fatty acids may increase the risk of autism, once a certain threshold is reached, further consumption doesn’t provide an extra benefit, the researchers said.

Because of the limited sample size and correlative link, the researchers recommended further testing be done.

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Childhood Vaccines NOT Linked To Autism

By Jon Hamilton

Number Of Early Childhood Vaccines Not Linked To Autism

A new study from the Centers for Disease Control and Prevention finds no link between the number of vaccinations a young child receives and the risk of developing autism spectrum disorders.

A large new government study should reassure parents who are afraid that kids are getting autism because they receive too many vaccines too early in life.

The study, by researchers at the Center for Disease Control and Prevention, found no connection between the number of vaccines a child received and his or her risk of autism spectrum disorder. It also found that even though kids are getting more vaccines these days, those vaccines contain many fewer of the substances that provoke an immune response.

The study offers a response to vaccine skeptics who have suggested that getting too many vaccines on one day or in the first two years of life may lead to autism, says Frank DeStefano, director of the Immunization Safety Office of the CDC.

To find out if that was happening, DeStefano led a team that compared the vaccine histories of about 250 children who had autism spectrum disorder with those of 750 typical kids. Specifically, the researchers looked at what scientists call antigens. An antigen is a substance in a vaccine that causes the body to produce antibodies, proteins that help fight off infections.

The team looked at medical records to see how many antigens each child received and whether that affected the risk of autism. The results, published in The Journal of Pediatrics, were unequivocal.

“The amount of antigens from vaccines received on one day of vaccination or in total during the first two years of life is not related to the development of autism spectrum disorder in children,” DeStefano says.

The finding came as no surprise to researchers who study the immune system, DeStefano says. After all, he says, kids are exposed to antigens all the time in the form of bacteria and viruses. “It’s not really clear why a few more antigens from vaccines would be something that the immune system could not handle,” he says.

The study also found that even though the number of vaccines has gone up, the number of antigens in vaccines has gone down markedly. In the late-1990s, the vaccination schedule exposed children to several thousand antigens, the study says. But by 2012, that number had fallen to 315.

That dramatic reduction occurred because vaccines have become much more precise in the way they stimulate the immune system, DeStefano says.

Hardcore vaccine skeptics are unlikely to be swayed by the new research. But many worried parents should be, says Ellen Wright Clayton, a professor at Vanderbilt University who helped write a report on vaccine safety for the Institute of Medicine.

“I certainly hope that a carefully conducted study like this will get a lot of play, and that some people will find this convincing,” Clayton says. That would let researchers pursue more important questions, she says.

“The sad part is, by focusing on the question of whether vaccines cause autism spectrum disorders, they’re missing the opportunity to look at what the real causes are,” she says. “It’s not vaccines.”

Autism Speaks, a major advocacy and research group, seems ready to move beyond the vaccine issue. Geraldine Dawson, the group’s top scientist, praised the new study and says the result should clear the way for research on other potential causes of autism.

These include factors like nutrition, which can affect a baby’s brain development in the womb, Dawson says. Other factors could include medications and infections during pregnancy, she says, or an infant’s exposure to pesticides or pollution.

“As we home in on what is causing autism, I think we are going to have fewer and fewer questions about some of these things that don’t appear to be causing autism,” Dawson says.


Professional Development Resources is featuring it’s Autism CE curriculum during the month of April to promote awareness among health professionals @


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Autism Linked to Fever or Flu in Pregnancy

By Joseph Brownstein, MyHealthNewsDaily Contributor

Autism Linked to Fever or Flu in PregnancyHaving a fever or flu in pregnancy may be linked with the development of autism in children, a new study suggests. While researchers are hesitant to draw strong conclusions, the study is at least the second showing such a link.

The researchers followed mothers in Denmark and the nearly 97,000 children they had between 1997 and 2003. During the study, 976 children in the study were diagnosed with autism.

Children were more likely to be diagnosed with autism if their mothers had the flu or developed a prolonged fever during the first or second trimester of pregnancy.

But the topic needs further study before stronger conclusions can be drawn, said study researcher Hjördis Osk Atladottir, of the University of Aarhus.

