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

1. 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

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

3. 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”

4. 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/resources_public_ebp.cfm

5. 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

6. 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)

7. Research to Practice: Application and Individualization of Evidence-based Practices in Authentic Settings

8. 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).

9. What works for whom when teachingtarget skills and under what conditions?

10. 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?

11. EPB & Scope /Sequence

12. EPB & Scope/Sequence

13. EPB & Scope/Sequence

14. What do we really know works? Using our professional knowledge and skills!

15. Linking EBP to Teach! • Instructional Strategies • Peer mediated interventions • Consequences • Reinforcement • Praise • Access to preferred materials • ABI • Preferred peer • Preferred social materials

16. Implementation with Integrity Procedural Integrity • Change agents • Adherence to practice • Quality of implementation • Dosage of implementation Positive Student Outcomes Reinforcement

17. 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

18. Evidence Supporting CIM • Lovaas • Denver Early Start Model • Floortime • Zigguart • TEACCH • LEAP **Remember to evaluate the evidence!!!!

19. Beyond EBP: EBP are necessary but not sufficient!

20. Foundational Program Components • Least Restrictive Environment • Inclusion opportunities • Systematic & data-based instruction • Accommodations & modifications • Arrangement of learning environmental • Staffing ratio & patterns • Teaming practices

21. What about promising or unproven practices?

22. 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 -> evidence-based practices

23. Keeping up the with evidence • National Organizations • IACC - http://iacc.hhs.gov/summary-advances/2009/index.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?id=D96A2E89-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

24. Evaluating the evidence! • CEC - Division of Research • Exceptional Children (2005) • Experimental & Quasi-experimental Group Designs • Single Subject Research Designs • Correlational Research • Qualitative Research

25. Creating new evidence • Promising or emerging practices • Collecting meaningful data on student progress

26. Questions & Discussion