Translating Evidence-Based Research Findings into Effective

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Translating Evidence-Based Research Findings into
Effective Intervention Practices for Individuals
with Autism Spectrum Disorders

• Diane Twachtman-Cullen, Ph.D., CCC-SLP
• Editor-in-Chief, Autism Spectrum Quarterly
• www.ASQuarterly.com
• ADDCON Center, LLC
• P.O. Box 709
• Higganum, CT 06441-0709
• Telephone [phone] Fax [phone]
• E-Mail addconcenter_at_snet.net

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Autism Spectrum Quarterly (ASQ)

• The Magajournal
• www.ASQuarterly.com
• Much of the information presented in this
  workshop has been reported on in Autism Spectrum
  Quarterly

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(No Transcript)
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The Agenda

• Science and pseudoscience
• Factors to consider regarding autism intervention
• Quality indicators for evidence-based practice
• Research related to key deficit areas in autism
  vis-à-vis quality indicators for EBP
• Evidence-based intervention snapshots
• The take-home messages

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Parents Beware The Downside of Autism Awareness

• It became instantly clear to me that families
  like mine are now a preyed-upon marketing
  demographicseemingly easy victims for less than
  ethical people.
• Amber Kane, Autism Connection
• Autism Spectrum Quarterly,
  Summer, 2008 pp 24-25

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What Have You Got to Lose?

• Ive come to see this as the most devastating
  question . . . Dont listen! WE HAVE A LOT TO
  LOSE. . . .Dont allow yourself to fall for
  marketing that offers optimism or perpetrates
  pessimism. It is our responsibility to sit
  midway on this spectrum of treatment choices and
  hover in the realm of realism.
• Amber Kane, Autism Connection
• Autism Spectrum Quarterly,
  Summer, 2008 pp. 24-25

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Science

• A set of methods designed to describe and
  interpret observed or inferred phenomena, past or
  present, and aimed at building a testable body of
  knowledge open to rejection or confirmation.
• Michael Shermer
• Why People Believe Weird Things

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Parents Beware Pseudoscience

• Relies on anecdotal evidence / testimonials often
  draped in scientific jargon
• Face-value acceptance
• May advance the idea that certain things just
  cant be tested
• Often uses emotive words (cure, recovery)
• Extremely resistant to change (true believer)

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DISCLAIMER!

• There is a vast difference between trying
  something to increase the comfort level of the
  individual with autism and claiming that it is
  the be all, end all CURE for autism.

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Facilitated Communication The Undisputed
Darling of Media Hype

• Call it a miracle. Call it an awakening.
  -Diane Sawyer, Prime Time
• At present, there are no scientifically
  controlled studies that unambiguously support
  benefits in expressive language function for
  people with mental retardation or autism by
  taking part in FC.
• Mulick, Jacobson, and Kobe (1993)

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The Unlearned Lesson from FC

• The dangers inherent in relegating scientific
  scrutiny to the scrap heap while elevating
  subjectivity and hype to the level of an art form
  may go undetected amid the evangelistic fervor of
  the moment. Such unrecognized dangers are
  nevertheless critical. Saying something is or is
  not so does not make it so. It is only through
  scientific investigation that one manages to get
  closer to what actually is.
• Diane Twachtman-Cullen, Ph.D., CCC-SLP
• A Passion to Believe Autism and the
  Facilitated Communication Phenomenon

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• Five Important Factors to Consider Regarding
  Autism Intervention Services

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1. Autism is a multi-faceted disorder and
as such, it requires a multi-faceted treatment
approach.
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Comprehensive Treatment

• Communication / Language Issues
• Social Behavior
• Sensory Issues
• Behavioral Issues
• Executive Function Deficits
• Theory of Mind Deficits
• Accompanying Physical Conditions

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• 2. Intervention practices should be rooted in,
  and informed by high-quality research across
  several fields.

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• Language Development
• Child Development
• Psychology / Neuropsychology
• Autism Literature
• Behavioral Literature

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• Attention to only one small aspect of the
  research literature is myopic and misleading.
• The mantra that ABA is the ONLY intervention in
  autism that has research evidence behind it is
  seriously misleading and the likely result of a
  very narrow research focus.
• Triangulating relevant research across several
  fields is a best practice approach to
  intervention.

