Although the number of children diagnosed with an autism spectrum disorder (ASD) continues to rise, there remains a shortage of teachers and other professionals available to provide individuals with ASD comprehensive services. While these shortages are experienced by educational facilities and care centers throughout the nation, a new tactic is being adopted, employing psychologists as a means to close the gap in ASD care. A psychologist is capable of not only determining whether an individual has an autism spectrum disorder, but also in becoming an active team member in caring for the person being served.
The Reason for the Increase in Autism Spectrum Disorders Diagnoses
Whereas, initially scientists were puzzled as to the reason for the substantial increase in the number of children being diagnosed with autism, studies indicate that the cause of this increase may actually relate to changes in diagnosing criteria, reporting practices, as well as the recently expanded definition of autism. The revised definition of autism includes more than just ASDs: It also includes a collection of developmental disorders of the brain, such as Asperger’s syndrome: Nonetheless, all of these children require adequate care.
Changes in Diagnosing Autism
The American Academy of Pediatrics has implemented an autism spectrum disorder screening test for all children when they attend their 18- and 24-month Well-Child doctor visit. In addition, the American Academy of Child and Adolescent Psychiatry has adopted the practice of routinely screening children for ASD during their developmental and psychological evaluation. Once a child is positively identified as having an autism spectrum disorder (or another developmental brain disorder now included in the definition for autism), a comprehensive evaluation is necessary.
Employ Psychologists to Close the Gap in ASD Care
Psychologists Can Fulfill Multiple Roles
Due to the gaps in ASD care, the wait to attain a proper assessment and find suitable treatment can be extremely frustrating for a child or an adult with an autism spectrum disorder, for his or her family, as well as for the medical, educational and developmental disabilities agencies dedicated to helping these individuals. Although the shortage of professionals extends across numerous disciplines, given the opportunity, psychologists have the ability to fulfill multiple roles.
- A school may request that a psychologist determine whether or not a student has an ASD.
- Psychologists in primary health care settings may review the results of previously administered autism spectrum disorder screening tools.
- A psychologist may screen the child for an autism spectrum disorder. While a screening tool can identify a child’s risk of having an autism spectrum disorder, these tools are not sufficient for intervention planning: To create a treatment plan, a comprehensive evaluation is necessary.
Although a comprehensive evaluation is not required by the ICD-10-CM and the DSM-5 to diagnose an individual with an autism spectrum disorder, attaining a diagnosis solely based on clinical judgment provides very little guidance for appropriate intervention techniques. However, psychologists in clinical practice can use the results of a screening to justify a more comprehensive evaluation. A multi-disciplinary comprehensive evaluation lets the medical team and family members clarify the individual's complex developmental profile as well as identify his or her strengths, and challenges.
During the evaluation process, a psychologist can:
- Recognize medical, behavioral and emotional barriers related to skill acquisition and adaptive functioning.
- Use evidence-based tools to assess an individual's social, cognitive and adaptive functioning skills.
- Administer and then interpret the ADOS-2 and the ADI-R ‘gold standard’ assessment tools.
- Work in conjunction with other professionals to identify the strengths and challenges of the person being served. These professionals may include a language pathologist, special educator, physical and/or occupational therapist.
Integrate data from numerous sources, including cultural, family and community related stressors, and strengths. A psychologist’s ability to integrate this data ensures that an individual’s evaluation leads to an all-inclusive view of the person being served and his or her family within their community.
Although a psychologist directly treating an individual with an ASD rarely involves individual psychotherapy or family therapy, there are multiple direct service roles the psychologist can fill.
Many times, parents of children who have recently been diagnosed with an ASD feel a sense of confusion. Furthermore, determining the best course of treatment can be taxing on the parent of a child with autism. In addition, seasoned parents state that they frequently feel overwhelmed as they begin to incorporate life transitions for their child. Psychologists can assist these families in numerous ways.
- Assist families with parental and occupational roles as they navigate the educational system, insurance and developmental services.
- Be a virtual case manager by enabling communication between what may seem to be a never-ending cast of providers in the program of the person being served.
- Serve as a psychotherapist for an individual with autism: A psychologist can assist the person being served with the development of more efficient language and cognitive skills. During cognitive behavior therapy (CBT), individuals learn self-management and daily living skills. This reduces the amount of anxiety that children and adolescents with autism experience.
- Treat issues such as depression, social anxiety and perseverative (repeated) behaviors.
- Help people with ASD manage their stims, dissect their social interactions, manage school/work relationships and understand social cues.
Psychologists Can Incorporate More Activities to Improve Social Skills
Despite the fact that every individualized education program for children with an autism spectrum disorder includes a social skills group, many of these programs are lacking in this respect. Some programs involve little more than playing a game and/or consuming lunch with classmates. However, children with an ASD can benefit greatly from participating in a structured-group environment, even if they do not understand the ‘how’ and the ‘why’ the activity being performed relates to the real world. Psychologists help individuals with autism improve their social skills by teaching them how to work with others, as opposed to just working near one another.
Although the effectiveness of participating in social skills groups is not as clear cut as the efficacy for applied behavior analysis and cognitive behavior therapy interventions, a psychologist has the ability to construe research findings; thus, improving the likelihood of recognizing the components necessary for teaching an individual with autism communication and social cognition skills.