“Around 99 percent of women experiencing influenza, fever or taking antibiotics during pregnancy do NOT have children with autism,” Atladottir wrote to MyHealthNewsDaily in an email.

Dr. Marshalyn Yeargin-Allsopp, chief of the Centers for Disease Control and Prevention Developmental Disabilities Branch, who was not involved in the study, said, “We’re not recommending clinically that physicians change their management of pregnant women based on these findings.”

One reason for the caution may be that pregnant women who are concerned about lowering their child’s risk of autism would, for the most part, simply need to adhere to existing guidelines, which recommend getting a flu shot, and treating fevers by taking acetaminophen and contacting their physician.

Some researchers were puzzled by the authors’ caution.

“The data indicates that maternal flu infection or an extended fever increases the risk for autism in the offspring — a twofold increase,” said Paul H. Patterson, a biology professor who researches the connections between infection and neurological development at the California Institute of Technology.

Noting that the new finding is consistent with other research, Patterson said, “I’m not clear on why they appear to soft-pedal their results in their conclusions.”

A study published in May from researchers at the University of California, Davis found a similar connection, showing that mothers of children with autism were more likely to have had a prolonged fever in the late first or second trimesters of pregnancy, compared with mothers of children who didn’t have autism.

Irva Hertz-Picciotto, an author of the UC Davis findings, said while the reason that fevers or flu during pregnancy may be linked with autism are unclear, it’s thought that inflammation may have an adverse effect on early brain development.

“I think there’s some growing evidence that perhaps inflammation in the wrong tissue at the wrong time could interfere with normal developmental processes,” Hertz-Picciotto said.

There is also evidence for a link between mothers who have inflammatory conditions such as diabetes and autism in children, but that link, too, has not been conclusively established, she said.

“There is some growing evidence that in neurodevelopment, this could be part of a pathologic process, this could lead to behavioral type syndromes,” Hertz-Picciotto said.

Indeed, researchers are just beginning to develop an understanding of autism’s causes, the experts said.

“We know a lot more than we knew five years ago, but the science is really in its infancy,” said Coleen Boyle, of the CDC.

A CDC-sponsored study, called the Study to Explore Early Development (SEED), is following more than 2,700 children in California, Colorado, Georgia, Maryland, North Carolina and Pennsylvania, with the hope of identifying factors that might influence autism spectrum disorders.

Boyle said that the possible environmental causes of autism can be more challenging to research than the disorder’s genetic causes. For example, data in the new study had to be collected starting in the late 1990s.

“You can just see the time that’s required to collect that kind of information,” Boyle said.

“There’s not a lot of people looking at these environmental factors,” Hertz-Picciotto said. “This is something people should be paying more attention to, because it’s actionable.”

Pass it on:A flu or fever during pregnancy may lead to autism in children.


Professional Development Resources, an accredited provider of online continuing education courses for health professionals, offers a number of courses that address the research, diagnosis and treatment of those on the Autism spectrum.

Animal Assisted Therapy Approved for ASHA CEUs

Animal Assisted TherapyIn Animal-Assisted Therapy (AAT) the human-animal bond is utilized to help meet therapeutic goals and reach individuals who are otherwise difficult to engage in verbal therapies. AAT is considered an emerging therapy at this time, and more research is needed to determine the effects and confirm the benefits. Nevertheless, there is a growing body of research and case studies that illustrate the considerable therapeutic potential of using animals in therapy. AAT has been associated with improving outcomes in four areas: autism-spectrum symptoms, medical difficulties, behavioral problems, and emotional well-being. This course is designed to provide therapists, educators, and caregivers with the information and techniques needed to begin using the human-animal bond successfully to meet individual therapeutic goals.

Course #20-62 | 2012 | 30 pages | 20 posttest questions
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Should We Really Worry About Obesity’s Link to Autism?

By Brian Fung

A new study this week linking motherhood obesity to childhood autism tells a seemingly horrible tale: pregnant women who are obese are 67 percent more likely to have a child who suffers from the disorder than her non-obese counterpart. It’s the kind of statistic that people latch on to, and dozens of stories in the media highlighted the stat.

But what can we actually make of such a figure? 67 percent sounds like a big deal. You’re well on your way to doubling your risk, it seems. But without context, it’s hard to gauge how much maternal obesity matters relative to the host of autism risk facts.

