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High-Functioning Autism Spectrum Disorder: A Framework for Evidence-Based Practice

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Abstract

Schools are being confronted with an increasing population of high-functioning students with autism spectrum disorder (HFASD). These students pose particular challenges to school-based practitioners and teachers given their social-communication deficits, restricted and repetitive behaviors/interests, and relative cognitive and language strengths. This article examines the impact of HFASD at the student, classroom, and district levels, and existing evidence-based strategies and techniques to improve social competence and daily functioning. It then proposes a comprehensive intervention framework for school practitioners and provides an example of a model comprehensive school-based program. Future directions and areas in need of study are also discussed.

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References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

    Book  Google Scholar 

  • Ashburner, J., Ziviani, J., & Rodger, S. (2008). Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder. American Journal of Occupational Therapy, 62, 564–573. https://doi.org/10.5014/ajot.62.5.564.

    Article  PubMed  Google Scholar 

  • Ashburner, J., Ziviani, J., & Rodger, S. (2010). Surviving in the mainstream: Capacity of children with autism spectrum disorders to perform academically and regulate their emotions and behavior at school. Research in Autism Spectrum Disorders, 4, 18–27. https://doi.org/10.1016/j.rasd.2009.07.002.

    Article  Google Scholar 

  • Attwood, T., & Scarpa, A. (2013). Modifications of cognitive-behavioral therapy for children and adolescents with high-functioning ASD and their common difficulties. In A. Scarpa, S. W. White, & T. Attwood (Eds.), CBT for children and adolescents with high-functioning autism spectrum disorders (pp. 27–44). New York, NY: Guilford.

    Google Scholar 

  • Baron-Cohen, S., Golan, O., Wheelwright, S., & Hill, J. J. (2004). Mind reading: The interactive guide to emotions. London: Jessica Kingsley Publishers.

    Google Scholar 

  • Bauminger-Zviely, N. (2014). School-age children with ASD. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelfrey (Eds.), Handbook of autism and pervasive developmental disorders: Vol 2: Assessment, interventions, and policy (4th ed., pp. 1029–1042). New York: Wiley.

    Google Scholar 

  • Bellini, S., & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73(3), 264–287. https://doi.org/10.1177/001440290707300301.

    Article  Google Scholar 

  • Bellini, S., Gardner, L., & Markoff, K. (2014). Social skill interventions. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelfrey (Eds.), Handbook of autism and pervasive developmental disorders Vol 2: Assessment, interventions, and policy (4th ed., pp. 858–870). New York: Wiley.

    Google Scholar 

  • Bellini, S., Peters, J. K., Benner, L., & Hopf, A. (2007). A meta-analysis of school-based social skills intervention for children with autism spectrum disorders. Remedial and Special Education, 28(3), 153–162. https://doi.org/10.1177/07419325070280030401.

    Article  Google Scholar 

  • Center for Disease Control and Prevention (CDC). (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 states, United States, 2010. MMWR, 63(SS-2), 1–21.

    Google Scholar 

  • Chan, J. M., Lang, R., Rispoli, M., O’Reilly, M., Sigafoos, J., & Cole, H. (2009). Use of peer-mediated interventions in the treatment of autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 3, 876–889. https://doi.org/10.1016/j.rasd.2009.04.003.

    Article  Google Scholar 

  • Chang, Y., & Locke, J. (2016). A systematic review of peer-mediated interventions for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 27(2016), 1–10. https://doi.org/10.1016/j.rasd.2016.03.2010.

    Article  PubMed  PubMed Central  Google Scholar 

  • Church, C., Alisanski, S., & Amanullah, S. (2000). The social, behavioral, and academic experiences of children with Asperger’s syndrome. Focus on Autism and Other Developmental Disabilities, 15(1), 12–20. https://doi.org/10.1177/108835760001500102.

    Article  Google Scholar 

  • Davis, J. L., Mason, B. A., Davis, H. S., Mason, R. A., & Crutchfield, S. A. (2016). Self-monitoring interventions for students with ASD: A meta-analysis of school-based interventions. Review Journal of Autism and Developmental Disorders, 3(3), 196–208. https://doi.org/10.1007/s40489-016-0076-y.

    Article  Google Scholar 

  • de Bruin, C. L., Deppeler, J. M., Moore, D. W., & Diamond, N. T. (2013). Public school-based interventions for adolescents and young adults with an autism spectrum disorder: A meta-analysis. Review of Educational Research, 83(4), 521–550. https://doi.org/10.3102/0034654313498621.

