Advancing the Use of Evidence-based Practices for Students with Autism Spectrum Disorders

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Advancing the Use of Evidence-based Practices
for Students with Autism Spectrum Disorders

• Maureen Conroy, PhD
• TTAC Autism Priority Project Conference
• Richmond, VA
• April 15, 2010

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Background

• NCLB (2001) principles
• Accountability
• Scientifically-based Instruction
• Support educational procedures, materials, and
  strategies backed by scientifically based
  research
• Highly qualified teachers and paraprofessionals

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IIP vs. CIM

• Isolated Intervention Practices
• Individual instructional strategies that
  practitioners use to promote specific outcomes
  for students
• Comprehensive Intervention Models
• Conceptually organized packages of practices and
  components that address a broad array of skills
  for students
• Not necessarily an evidence-based practice

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National Professional Development Center on ASD

• Randomized or quasi-experimental design studies
• Two high quality experimental or
  quasi-experimental group design studies
• Single-subject design studies
• Three different investigators or research groups
  must have conducted five high quality single
  subject design studies
• Combination of evidence
• One high quality randomized or quasi-experimental
  group design study and three high quality single
  subject design studies conducted by at least
  three different investigators or research groups
  (across the group and single subject design
  studies)
• http//www.fpg.unc.edu/autismPDC/resources/resour
  ces_public_ebp.cfm

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NPDC Evidence-based Practices

• Environmental
• Antecedent-based
• Visual Supports

• Instructional
• CAI
• Naturalistic practices
• Peer-mediated Practices
• Prompting
• Self-management
• Time delay
• Task Analysis
• Video-modeling

• Consequence-based
• DRO
• Extinction
• Reinforcement
• Response Interruption

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NPDC (2010)

• Packaged EBP
• Discrete Trial Training
• Functional Behavioral Assessment
• Functional Communication Training
• Parent-Implemented Interventions
• Picture Exchange Communication System
• Pivotal Response Training
• Social Skills Groups
• Structured Work Systems (TEACCH)

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Research to Practice

• Application and Individualization of
  Evidence-based Practices in Authentic Settings

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Applied Definition of EBP

• Practices that are informed by research in which
  the characteristics and consequences of the
  environmental variables are empirically
  established and the relationship directly informs
  what a practitioners can do to produce a desired
  outcome (Dunst, Trivette, Cupsek, 2002).

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What works for whom when teachingtarget skills
and under what conditions?
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Evidence Contexts

• What skills/behaviors are most appropriate for
  this practice?
• Behavioral, communication, social, play/leisure,
  academic
• What ages has this practice been tested on?
• Early Intervention, PK, Elementary, Secondary
• What settings has the practice been implemented
  in?
• Home
• Classrooms/Schools
• Community
• What skills does the change agent need to learn
  to implement the practice with integrity?
• Is this practice socially valid and acceptable
  for this particular context?

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EPB Scope /Sequence
Behavioral/Social Communication Play/ Leisure Academic
Prompting X X X ?
Reinforcement X X X ?
DTT X X X X
Naturalistic Interventions X X ? ?
PECS X X ? ?
PRT X X X ?
FCT X X ? ?
Parent implemented X X ? ?
DRO/ Extinction X X ? ?
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EPB Scope/Sequence
Behavioral/ Social Communication Play/ Leisure Academic
ABI X ? ? ?
CAI ? ? ? X
FBA X X ? ?
PMI X X ? ?
Response Interruption X ? ? ?
Self-management X X ? X
Social Narratives X X ? ?
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EPB Scope/Sequence
Behavioral/Social Communication Play Academic
Social Skills Groups X ? ? ?
Structured Work Environments ? ? X X
Task Analysis X X X X
Time Delay X X X ?
Video Modeling X X ? ?
Visual Supports X X ? X
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What do we really know works?

• Using our professional knowledge and skills!

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Linking EBP to Teach!

• Instructional Strategies
• Peer mediated interventions

• Consequences
• Reinforcement
• Praise
• Access to preferred materials

• ABI
• Preferred peer
• Preferred social materials

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Implementation with Integrity

• Procedural Integrity
• Change agents
• Adherence to practice
• Quality of implementation
• Dosage of implementation

Positive Student Outcomes
Reinforcement
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Application Individualization

• What skill(s) does the student need to learn?
• What is the most effective strategy for teaching
  the skill(s)?
• Where is/are the skill(s) being taught?
• Who is going to teach the skill(s)?
• When and how often will instruction occur?
• How will procedural integrity be measured?
• Data collection on dosage, quality, integrity
• How will student outcomes be measured?
• Data collection strategies on student skills
  behaviors

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Evidence Supporting CIM

• Lovaas
• Denver Early Start Model
• Floortime
• Zigguart
• TEACCH
• LEAP
• Remember to evaluate the evidence!!!!

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Beyond EBP

• EBP are necessary but not sufficient!

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Foundational Program Components

• Least Restrictive Environment
• Inclusion opportunities
• Systematic data-based instruction
• Accommodations modifications
• Arrangement of learning environmental
• Staffing ratio patterns
• Teaming practices

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What about promising or unproven practices?
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Keeping up with the evidence

• Obstacles
• Rapid growth in knowledge in ASD
• Education
• Medicine
• ASD is a cottage industry
• Media attention to untested interventions cures
• Research to practice gap
• Promising practices -gt evidence-based practices

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Keeping up the with evidence

• National Organizations
• IACC - http//iacc.hhs.gov/summary-advances/2009/i
  ndex.shtml
• NPDC - http//autismpdc.fpg.unc.edu/content/briefs
  
• CEC - Division of Research
• Intervention in School and Clinic (2008)
• http//www.cecdr.org/subpage.cfm?idD96A2E89-C09F-
  1D6F-F9C82C33EC634BCC
• What Works Clearinghouse
• Peer-reviewed Journals
• JADD
• Autism Research
• Linking with researchers others
• Communities of Practice
• The Institute for Educational Sciences funded
  projects
• The National Institutes of Health funded projects

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Evaluating the evidence!

• CEC - Division of Research
• Exceptional Children (2005)
• Experimental Quasi-experimental Group Designs
• Single Subject Research Designs
• Correlational Research
• Qualitative Research

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Creating new evidence

• Promising or emerging practices
• Collecting meaningful data on student progress

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Questions Discussion