Evidence Based Practices And The Benefits For Autism
Evidence based practices for autism spectrum disorder are a procedure or group of procedures that use a combination of instruction and intervention approaches.
Evidence based practices for autism are a procedure or group of procedures that use a combination of instruction and intervention approaches.
For a practice to qualify as evidence based, researchers provide information that shows it provides positive outcomes for people with autism spectrum disorders . These practices can be very individual, or can be conducted and accomplished in a group.
The quality of the application of these practices is dependent on skills and education of healthcare professionals. How therapists go about facilitating and selecting what practices are appropriate for a person with autism and implementing them accordingly is highly important.
How these practices are selected and used needs to be consistent with the skills, preferences, and variables dependent on the individual. They need to meet the individuals learning abilities and the skill needs of the person.
Afirm: Autism Focused Intervention Resources And Modules
The NPDC created online modules for each of the 27 evidence-based practices identified in the 2014 NPDC review. The modules are called Autism Focused Intervention Resources and Modules .
Each module will guide the learner through how to use the practice by focusing on the three specific steps of
The National Clearinghouse on Autism Evidence and Practice
NCAEP is a continuation of the evidence review that was completed by the National Professional Development Center on Autism Spectrum Disorders which included research published through 2011. We will review research studies published in the last six years which examine the impact of behavioral, educational, clinical and developmental practices and service models used with individuals on the autism spectrum from birth through age 21. NCAEP reviewed research studies published from 2012-2017 and in 2020 published their new report on EBPs identified between 1990-2017.
Therapies For Children With Autism Spectrum Disorder: Behavioral Interventions Update
This study finds that there is a growing evidence base suggesting that behavioral interventions – especially early, intensive therapies based on applied behavior analysis – can be associated with positive outcomes for children with autism. However, more research is needed to understand which interventions are most effective for specific children and to isolate elements or components of interventions most associated with effects. This systematic review was produced for the Agency for Healthcare Research and Quality by the Vanderbilt Evidence-based Practice Center. It is an update to a 2011 report.
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Can Evidence Based Practices Work For You
There is so much information available to help you make an informed decision based on your needs or the person in your life that has autism spectrum disorder. With the information that has been provided, speaking with a medical professional can help make appropriate decisions and ideas for therapies, education, etc.
Also, knowing the needs and targeted behaviors that an individual may need to work toward will help. These practices are very individual, although there are some that can take place in a group, so knowing individual needs and goals will help determine which practice is the best for the individual.
References:
Hume, K., McIntyre, Morin, K., N., Nowell, S., Odom, S., Savage, M., Steinbrenner, J., Szendrey, S., Tomaszewski, B. & Yücesoy-Özkan, S. . Evidence-Based Practices for Children, Youth, and Young Adults with Autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team.
Katsiyannis, A., Shriner, J., Yell, M. . Individuals with Disabilities Education Improvement Act of 2004 and IDEA Regulations of 2006: Implications for Educators, Administrators, and Teacher Trainers. Focus on Exceptional Children.
Which Ebp Should I Choose
These EBPs are all unique in their own ways and sometimes complement each other very effectively. For instance, task analysis is often combined with reinforcement, time delay, or video modeling. Modeling is sometimes used in conjunction with prompting and reinforcement.
The number of evidence-based practices available can seem overwhelming. While the list has been significantly narrowed down, 27 is still a lot to choose from. So, how do you?
Theres no one-size-fits-all answer. Intervention approaches should be highly personalized, as every individual with ASD is so unique. What works for one person wont necessarily work for the next. The EBPs that are most effective will depend on the individuals age, developmental level, personality characteristics, the service provider, the values and preferences of both the family and the person with ASD, and a number of other factors.
To choose an EBP, youll also want to consider the specific behavior youre looking to address and correct, the extent of those behaviors, and the measurable goal you want to achieve.
While it might feel like a never-ending maze trying to select the best-fitting EBP, rest assured that this means theres an approach for customizing the most powerful method for you. Also bear in mind that you can combine EBPs as needed.
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Reference And Suggested Readings
The Missouri Autism Guidelines Initiative. Autism Spectrum Disorders: Guide to Evidence-based Interventions: a 2012 Consensus Publication. The Missouri Autism Guidelines Initiative. www.autismguidelines.dmh.mo.gov. Accessed June 5, 2917.
Zwaigenbaum L, Bauman ML, Choueiri R, et al. Early intervention for children with autism spectrum disorder under 3 years of age: recommendations for practice and research. Pediatrics. 2015 136 Suppl 1:S60-S81.
Makrygianni MK, Reed P. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autistic spectrum disorders. Research in Autism Spectrum Disorders. 2010 4 577-593.
The Lovaas Model. The Lovaas Institute website. . Accessed June 5, 2017.
Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics. 2010:125:e17-e23.
Arnold LE, Vitiello B, McDougle C, et al. Parent-defined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials. J Am Acad Child Adolesc Psychiatry. 2003 42:1443-1450.