    Article  Google Scholar 

  • Gates, J. A., Kang, E., & Lerner, M. D. (2017). Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis. Clinical Psychology Review, 52, 164–181. https://doi.org/10.1016/j.cpr.2017.01.006.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goldstein, A. P., McGinnis, E., Sprafkin, R. P., Gershaw, N. J., & Klein, P. (1997). Skillstreaming the adolescent: New strategies and perspectives for teaching prosocial skills (Rev ed.). Champaign, IL: Research Press.

    Google Scholar 

  • Gresham, F. M., Sugai, G., & Horner, R. H. (2001). Interpreting outcomes of social skills training for students with high-incidence disabilities. Exceptional Children, 67(3), 331–344. https://doi.org/10.1177/001440290106700303.

    Article  Google Scholar 

  • Humphrey, N., & Lewis, S. (2008). ‘Make me normal’: The views and experiences of pupils on the autistic spectrum in mainstream secondary schools. Autism, 12(1), 23–46. https://doi.org/10.1177/1362361307085267.

    Article  PubMed  Google Scholar 

  • Kasari, C., Dean, M., Kretzmann, M., Shih, W., Orlich, F., Whitney, R., et al. (2016). Children with autism spectrum disorder and social skills groups at school: A randomized trial comparing intervention approach and peer composition. Journal of Child Psychology and Psychiatry, 57(2), 171–179. https://doi.org/10.1111/jcpp.12460.

    Article  PubMed  Google Scholar 

  • Kasari, C., Rotheram-Fuller, E., Locke, J., & Gulsrud, A. (2012). Making the connection: randomized controlled trial of social skills at school for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 53(4), 431–439. https://doi.org/10.1111/j.1469-7610.2011.02493.x.

    Article  PubMed  Google Scholar 

  • Kasari, C., & Smith, T. (2013). Interventions in schools for children with autism spectrum disorder: Methods and recommendations. Autism, 17(3), 254–267. https://doi.org/10.1177/1362361312470496.

    Article  PubMed  Google Scholar 

  • Kim, S. H., Paul, R., Tager-Flusberg, H., & Lord, C. (2014). Language and communication in autism. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelfrey (Eds.), Handbook of autism and pervasive developmental disorders: Vol 1: Diagnosis, development, and brain mechanisms (4th ed., pp. 230–262). New York: Wiley.

    Google Scholar 

  • Klin, A., Danovitch, J. H., Merz, A. B., & Volkmar, F. R. (2007). Circumscribed interests in higher-functioning individuals with autism spectrum disorders: An exploratory study. Research and Practice for Persons with Severe Disabilities, 32(2), 89–100. https://doi.org/10.2511/rpsd.32.2.89.

    Article  Google Scholar 

  • Klin, A., Sparrow, S. S., Marans, W. D., Carter, A., & Volkmar, F. R. (2000). Assessment issues in children and adolescents with Asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 309–339). New York: Guilford.

    Google Scholar 

  • Klin, A., & Volkmar, F. R. (2000). Treatment and intervention guidelines for individuals with Asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 340–366). New York: Guilford.

    Google Scholar 

  • Koegel, L., Matos-Freeden, R., Lang, R., & Koegel, R. (2012). Interventions for children with autism spectrum disorders in inclusive school settings. Cognitive and Behavioral Practice, 19(3), 401–412. https://doi.org/10.1016/j.cbpra.2010.11.003.

    Article  Google Scholar 

  • Kokina, A., & Kern, L. (2010). Social Story™ interventions for students with autism spectrum disorders: A meta-analysis. Journal of Autism and Developmental Disorders, 40, 812–826. https://doi.org/10.1007/s10803-009-0931-0.

    Article  PubMed  Google Scholar 

  • Lecavalier, L. (2014). Phenotypic variability in autism spectrum disorder: Clinical considerations. In T. E. Davis, S. W. White, & T. H. Ollendick (Eds.), Handbook of autism and anxiety (pp. 15–29). New York: Springer.

    Google Scholar 

  • Leekam, S. R., Prior, M. R., & Uljarevic, M. (2011). Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade. Psychological Bulletin, 137(4), 562–593. https://doi.org/10.1037/a0023341.

    Article  PubMed  Google Scholar 

  • Locke, J., Olsen, A., Wideman, R., Downey, M. M., Ketzmann, M., Kasari, C., et al. (2015). A tangled web: The challenges of implementing an evidence-based social engagement intervention for children with autism in urban public school settings. Behavior Therapy, 46(1), 54–57. https://doi.org/10.1016/j.beth.2014.05.001

    Article  PubMed  Google Scholar 

  • Lopata, C., Thomeer, M. L., Volker, M. A., & Lee, G. K. (2013a). A manualized summer program for social skills in children with high-functioning ASD. In A. Scarpa, S. W. White, & T. Attwood (Eds.), CBT for children and adolescents with high-functioning autism spectrum disorders (pp. 199–225). New York, NY: Guilford.

