As the school year is drawing to a close, I'm going to be doing a lot of looking back and making observations on my first year as a school psychologist (assuming I have time, since the end of the year is B-A-N-A-N-A-S right now). One case I want to highlight is A, one of the boys in my social skills/anger management group.
Mrs. C, A's teacher, came to me with concerns that A exhibits characteristics of an autistic spectrum disorder. These are signs that I noticed in the times I visited the classroom prior to beginning group, and have also documented a little bit in blogging about our sessions. Mrs. C's primary concerns were A's severe lack of social skills, resistance to changes in his environment, and his unusual reactions to his environment (i.e. smells, sounds, touches). She noted that these are really interfering with his ability to make friends and function fully within the room. In a 6:1+1 classroom of severely learning disabled and emotionally disturbed kids, A doesn't quite fit.
The Committee on Special Education began the reevaluation process, so that we could take a look at A's classification and program to determine if he needed something more or different to better meet his needs. I ran into a little roadblock because A is not currently diagnosed as autistic from a medical doctor, something I was worried would impede me from possibly classifying him as a student with autism. However, after talking to my psychologist colleagues, I got a resounding "YES," I could classify A as a student with autism, despite the fact that he does not have a diagnosis. One of the psychs summed it up best, "There is a medical model diagnosis and an educational model diagnosis. We are making educational classifications, not medical diagnoses."
In order to evaluate whether A may be educationally disabled due to an autistic spectrum disorder, I gave Mrs. C oodles of ratings scales to fill out to gain more information about A's behavior, including the Asperger Syndrome Diagnostic Scale (ASDS), the Childhood Autism Rating Scale (CARS), and the Vineland II Adaptive Behavior Scale. I also observed A within the classroom, which was easy because I see him for group every week. The rating scale results, Mrs. C's notes, and my observations all showed overwhelming evidence that A may have an autistic spectrum disorder.
I did a record review of A's previous evaluations and reports. What I found was both surprising and upsetting. The more I reviewed old documents, the more I realized that A has grown exponentially over the past five years. He started out nonverbal, violent, and what appeared to be very mentally delayed. Today, he scores with generally average intelligence and academic skills. However, I also found that for just as long, folks have noticed "oddities" that have been described as those similar to an autistic spectrum disorder. What frustrated me the most was A's most recent psychological evaluation. He was described very plainly as having autistic behaviors, but his classification was changed to Learning Disabled, despite him having fairly average skills across the board. Why had no one investigated the possibility of a classification of autism for A?
It seemed totally unfair to A that no one had stepped up to the plate. True, "autism" can spook the best psychologists, so it certainly spooks me (since I can in no way claim to be in the "best" category). It's like Mental Retardation or Emotional Disturbance: it sticks and it can be harsh. But, for all my reservations, it became extremely important to me to "do right" by A and get him services that would benefit him. Our district has a program at one of it's schools solely for high-functioning students with autism. It provides them with great social skills training, job training and transition help, and just real life skills in general. A's mom, Mrs. C, and I all thought this would be a great program for him.
At A's CSE meeting this week, I changed his classification from Learning Disabled to Autism. We're in the process now of getting paperwork together so A can attend the specialized program for students with autism next year (if all goes according to plan). Rock on.
In no way do I mean for this blog post to be self-serving or "tooting my own horn." For those that know me, I put others before myself constantly, maybe more than I should, and don't really want much in return. For me, it's for the kids, not any pats on the back I may get. So, I call this blog post "Accomplishment: Autism" because if I look back and find nothing else to be proud of after this year (unlikely), I can be happy knowing that A will be in the right setting for him next year with the right classification. That's what matters!