Monday, February 14, 2011

Seek Formal Evaluations 
Why do I need to spend all this money and travel to a clinic when I already know my son has Autism?  I have two, very good reasons:  1) A formal diagnosis gets you targeted therapy goals and objectives and 2) A formal diagnosis can provide ammunition to get therapy funded by your district.  An evaluation can validate your request for services. 

Any child with issues can benefit greatly from an intensive formal evaluation.  You’ll get detailed feedback that will assist you in designing the best possible therapy program.  A multidisciplinary evaluation is ideal since many people of various professions will be testing and assessing your child.  Tests, like research, are designed to FIND certain things. 

Even if your school district has tested and diagnosed your child, you still need to pursue testing performed by an Autism clinic or doctor.  School district tests and other basic testing are designed for academic purposes, not for a pervasive disability.  Ask for the names of the tests offered and/or recommended by your district, then look them up to see if these make sense to you.  Do your homework on which testing YOU feel would benefit your child by providing the answers you are looking for.  Testing is designed to find things.  If what you are looking for isn’t on it, the testing will not be helpful to you.  High academic scores can be used against you when advocating for therapy hours.  Your district may say “he is doing so well” because of the test and deny you services. 

A true Autism evaluation will detail your child’s deficits.  Our first evaluation was about 30 pages long.  The evaluators write a report detailing these deficits and strengths.  Specifically, they will address them by providing written objectives and goals which can help you fine-tune your overall intervention program.  A tangible, measurable program will help you assess progress.  The more targeted the child’s program is, the more efficient your therapy choices will be, and a child’s progress will reflect this.  

As an aside, ask your evaluator for detailed recommendations for your child’s intervention, as part of your evaluation report.  For example, you want pages and pages of recommendations like this: 

“Leo would benefit from an intervention/educational program consisting of a combination of one-to-one therapy, and participating in a language-based, typical preschool with facilitation and support.  Leo would benefit from intensive behavioral modification therapy (25 hours per week minimum)”  

“Leo would benefit from intensive and individualized speech and language therapy (2 to 3 hourly sessions/week of direct speech and language therapy).” 

“Leo will increase the sophistication of his expressive language to include a greater range of sentence types, elaborated noun/verb phrases, and age-appropriate grammatical forms to clarify his intent for his listeners.” 

Be sure to have them include the number of hours they recommend for each type of therapy or school environment (mainstream or special ed, or a combination).  A description of an ideal school environment for your child would also be helpful. 

These examples are far more helpful for creating goals and objectives, and also as back-up support for funding from the school.  You do not want a vague paragraph containing a sentence like this:  “Leo will work on his social goals with various therapies and supports for the 02/03 school year.”  

These clinics are busy, so they may only give you bare bones unless you say something.  Do it!  This is your ammo for funding, better goals and objectives! 

Therapy providers, especially school districts, are not used to these specific tests, as they are expensive and require training on how to administer them.   School providers often appreciate these evaluations.  It makes their lives much easier, and in the end makes them and the child look good.

As a side note, it’s ironic to me that therapists and school districts take credit for your child’s progress, when parents were the ones advocating for this evaluation in the first place.  Either way, let them take credit!  Their “accomplishment” will help other families secure an evaluation because they see the pay-off.  

Schools are typically only interested in educational goals due to economics.  A sad fact when school is 80% social (feedback from various special ed teachers and therapists).   You can’t succeed in school if you can’t make inferences or understand the body language of your teacher or peer.  Social survival is just as important, if not more, than academics.  Academics is the easy part!  You can do that any time anywhere, especially with our smart children. 

Even if your child seems normal in gross motor and fine motor areas, get OT and PT evaluations anyway.  This disorder affects ALL areas of development for most of our children, and something that looks like a strength now may fall and become a weakness later.  These professionals will find things to be watchful for, which you may want to monitor if the child is about to fall out of the “normal” age range for skills.   A heads up is golden. All evaluation expense should be covered by the school district and/or insurance.  In most cases the only area they do not have to cover is biomedical.
As with an Autism clinical eval, be sure your SLP, OT, and PT reports contain detailed recommendations for hours and type of therapy, and specific goals and objectives if appropriate.  A simple test done by the school may not be enough to get all of the therapy you need funded.  A more detailed, clinical evaluation will provide all the ammo you need to receive appropriate hours and types of therapy you feel your child requires. 

Be sure to get evaluations done at least once a year.  Different evaluators are also helpful.  They provide a different perspective that could be helpful in a weak area in your evaluation if you need something flushed out.  The same evaluator is also great if you found him beneficial the first time around.  Comparing the previous to current eval is extremely helpful in assessing your therapy program.  Tracking progress year to year reaps benefits. 

Ask your Autism parent friends if you could take a look at their child’s evaluations.   
Many of us have to wait a long time for their evaluation appointment.   A fantastic way to learn how to understand evaluations, in particular, an evaluation by a clinic you have an appointment with, is comprehending a sample eval.  This will help you learn about what you are looking for, and what your money will pay for.  You can compare and contrast them.  Think of college and seeing last year’s test before an exam.  It gives you an advantage.  

If you are good friends, they may even let you make a copy of it (they can be dense, my Yale evals were approximately 30 pages).  You can go through it at your leisure, highlighting the items you do not understand, highlighting goals and objectives you may want to incorporate into a current IEP.   If the children are similar, this is a great way to accelerate your learning.  

For more advice like this, consider purchasing "High Functioning Autism: Advice From A Mom, From Diagnosis To Recovery" by Ashley Morgan