10/17/2014 Brian A. Boyd, Ph.D. University of North Carolina at - PDF document

10/17/2014   Brian A. Boyd, Ph.D. University of North Carolina at Chapel Hill Supported by OSEP #H325G070004 and IES #R324B090005 (PI: Odom)  Colleagues at FPG & beyond o Sam Odom, Connie Wong, Suzanne Kucharczyk & Kara Hume – FPG Child Development Institute, UNC-CH o Laura Hall (SDSU) o National Professional Development Center on ASD • http://www.fpg.unc.edu/~autismPDC/  National Standards Project o Susan Wilczynski • http://www.nationalautismcenter.org/about/national.php  Autism Guidelines Project funded by the State of California Department of Development Services  Much of this work is cited from: o Boyd, B.A., Odom, S., L., Humphreys, B., & Sam, A. (2010). Infants and toddlers with autism spectrum disorder: Early identification and early intervention. Journal of Early Intervention, 32, 75-98. o Odom, S. L., Boyd, B. A., Hall, L. J., & Hume, K. (2010). Evaluation of comprehensive treatment models for individuals with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 4, 425-436. o Odom, S., Collet-Klinenberg, L., Rogers, S., & Hatton, D. (2010). Evidence- based practices in interventions for children and youth with autism spectrum disorders. Preventing School Failure, 54, 275-282. o Wong, C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S., ... Schultz, T. R. (2013). Evidence-based practices for children, youth, and young adults with Autism Spectrum Disorder. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group. http://fpg.unc.edu/sites/fpg.unc.edu/files/resources/reports-and-policy- briefs/2014-EBP-Report.pdf 1

10/17/2014  Worked in the field for 17 years o Assistant Classroom teacher (self-contained) o Classroom teacher (inclusive setting) o District consultant o Trainer in TEACCH Model o Researcher at UNC  Evidence based practices o What are they? o Why are they important?  Determining EBP in ASD o Process of NPDC  Selecting & using EBP  Case study on use of EBP? o Visual Supports  Understand criteria and process for identifying EBPs in autism  Become familiar with the evidence based practices identified by the National Professional Development Center on Autism  Identify the practices that have proven to be effective with students of specific age ranges and/or with specific characteristics  Learn practical ways to implement practices across the classroom setting with a number of students  Discover a number of resources designed to assist in high quality implementation, data collection, and troubleshooting 2

10/17/2014  75% are male  Multiple etiologies related to neurobiological causes  Unrelated to socioeconomic status or race  Range of IQ scores, but stretches across the continuum  Autism tism h has s hist storica ically lly been s been shroud uded in m misi sinf nform ormati tion on o In the 1940s-1950s, prevailing professional and scientific opinion was that the disease was caused by the families (Bruno Bettleheim’s refrigerator mother theory)  Othe her i r interven enti tion ons s wi with th v very l little ttle or n no e evid idence ce of e of effect ctiv iven enes ess inc include  Antifungal treatment  Hyperbaric oxygen  Medical marijuana  Sound therapy  Trea eatm tmen ent t an and p d progra ogram m practice actices s need eed to be be based based o on s scie ienti ntific eviden ev ence Siri and Lyons, 2012. 3

10/17/2014 Best available empirical evidence Individualized practice decisions Family wisdom Professional & values wisdom & values 10 Many challenges impede the integration of different sources of evidence &/or translation &/or access to EB services Best available empirical evidence Individualized practice decisions Family wisdom & values Professional wisdom & values Result: Empirically based interventions often are not implemented in the “real world” 11 Evidence- based Education Professional Empirical Wisdom Evidence Scientifically- Individual Empirical Consensus based Experience Information Research Grover J. (Russ) Whitehurst Assistant Secretary Educational Research and Improvement United States Department of Education 4

