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

Background NCLB (2001) principles

Accountability Scientifically-based Instruction

Support educational procedures, materials, and strategies backed by scientifically based research

Highly qualified teachers and paraprofessionals

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”

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

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

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)

Research to Practice:

Application and Individualization of Evidence-based Practices in

Authentic Settings

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).

What works for whom when teaching

target skills and under what conditions?

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?

EPB & Scope /SequenceBehavioral/

SocialCommunication 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 ? ?

EPB & Scope/SequenceBehavioral/

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 ? ?

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

What do we really know works?

Using our professional knowledge and skills!

Linking EBP to Teach!

ABI

•Preferred peer

•Preferred social materials

Instructional Strategies

•Peer mediated interventions

Consequences

•Reinforcement

•Praise

•Access to preferred materials

Implementation with Integrity

Reinforcement

Procedural IntegrityChange agentsAdherence to practiceQuality of implementationDosage of implementation

Positive Student Outcomes

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

Evidence Supporting CIM Lovaas Denver Early Start Model Floortime Zigguart TEACCH LEAP

**Remember to evaluate the evidence!!!!

Beyond EBP:EBP are necessary but not

sufficient!

Foundational Program Components Least Restrictive Environment

Inclusion opportunities Systematic & data-based instruction

Accommodations & modifications Arrangement of learning environmental Staffing ratio & patterns Teaming practices

What about promising or

unproven practices?

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

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

Evaluating the evidence! CEC - Division of Research Exceptional Children (2005)

Experimental & Quasi-experimental Group Designs

Single Subject Research Designs Correlational Research Qualitative Research

Creating new evidence Promising or emerging practices

Collecting meaningful data on student progress

Questions & Discussion