TTAC Autism Priority Project Conference 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 Bandwagon about EBP Stop and think about what it means and how it applies to our work with students with ASD Huge gap between what we know, what is being used in applied settings - Research to practice gap

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” EBP are necessary, but not sufficient CIM are a package of EBP (usually), but no data has been taken on the “package” - where is the evidence?

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 Different researchers/professional organizations have defined EBP in different ways, which makes it hard to determine EBP National Professional Development Center National Autism Standards Project National Research Council

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 a list of EBP that basically all include principles of ABA (according their definition) - how do these fit into classrooms, how do you know when to use them and with whom, how do they fit together?

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) Some are umbrella/general categories and others are specific packaged approaches that have been researched Remember - information from NPDC is still evolving! Narrow approach to EBP & data is limited

Research to Practice: Application and Individualization of Evidence-based Practices in Authentic Settings Know what they are. What happens now? How do you implement them in classrooms with children?

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). Challenge is knowing a practice but knowing how to implement it with integrity

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 /Sequence Behavioral/Social Communication Play/ Leisure Academic Prompting X ? Reinforcement DTT Naturalistic Interventions PECS PRT FCT Parent implemented DRO/ Extinction Other scope/sequence skills - general education curriculum self-help/functional skills Motor Sensory Executive functioning skills

Response Interruption EPB & Scope/Sequence Behavioral/ Social Communication Play/ Leisure Academic ABI X ? CAI FBA PMI Response Interruption Self-management Social Narratives

Structured Work Environments EPB & Scope/Sequence Behavioral/Social Communication Play Academic Social Skills Groups X ? Structured Work Environments Task Analysis Time Delay Video Modeling Visual Supports

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

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

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

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!!!! How many of these are EBP?

EBP are necessary but not sufficient! 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? Sensory interventions Gluetin Free Diets

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 Takes a village

Evaluating the evidence! CEC - Division of Research Exceptional Children (2005) Experimental & Quasi-experimental Group Designs Single Subject Research Designs Correlational Research Qualitative Research Need to understand different types of research - remember research methods courses that you have taken? Now is the time to use that information. Different types of research methodologies contribute to the literature in different ways. All research is valuable

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

Questions & Discussion