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Helping Parents Separate the Wheat From the Chaff: Putting Autism Treatments to the Test

Helping Parents Separate the Wheat From the Chaff: Putting Autism Treatments to the Test. Shannon Kay and Stuart Vyse Alex Mellor Caldwell College. Overview.

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Helping Parents Separate the Wheat From the Chaff: Putting Autism Treatments to the Test

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  1. Helping Parents Separate the Wheat From theChaff: Putting Autism Treatments to the Test Shannon Kay and Stuart Vyse Alex Mellor Caldwell College

  2. Overview • This chapter describes a method to encourage parents to become the experimenter to determine for themselves the interventions that are supported by scientific evidence. • Searching for the best treatment – how can parents and professionals work together? • Case examples • Conclusions of the chapter.

  3. Power to the parents!Kay and Vyse (2005) • Parents have the power to alter treatment, unfortunately this “power” is often influenced by personal philosophies and not scientific evidence. • Parents are supposed to “fix” the problem • No standard treatment for autism • Parents are motivated to see their child improve, single-case designs are one way to show scientifically that this is or is not happening • Right to Effective Behavioral Treatment (ABA Taskforce 1987) • “most effective treatment available” – need to help parents understand the “most effective treatment”.

  4. What would you do? • http://www.youtube.com/watch?v=tXoD91vjFcI • http://www.youtube.com/watch?v=zo375AcwlS4

  5. Searching for the best treatmentKay and Vyse (2005) • Parent Education • What constitutes reliable evidence? • Who is telling them that the intervention is working? • Parenting is a tough job! • What are the characteristics of sound empirical evidence? • If parents are still motivated by unproved therapies 1. Ignore and continue 2. Advise and hope to “wear them down” 3. Refuse to provide service 4. Encourage parents to collect data

  6. Data-based decision?Kay and Vyse (2005) • Parents objectively determine effectiveness of interventions • Is intervention causing deterioration? • If other therapies are proven to work – important step in proving effectiveness for other parents. • Based on their OWN CHILD!

  7. Designing the testKay and Vyse (2005) • Target behavior • Which behavior? • Operationally define – not just “less autistic” • How to measure reliably? • Designing the test • Alternating treatments design • How is data collected? By whom? Reliability check? • Developing the rules • Decide level of behavior change • Hypothetical graphs – based on goal • Collecting data • Reliability for DV • Treatment integrity for IV • Evaluating the results and making a decision • Explain graphs – compare real data to hypothetical graphs • Data based decision – or continue if there is no difference

  8. Case 1: Brushing and Joint CompressionKay and Vyse (2005) • Non-verbal, 8 year old boy with autism • Occupational therapist recommended brushing and joint compression as “sensory overload” was causing aggressive behavior. • TB – hitting behavior defined as blows directed at himself, staff members, or his table. • Brushing and join compression alternated with a neutral condition. • Results showed that in every instance except one, episodes of hitting were higher after the brushing and joint compression. • Showed that this therapy was having a detrimental effect on the child, OT was surprised but agreed that treatment should be stopped.

  9. Case 2 : Prism GlassesKay and Vyse (2005) • 8 year old boy with autism, problems walking appropriately. • Optometrist believed autism was caused by visual processing problems, could “recover” by wearing prism glasses. • TB – Appropriate walking, defined as two steps with alternating feet. • Prism glasses compared to glasses with clear lenses. • Results – after initial increase in appropriate walking while wearing the glasses, quickly decreased. • Parents chose to discontinue the prism glasses.

  10. Case 3: Sensory Integration Therapy to Reduce an Inappropriate Sitting BehaviorKay and Vyse (2005) • 5 year old boy with autism. • Behaviors to avoid task demand – throwing himself on the floor. • Decreased with DRO procedure • Occupational therapist disagreed with DRO, did not believe behavior was in his control. • TB – falling out his chair, defined as buttocks or stomach in contact with the floor. • DRL condition alternated with sensory integration training. • Results – TB decreased during DRL and increased during sensory integration training. • School discontinued sensory integration training – parents were relieved!

  11. To conclude…Kay and Vyse (2005) • Applied behavior analysts have tools to help make treatment decisions • Teach the basics of science problem solving, related to behavioral interventions. • Decision based on objective data! • Collaborate rather than argue with parents. • Parents learn whether they are making wise choices! • SEPARATE THE WHEAT FROM THE CHAFF!

  12. Any questions? ? Thank you 

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