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Evidence-based Practice in Autism Intervention

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One of the current issues that everyone is aware of in autism education is the need to use evidence-based practice.  While the idea sounds easy enough, what comprises an acceptable level of evidence is not as easy as it looks in any field, and in a field as diverse as autism, it is even less clear (see this explanation).  In addition, while some of us may have time to read and evaluate the scientific literature, many of us are too busy trying to live and work in the field of education to have that luxury.  Fortunately there are some tools that can help us to identify which practices have an evidence base and which are less supported.  Also, there are many areas, such as technology and social skills instruction, where the strategies are so new that there is little evidence accumulated about them.  For instance, few in the autism communities can escape the publicity that the iPad and iPhone have garnered about their effects with individuals with autism. Links about them can be found here and here.  However, the iPad is only one year old and the iPhone is only 5 at the time of this writing. Consequently there has been limited time for the scientific community to evaluate the effectiveness of them as tools for communication and other skills.  So, to help teachers, parents and other interested readers to evaluate strategies, this post will provide resources that evaluate practices in autism and my next post will focus on strategies for evaluating new practices that have limited evidence accumulated this time.
The Autism Society (thanks I believe to Brenda Smith Myles) has done a great service of summarizing the conclusions of three groups that summarized the findings a out practices in autism.  While there is significant overlap between the reports, it is clear that even a review of the evidence can be done in different ways to yield different results. To help address this, the table outlines a comparison of the findings of the National Autism Center, The Center for Medicaid and Medicare Services (CMMS), and the National Professional Development Center on Autism Spectrum Disorders (NPD).  the National Autism Center has provides the results of its evaluation of practices and an educators guide for implementing the evidence-based practices outlined in their report.  Similarly the NPD has published a chart that compares EBD from their evaluation and the NAC project and  how they overlap.  They also provide a summary of EBD briefs for many practices in autism.  
Another way to gain information about EBD in ASD is to look at training tools like the Autism Internet Modules.  These online learning modules are provided by OCALI and the NPD among others and each one provides the evidence base for the practice it addresses. The Texas Autism Research Guide for Effective Teaching (TARGET), which was also discussed in a post on reinforcement, also publishes briefs on practices including information about their evidence base. The Association for Science in Autism Treatment also provides evidence briefs of specific practices and includes many practices that do not have evidence supporting them, something that other sites sometimes leave out of their lists as absence indicates no support. 
There are also several books out that are helpful in evaluating evidence based practice, but books quickly become outdated in such an endeavor.  The National Research Council’s Educating Children with Autismwas one of the first summary of recommended practices for the field for children up to 8 years old based in part on the research. It was published in 2001, so it’s findings are a bit dated.  In 2005, Richard Simpson and his colleagues published a book, Autism Spectrum Disorders: Interventions and Treatments for Children and Youth, that is a good desk reference for professionals in autism and categorizes practices as harmful, limited evidence, promising practices, and evidence-based practice.  In addition, many professional books are now providing an overview of the research supporting their work within the book that practitioners can refer to.  Many websites similarly point to the accumulation of research on the intervention practice.  For instance, the Pyramid Educational Services group provides a list of research articles supporting the use of PECS.  The only drawback is that they simply list the articles and the reader is left to evaluate and locate them on his or her own.
Finally , for strategies that are too new there are some summaries of the research that can be helpful in evaluating their use until the evidence base grows. For social thinking and social skills interventions that have a more cognitive behavioral base, Michelle Garcia Winner has done a great job in her book
evaluating the research that exists thus far.  She also recently posted an explanation of the evidence base for social thinking.  For the iPad and similar technology iAutism has provided an overview of research evaluating the use of technology for different purposes in autism intervention.  As more research comes along, I will do my best to pass it along to you in an easy to digest format.  In addition, I will post in the next few days guidelines for how to evaluate practices effectiveness with your students, since having an overall evidence base is a good start, but it does not guarantee that the practice will be effective for each of your students.      

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