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• 3. One size does NOT fit all!

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If You Know One Child with Autism, You Know How
Autism Affects One Child!

• According to the National Research Council,
• Studies have reported substantial changes in
  large numbers of children receiving a variety of
  intervention approaches, ranging from behavioral
  to developmental.
• Barry M. Prizant, Ph.D.

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Characteristics of Effective Interventions

• According to the National Research Council, six
  kinds of interventions should have priority
• Functional, spontaneous communication
• Social instruction in various settings
• 3. Play skills (appropriate use of toys and play
  with peers) leisure skills for older individuals

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Characteristics of Effective Interventions

• According to the National Research Council, six
  kinds of interventions should have priority
• 4. Instruction leading to generalization and
  maintenance in natural contexts
• 5. Positive approaches regarding problem
  behavior
• 6. Functional academic skills when appropriate

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• In order for an intervention method to be
  considered effective, there must be functional
  application of skills in real-world settings
  (generalization).
• Needs to be a component that involves application
  of the skill
• Can be done via parent training, and/or including
  a functional training component within the
  therapeutic setting

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• 5. Effective interventions in autism require
  direct and sustained attention to the core
  deficits associated with the syndrome.

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What Are the Core Features of Autism?

• Deficits in the understanding and use of language
• Deficits in social understanding and expression
  and social relatedness

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ASHA Position Statement

• Evidence-based practice refers to an approach in
  which current, high-quality research evidence is
  integrated with practitioner expertise and client
  preferences and values into the process of making
  clinical decisions.
• ASHA, 2005

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What Does EBP Mean for Individuals with ASD?

• According to Attorney Wayne Steedman of
  Wrightslaw, new language in IDEA 2004 creates
  a new requirement that instructional practices or
  interventions be based on accepted research.
• Autism Spectrum Quarterly
• Summer, 2006

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Quality Indicators for EBP

• The 1 1 Correspondence Test
• The Concordance Test
• The Goodness of the Fit Test

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Connecting the Research Dots to Create
Intervention Snapshots

• How Can Research Findings Related to the Role of
  Experience in Brain Development Inform
  Intervention Practices in Autism?

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Research into Experiential Learning

• Early experiences have the capacity to influence
  the structure and formation of the brain.
• W.T. Greenough J.E. Black (1992).
• Induction of Brain Structure by Experience
• Substrates for Cognitive Development.
• Developmental Behavioral Neuroscience, 24
• pp 155-299
• Time Magazine, February 3, 1997

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The Take Home Message

• Experience shapes brains, but you need to
  interact with the experience.
• Jane Holmes Bernstein, M.D.

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• Mere exposure to an enriched environment will
  not suffice. Direct interaction with it is
  required to produce cerebral i.e., cognitive /
  brain effects.
• Eric Shopler, Founder of Division TEACCH

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Caution

• It has to be the right type of experience,
  delivered at the right time!

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The Downside Risks of Inappropriate Developmental
Practices

• Trying to drill higher-level learning into
  immature brains may force them to perform with
  lower-level systems and thus impair the skill in
  question.
• Jane M. Healy, Ph.D.
• Endangered Minds

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Experiential Research (continued)

• Studies demonstrate an increase in metabolic
  activity in those areas of the brain having to do
  with emotional regulation, interaction, and
  sequencing at the time when infants are involved
  in reciprocal interactions, choice-making, and
  search behavior.
• M.A. Bell N.A. Fox (1994).
• Brain Development Over the First Year of
• Life Relations between EEG Frequency and
  Coherence and Cognition and Affective
  Behaviors. In G. Dawson K. Fischer, Eds.,
  Human Behavior and the
  Developing Brain. Guilford Press. pp 314-45

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Implications for Early Intervention

• In the past weve shown that young children with
  autism have atypical brain responses to social
  and language information which we think could be
  the result of not having had early stimulation of
  the brain systems that underlie those areas. . .
  .by intervening early we may be able to actually
  alter the course of development, and we want to
  measure that.
• Dr. Geraldine Dawson
• Chief Science Officer, Autism Speaks
• Autism Spectrum Quarterly, Summer 2008

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Use It or Lose It!!!