    Google Scholar 

  • Lopata, C., Thomeer, M. L., Volker, M. A., Lee, G. K., Smith, T. H., Rodgers, J. D., et al. (2013b). Open-trial pilot study of a comprehensive school-based intervention for high-functioning autism spectrum disorders. Remedial and Special Education, 34(5), 269–281. https://doi.org/10.1177/0741932512450518.

    Article  Google Scholar 

  • Lopata, C., Thomeer, M. L., Volker, M. A., Lee, G. K., Smith, T. H., Smith, R. A., et al. (2012). Feasibility and initial efficacy of a comprehensive school-based intervention for HFASDs. Psychology in the Schools, 49(10), 963–974. https://doi.org/10.1002/pits.21649.

    Article  Google Scholar 

  • Lopata, C., Toomey, J. A., Fox, J. D., Volker, M. A., Chow, S. Y., Thomeer, M. L., et al. (2010). Anxiety and depression in children with HFASDs: Symptom levels and source differences. Journal of Abnormal Child Psychology, 38(6), 765–776. https://doi.org/10.1007/s10802-010-9406-1.

    Article  PubMed  Google Scholar 

  • Marriage, K. J., Gordon, V., & Brand, L. (1995). A social skills group for boys with Asperger’s syndrome. Australian and New Zealand Journal of Psychiatry, 29, 58–62. https://doi.org/10.3109/00048679509075892.

    Article  PubMed  Google Scholar 

  • Martins, M., Harris, S. L., & Handelman, J. S. (2014). Support inclusive education. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelfrey (Eds.), Handbook of autism and pervasive developmental disorders Vol 2: Assessment, interventions, and policy (4th ed., pp. 858–870). New York: Wiley.

    Google Scholar 

  • McCoy, A., Holloway, J., Healy, O., Rispoli, M., & Neely, L. (2016). A systematic review and evaluation of video modeling, role-play and computer-based instruction as social skills interventions for children and adolescents with high-functioning autism. Review Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s40489-015-0065-6.

    Article  Google Scholar 

  • McDonald, C. A., Lopata, C., Nasca, B., Donnelly, J. P., Thomeer, M. L., & Rodgers, J. D. (2016). ABAS-II adaptive profiles and correlates in samples of children with HFASD and LFASD. Journal of Developmental and Physical Disabilities, 28(5), 769–783. https://doi.org/10.1007/s10882-016-9508-y.

    Article  Google Scholar 

  • McGinnis, E., & Goldstein, A. P. (1997). Skillstreaming the elementary school child: New strategies and perspectives for teaching prosocial skills (Rev ed.). Champaign, IL: Research Press.

    Google Scholar 

  • National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: National Autism Center.

    Google Scholar 

  • O’Neill, R. E., Jenson, W. R., & Radley, K. C. (2014). Interventions for challenging behaviors. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelfrey (Eds.), Handbook of autism and pervasive developmental disorders Vol 2: Assessment, interventions, and policy (4th ed., pp. 858–870). New York: Wiley.

    Google Scholar 

  • Odom, S. L., Boyd, B. A., Hall, L. J., & Hume, K. (2010). Evaluation of comprehensive treatment models for individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 40(4), 425–436. https://doi.org/10.1007/s10803-009-0825-1.

    Article  PubMed  Google Scholar 

  • Ostmeyer, K., & Scarpa, A. (2012). Examining school-based social skills program needs and barriers for student with high-functioning autism spectrum disorders using participatory action research. Psychology in the Schools, 49(10), 932–940. https://doi.org/10.1002/pits.21646.

    Article  Google Scholar 

  • Reichow, B. (2011). Development, procedures, and application of the evaluative method for determining evidence-based practices in autism. In B. Reichow, P. Doehring, D. V. Cicchetti, & F. R. Volkmar (Eds.), Evidence-based practices and treatments for children with autism (pp. 25–39). New York: Springer.

    Chapter  Google Scholar 

  • Reichow, B., & Barton, E. E. (2014). Evidence-based psychosocial interventions for individuals with autism spectrum disorders. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelfrey (Eds.), Handbook of autism and pervasive developmental disorders Vol 2: Assessment, interventions, and policy (4th ed., pp. 858–870). New York: Wiley.

    Google Scholar 

  • Reichow, B., Steiner, A. M., & Volkmar, F. R. (2012). Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD). Evidence-Based Child Health, 7, 266–315. https://doi.org/10.4073/csr.2012.16.

