http://bestpracticeautism.blogspot.com/2012/01/best-practice-review-autism-diagnostic.html

The role of the ADOS in the assessment of ASD in school and community settings has received attention as well. The perceived advantages and disadvantages of the ADOS were examined via a national survey of practicing school and clinical psychologists (Akshoomoff, Corsello, & Schmidt, 2006). Perceived advantages of the ADOS included its strength in capturing ASD-specific behaviors and the standardized structure provided for observation, while diagnostic discrimination and required resources were the most commonly identified disadvantages. Respondents listing advantages of the ADOS indicated that it captured ASD behaviors, both generally and specifically, and that it was a good measure for identifying behaviors that are difficult to observe or probe in other situations. Respondents indicated that a disadvantage of the ADOS is that it tends to over classify other diagnostic groups as ASD and does not discriminate well within ASD subgroups. Of those that indicated resources as a disadvantage, nearly all indicated time of administration as a disadvantage.

Anonymous wrote:You sound like you don't understand basic math. The average class size in public schools is usually about 20-30 for elementary. For MS and HS teaching multiple sections a day it would be mathematically improbable for a teacher to NOT have a child with autism in one of the classes.

How much time do you think a teacher spends with one child per day with 20-30 kids per classroom or more?

It actually is possible. Our school dumps all kids with any IEP in one classroom regardless of the issue. We had to fight to get out of the classroom as it was not a good fit. My child is the only child according to the school with an IEP in the classroom.

Anonymous wrote:I haven't read this thread. We had a similar issue when DS was in K. He hated school that year often saying his teacher was mean. He also takes some time to warm up and took a long time to make friends. We had him evualated and he was found to be borderline ADHD and the recommendation was not to treat him at that time, just to keep our eyes on him. DCUM all weighed in that DS sounded like he was on the spectrum and he must have issues if the school was telling us so.

We requested a certain teacher for 1st grade who is very patient, loving and kind. DS flouished in her class, hasn't had any issues since and has made many friends.

We didn't request a specific teacher as we don't know them but said our child would do best with XXX teacher and its a much better situation than last year. A teacher/classroom can make a huge difference.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Get the ADOS done independently. Rookie mistake not to include it in the first place. The schools are supposed to consider outside reports, but the often don't, so it may not change their stance. Iep labels are incredibly general. Focus on the supports your kid needs no matter what label it comes under.

Total blergh.

Interestingly, dev ped thinks it's not worth doing—doesn't think it will show much in his case.

PP is wrong. BTDT. ADOS is not a standard part of a neuropsych. It's a matter of professional judgement whether to do it, not a rookie mistake. You may want one anyway for the school or for your own peace of mind. If you do want an ADOS, go to David Black, he's a neuropsych specializing in autism.

In our situation, the tester decided not to do the ADOS after doing a bunch of other testing and spending hours with my son. He said it wasn't even close -- my DS didn't have autism, and wasn't going to test in the autistic range on the ADOS. He'd done hundreds of ADOS testing through the years.

See the difference? He's done hundreds of the tests and followed the kids through adulthood. He knows the difference. Elementary school teachers do not have this training and should not be using it to diagnose kids. I think they like it because it's a checklist and it looks easy but it's not.

I am not sure what you are talking about. The ADOS is not a checklist and it is not administered by teachers. There ARE checklists a teacher might fill out as part of an evaluation, which is totally appropriate. While I understand it might be distressing to have a teacher think they know the diagnosis, try to focus more on what your child needs.

Sorry, I think that it was CARS checklists that I used to see teachers following kids around with at my daughter's school. Photocopied autism checklists when honestly I'm pretty sure these teachers had never seen an autistic kid in their life were filling out.


This is CARS-2 but there was a first/original CARS too.
http://www.proedinc.com/customer/productView.aspx?ID=4754

Just to expand, the actual CARS scoring tests can only be scored by a clinician who has been trained and observes the child in person. The tested is calibrated and each item has definite criteria.