• The plasticity of the young brain is based on
  the overabundance of synapses, which allows only
  emphasis supplied those that are used to become
  part of enduring circuits that underlie thinking,
  feeling, responding, and behaving (p. 129).
• Schwartz, J.M. Begley, S. (2002). The mind and
  the brain Neuroplasticity and the power of
  mental force. NY Regan Books.

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How Does This Research Measure Up to the Quality
Indicators?

• Studies demonstrate a 1 1 correspondence
  between actual experience and brain function.
• There is concordance among many research studies
  and centers regarding the relationship between
  experience and brain function.
• 3. Experiential learning is a good fit for
  children with autism, since it helps them to
  establish meaning and sense-making.

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1st Evidence-Based Intervention Snapshot

• Given the importance of experience in brain
  development, emotional regulation, and
  interaction, language development activities
  should be embedded in experiences that provide a
  context for learning, sense-making, and language
  use.

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Connecting the Research Dots to Create
Intervention Snapshots

• How can research findings related to joint
  attention inform intervention practices in autism?

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What is Joint Attention?

• Joint attention is a cluster of behaviors that
  share the common goal of communicating with
  another person about a third entity in a
  nonverbal way, including eye gaze alternation and
  gesturing.
• Bruinsma, Koegel, Koegel (2004)

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Initiating JA Behaviors

• Eye gaze
• Affect
• Gesture
• Vocalization
• Symbolic communication
• From Yoder McDuffie

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Behavioral Acts Devoid of Joint Attention

• Leading / staring without a gaze shift
• Signing under the table
• Verbally requesting in an empty room
• The use of unconventional or undesirable behavior
  to obtain something
• Bottom Line These behaviors are Not indicative
  of intentional communication!

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What is Missing in these Requestive Behaviors?

• The basic IDEA of COMMUNICATION
• That it requires at least two people a SENDER
  and a RECEIVER
• That BOTH have to be AWARE of the other
• That BOTH have to KNOW that they SHARE AWARENESS

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• Protodeclarative pointing involves using the
  pointing gesture not only to direct attention,
  but also to comment on the object of ones
  attention as a topic of interest. It is a joint
  attention behavior.
• Protoimperative pointing is requestive behavior
  (i.e., using the index finger as an instrumental
  strategy to obtain something for ones own sake).

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What Do We Know About Joint Attention Children
with Autism?

• Numerous studies have shown that children with
  autism have a specific deficit in joint
  attention, and this deficit is one of the most
  robust predictive behavioral indicators of
  autism.

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Leekham, Lopez, Moore Study

• These findings appear to support the proposal
  that children with autism have difficulty in
  social orienting and indicate that this
  impairment is related not only to gaze following
  but also to the ability to initiate acts of joint
  attention and language ability.
• Leekham, Lopez, Moore (2000)

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Implications for Diagnosis and Intervention

• These results therefore provide support for
  focusing on both dyadic orienting and triadic
  joint attention in the development of early
  diagnostic and early intervention measures.
• Leekham, Lopez, Moore (2000)

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Two Important Questions to Ask

• How is joint attention related to language
  development?
• Are research findings regarding language
  development for neurotypical children also
  relevant for children with autism?

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Joint Attention and Language Development

• Research has demonstrated in study after study
  that joint attention is a critical
  social-cognitive precursor to language
  development in neurotypical children.

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Relevance to Children with Autism

• Loveland and Landry, 1986 Mundy, Sigman, and
  Kasari, 1990 found the same trend in autism.
• Joint attention and vocabulary size are related
  in children with autism in the same manner in
  which they are related in typically developing
  children, suggesting that the same principles
  governing language acquisition in typically
  developing children also govern language
  acquisition in children with autism.

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Furthermore . . .

• Siller and Sigman (2002) found that for children
  with autism, joint attention in their early years
  had predictive value for language development in
  their adolescent years.

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• Can Joint Attention Be Trained Up in Children
  with Autism?

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Changes in Affect / Joint Attention

• Language and Social Change in Toddlers with ASD
  Early Intervention. R. Landa, K. Holman, M.
  Sullivan and J. Cleary. Kennedy Krieger
  Institute.
• Objectives To determine whether language and
  communication development in toddlers would be
  related to changes in affective and joint
  attention development during an intervention
  program.

