What is the role of a psychologist in childhood conditions?
Psychologists work with other health professionals including general practitioners, paediatricians and psychiatrists to identify and treat childhood disorders such as ASC. Psychologists use a range of assessment processes to determine whether individual children meet the criteria for an ASC, whether a different diagnosis is appropriate, or whether difficulties of a more general nature are being experienced. The information gathered from assessments is used by psychologists to make recommendations for individually-designed intervention programs that meet the specific needs of each child.
Tania works closely with a variety of professionals including speech pathologists, occupational therapists, psychiatrists, medical doctors and special education teachers
When should a child see a psychologist?
Professionals who are concerned about a child’s intellectual, behavioural, social and/or communication abilities should refer the child for assessment by a psychologist. This will provide information about whether the child is developing at an appropriate level for his or her age. For example, a child should be referred for assessment by a psychologist if he or she is exhibiting unusual levels of fear, stress, and anxiety; has difficulty socialising; is experiencing difficulties with learning; or is engaging in unusual behaviours.
What does an assessment involve?
A psychologist’s assessment of a child for ASC involves interviewing significant people in the child’s life. These people usually include parents, other carers, and teachers. The psychologist would also observe the child, often in different settings, and administer formal assessments. Depending on the situation, tests of intelligence and of adaptive behaviour may also be administered.
Areas that the psychologist will look at as part of this process include:
• how the child responds emotionally to physical contact;
• how the child responds to his or her name;
• use of eye contact, gestures, and facial expressions;
• evidence of unusual levels of fear, distress, or anxiety;
• evidence of stereotypical or repetitive body movements or mannerisms;
• the child’s ability to communicate wants and needs;
• unusual or intense interests in particular topics or activities and the child’s play;
• abnormal or repetitive use of language;
• the child’s capacity to express themselves and to reason and problem solve;
• the quality of the child’s interactions with adults and other children;
• the child’s ability to cope with everyday situations – for example a change in routine.
In addition, Tania assesses sensory processing issues, executive function, working memory, theory of mind, intelligence and talents, including investigating gifts, talents or special interests.
Some Formal assessment may involve the administration of instruments that have particular relevance to the diagnosis of ASC including:
• The Child Autism Rating Scale (CARS),
• Autism Detection in Early Childhood (ADEC),
• The Social Communication Questionnaire (SCQ),
• The Autism Diagnostic Observation Schedule (ADOS), and
• The Autism Diagnostic Interview — Revised (ADI-R)
In addition, psychologists often administer more general tests to gather information about the child’s developmental level and intellectual functioning such as:
• Psychoeducational Profile (PEP),
• Mullen Scales of Early Learning,
• Weschler Pre-school and Primary Scale of Intelligence (WPPSI),
• Wechsler Intelligence Scale for Children (WISC),
• Universal Nonverbal Intelligence Test, and
• Stanford-Binet Intelligence Test.
Psychologists also administer scales of adaptive functioning, such as the Vineland Adaptive Behaviour Scales.
Formal assessment provides the psychologist with a more comprehensive understanding of children’s difficulties, their intellectual abilities, and how they cope in everyday situations.
The psychologist considers the information collected during the assessment to determine if the child meets the criteria for autistic disorder, Asperger’s syndrome, or PDD-NOS — or whether a different diagnosis or further assessment is warranted.
Formal assessment or may not involve these assessment tools. It depends on the child, age and gender. Many of these tools are not sensitive enough to the female profile. In particular the ADOS may show elevated traits, however many females have missed out on their diagnosis due to the lack of sensitivity for females characteristics and traits.
What kind of treatments do psychologists who work with individuals with developmental conditions or Autism provide?
The information collected during the assessment also assists the psychologist in the development of a treatment plan that is tailored to the child’s needs.
Intervention by a psychologist is important for children with an ASC. Psychologists use a range of techniques including behavioural strategies, skills training, and emotional regulation to help children with ASC cope better in their everyday lives. Psychologists:
• use behavioural interventions to reduce specific behaviours that are undesirable, while simultaneously promoting new behaviours and skills that are desirable;
• provide social skill development using behavioural strategies and interventions such as social/behavioural scripts, role-play, and social stories to:
o improve interaction and communication skills including making eye contact, using appropriate greetings, developing listening and turn-taking skills;
o develop children’s awareness of their difficulties and emotions, and to increase understanding of social cues and conventional behaviour;
• work with parents, other carers, and professionals such as teachers to provide them with strategies to assist the child function better in the home, school and other environments;
• help children with ASC to manage their anxiety levels. Because children with ASC have difficulty understanding their environment and the behaviour of others, they are at risk of developing anxiety disorders. Psychologists work with children who have ASC, as well as with their families and other carers, to teach them how they can monitor and reduce anxiety;
• assist children throughout development as children with ASC often experience difficulties with transitions such the first year of school or entry into adolescence.
Tania also provides the following interventions but are not limited to:
• perspective taking and friendship
• mind reading
• understanding and expressing emotions
• development of special interests
• sensory sensitivity
• rigidity in thinking
• context blindness training
• theory of mind training
• executive function deficits
• sensory processing training
• teaching awareness of the child or adults sensory profile
• assists in the creation of a sensory coping kit and the utilization of these tools
• the “friendly” five
• the social hierarchy
• Intelligence testing
• Social stories training
• Comic strip conversations
• The CAT Kit
• The Secret Agent Society Materials (emotional, social intelligence, non-verbal body language, emotions, communication)