There are CARS checklists for teachers and parents, but those only inform the clinician. The actual test has to be done by someone who is trained. My son had the original CARS twice, once by someone the school brought in to do behind our back, and the second by Dr. Stephen Camarata of Vanderbilt; the scores were within a half-point of each other in the non-autistic range. Dr. Camarata didn't see the first result before he did his CARS assessment; that's how controlled the process is, scoring wise.


https://www.chadis.com/site/content/childhood-autism-rating-scale-second-edition-cars2-hf

The Childhood Autism Rating Scale (CARS) helps to identify children (2 years and older with Autism, specifically, distinguishing them from developmentally handicapped children who are not Autistic. In addition, it distinguishes between mid-to-moderate and severe Autism. Its brevity makes it a very useful tool to help recognize and classify Autistic children. The CARS was developed over a 15-year period with more than 1,500 cases, the CARS includes items drawn from five prominent systems for diagnosing Autism, and provides quantifiable ratings based on direct behavior observation. Each item covers a particular characteristic, ability of behavior. Note that this is a strictly a clinician rating tool and is not to be administered directly to parents but can be used in conjunction with the CARS parent questionnaire (QPC) which is an unscored data collection tool. CHADIS, with guidance from the authors, has created a way for relevant parent data for each CARS item to be viewed above each clinician item. This should greatly facilitate the clinical process when meeting with parent and child.

I haven't read this thread. We had a similar issue when DS was in K. He hated school that year often saying his teacher was mean. He also takes some time to warm up and took a long time to make friends. We had him evualated and he was found to be borderline ADHD and the recommendation was not to treat him at that time, just to keep our eyes on him. DCUM all weighed in that DS sounded like he was on the spectrum and he must have issues if the school was telling us so.

We requested a certain teacher for 1st grade who is very patient, loving and kind. DS flouished in her class, hasn't had any issues since and has made many friends.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm pretty sure every teacher has seen a kid with autism. It's now one out of every 68 kids who are diagnosed.
It's not a check list that tells you if a child has autism. It tells you if the child has difficulty in certain areas and the more of them you check the more of a red flag it is and the more the school will recommend further screening. I don't know of any school district that makes placement or IEP coding recommendations based on one test. Do they?

I've seen private, mostly oversubscribed catholic schools, have teachers perform various evaluations of children using 'checklists' or crude evaluation methods to assess children - mostly with the endgame of pressuring parents to medicate the child (mostly boys) or to counsel them out of the school so that the child's needs could be 'met elsewhere'. In every case a smaller class size and better and more creative teaching methods could have meant that all of these children could have functioned fine at those schools but that was not what they did. None of these kids was seriously disabled and virtually none of them had anything close to ASD and no - these teachers had not seen a real ASD kid much less a classroom of them in their lives.
If teachers are going to evaluate kids they should get some training first - some weeks in a Kennedy Krieger clinic, acsemester in various special ed classrooms. Or - maybe they could leave the diagnosing up to those that have dedicated their lives to that and just focus on teaching the children in their classrooms.

The checklists are not designed for clinicians. They are designed for laypeople, like teachers.
You are really getting tiresome.

Out developmental ped reads questions for me and child, that is what these tests are. He does not talk to the therapists or teachers. It really varies.

Anonymous wrote:

Anonymous wrote:I'm pretty sure every teacher has seen a kid with autism. It's now one out of every 68 kids who are diagnosed.
It's not a check list that tells you if a child has autism. It tells you if the child has difficulty in certain areas and the more of them you check the more of a red flag it is and the more the school will recommend further screening. I don't know of any school district that makes placement or IEP coding recommendations based on one test. Do they?