10/17/2014  Without professional wisdom education cannot o adapt to local circumstances o operate intelligently in the many areas in which research evidence is absent or incomplete  Without empirical evidence education cannot o resolve competing approaches o generate cumulative knowledge o avoid fad, fancy, and personal bias Grover J. (Russ) Whitehurst Assistant Secretary Educational Research and Improvement United States Department of Education  Challenge of sorting among effective and ineffective interventions, discriminating between new & promising and deceptive & improbable  To rule out placebo effects  Cause of ASD is still largely a mystery Simpson, R., McKee, M., Teeter, D., Beytien, A. (2007) Evidence- based methods for children and youth with ASD: Stakeholder issues and perspectives. Exceptionality, 15 , 203-217.  Take a moment to write down (or at least think about) several practices you use with your students/individuals with ASD.  Rate them from 1-5 on the level of evidence you think they have (1=no empirical evidence to 5=strong empirical evidence)  Describe why you selected to use the practices that have the lowest ratings. Example: - Discrete Trial Training= 5 -Weighted vest=3 Use it because the family has seen benefits from using it 5

10/17/2014 Co Comprehens rehensiv ive e Fo Focused I Inte tervention Treatment M tment Models ls Pr Practices set of practices designed designed to address a to achieve a broad single skill or goal of a learning or student with ASD developmental impact on the core deficits of ASD  Translation of the intervention research literature  Most based on applied behavior analysis  Some from other theoretical perspectives 6

10/17/2014   Published between 1990-2011 in English P opulation/Participants: Have clear inclusion criteria for individuals with ASD between birth and 22 years of age I nterventions: Focused interventions that must be behavioral, developmental, or educational in nature and could be implemented in typical educational intervention settings (school, home, community) C omparison: Interventions were compared to no intervention or alternate interventions O utcomes: Generate behavioral, developmental, or academic outcomes. S tudy Design: Employed an experimental or quasi-experimental group design or single-case design 7

10/17/2014 • Experience with/ knowledge about ASD • Previous training related to group design/ SCD Application methodology • Online training module • Review protocols for article inclusion Training • Coding descriptive features of articles • Evaluate one article- compared to master code file • 80% accuracy Inter-rater • Correctly determine if the article met inclusionary criteria Agreement Reviewer Demographics # Reviewer Demographics # Degree level Position Masters Degree or Current Graduate Students 65 Faculty 68 Doctorate 94 Researcher 14 Degree area Graduate Student 46 Applied Behavior Analysis 9 Education 11 Practitioner/ Administrator 31 Occupational Sciences 3 Experience with ASD Teaching in classroom setting 109 Psychology 28 Providing intervention in clinical setting 76 School Psychology 5 Providing intervention in home setting 103 Special Education 97 Conducting ASD research 117 Speech/Language 3 Teaching college level course on ASD 84 Other (music, neurology, social work) 3  Criteria for Qualification as an Evidence-Based Practice o At least two high quality experimental group or quasi-experimental design articles • Conducted by at least two different researchers or research groups OR o At least five high quality single case design articles • Conducted by at least three different researchers or research groups • Having a total of at least 20 participants across studies OR o A combination of at least one high quality group experimental or quasi-experimental design article and at least three high quality single case design articles • Conducted by at least two different research groups 8

10/17/2014   90 Excluded 544 Excluded based on full- 25,656 Excluded 2,359 Excluded based on full- text review based on title based on text review (by (after final check review abstract review external by NPDC review reviewers) team) 456 29,105 1,090 Potentially 546 Potentially Intervention 3,449 Potentially eligible eligible articles Published intervention eligible articles intervention included in articles articles articles evidence base 27 Evidence-Based Practices Functional Antecedent –Based Structured Play Communication Prompting Interventions Groups Training Cognitive Behavior Modeling Reinforcement Task Analysis Intervention Technology-Aided Differential Naturalistic Response Interruption/ Instruction/ Reinforcement Interventions Redirection Intervention Discrete Trial Parent-Implemented Scripting Time Delay Teaching Interventions Exercise PECS Self-Management Video Modeling Peer-Mediated Extinction Instruction/ Social Narrative Visual Supports Intervention Functional Behavioral Pivotal Response Social Skills Training Assessment Training 9