Evidence-Based Practice and Crisis Intervention

Abstract

The adoption of systematic reviews and meta-analyses by government agencies and professional organizations as the rational basis for investing in evidence-based practice (EBP) and guiding clinical practice attests to the continuing importance of EBP in psychological treatment and professional training. Despite its vigorous pursuit with other populations, EBP has had a more modest impact in the field of developmental disabilities. This chapter reviewed the evidence for effective psychological and educational interventions for people with developmental disabilities, by reviewing the nature of behavioral crises and the evidence for both prevention and treatment of such crises. The most promising prevention strategies are activity choice; activity schedules; functional communication training combined with extinction, punishment, or both; other language and communication interventions; and instructional fading combined with extinction or noncontingent escape. As for treatment, robust evidence was found for the effectiveness of behavioral interventions based on functional assessments and analyses including differential reinforcement, antecedent control, extinction plus reinforcement, and response cost plus reinforcement to address target behaviors directly relevant to crises, including aggression, tantrums, noncompliance, and self-injurious behavior, in people with developmental disabilities. There was little evidence for the effectiveness of other treatments.