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Results

• The children showed clinically significant change
  in language and social domains.
• Conclusions
• Intervention was multi-modal and classroom-based.
• The greatest language gains were observed in
  toddlers with the strongest pre-treatment joint
  attention skills.
• Improvements in language and joint attention were
  related.

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Joint Attention Symbolic Play

• Growth in Joint Attention and Symbolic Play. C.
  Kasari. UCLA.
• Objective To assess both the generalization and
  maintenance of newly learned skills in joint
  attention and play.
• Design/Methods 58 children with autism between
  the ages of 3 and 4 randomized to a joint
  attention intervention, a symbolic play
  intervention, or a control group. (Interventions
  were conducted 30 minutes daily for 5-6 weeks).

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Results

• Children who received the joint attention
  intervention initiated significantly more joint
  attention interactions with their mothers than
  did children in the other two groups.
• Similarly, children in the symbolic play
  intervention initiated significantly more
  symbolic play acts with their mothers than did
  children in the other two groups.

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One-Year Follow Up

• Children in both the joint attention and symbolic
  play groups increased their joint attention and
  symbolic play skills, respectively, at faster
  rates than did children in the control group.

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Conclusion

• Children with autism can learn to initiate joint
  attention and symbolic play skills, and these
  skills can generalize to other people not
  involved in the intervention and be maintained
  over a long period of time.

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How Does This Research Measure Up to the Quality
Indicators?

• There is a 1 1 correspondence between the
  capacity for joint attention (JA) and language
  ability / treatment gains.
• There is concordance among research studies and
  centers regarding the link between JA and
  language development in children with autism.
• 3. Joint attention intervention passes the
  goodness of the fit test, because children with
  autism demonstrate the need for specific
  attention to it.

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2nd Evidence-Based Intervention Snapshot

• Given that joint attention is a critical
  social-cognitive precursor to language
  acquisition and development and given that its
  presence in the early years has predictive value
  for language development in adolescence, specific
  and sustained attention should be directed toward
  the development of joint attention.

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Types of Activities

• Turn-Taking Games
• The anticipatory moment
• Sensory-based activities
• Play with toys

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• Shared Storybook Reading as a Context for
  Establishing Joint Attention

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Advantages

• Adult-child reading interactions provide an
  excellent vehicle for establishing joint focus
  and shared affect.
• Storybooks may be used to foster communicative
  opportunities for the child in highly
  contextualized and facilitative routines.
• Kaderavek Justice
• American Journal of Speech- Language
  Pathology, November, 2002

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What Could Cause Information Processing Problems
for the Student with ASD?

• Insufficient background knowledge to afford
  understanding
• Difficulty understanding idioms, multiple
  meanings of words, high-level vocabulary, etc.
• Possibly delayed processing
• Background noise / Sensory overload
• Difficulty dealing with the distractions and
  rapid pace of the inclusive classroom setting

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Connecting the Research Dots to Create
Intervention Snapshots

• How can research findings related to language /
  information processing in autism inform
  intervention practices?

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• Just, M.A., Cherkassky, V.L., Keller, T.A.,
  Minshew, N.J. Published in June, 2004 in Brain
  Cortical Activation and Synchronization During
  Sentence Comprehension in High-functioning
  autism Evidence of Underconnectivity

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The results of this study demonstrated that
individuals with autism had enhanced reliance on
local processing of individual words, and reduced
processing of sentences (i.e., complex
information processing). Reported in Autism
Spectrum Quarterly, Summer 2004, The Cutting
Edge From the Decade of the Brain to the 21st
Century.
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Physical Correlates of Findings

• Subjects with autism showed less activation in
  the area of the brain that is associated with
  semantic, syntactic, and working memory
  processes, all of which serve to integrate the
  meanings of individual words into a coherent
  conceptual and syntactic structure (i.e.
  information processing).

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• The subjects also had reduced synchronization
  between multiple cortical language regions
  indicating functional underconnectivity.
• Reported in Autism Spectrum Quarterly, Summer
  2004, The Cutting Edge From the Decade of the
  Brain to the 21st Century.