Should We Really Worry About Obesity's Link to Autism?While the 67 percent figure is “non-trivial,” according to Dr. William Eaton, a professor of mental health at Johns Hopkins University, maternal obesity isn’t exactly considered a leading risk factor. There are others that raise the risk for childhood autism by roughly the same amount, and still others that cause it to skyrocket.

For example, when a baby comes out of the womb feet-first, “a breech birth,” the child’s risk for autism increases about 63 percent. Babies with an Apgar score — an indicator, from one to ten, of a child’s relative health five minutes after birth — of less than seven are about 89 percent more likely to be autistic, Eaton said.

“There are some studies about autism which have much stronger risk factors,” Eaton added, “with hazard ratios like two or three or four,” that is to say, a 200 or 300 or even 400 percent increase in risk.

Some of these more serious risk factors are simply out of our control. A child born before 35 weeks carries two and a half times the risk for autism. Family mental history can also play a role. If someone in your family suffers from psychosis or a mood disorder, the risk for childhood autism increases two to three times.

So, maternal obesity may be a risk factor for autism, but it’s important to remember that it’s only one among many and not even the strongest link.

And, Eaton said, separating out obesity, itself, from other linked disorders is a challenge in itself. “Just to show you how complicated things are, obese women could have a higher rate of mood disorder,” he said. “And we wouldn’t know if it was the mood disorder doing the work or the obesity.”


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25% Off Autism CE – Autism Awareness Month

April is National Autism Awareness Month

25% off autism continuing education courses during National Autism Awareness MonthIn order to highlight the growing need for concern and awareness about autism, the Autism Society has been celebrating National Autism Awareness Month since the 1970s. The United States recognizes April as a special opportunity for everyone to educate the public about autism and issues within the autism community.

Professional Development Resources, a proud member of the Autism Society, is offering 25% off all Autism continuing education courses during the month of April to promote education and awareness.

Autism is More Common Than Previously Thought

New research showing one in 88 U.S. children have autism spectrum disorders is focusing national attention on the need for earlier diagnosis and treatment, especially in rural and minority communities.

Figures released Thursday by the Centers for Disease Control and Prevention show a 23% increase in autism spectrum cases from 2006 to 2008, and 78% increase since 2002.

“Clearly, we have a national emergency and clearly, we need a national plan,” said Mark Roithmayr, the president of Autism Speaks. “It’s time for us as a nation to see these numbers for what they truly are, and for us as a nation to commit to doing much more than we’ve done for date.”

Read more:

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Parents of Kids with Autism Earn Less

By Rachael Rettner, MyHealthNewsDaily Staff Writer

Parents of Kids with Autism Earn LessAdriana Lara, a mother in Hutto, Texas, is not able to work because her 5-year old son Joshua has autism. Lara must stay home to give Joshua the care he needs, and to drive him to his therapy sessions five days a week.

“It’s just impossible for me to be able to hold a job and do all these things with Josh,” Lara, 31, said. The family depends on the salary of Lara’s husband, a psychologist at a Veteran’s Affairs hospital.

Joshua’s therapies, including speech, music and occupational therapy, cost about $5,000 a month. Eighty-five percent of the cost is currently covered by a government grant, but the grant will run out this summer, and the family’s insurance policy won’t cover Joshua’s therapies, Lara said.

“We don’t know how we’re going to afford it,” Lara said. While public schools offer autism therapies, Joshua’s school does not offer the type of intensive therapies he needs, Lara said. For instance, the therapies provided by Joshua’s school are not one-on-one, Lara said.

A new study highlights the unique financial burden faced by families of children with autism, like Lara’s. The burden is particularly significant for mothers, the study finds.

On average, mothers of autistic children earn $14,755 less per year than mothers of healthy children, and $7,189 less per year than mothers of children with other health conditions (such as asthma and ADHD) that limit their ability to engage in childhood activities, according to the study.

Despite the fact that they tend to have completed more years of education, mothers of autistic children are 6 percent less likely to be employed, and they work on average 7 hours less weekly than mothers of healthy children, the researchers say.

