Evidence-Based Practices for Supporting Students with Autism Spectrum Disorder

Kathy Gould, Program ManagerIllinois Autism Partnership at Easter Seals Metropolitan Chicagokgould@eastersealschicago.org

Briana WeinerIllinois Statewide Technical Assistance Collaborative briana.weiner@istac.netEvidence-Based Practices for Supporting Students with Autism Spectrum Disorder

DSM IV vs DSM 5 SUMMARY

No separate categories / levels of severity

Communication and social deficits are merged

Restrictive interests/repetitive behaviors include sensory

Decrease emphasis on actual language delay

Increase emphasis on social behavior

Later onset of symptoms with increased social demands

DSM IVDSM 5Social Interaction

Communication

Repetitive/ Restrictive BehaviorsSocial Communication

Restricted Interests/Repetitive Behaviors/SensoryMajor ChangesNational PrevalenceBetween 2000 to 2008, autism prevalence has grown from 1 in 150 children to 1 in 68* from the year 2000 until 2010. (Centers for Disease Control Report, 2014).

Between1998 to 2010, the number of 6 to 21 year old children receiving services for an ASD in public special education programs increased from 54,064 to 370,011.

In 2010, 370,011 children 6 through 21 years of age and 49,251 children 3 through 5 years of age were served under the "autism" classification for special education services.

PBIS Outcomes for Students with Disabilities

Students with disabilities in the US are being suspended at twice the rate of students w/o disabilities resulting in loss of time in school (instructional time) and often resulting in more segregated placements. In a sample of 166 Illinois schools, students with disabilities had a 72% reduction in out of school suspensions (OSSs) from 2010 to 2013. (59% reduction for students without disabilities).

5PBIS Outcomes for Students with DisabilitiesThe impact of PBIS implementation on elementary school students with disabilities is being found to be even greater than on those students without disabilities!

Why Evidence-Based Practices?Promotes positive outcomes for individuals with ASD

IDEIA (2004) requires that educational strategies be used that are based on scientifically based research

Accountability for schools and teachers for instructional practices employed

Data driven decision making for instructional practice choices

National Standards ProjectNational Autism CenterPublished 2009 National Standards ReportEducational and Behavioral Interventions (Comprehensive Treatment packages)Designed to achieve a broad learning or developmental impact on the core deficits of ASDStrength of Evidence Ratings11 Established22 Emerging 3 Unestablished 0 Ineffective/harmful

Criteria for Inclusion in the StudyPopulation/ Participants-Individuals with ASD between birth and 22 years of age Interventions-Behavioral, developmental, or educational in nature and could be implemented in typical educational intervention settings (school, home, community) Comparison-Interventions compared to no intervention or alternate intervention conditions Outcomes-Behavioral, developmental, or academic outcomes Study Design-Experimental group design, quasi-experimental group design, or single-case design

Strength of Evidence Classification System used to determine how confident we can be about the effectiveness of a treatment. Ratings reflect the level of quality, quantity, and consistency of research findings for each type of intervention.

Established. Sufficient evidence is available to confidently determine that a treatment produces favorable outcomes for individuals on the autism spectrum. That is, these treatments are established as effective.

Emerging. Although one or more studies suggest that a treatment produces favorable outcomes for individuals with ASD, additional high quality studies must consistently show this outcome before we can draw firm conclusions about treatment effectiveness.

Unestablished. There is little or no evidence to allow us to draw firm conclusions about treatment effectiveness with individuals with ASD. Additional research may show the treatment to be effective, ineffective, or harmful.

Ineffective/Harmful. Sufficient evidence is available to determine that a treatment is ineffective or harmful for individuals on the autism spectrum.2009 NSP - 11 Established Comprehensive TreatmentsAntecedent PackageBehavior PackageComprehensive Behavioral Treatment for Young Children Joint Attention InterventionModeling Naturalistic Teaching Strategies Peer Training PackagePivotal Response PackageStory-based Intervention Package SchedulesSelf-Management

How many are you currently implementing?

2008 NPDC 24 Focused InterventionsPromptingAntecedent- Based InterventionTime DelayReinforcementTask AnalysisDiscrete Trial TrainingResponse Interruption/RedirectionDifferential ReinforcementSocial NarrativesVideo ModelingNaturalistic InterventionsPeer Mediated Intervention

Pivotal Response TrainingVisual SupportsStructured Work SystemsSelf-ManagementParent Implemented InterventionSocial Skills Training GroupsSpeech Generating DevicesComputer Aided InstructionPicture Exchange CommunicationExtinction

Newly Updated 2014 NPDC EBPIncorporate more recent studies (2007-2011) 456 articlesExpand timeframe (to 1970-1990)

Broader more rigorous review of studies

2014-EBP-Report

Whats INCognitive Behavior InterventionStructured Play GroupsModeling including Video - ModelingExerciseScriptingTechnology based instruction and intervention*

Whats OUTStructured work systems

Do you have specific knowledge of the focused interventions and when/why to use them?Updated NPDC EBP

Intervention ApproachesNational Standards Project Comprehensive Treatment Model (CTMs) consist of a set of practices designed to achieve a broad learning or developmental impact on the core deficits of ASD. National Professional Development Center for ASD Focused Intervention Practices are designed to address a single skill or goal of a student with ASD. These practices are operationally defined, address specific learner outcomes, and tend to occur over a shorter time period than CTMs. Evidence Based PracticeAutism Spectrum Disorders: Guide to Evidence-based Practice Missouri Guidelines Autism InitiativeSelecting EBP16Selecting EBPConsiderAge of studentEnvironment/SettingIndividual characteristicsSkills to be taughtCapacity to implement Include familiesInvolve studentsNon-examplesPick a package and go with itDo what feels rightThis is what we have staff trained inParents are asking for this

Supporting Family Involvement in EBPServe as a classroom volunteerMaintain frequent communication Attend school-sponsored eventsIncorporate learning activities into home routines (working on greetings at grocery store)Secure student inputConsider family culture, values, and socioeconomic status

Building Sustainability with EBP Step 1: Establish the Planning Team Step 2: Problem Clarification and Needs Assessment Step 3: Evaluating Outcomes Step 4: Developing a Training Plan and a method to assess implementation fidelity Step 5: SustainabilityTaken fromEvidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum DisorderAutism Evidence-Based Practice Review GroupFrank Porter Graham Child Development InstituteUniversity of North Carolina at Chapel Hill

The National Autism Centers Evidence-Based Practice and Autism in the SchoolsA guide to providing appropriate interventions to students with autism spectrum disordersThe purpose of this report is to describe a process for the identification of evidence-based practices (EBPs) and also to delineate practices that have sufficient empirical support to be termed evidence-based. 20