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So, whats the big deal if individuals with
autism process information using a word-by-word
strategy instead of a more holistic
sentence-by-sentence processing strategy???
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Where is Meaning Carried?
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The embeddedness of speech in a communicative
context is something we take for granted we do
not realize that we are NOT relying simply on the
meanings of words put together in a grammatical
way. p. 15 Jerome Bruner Helen
Haste Making Sense The Childs
Construction of the World
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Indeed, it is because speech and thought are
usually embedded that the young child is able to
engage in apparently complex logical
exercisessuch as negationwhich are way beyond
her if presented in disembedded language. p. 15
Jerome Bruner Helen Haste Making Sense
The Childs Construction of the World
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• Based upon the findings of this study the
  authors proposed a theory of underconnectivity
  which they describe as an under-functioning in
  the integrative circuitry necessary for the
  integration of complex information at both the
  neural and cognitive levels.
• Reported in Autism Spectrum Quarterly, Summer
  2004, The Cutting Edge From the Decade of the
  Brain to the 21st Century.

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How Does This Research Measure Up to the Quality
Indicators?

• There is a 1 1 correspondence between the
  information processing problems in autism and the
  decreased activation seen in those areas of the
  brain responsible for the integration of meaning
  (complex information processing).
• There is concordance among many research studies
  regarding the link between information processing
  problems and brain function in autism.

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Robust Findings

• Underconnectivity theory enriches Minshews
  previous statements of the theory of complex
  information processing with new findings from
  fMRI, thus linking the information abnormalities
  to a specific neurobiologic phenomenon, the brain
  connectivity itself.
• Just, M.A., Cherkassky, V.L., Keller, T.A.,
  Minshew, N.J. (2004, June 23). Cortical
  activation and synchronization during sentence
  comprehension in high-functioning autism
  Evidence of underconnectivity. Brain, doi
  10.1093/brain/awh199. Retrieved July 17, 2004,
  from http//brain.oupjournals.org/

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How Does This Research Measure Up to the Quality
Indicators?

• 3. This research passes the goodness of the fit
  test, because individuals with autism demonstrate
  the type of language and information processing
  problems that reflect word-by-word processing.

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Robust Findings

• This new view of the basis of autism stands on
  the shoulders of previous proposals. It makes
  sense of some of the lack of convergence of many
  previous findings, makes good contact with the
  clinical observations, and provides a link
  between cognition and brain function (p. 9).
• Just, M.A., Cherkassky, V.L., Keller, T.A.,
  Minshew, N.J. (2004, June 23). Cortical
  activation and synchronization during sentence
  comprehension in high-functioning autism
  Evidence of underconnectivity. Brain, doi
  10.1093/brain/awh199. Retrieved July 17, 2004,
  from http//brain.oupjournals.org/

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The Bottom Line

• The Whole is Greater than the Sum of Its Parts

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3rd Evidence-Based Intervention Snapshot

• 1. Embed units of language (not just individual
  words) in pragmatically-appropriate, meaningful
  CONTEXTS that help to fuel understanding and
  promote sense-making.

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3rd Evidence-Based Intervention Snapshot

• 2. To enable students with autism to process
  information, teachers should supplement verbal
  information with visual supports use repetition
  and re-phrasing and provide clarification.

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The Ultimate Clarification Strategy???

• By that I mean . . .

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The findings of Just et al. (2004) are also
consistent with their earlier findings of
decoding strengths and comprehension
weaknesses.Reported in Autism Spectrum
Quarterly, Summer 2004, The Cutting Edge From
the Decade of the Brain to the 21st Century.
84

• What Does Research into the Cognitive Strengths
  and Weaknesses of Individuals with ASD Reveal???
• Minshew, N.J. Goldstein, G., Taylor, H.G.,
  Siegel, D.J. (1994). Academic achievement in
  high functioning autistic individuals. Journal
  of Clinical and Experimental Neuropsychology,
  16(2) ,261-270
• Minshew, N.J., Goldstein, G., Siegel, D.J.
  (1995). Speech and language in high-functioning
  autistic individuals. Neuropsychology, 9(2),
  255-261.

