The psychological assessment is an important component of the diagnostic evaluation in young children suspected of having an autism spectrum disorder but can be hampered by behavioral difficulties. Overt behaviors during administration of the Mullen Scales of Early Learning were coded in 22 preschoolers with an autism spectrum disorder and 20 age-matched typically developing children. Children in the autism spectrum disorder group required less time to complete the assessment but spent proportionally more time exhibiting off task behaviors and less time engaged with the assessment. Scores obtained on the Mullen Scales were positively correlated with level of engagement and negatively correlated with off task behaviors.Assessing young children can be difficult, particularly when one considers the type of test behavior required for a psychological evaluation (Culbertson & Willis, 1993). Young children who are referred for a developmental evaluation because they appear to have features of autism can be particularly challenging, given their limited social interaction and communication skills (Marcus, Lansing, & Schopler, 1993; National Research Council, 2001). Many features and behavior problems can further interfere with the accurate assessment of a young child's cognitive abilities, including difficulty maintaining attention, overactivity, sensory issues, and poor compliance, particularly in an unfamiliar setting. Young children with autism can be easily frustrated, and may not appear "eager to please" due to their social difficulties or limited understanding of what is being asked of them.It is critical to identify cognitive strengths and weaknesses and developmental delays in the young child suspected of an autism spectrum disorder (ASD) as part of the initial diagnostic workup and to assist with treatment planning. With preschoolers, IQ scores are more limited in their predictive value. It is therefore important to consider what skills may be "emerging" and that the child may be more capable than they are able to demonstrate during the assessment session. However, it is often this inconsistency in behavior that interferes with the learning process in these children. The process of administering a standardized psychological test can therefore give the clinician a great deal of information about the child's abilities as well as their behavioral difficulties.While experienced clinicians can identify the behaviors associated with an autism spectrum disorder in very young children, it is more difficult to make distinctions between a diagnosis of Autistic Disorder or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) (Lord & Risi, 1998; National Research Council, 2001). A proportion of the children identified with ASD before age three may not meet criteria for DSM-IV Autistic Disorder at later follow-up but are highly likely to meet criteria for PDD-NOS, a less severe form of autism (Cox et al., 1999;Lord, 1995;Stone et al., 1999
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