Importance of Assessment in Treatment Planning

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Jordan, Age 5

The Importance of Assessment in Treatment Planning By Mark Sundberg, Ph.D.

Every child with autism or other developmental disabilities presents unique needs and challenges. An important step in developing a treatment plan and curriculum for a child is a thorough assessment of his or her abilities, as well as the barriers that might be affecting learning. To establish a starting point in a language intervention program information should be obtained as to what the child can do

consistently and reliably, and how his or her skills compare to those of typically developing children. Can the child repeat words on command (e.g., say “Ball”) and imitate motor actions when asked to do so (e.g., claps when an adult claps)? Does the child use specific words to ask for items and actions when he or she wants them (e.g., “Drink”)? Does the child use words to name items he or she sees when asked to

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do so (e.g., When asked “What is that?” the child says, “Car”). Finally, can the child select a specific item from an array of items when asked to do so (e.g., “Find the dog”). These five early language skills, along with play skills, social skills, and matching-to-sample serve as the basis for most ABA (Applied Behavior Analysis) early intervention programs. While it is critical to assess the child’s skill strengths and weaknesses, it is also important to identify problem behaviors or other obstacles that may be in the way of progress. Thus, another step in assessment is to identify the barriers that the child may present (e.g., self-stimulation, rote responding, delayed echolalia, sensory defensiveness). For example, if a child tantrums in order to obtain desired items, actions, or attention, a program to reduce tantrums and teach more acceptable forms of communication (i.e., mands) is necessary. In addition, some children may become stuck or fail to use the skills they have learned. If the child initially made progress, but then seems to have plateaued it is important to look beyond a basic assessment of skills and be the “CSI” for the child. While behavior problems such as tantrums may be obvious, other less obvious behaviors may be in the way of effective teaching. A few questions that should be asked include: Does the child continue to need excessive prompting to complete an activity or skill? Does the child wait for reinforcement until moving on to the next step? Does the child use the skills they have learned in a natural and functional way? Once the child’s skills and barriers are identified, intervention priorities can be established. In cases where the child exhibits problem behaviors such as


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tantrums, a functional assessment and curriculum to teach replacement behaviors should be a priority. If the child does not use words to request things he wants, then a priority will be to teach the child that particular language skill. In addition, some children with articulation disorders may benefit from the use of augmentative communication such as sign language or PECS. Thus, a wellplanned intervention program will contain a combination of procedures designed to increase desired skills and behaviors, as well as procedures to reduce barriers that impede learning, language, and social skills.

“Once the child’s skills and barriers are identified, intervention priorities can be established.” Children and adults with more advanced language and social skills can also benefit from a comprehensive assessment. These skills become increasingly complicated as they learn how to master skills such as initiating verbal interactions and engaging in conversations in less structured settings. An assessment can help to establish priorities and designing a long-term intervention program. Behavior analysis (ABA) in general, and a behavioral analysis of language provide valuable tools for establishing and guiding intervention programs for children with autism.

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