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Strengths of Individuals with ASD

• Individuals with ASD demonstrate strengths in
  procedural knowledge (i.e., knowledge for doing
  things).
• Minshew, et. al. (1994)
• Minshew, et. al. (1995)

• The following skills require this type of
  knowledge
• rote memorization
• word recognition
• spelling
• reading decoding

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Decoding Words Vs. Reading Comprehension

• Decoding words requires procedural competence
  (sets the stage for literalness)
• Comprehending what you read requires a different
  type of knowledgeone that is a weakness in
  individuals with ASD

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Linguistic vs. Pragmatic Comprehension

• I have a dog (i.e., an animal with four legs that
  barks). (Tied to linguistic comprehension which
  is underpinned by procedural knowledge)
• Vs.
• That movie was a real dog (i.e., worthless).
  (Tied to pragmatic comprehension which is
  underpinned by declarative knowledge.)

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Its not enough to exchange words. You also have
to exchange meaning!
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The Bottom Line

• Pragmatic comprehension ability enables you to
  read between the lines and infer meaning.

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Implications for Functioning

• Given their strengths in procedural knowledge,
  and their weaknesses in declarative knowledge,
  individuals with ASD are prone to
• Concrete Thinking
• Literalness

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Implications for Functioning

• Individuals with ASD exhibit
• Competence re memorization of numbers, colors,
  letters
• A predilection for facts

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Academic Weaknesses in Students with ASD
Individuals with ASD demonstrate weaknesses in
declarative knowledge (i.e., knowledge about
things), and in tasks requiring comprehension of
complex linguistic directions and
interpretation. Minshew, et. al. (1994)
Minshew, et. al. (1995) Goldstein, et.
al.(1994)

• The following skills require this type of
  knowledge

• complex information processing
• concept formation
• language comprehension
• problem solving

• reading comprehension
• inferential reasoning
• analyzing synthesizing information

93
How Do These Research Findings Square with What
We See in Students with ASD?

• Students with ASD have excellent rote memories
• They tend to be better at reading decoding than
  comprehension
• They tend to have difficulty with high-order /
  critical thinking

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How Does This Research Measure Up to the Quality
Indicators?

• There is a 1 1 correspondence between the
  pattern of cognitive strengths and weaknesses
  that individuals with ASD demonstrate, and the
  research findings regarding underconnectivity in
  those areas of the brain having to do with
  higher-order thinking.
• There is concordance among several research
  studies regarding the strengths and weaknesses in
  ASD.
• 3. This research demonstrates a good fit for
  children with autism, given the procedural
  strengths they evidence, and the difficulty they
  have with higher-order / critical thinking
  (underpinned by declarative knowledge).

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4th Evidence-Based Intervention Snapshot

• Give direct and sustained attention to the
  development of critical thinking skills beginning
  in the preschool years and continuing on
  throughout ALL of schooling.

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What Does Research Tell Us About Conceptual
Development in Children with Autism?

• There are differences between the way in which
  children with autism and neurotypical children
  learn concepts.

97
Concept Formation in Neurotypical Children

• Typical infants innately abstract generalized
  representations of categories

• Dog
• Four legs
• Tail that wags
• Barking sound
• Fur

98
Concept Formation in Children with ASD

• Individuals with ASD do not do this. They learn
  each example as a separate entity.

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The Bottom Line

• People with ASD live in a world of details (cant
  see the forest for the trees phenomenon)
• Leads to situation-specific learning style
  (cognitive inflexibility)

100
Connecting the Research Dots to Create
Intervention Snapshots

• How can research findings related to concept
  formation and concept identification in autism
  inform intervention practices?

101

• There is a dissociation in nonmentally retarded
  individuals with autism between concept formation
  and concept identification. The deficit in
  concept formation results in cognitive
  inflexibility and in the inability to
  spontaneously form schemata or paradigms that
  organize information. p. 333
• Minshew, N.J., Meyer, J. Goldstein, G.
  (2002). Abstract
• Reasoning in Autism A Dissociation Between
  Concept
• Formation and Concept Identification.
  Neuropsychology,
• Vol. 16, No. 3, 327-334.