McCracken JT, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. N Engl J Med. 2002 347:314-321
Myers SM, Johnson CP. Management of children with autism spectrum disorders. Pediatrics. 2007 120:1162-1182.
What Are The Evidenced
Lets briefly look at each EBP individually, based on definitions from the IRIS Center. Click on each individual term to reveal the definition.
Visual supports aid the learner in acquiring a new behavior or skill without the assistance of prompts. Types of support include pictures, words, objects, maps, and labels.
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Why Are Evidence Based Practices Important
Evidence based practices are implemented as a way of ensuring individuals with autism spectrum disorder are receiving services that will help improve their quality of life. These practices are used when developing laws and service providers for these individuals.
The Individuals with Disabilities Act was a law that made special education and related services available to those who qualified. There were some issues and solutions brought up in 2004, so the Disabilities Education Improvement Act went through a reauthorization through the Every Student Succeeds Act.
It was discussed that the special education model and services provided were becoming more compliance-based, making sure that all the paperwork was being filed and the curriculum implemented. That didnt help and cover all the special education needs and there were individuals who were struggling in this system.
The Disabilities Education Improvement Act transitioned into a results based approach that focused more on the individuals needs. There were evidence based practices used to help each person where they need support.
Required Skills To Conduct Evidenced
Applied behavior analysts need leadership skills combined with the ability to implement effective evidence-based treatment strategies, conduct behavioral assessments, and evaluate treatment strategies. Strong communication skills also are crucial for applied behavior analysts, as their jobs involve interaction with patients, family members, and other clinicians and professionals. Competent therapists possess interpersonal skills encompassing empathy, acceptance, affective expressiveness, and the ability to focus on others. Therapists need these skills to build trust and help patients feel understood. Therapists also must be flexible enough to adjust treatment plans if a client is not making progress.
Regis Colleges online Master of Science in Applied Behavior Analysis program can help students develop these critical skills on an advanced level. The curriculum combines research and hands-on experience to prepare students from various health science backgrounds to enter the field of applied behavior therapy or to build on previous training. Students also gain firsthand knowledge of evidence-based treatments through ABA training and practicums.
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Prepare To Move Your Career Forward
Applied behavior analysis and evidence-based treatments increasingly are used to help people who have been diagnosed with autism. Learn how Regis Colleges online Master of Science in Applied Behavior Analysis program can help build the skills needed for professional advancement.
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Manualized Interventions Meeting Criteria For Ebps
Emerging from the current review were interventions that clearly fit the EBP categorical definitions but had themselves enough evidence to be classified as an EBP. The NCAEP team identified these practices as Manualized Interventions Meeting Criteria and grouped them within established EBP categories. The rationale for this classification was to provide conceptual clarity of the EBP organization but also to highlight the particular approach. In addition to having sufficient evidence, MIMCs had to have clearly established manualized procedures or software. In total, there were 10 MIMCs classified within six of the EBP categories. These MIMCs appear in Table Table3.3. More detail about the reclassification process may be found in the full report .
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Comparison Of Npdc And Nsp Ebps
In a subsequent analysis, researchers compared the practices identified by NPDC and the National Standards Project , finding substantial agreement between the two reviews. Twenty-one of the practices identified by NPDC as evidence-based were considered established practices by NSP. Four NPDC EBPs were considered emerging practices by NSP . Two NPDC EBPs were not identified by NSP .
How Is Asd Diagnosed
The diagnostic assessment of ASD allows a physician to determine if a child meets the accepted ASD criteria , identify comorbid medical or genetic syndromes or psychopathology, and identify the patients treatment needs. Figure 1 shows the typical paths to diagnosis, starting with concerns raised by parents, teachers, childcare providers, early childhood educators, family physicians or pediatricians. Primary care providers then determine whether an assessment is needed for ASD or another developmental issue. A detailed developmental history is collected from the parents, and additional information is collected from teachers, early childhood educators and health professionals. It is essential for the primary care provider to spend time with the child engaged in structured play activities that assess socialemotional relatedness, the ability of the child to respond to and direct the attention of others, and his or her use of gestures, imitation, imagination and conversation. Multiple prospective and retrospective studies support the recommendations of comprehensive reviews and guidelines on diagnosis.18,19
Among people with ASD, 10%25% have an associated medical disorder .20,21 Assessment of an individual with ASD should include obtaining thorough prenatal, perinatal, medical and family histories, and a physical examination to document growth parameters and the presence or absence of dysmorphic features.
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What Are The Two Classes Of Intervention Approaches
Comprehensive Treatment Models: these include a set of practices that were created to achieve broad learning and/or developmental impact on the core attributes of autism spectrum disorder . There have been 30 different treatment models identified by Odom Boyd, contrary to the original 10 identified. They were characterized and identified by how they were organized, how they were operated, intensity levels, longevity, and how intense the outcome focus was.
