Martinez, E. M., & Spada, P. (2022). Multiple choice tests to assess academic achievements in Down Syndrome and autism spectrum disorder. A longitudinal single case study . International Journal of Disability, Development and Education , 69 (3), 807–821. https://doi.org/10.1080/1034912X.2020.1740184

The use of multiple choice tests to measure the academic ability of a nonverbal student with autism spectrum disorder, Down syndrome, and cerebellar damage was examined. Multiple choice tests (MCT) include questions with a fixed number of possible responses where only one of the responses is correct. MCTs are often used for students with communication impairments.

A male student, “A,” who was 14 years old at the start of the study in 2004 and 21 years old at the completion of the study in 2011, participated. He was born in Italy and was diagnosed with Down syndrome, autism spectrum disorder, and cerebellar damage, which caused motor coordination issues. He participated in a home-based early intervention program that targeted language and sign language since infancy to promote the development of language and communication skills. He learned around 10 signs at a young age to communicate, but this ability disappeared as signs of autism appeared. For a brief period, A moved to Colorado (U.S.) where he attended mainstream school, but he later returned to Italy and eventually moved to the U.K where he attended a specialized school.

A took 268 MCT on subjects determined by his teachers. For each test, three measures were computed. "Mark1" was the first measure and was computed by giving 1 point for each correct answer, no points for missed answers, and -1/(c-1) for each missed answer. The second measure, "Mark2,” was computed by calculating the ratio of correct answer to total number of questions with no error penalty. The third measure was the p-value, which indicated the probability that the score was achieved by random guessing.

The student's score was higher when measured using the Mark1 method, a difference that was marginally statistically significant. His mean accuracy was fairly constant throughout the years of the study. A's greatest gains were observed in science and spelling.