I've seen private, mostly oversubscribed catholic schools, have teachers perform various evaluations of children using 'checklists' or crude evaluation methods to assess children - mostly with the endgame of pressuring parents to medicate the child (mostly boys) or to counsel them out of the school so that the child's needs could be 'met elsewhere'. In every case a smaller class size and better and more creative teaching methods could have meant that all of these children could have functioned fine at those schools but that was not what they did. None of these kids was seriously disabled and virtually none of them had anything close to ASD and no - these teachers had not seen a real ASD kid much less a classroom of them in their lives.
If teachers are going to evaluate kids they should get some training first - some weeks in a Kennedy Krieger clinic, acsemester in various special ed classrooms. Or - maybe they could leave the diagnosing up to those that have dedicated their lives to that and just focus on teaching the children in their classrooms.

The checklists are not designed for clinicians. They are designed for laypeople, like teachers.
You are really getting tiresome.

You sound like you don't understand basic math. The average class size in public schools is usually about 20-30 for elementary. For MS and HS teaching multiple sections a day it would be mathematically improbable for a teacher to NOT have a child with autism in one of the classes.

Anonymous wrote:I'm pretty sure every teacher has seen a kid with autism. It's now one out of every 68 kids who are diagnosed.
It's not a check list that tells you if a child has autism. It tells you if the child has difficulty in certain areas and the more of them you check the more of a red flag it is and the more the school will recommend further screening. I don't know of any school district that makes placement or IEP coding recommendations based on one test. Do they?

No they don't. The GARS checklist in the op's case is the first step in documenting moving from a 504 to an IEP. There are a few similar screening checklists or questionnaire type tools that the schools use. Most of them have autism in the name. The schools don't have to be thorough. They're not diagnosing anyone your kid they are documenting the need for services following a legal framework with what is available to them.

Schools don't do the ADOS, and for all the parents are railing against it, it is much more reliable, specific, and sensitive than any of the screening tools that the schools use. So to review, parents it is possible to get an IEP under Ohi for ADHD. It is a lot harder to do so if your child has other confounding behaviors or LDs. Include the ADOS as part of your neuropsych for the sake of thoroughness if you care what your IEP label says. Keep in mind it may not change the school's choice of what they think is accurate. Yes, you can follow formal challenge routes. You can hire lawyers or IEP consultants and still be facing the same situation.

So instead of obsessing about the label, focus on getting appropriate services, which regardless is a huge challenge unto itself.

Anonymous wrote:I'm pretty sure every teacher has seen a kid with autism. It's now one out of every 68 kids who are diagnosed.
It's not a check list that tells you if a child has autism. It tells you if the child has difficulty in certain areas and the more of them you check the more of a red flag it is and the more the school will recommend further screening. I don't know of any school district that makes placement or IEP coding recommendations based on one test. Do they?

I've seen private, mostly oversubscribed catholic schools, have teachers perform various evaluations of children using 'checklists' or crude evaluation methods to assess children - mostly with the endgame of pressuring parents to medicate the child (mostly boys) or to counsel them out of the school so that the child's needs could be 'met elsewhere'. In every case a smaller class size and better and more creative teaching methods could have meant that all of these children could have functioned fine at those schools but that was not what they did. None of these kids was seriously disabled and virtually none of them had anything close to ASD and no - these teachers had not seen a real ASD kid much less a classroom of them in their lives.
If teachers are going to evaluate kids they should get some training first - some weeks in a Kennedy Krieger clinic, acsemester in various special ed classrooms. Or - maybe they could leave the diagnosing up to those that have dedicated their lives to that and just focus on teaching the children in their classrooms.

I'm pretty sure every teacher has seen a kid with autism. It's now one out of every 68 kids who are diagnosed.
It's not a check list that tells you if a child has autism. It tells you if the child has difficulty in certain areas and the more of them you check the more of a red flag it is and the more the school will recommend further screening. I don't know of any school district that makes placement or IEP coding recommendations based on one test. Do they?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Get the ADOS done independently. Rookie mistake not to include it in the first place. The schools are supposed to consider outside reports, but the often don't, so it may not change their stance. Iep labels are incredibly general. Focus on the supports your kid needs no matter what label it comes under.

Total blergh.