Focused Intervention Practices: These practices are more individualized and based on a single skill and/or goal of a person with autism spectrum disorder . These outlined and addressed certain outcomes, like a new behavior, and would cover a short length of time. These focused interventions could be the building blocks and structure for the future of education. These practices could include tactful trial teaching, use of visual supports, prompting, and video modeling.
Early Intensive Behavioral Intervention
Experts urge parents who suspect their young child of having an autism spectrum disorder to communicate their concerns as soon as possible to the childs pediatrician. Shortly after a diagnosis of an autism spectrum disorder, an applied behavior therapist can use early intensive behavioral intervention. This type of ABA therapy is for children diagnosed with autism who are five years old or younger. This evidence-based treatment for autism helps children learn communication and walking skills and teaches competencies in social interactions.
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Comparison Of Ncaep And Nsp Ebps
NCAEP and the National Standards Project published reports of their systematic reviews of the literature and identification of evidence-based practices. Nineteen of the NCAEP EBPs were also identified as established interventions in the NSP report Five of the NCAEP EBPs were identified as emerging interventions . NCAEP identified four EBPs that were not included in the NSP previous report and NSP identified Language Training as an established intervention, whereas it was not included in the current NCAEP report. NSP also included Comprehensive Behavioral Treatment for Young Children, and NCAEP did not consider comprehensive treatment models in the current review. In summary, there continues to be a substantial overlap in EBPs identified by these two independent reviews.
To print out the NCAEP NSP Comparison table, download the table here and open using Adobe Reader.
Early Start Denver Model
ESDM is a comprehensive ABA program for infants, toddlers and preschoolers ages 12 to 48 months with ASD. ESDM includes naturalistic ABA, interpersonal exchange, shared enjoyment in joint activities, and promotion of language and communication. The emphasis is on having fun within a developmental framework. Parent involvement is key to the success of the intervention. ESDM has been shown to be effective in a randomized clinical trial. Children who received 20 hours of ESDM per week over 2 years showed more improvement in cognitive testing , adaptive skills, and autism symptoms than those who received typical community treatment.
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What Are The Three Components Of Evidence Based Practice
There are many evidence based practices that are available. They all incorporate and include three essential components that make them dependable.
The three components include the use and integration of the best evidence available, the use of clinical expertise, and how the patients outcomes are in relation to client and practice management, as well as the health policy stance on decision making.
The use and implementation of these components are necessary to the improvement of current evidence based practices. Having professionals that acknowledge and stay up-to-date on these practices and their implementation will help with this improvement and any changes that may need to be made.
What Changes Were Made
Due to the focus change and need for more individualized and results based approaches, the National Professional Development Center on Autism Spectrum Disorder was funded and created.
This was done through the Office of Special Education Programs in the US Department of Education between 2007-2014. This helped shape the future of special education services.
The NPDC collaborated between three different universities. They figured out the best ways of implementing additional evidence based practices in the special education classroom.
This benefitted people from birth to age 22 and was accomplished through education and professional development at state and local levels. This professional development was the necessary step and provided educators with tools to improve this system.
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Previous Literature Reviews Of Ebps For Children And Youth With Autism
Before the mid-2000s, the identification of EBPs for children and youth with autism was accomplished through narrative reviews by an individual or set of authors or organizations , which were useful, but did not follow a stringent review process. Many traditional systematic review processes, such as the Cochrane Collaborative or Project AIM , have only included studies that employed a randomized experimental group design and have excluded single case experimental design studies. By excluding SCD studies, such reviews omit a vital experimental research methodology recognized as a valid scientific approach .
Many systematic reviews of interventions for autistic children and youth now appear in the research literature. Such reviews are useful in their focus on individual practices like functional communication training , intervention for autistic children/youth of a certain age , or interventions occurring in certain locations such as schools , and allow for more in depth review of contextual factors impacting the intervention or outcomes. They do not, however, provide a comprehensive critical summary of evidence across practices, ages, and outcomes. To date, only the National Professional Development Center on ASD and National Standards Project have conducted comprehensive reviews of focused intervention practices for children and youth with autism and included both group and SCD studies.
Discrete Trial Training And Verbal Behavior Intervention
Discrete trial training consists of several trials to teach patients a desired behavior. This highly researched teaching style classifies each lesson, breaking down the steps of the desired action. There are three possible outcomes for each trial: independent correct response, correct response with prompting, and incorrect response. Therapists reward correct responses, promoting positive reinforcement. Incorrect responses are ignored.
Using discrete trials, the application of verbal behavior intervention motivates patients to learn language by connecting words with their intended purpose. It can help address the language deficits of people diagnosed with autism. Heres an example of how it works. Before a session, a therapist prepares an item that correlates with a word. The therapist then teaches the patient that saying the word could produce the item. For a child, the word could be cookie. If the child says the word, the therapist repeats it and hands over the cookie. The lesson is that a request can produce a wanted item that is, if the request is verbalized.
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