“We don’t think that autism creates more of a strain on the family per se than other chronic conditions of childhood,” said study researcher David Mandell, associate professor of psychiatry and pediatrics at the University of Pennsylvania School of Medicine. “I think the reason these mothers are leaving the workforce is because the service system for children with autism is so fragmented,” Mandell said.

Health care and workplace policies need to recognize the full impact of autism, and alleviate costs for the families with greatest needs, the researchers concluded, writing in the March 19 issue of the journal Pediatrics.

Higher Bills, Lower Salaries

About 1 in 110 children in the United States have an autism spectrum disorder, a developmental disability that can cause language delays, impaired communication skills and social challenges, according to the Centers for Disease Control and Prevention.

The new study results are based on yearly surveys of U.S. households conducted between 2002 and 2008. The study included 64,349 families with healthy children, 2,921 families of children with other health limitations and 261 families of children with autism.

While fathers’ salaries, by themselves, were not affected by having a child with autism, total family income was, the study showed. On average, families with autistic children earned $17,763 less than families with healthy children, and $10,416 less than families with children with other health limitations.

As Lara’s story shows, having a child with autism may limit the parents’ abilities to work because these children require more care. Finding quality, specialized childcare for autistic children may be difficult and costly, the researchers say.

“A traditional daycare setting really is really not conducive,” for children with autism to thrive, said Carolyn Price, whose 7-year old son has autism. Autistic children are very sensitive to sights and sounds, and may be overwhelmed at a day care, Price said.

When Price’s son was in daycare — before he was diagnosed with autism — he would bite other children because he couldn’t cope with the environment, Price said. In addition, autistic children need one-on-one interaction that is generally not feasible at day care, Price said.

When Price’s son, also named Joshua, was young and had to be at home, she and her husband felt uncomfortable having anyone beside themselves or close friends look after him.

“It’s really challenging when you have a child with special needs, to really turn that responsibility over to someone else and feel like they are getting the best care,” Price said. Price’s husband Joel still works only part time, so he can drive his son to therapy sessions.

Financial Support

Children with autism need to be immersed in their therapies in order to benefit, Price said. Providing therapy one day a week, when a child needs five sessions, won’t have the same impact, Price said.

In 2010, Price and her husband started a non-profit organization called Imagine a Way to provide financial assistance to families with autistic children. The organization focuses trying to provide funds to support for children for two years.

While other nonprofits and government subsidies offer support to families of children with autism, it’s often comes in the form of a little bit at a time, Price said.

“There’s a recognized need for it, I just don’t think there’s a consolidated organization like Autism Speaks, that’s able to do something on a major scale,” Price said. While any source of funding is valuable, “For the magnitude of what these kids need, a little bit is just not enough,” Price said.

Pass it on: Autism places a significant financial burden on families.


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Animal Assisted Therapy – New Online Course!

Animal Assisted Therapy

Click to view course details

In Animal-Assisted Therapy (AAT) the human-animal bond is utilized to help meet therapeutic goals and reach individuals who are otherwise difficult to engage in verbal therapies. AAT is considered an emerging therapy at this time, and more research is needed to determine the effects and confirm the benefits. Nevertheless, there is a growing body of research and case studies that illustrate the considerable therapeutic potential of using animals in therapy. AAT has been associated with improving outcomes in four areas: autism-spectrum symptoms, medical difficulties, behavioral problems, and emotional well-being. This course is designed provide therapists, educators, and caregivers with the information and techniques needed to begin using the human-animal bond successfully to meet individual therapeutic goals.

The author, Lois Jean Brady, MA, CCC-SLP, is a practicing speech-language pathologist registered in animal-assisted therapy. She has a very loveable potbelly pig named Buttercup who accompanies her to therapy sessions, where he enhances her work with students on the spectrum. Buttercup has made a lasting impression on students, staff, and caregivers – essentially all who meet him. He has helped some students attain their goals and others just feel safer and more secure in the therapy environment, allowing them to focus their attention on a task. He has heard many students utter their first words, start conversations, or ask questions. He has been combed, brushed, fed, and cared for by many students. Lois has found that having an animal creates an atmosphere of trust that motivates children to expand their skills, strive to do their best, and strengthen the relationship between them and her.

Rosy Chu interviews Lois and Buttercup on KTVU Bay Area People:

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