A registered psychologist has completed a minimum of six years of professional training. This training includes the completion of a four-year Australian Psychology Accreditation Council (APAC) endorsed university degree followed by an APAC endorsed postgraduate degree or two years supervised professional training. Through postgraduate and further training, some psychologists choose to specialise in assessing the intellectual, social and behavioural functioning of children, and in diagnosing and treating ASD.
The role of psychologists
Psychologists work with other health professionals including general practitioners, paediatricians and psychiatrists to identify and treat childhood disorders such as ASD. Psychologists use a range of assessment processes to determine whether individual children meet the criteria for an ASD, 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.
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 ASD 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.
Formal assessment may involve the administration of instruments that have particular relevance to the diagnosis of ASD 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.
What kind of treatments do psychologists 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 ASD. Psychologists use a range of techniques including behavioural strategies, skills training, and emotional regulation to help children with ASD 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 ASD to manage their anxiety levels. Because children with ASD have difficulty understanding their environment and the behaviour of others, they are at risk of developing anxiety disorders. Psychologists work with children who have ASD, 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 ASD often experience difficulties with transitions such the first year of school or entry into adolescence.