Interestingly, dev ped thinks it's not worth doing—doesn't think it will show much in his case.

PP is wrong. BTDT. ADOS is not a standard part of a neuropsych. It's a matter of professional judgement whether to do it, not a rookie mistake. You may want one anyway for the school or for your own peace of mind. If you do want an ADOS, go to David Black, he's a neuropsych specializing in autism.

In our situation, the tester decided not to do the ADOS after doing a bunch of other testing and spending hours with my son. He said it wasn't even close -- my DS didn't have autism, and wasn't going to test in the autistic range on the ADOS. He'd done hundreds of ADOS testing through the years.

See the difference? He's done hundreds of the tests and followed the kids through adulthood. He knows the difference. Elementary school teachers do not have this training and should not be using it to diagnose kids. I think they like it because it's a checklist and it looks easy but it's not.

I am not sure what you are talking about. The ADOS is not a checklist and it is not administered by teachers. There ARE checklists a teacher might fill out as part of an evaluation, which is totally appropriate. While I understand it might be distressing to have a teacher think they know the diagnosis, try to focus more on what your child needs.

Sorry, I think that it was CARS checklists that I used to see teachers following kids around with at my daughter's school. Photocopied autism checklists when honestly I'm pretty sure these teachers had never seen an autistic kid in their life were filling out.


This is CARS-2 but there was a first/original CARS too.
http://www.proedinc.com/customer/productView.aspx?ID=4754

A dev pediatrician who sees your child once a year or twice a year for an hour gets different kind of information from a teacher who has your child in class every day. Notice I say different, not more or better or less or worse.
Teachers aren't usually trained to spot autism but developmental pediatricians do not see your child interact with other children and usually do not see your children in "natural" settings.
When doctors and therapists meet my DS in the clinic they think he is engaging, articulate, mature, and focused. Several therapists who have worked with DS weekly even question whether he should have any diagnosis at all because he is so consistently well-behaved. When this happens we point to the teacher report. In class he is hyper and sometimes can't get a lick of work down to save his life.

Dev. pediatricians rely on teacher and parent reports to make diagnoses and recommendations. There are ignorant teachers and teachers with biases, but you can't discount them blindly. If I were OP I would take the checklist the teacher produced to a new developmental pediatrician or neuropsychologist to try to get more recommendations about what evaluations to do next.

Again oddly obsessed PP. the school is following their protocol for switching from a 504 to an IEP.

Please find someone to talk to. Paranoia isn't healthy.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm not saying this is you but there are many parents who are in denial that their child is on the spectrum until they are older and the social problems become really apparent. These are usually kids with Asperger's who are very verbal and in early elementary you tend to think they are immature, it's part of their ADHD, and they will grow out of it. A lot of kids do but some don't and the fact your teacher is and the school is pushing you in that direction means something. I don't think it means your child is on the spectrum but it means you should consider the possibility.

The schools really shouldn't be pushing anyone or diagnosing anyone. They are there to teach and not to diagnose. It could just 'mean' that they are ignorant.
How many teachers follow a kid after he leaves elem school? None.
How many developmental PEDS a kid after elem school and beyond? All of them.

Who has diagnostic training? Not the teacher but the developmental ped.
A teacher following a kid around with an ADOS checklist is NOT a good thing - they have no business doing this as they do not have the large scope of training spread out from infancy through adulthood of the kids. They should just stick to teaching the kids they have (though doing a checklist is much easier I'm sure).

PP, an elementary teacher who follows your kid for life would be a stalker. Sheesh, you sound unwell.

Many people whose kids actually have ADHD don't need to perpetually see a developmental pediatrician; many parents whose kids have autism do. So by protesting the ADOS so vehemently makes you seem like you are projecting your own insecurities upon the Op.

ADOS is not a checklist and a much better tool than the GARS, which is.

The developmental pediatrician who follows a kid through adulthood is not unwell.
Leave the diagnosing to the developmental pediatrician and other professionals - you should stick to teaching which is the job you were trained for and hired to do.