    Article  Google Scholar 

  • Reichow, B., & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40(2), 149–166. https://doi.org/10.1007/s10803-009-0842-0.

    Article  PubMed  Google Scholar 

  • Reynhout, G., & Carter, M. (2006). Social Stories™ for children with disabilities. Journal of Autism and Developmental Disorders, 36, 445–469. https://doi.org/10.1007/s10803-006-0086-1.

    Article  PubMed  Google Scholar 

  • Rotheram-Fuller, E., & MacMullen, L. (2011). Cognitive-behavioral therapy for children with autism spectrum disorders. Psychology in the Schools, 48(3), 263–271.

    Article  Google Scholar 

  • Sansosti, F. J. (2010). Teaching social skills to children with autism spectrum disorders using tiers of support: A guide for school-based professionals. Psychology in the Schools, 47(3), 257–281. https://doi.org/10.1002/pits.20469.

    Article  Google Scholar 

  • Sansosti, F. J., Powell-Smith, K. A., & Kincaid, D. (2004). A research synthesis of social story interventions for children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19(4), 194–204. https://doi.org/10.1177/10883576040190040101.

    Article  Google Scholar 

  • Sansosti, J. M., & Sansosti, F. J. (2012). Inclusion for students with high-functioning autism spectrum disorders: Definitions and decision making. Psychology in the Schools, 49(10), 917–931. https://doi.org/10.1002/pits.21652.

    Article  Google Scholar 

  • Smith-Myles, B., & Simpson, R. L. (2001). Understanding the hidden curriculum: An essential social skill for children and youth with Asperger syndrome. Intervention in School and Clinic, 36(5), 279–286. https://doi.org/10.1177/105345120103600504.

    Article  Google Scholar 

  • Solish, A., Perry, A., & Minnes, P. (2010). Participation of children with and without disabilities in social, recreational, and leisure activities. Journal of Applied Research in Intellectual Disabilities, 23, 226–236. https://doi.org/10.1111/j.1468-3148.2009.00525.x.

    Article  Google Scholar 

  • Thomeer, M. L., Lopata, C., Donnelly, J. P., Booth, A. J., Shanahan, A., Federiconi, V., et al. (2016). Community effectiveness RCT of a comprehensive psychosocial treatment for high-functioning children with ASD. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1080/15374416.2016.1247359.

    Article  PubMed  Google Scholar 

  • Volker, M. A., Lopata, C., Smerbeck, A. M., Knoll, V., Thomeer, M. L., Toomey, J. A., et al. (2010). BASC-2 PRS profiles for students with high-functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 40(2), 188–199. https://doi.org/10.1007/s10803-009-0849-6.

    Article  PubMed  Google Scholar 

  • Volkmar, F. R., & Klin, A. (2000). Diagnostic issues in Asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 25–71). New York: Guilford.

    Google Scholar 

  • Whalon, K. J., Conroy, M. A., Martinez, J. R., & Werch, B. L. (2015). School-based peer-related social competence interventions for children with autism spectrum disorder: A meta-analysis and descriptive review of single case research design studies. Journal of Autism and Developmental Disorders, 45(6), 1513–1531. https://doi.org/10.1007/s10803-015-2373-1.

    Article  PubMed  Google Scholar 

  • Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., et al. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z.

    Article  PubMed  Google Scholar 

  • Zhang, J., & Wheeler, J. J. (2011). A meta-analysis of peer-mediated interventions for young children with autism spectrum disorders. Education and Training in Autism and Developmental Disabilities, 46(1), 62–77. Retrieved from http://www.jstor.org.gate.lib.buffalo.edu/stable/23880031.

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Acknowledgements

Some of the data reported in this article was supported by Department of Education, Institute of Education Sciences Grant R324A130216. Findings and conclusions are those of the authors and do not necessarily reflect the views of the funding agency.

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Authors and Affiliations

  1. Institute for Autism Research, Canisius College, 2001 Main Street, Buffalo, NY, 14208, USA

    Marcus L. Thomeer, Christin A. McDonald, Jonathan D. Rodgers & Christopher Lopata

  2. Center for Autism Spectrum Disorders, Nationwide Children’s Hospital, Westerville, OH, USA

    Christin A. McDonald

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  1. Marcus L. Thomeer
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  2. Christin A. McDonald
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  3. Jonathan D. Rodgers
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  4. Christopher Lopata
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Correspondence to Marcus L. Thomeer.

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Thomeer, M.L., McDonald, C.A., Rodgers, J.D. et al. High-Functioning Autism Spectrum Disorder: A Framework for Evidence-Based Practice. School Mental Health 11, 29–39 (2019). https://doi.org/10.1007/s12310-017-9236-1

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