According to the National Autism Association, diagnosis of autism in children has steadily increased in the past 20 years. In the United States, about 1 in 36 students learn, communicate, and interact differently in school than their neurotypical peers. Unfortunately, conventional school environments are not terribly conducive to supporting neurodivergent students. How can we ensure our kids are getting the help they need throughout their education?
We spoke with special education advocate and owner of KnowIEPs Dr. Sarah Pelangka (BCBA-D) to learn more about the supports available to kids with autism and how to ask for them.
There are 13 qualifying eligibility categories for special education services, one of which is autism. According to the IDEA’s definition, autism is “a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s educational performance.”
Remember: Schools can assess whether a student meets the eligibility criteria for an IEP, but they cannot medically diagnose a child. It’s important to understand that the criteria a child must meet to be eligible for special education under autism is not the same as the criteria for a medical diagnosis of autism.
“It is possible for a child to hold a medical diagnosis of autism and not qualify for special education services under autism per the Ed Code,” Dr. Pelangka tells us. “This can happen, for example, when a student’s primary area of difficulty is attention/hyperactivity/distractibility and the team offers an Other Health Impairment (OHI) eligibility, as opposed to an autism eligibility, or when the team doesn’t see the symptoms of autism in the school setting at all.”
Conversely, if a school team evaluates a student and finds the student eligible under autism, but the student has yet to be evaluated for a medical diagnosis, families should have their child assessed by a specialist such as a developmental pediatrician or a child psychologist, pediatric neuropsychologist, or pediatric neurologist. Keep in mind that it’s relatively common for children with autism to have other co-occurring conditions that may complicate an autism diagnosis, including ADHD, medical and mental health conditions, sleep disorders, and mood and anxiety disorders.
In this clip, Dr. Pelangka explains how a student with autism qualifies for special education services:
To qualify for special education services through an Individualized Education Program (IEP), a student will receive a multidisciplinary set of assessments conducted by a school psychologist, special education teacher, and any additional service providers that are relevant to the student’s needs such as speech, occupational, behavioral, and physical therapists.
The school will gather information from a school psychologist, any relevant therapists such as a speech-language pathologist, teachers, parents, and others. Families should share any relevant medical history and observational information they have. A school psychologist will administer questionnaires (such as ASRS, CARS, or GARS) that accompany autism eligibility. Certain school psychologists are certified in completing the Autism Diagnostic Schedule (ADOS), but this isn’t true for all.
“The school psychologist or school team cannot just tell you what diagnosis the student qualifies under and move on,” Dr. Pelangka says. “Per the law, it is a team discussion — and you are a part of the team. Also, if the team failed to complete an ADOS as part of the assessment, don’t agree with the evaluation and request that the ADOS be done by a qualified psychologist.” Listen to Dr. Pelangka break down the importance of the ADOS here:
In some cases, a child’s behaviors can be misinterpreted as autism or mistaken for diagnoses other than autism. Sometimes, a child’s behaviors can lead to a lack of diagnosis all together. This is especially true when it comes to girls and children of color. We all carry around plenty of unconscious biases or learned beliefs in our subconscious, and this can also play into how or whether children are accurately assessed at school.
If you believe that the school psychologist assigned to your child’s case is not qualified to assess students with autism, you can request an alternate assessor who is experienced in supporting students with autism.
If you disagree with the district’s assessment results because you believe their assessment was not thorough enough, you have the right to request an Independent Educational Evaluation (IEE). An IEE is a comprehensive assessment conducted conducted at the district’s expense by a qualified clinician, such as a psychologist or neuropsychologist, who is not associated with the school district. (Note that the school is required to consider its findings; however, they are not required to act on its recommendations.)
Having an autism diagnosis should not automatically disqualify a family from discussing all placement options during the IEP, from inclusion in general education to a more specialized setting. Most students with autism are likely to have behaviors that impede their learning. If a student’s behavior is the primary cause for concern, and the IEP team believes a change in placement would be appropriate because of those behaviors, a Functional Behavioral Assessment (FBA) helps everyone stop and listen to what kids are trying to say with their behavior.
Often, when behaviors are present, there are other underlying deficits in place, such as communication deficits, underlying learning needs, sensory needs, etc. An FBA can help determine if the child could benefit from a behavioral intervention or support plan (BIP or BSP), which will then be written into the IEP. (Keep in mind that not only does an FBA identify behaviors, but it can also show the absence of them.)
If the student’s plan is intricate and/or requires a high level of consistency, a paraeducator trained in behavior support may be added as a related service. If so, it is important that you ensure behavior supervision minutes are also added to the IEP. Supervision minutes include the minutes that the district’s BCBA/Behavior Specialist comes out to the site to train the staff and aide.
