Guide for Judging Treatments & Therapies

1. Guide for Judging Treatments & Therapies

2. …SO many ASD treatments, practices, strategies, information, etc…. How to choose???

3. Opinions; Opinions; Opinions!!!

4. Why not just use the therapy / treatment I like best? • Possibility of Harm • Time, money, and energy is NOT directed toward interventions that WILL get the expected outcomes…

5. …SO many ASD treatments, practices, strategies, information, etc…. How to choose??? TEACH PEOPLE TO BE CRITICAL CONSUMERS!!

6. Guiding Principle • ALL DECISIONS INFORMED BY…. • THE LAW • THE RESEARCH • THE DATA

7. The LAW…. NCLB Requires experimental studies that are similar to the medical model of research used by scientists. These studies require many steps to prove strong evidence of effectiveness. • Well designed studies that use random samples of the population • Trials must also include a random “control group” for comparison • Valid and reliable outcome measures • Data on long-term outcomes • Trials in more than one site of implementation

9. Science, Pseudoscience or Anti-science • Science: • Does not take assertions or observations at face value • Seeks proof. • Differentiates opinions, beliefs, and speculations from demonstrated facts. • Pseudoscience: • Tries to lend credibility to beliefs, speculations, and untested assumptions by making them appear scientific. • Instead of objective measurements from well-controlled experiments, offer testimonials, anecdotes, and unverified personal reports to back up their claims. • Antiscience: • The outright rejection of the scientific method as a means of producing valid and useful knowledge. Adapted from asatonline.org (2011)

10. Pseudoscientific Therapies: Some Warning Signs 1. High "success" rates are claimed. 2. Rapid effects are promised. 3. The therapy is said to be effective for many symptoms or disorders. 4. The "theory" behind the therapy contradicts objective knowledge (and sometimes, common sense). 5. The therapy is said to be easy to administer, requiring little training or expertise. 6. Other, proven treatments are said to be unnecessary, inferior, or harmful. 7. Promoters of the therapy are working outside their area of expertise. 8. Promoters benefit financially or otherwise from adoption of the therapy. 9. Testimonials, anecdotes, or personal accounts are offered in support of claims about the therapy's effectiveness, but little or no objective evidence is provided. 10. Catchy, emotionally appealing slogans are used in marketing the therapy. 11. Belief and faith are said to be necessary for the therapy to "work." 12. Promoters resist objective evaluation and scrutiny of the therapy by others. 13. Negative findings from scientific studies are ignored or dismissed. 14. Critics and scientific investigators are often met with hostility, and are accused of persecuting the promoters, being "close-minded," or having some ulterior motive for "debunking" the therapy. Retrieved from asatonline.org (2011)

11. CONGRESSIONAL FINDINGS Understanding Federal Law U.S. Code (U.S.C.) 50 Titles Title 20: Education 78 Chapters Chapter 33: IDEA — IV Subchapters Subchapter I: General Provisions 82 Sections -- denoted as § § 1400: Findings / Purpose “…the implementation of this chapter (33 : IDEA) has been impeded by low expectations, and an insufficient focus on applying replicable research on proven methods of teaching and learning for children with disabilities.”

12. What ARE Evidence-Based Practices? • Practices that have empirical support • Practices that show effectiveness through documented improved measurable outcomes (DATA) that result in improved functioning. • NOT: • “I’ve seen this work” OR “I heard this works” • It works because I WANT it to work (Placebo)

13. Placebo Effects—Points to Consider • Natural Growth & Maturity • Would this change have occurred anyway as the student grows and matures? • Other Interacting Interventions • During the time of treatment, interventions currently in place are not generally stopped to try the new one, and often other interventions are added during the time of treatment so it is difficult to determine what intervention is causing the change. • Expectations of Improvement • Expectations have a POWERFUL impact on outcomes. • The more invested we are in the treatment (i.e. emotionally, financially, in terms of time, etc.), the more expectations we have for outcomes. • Possible reasons this occurs: • More attention to small changes • More investment into the student generally (e.g. time interacting with the student)

14. What ARE the EBPs for Students with ASD?

15. The National Professional Development Center on ASD (NPDC) • The National Professional Development Center on Autism Spectrum Disorders is a multi-university center to promote the use of evidence-based practice for children and adolescents with autism spectrum disorders. • EBP Briefs: Step by Step Implementation Guides http://autismpdc.fpg.unc.edu/content/briefs

17. EBPs by Age Level & Skill Addressed

18. National Standards Project The National Autism Center launched the project in 2005 with an expert panel. The culmination of this rigorous multi-year project is the National Standards Report, the most comprehensive analysis available about treatments for children and adolescents with ASD. The National Standards Report will serve as a single, authoritative source of guidance for parents, caregivers, educators, and service providers as they make informed treatment decisions. National Autism Center -- National Standards Project: http://www.nationalautismcenter.org/nsp/dissemination.php • Overview Manual • Educators Manual

19. NSP – NPDC Comparison Chart

20. OCALI Online Modules http://www.autisminternetmodules.org/

21. http://media.mindinstitute.org/education/ADEPT/Module1Menu.htmlhttp://media.mindinstitute.org/education/ADEPT/Module1Menu.html

22. The Association for Science in Autism Treatment ASAT is a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of people with autism. Since autism was first identified, there has been a long history of failed treatments and fads, levied on vulnerable individuals as well as on their families. Since ASAT was established in 1998, it has been our goal to work toward adopting higher standards of accountability for the care, education and treatment of all individuals with autism. http://www.asatonline.org/intervention/treatments_desc.htm

23. Additional Resources for EBPs in ASD • Classroom / Building Tools: • USAPT (Universal Supports Assessment & Planning Tool)-- Building Tool: http://www.gvsu.edu/autismcenter/usapt-online-326.htm • Georgia State University’s EIC-ASD (Enhancing Instructional Contexts for Students with ASD)—Classroom Tool: http://education.gsu.edu/autism/index.htm • Texas Statewide Leadership for Autism Training: http://www.txautism.net/manual.html

24. Questions to Ask to Judge Treatments, Therapies, & Strategies against the EBP Standard

25. Why are you seeking a new treatment, therapy, strategy? • Concerns/Issues? Skill Acquisition? • Behavioral? • Communication? • Social? • Academic? • Will this treatment, therapy, strategy, etc. address these issues?

26. Does the treatment align with EBPs? http://autismpdc.fpg.unc.edu/content/briefs

27. Does the treatment align with practices with no / limited research support? http://www.asatonline.org/intervention/treatments_desc.htm

28. Additional Questions to Ask… • What research is available that supports the use of this intervention? Does this research have strong research design with control groups? • Who has performed the research? Has it been published in peer reviewed journals? (GET COPIES) • Are the outcomes supported by data (get the information) or anecdotal stories or testimony from individuals, not based on scientific method? • What specific changes / improvements are expected and how are they measured? (Does is “WORK”?) • What are the qualifications of the person(s) implementing this intervention? (e.g. degree / certificate; training requirements) • What are the potential side effects?

29. NOW… YOU DECIDE…..