Autism Evaluations at Home
Autism Evaluations at Home
Proposed Problem Statement
According to the CDC 1 in 68 children in the U.S. will receive an autism spectrum disorder diagnosis (ASD). There is a vast distinction of cases in boys and girls with boys being 1 in 42 and girls 1 in 189 (Aggarwal & Angus, 2015). Autism spectrum disorder is a neurological condition that presents with social and communication deficiencies, restricted or repetitive behaviors, and sensory disorders (American Psychiatric Association, 2013). Children, in general, tend to change behavior pattern in an environment that is not familiar. Evaluations for ASD are typically conducted in an office or specialist environment that the child is unfamiliar with. This being the case, there have been missed and mis-diagnosis of ASD (Takara, Kondo, & Kuba, 2015). There are a few cases of an ASD diagnosis being removed from individuals, when they were later given a correct diagnosis of other psychological disorders like schizophrenia and bi-polar 1 or 2 disorder (Takara, Kondo, & Kuba, 2015).
Hypothesis
When a child is evaluated in an environment in which they are comfortable in, the diagnosis will be more accurate and therefore a more efficient therapy plan can be devised to enable the child to improve on all deficiencies. The home environment can present information about behavior at home and confirm parental concerns that are given through the parent questionnaire on the initial primary care appointment. School evaluations can present accurate information about social and communication deficiencies that may be of concern to parents and also may give an idea of other problems, such as dyslexia, that could cause some learning disabilities. This study seeks to provide a more accurate diagnosis of ASD and allow for more effective therapies to be provided.
Participants
This study will include 20 participants. Each participant will be aged 3-17 and have a previous autism diagnosis, with the evaluations having been conducted in the office of a therapist. Each individual participant may vary in severity of diagnosis and exhibited behavior. There will be five girls and five boys. For every age category, there will be one male and one female participant.
Design
This study will take place in two places and also utilize previous evaluations. Video cameras will be set up in multiple areas of the home, where the children interact with other family members. The researcher will have access to these videos on a daily basis. If the participant is of school age, the researcher will observe, through video or personal observation, the social behavior of the participant with their peers and instructors.
Points of Importance in Study
Observation at home to study behavior with siblings and parents.
Observation to see how the participant reacts to sensory manipulations.
Observation of communication and language skills.
Observation to routine.
Confirmation of parental questionnaire responses.
Observation of attention span in classroom setting.
Observation of interaction with peers and instructors in class.
Observation of accommodation effectiveness in classroom setting.
Breakdown of Statistics Used
Population
A population statistic will be appropriate to display the results of accuracy between male and female participants from both learning and home environments.
ANOVA
An ANOVA will be run to compare the results of the previous evaluation and the current evaluation. The accuracy of the previous evaluation will also be compared with the results of the current evaluation done through this study. The parent questionnaire accuracy will also be issued a numerical status for the observations the researcher has made.
Overall
The research must display all statistics for each of the following areas: behavior analysis, communication analysis, language analysis, social interaction, and sensory analysis.
Concerns of Study
Parents
Parents may cause a disruption to at home studies intentionally.
The parents may adjust routines, so that they can validate their claims.
School
Classroom setting that is not inclusive, may not allow for typical interaction with peers.
Accommodations made in the classroom are after a previous evaluation and may conflict with current results.
Results
Current results of evaluations at home may confound with the results of a previous evaluation and therefore change a diagnosis.
The parents may insists upon a diagnosis change if the results are not conclusive for ASD.
One Major Concern
When developing this study, a major concern developed that must be addressed. It has been studied and concluded that some children develop ASD characteristics as defense mechanism for abuse or bullying (Baudino, 2010). If abuse at home is suspected at any point during the study, that participant will not be included in the results and the proper measures will be taken to assist the participant. If bullying in any environment is suspected, the participant will be excluded from the results and it will be immediately reported to the proper authorities, being school authorities or others. The health of the participants will remain of the upmost importance throughout the entire study.
Final Comparison
Once each participant has been observed and the results compiled, there will then be a comparison of the previous evaluation results and the parent questionnaire to confirm or deny the claims made by the previous evaluation and the parents. This study does not seek to disclaim or discredit parents or other researchers and therapist in the medical field, but its purpose it to allow for a more productive, conclusive, and efficient evaluation to be conducted so that missed diagnoses and mis-diagnosis may be avoided.
Ways to Improve Conflict with Study
To keep the results from disrupting previous evaluation results, the results of the current study will not be released to the parents or doctor and the participants, parents, and physicians will all remain anonymous. With many studies that are conducted at home, the participants or others in the environment on a regular basis, may change their regular behavior to satisfy what they feel the researcher is searching for. With the study taking place for two weeks, this could eliminate that over a week by allowing the participants and others to become more comfortable and therefore acting in their natural behavior.
Future Studies
Future studies are recommended to conclude how an initial evaluation at home may produce results for an ASD diagnosis. It is also suggested that future studies include a distinction for other psychiatric disorders like schizophrenia, bi-polar disorder, and depression.
References
Takara, K., Kuado, T., Kuba, T. (2015). How and why is autism spectrum disorder misdiagnosed in adult patients?: from diagnostic problem to management for adjustment. Mental Health in Family Medicine.
Aggarwal, S., Angus, B. (2015). Misdiagnosis versus missed diagnosis: diagnosing autism spectrum disorder in adolescents. Australian Psychiatry.
Baudino, L. (2010). Autism spectrum disorder: A case of misdiagnosing. American Journal of Dance Therapy.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
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