102
Concept Formation vs. Concept Identification
Replication from the M.I.N.D. Institute

• Concept Formation and Concept Identification in
  High Functioning Children with Autism Spectrum
  Disorders. J. Brown, M. Solomon, N. Bauminger
  and S. Rogers. UC Davis M.I.N.D. Institute.
• Objective To investigate abstract reasoning in
  children with ASD through an examination of
  concept formation and concept identification in a
  sample of 35 children with ASD vs. 35 TD subjects.

103
Results

• Children with autism were less able than TD
  children to form concepts
• They were not impaired relative to controls in
  their ability to identify concepts.

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How Does This Research Measure Up to the Quality
Indicators?

• There is a 1 1 correspondence between the
  language use and generalization issues we see in
  autism and the weaknesses that research
  demonstrates in concept formation.
• There is concordance among research studies
  regarding the dissociation between concept
  identification and concept formation.
• 3. This research demonstrates a good fit for
  children with autism, given the strengths and
  weaknesses that they demonstrate in language that
  stem from conceptual understanding.

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Concept Development Word Learning Are
Intimately Related
106

• TRUE word learning requires an understanding of
  its associated concept (i.e., meaning)

107
You Cant Learn Words without Learning Concepts
because . . .

• The concept that is associated with the word is
  the words meaning

108
The Link between Conceptual Understanding and
Word Learning

• True word learning requires an understanding of
  its associated concept (i.e., meaning)
• When you understand the meaning, you have formed
  the concept and can use the word
• When you fail to understand the meaning, you may
  still be able to identify the concept (especially
  if youve been trained to do so). USE of the
  word, however, will be problematic

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5th Intervention Snapshot

• Concepts (and hence, words) are best learned
  experientially over time in a social-pragmatic
  context that supports meaning and language use.

110
How Do We Know This?

• Because nobody doubts that for children to learn
  words they have to be exposed to them in contexts
  in which they can infer their meanings this is
  a truism.
• Bloom, P., How Children Learn the
• Meanings of Words

111
The Power of Experiential Learning

• Preschoolers dont learn language and concepts
  from two-dimensional flash cards but from
  multidimensional experience.

The above quotation was taken from Failure to
Connect by Jane M. Healy, Ph.D.
112
What Are the Take-Home Messages?
113

• Interventions should be rooted in high-quality
  research evidence, guided by clinical expertise
  and family values and preferences (i.e.,
  evidence-based practices).
• Interventions should target the core deficits in
  autism, as well as the associated challenges that
  accompany them (comprehensive in focus).

114

• Since not all evidence is created equal, quality
  indicators related to 11 correspondence,
  concordance among studies and centers, and
  goodness of the fit should be applied to research
  findings.
• A best practice approach to intervention in
  autism requires that practices be rooted in, and
  informed by high-quality research across several
  different fields.

115

• One size does NOT fit all when it comes to
  intervention!
• SCERTS
• Pivotal Response Training (PRT)
• ABA
• FCT
• RDI
• Floor Time
• Treatment efficacy requires that skills learned
  in the treatment setting be functionally applied
  in the real-world environment.

116
Be awareand steer clearof the please dont
confuse me with the facts, Ive already made up
my mind phenomenon.
117
Dont Believe Everything You Read (or Hear) in
the Popular Press!

• Journalists typically cover the news with the
  finding that upsets the apple cart rather than
  the consensus. Dr. Steven Pinker
• Harvard University
• Journalists often use deceptively definitive and
  sensational language that can be very misleading
  (e.g., Call it a miracle. Call it an
  awakening. -Diane Sawyer, Prime Time)

118

• BEWARE HYPE What is popular isnt always
  right, and what is right isnt always popular.
• Develop a critical eye and ear when it comes to
  evaluating research findings, and triangulate the
  information.

119

• Scientific research is NOT static hence, it is
  necessary to remain OPEN to hypotheses that may
  be rejected over time, as well as to NEW findings
  that may be added to the research literature.
• Resist the urge to kill the messenger!!!
• Last, but not least . . .

120
Some Things Simply Cannot Be Measured!

• What was educationally significant and hard to
  measure has been replaced by what is
  educationally insignificant and easy to measure.
  So now we measure how well weve taught what
  isnt worth learning!
• Dr. Arthur Costa
• The School as Home for the Mind