A small number of students with autism may engage in severe behaviors that harm themselves or others. For those students, an FBA is essential to identify the function(s) of the behaviors and to support the development of a comprehensive or tier 3 behavior plan. Students with more significant behavior needs may also benefit from aide support.
Before a change in placement, It’s important to consider all other services and supports that may prove to be of benefit to the student, including but not limited to assistive technology supports, augmentative communication supports, intensive counseling, etc.
An IEP can provide support for mental health conditions such as anxiety, but some students with autism may need additional resources. In the state of California, a student cannot be identified as having both autism and emotional disturbance (ED) on an IEP unless autism is primary. Although it is relatively common for students with autism to have co-occurring diagnoses, the CA Ed Code states that the deficits that present in autism need to be accounted for and identified before considering emotional disturbance as the cause of behaviors.
For example, one of the five qualifiers for an emotional disturbance diagnosis is “an inability to build or maintain satisfactory interpersonal relationships with peers and teachers.” If a student has autism, which is a social-communicative disorder, the school psychologist has to prove that the student’s inability to maintain social relationships is not a direct result of their autism before labeling the student as ED. If a student does qualify under both autism and ED, the team may consider an ED-specific placement, as it may be the only way the student can access the specific supports they need to remain safe and thrive while at school.
Supports provided in an ED class that may not be offered in a traditional autism/behavior class include:
“A common misstep taken by IEP teams is misqualifying students with emotional disturbance and instead recommending placement in an emotional disturbance program,” Dr. Pelangka says. “This is unacceptable for many reasons and may even speak to the question of bias. In my opinion, this is an effort to get a student out of their current setting. Emotional disturbance is a very heavy label and can be stigmatizing.”
In other words, educators can misunderstand students with an emotional disturbance label and decide they cannot accommodate them, so the students are referred out to other programs or even other schools. “I see this happen most often when students exhibit outwardly challenging behaviors such as aggression or verbal aggression,” Dr. Pelangka says. “General education teachers and many SpEd teachers just don’t have the support they need to adequately ensure a safe and successful learning environment, not only for that child but the remainder of the students within the classroom. A consideration of ED is then brought to the table, and the recommendation for a change in placement occurs as a result of that label.”
Many students with autism benefit from individualized services and supports provided through an Individualized Education Plan, or IEP. For a small number of students with autism, a 504 plan may be sufficient. Because the needs of a student with autism are determined on a case-by-case basis, keep in mind that these services and supports will never be one-size-fits-all.
Many students who qualify for special education under autism eligibility may benefit from the following services:
Remember that the amount of time a student needs to make meaningful progress in a particular area is a discussion to be had as a team, knowing that services mean time pulled away from academic instruction.
As for behavior support, Dr. Pelangka says, “It’s important to understand that a student will not receive behavior intervention services through their IEP unless they manifest pretty significant behavior needs. This includes students who require frequent oversight and check-ins by a behavior specialist to manage their behavior, students who have tier 2 or 3 behavior plans, and students who have crisis management plans.”
For a complete list of related services and what they provide, read our article What Are Related Services in an IEP?
The most common accommodations that help students with autism achieve academic success include:
Dr. Pelangka reminds us that anything that has to be specifically purchased or made for a student technically qualifies as assistive technology. This can include low-tech visuals (schedules, token boards, checklists, etc.) as well as high-tech word processing software (predictive text, text-to-speech, and speech-to-text), AAC apps and devices, and more. Check out our list of assistive tech tools as well as our list of example IEP and 504 accommodations for many more ways to support kids in school.
In order for any service to be implemented, a service provider needs to be attached to an IEP goal. Service minutes are dependent on goals — the more goals there are in any given area, the more service minutes the student will need to meet said goals.
Goals will be individualized to meet each individual student’s needs, and they should be meaningful, measurable, appropriately challenging, and aligned with a student’s strengths, needs, and interests. Here’s an example of a goal that is written to support a child in building self-regulation skills:
By (annual due date), in the classroom setting, when given a menu of self-regulation strategies and when suggested to take a break before and/or during whole group instruction, Sarah will select and engage in a self-regulating strategy for at least one minute before returning to group, in 80% of opportunities over a two-week period, as measured by observation data.
If there are specific tools and accommodations the student needs in order to achieve a goal, Dr. Pelangka says it’s important to ensure that those accommodations are written into the goal. This will hold the school team accountable and make sure the child has access to those accommodations when they need them.
Check out our article How to Write IEP Goals for more strategies and printable templates for writing effective goals.
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