Evidence-based Practice For Individuals Research Articles

Miniature Linguistic Systems for Individuals With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.

Miniature linguistic systems (also known as matrix training) is a method of organizing learning targets to achieve generative learning or recombinative generalization. This systematic review is aimed at determining whether matrix training is effective for individuals with autism spectrum disorder (ASD) in terms of improving recombinative generalization for instruction-following, expressive language, play skills, and literacy skills. A systematic review methodology was employed to limit bias in the various review stages. A multifaceted search was conducted. Potential primary studies were imported into Covidence, a systematic review software, and inclusion criteria were applied. Data were extracted regarding (a) participant characteristics, (b) matrix designs, (c) intervention methods, and (d) dependent variable. A quality appraisal using the What Works Clearinghouse (WWC) Single-Case Design Standards (Version 1.0, Pilot) was carried out. In addition to the visual analysis of the data, an effect size estimate, non-overlap of all pairs (NAP), was generated for each participant. Independent t tests and between-subjects analyses of variance were conducted to identify moderators of effectiveness. Twenty-six studies including 65 participants met criteria for inclusion. All included studies were single-case experimental designs. Eighteen studies received a rating of Meets Standards Without Reservations or Meets Standards With Reservations. The aggregated combined NAP scores for acquisition, recombinative generalization, and maintenance of a range of outcomes were in the high range. Findings suggested that matrix training is an effective teaching method for individuals with ASD for acquisition, recombinative generalization, and maintenance of a range of outcomes. Statistical analyses to identify moderators of effectiveness were insignificant. Based on the WWC Single-Case Design Standards matrix training meets criteria to be considered an evidence-based practice for individuals with ASD.

Efficacy of Teachers Supporting Paraeducators to Implement Functional Communication Training

Functional communication training (FCT) is an evidence-based practice for individuals with autism spectrum disorder (ASD) that can be implemented by practitioners in school settings. However, few studies have explored effective and sustainable training approaches to support paraeducators in their implementation of FCT. The purpose of this study was to evaluate the effectiveness of special education teacher–delivered training on paraeducator implementation of FCT for students with ASD. Paraeducator FCT implementation included delivery of a teacher-identified response prompting system to teach a predetermined functionally equivalent communicative response. All paraeducators delivered FCT with high levels of implementation after receiving training, with two paraeducators requiring additional follow-up coaching to meet the criteria for mastery. We present implications for practice and future research directions as it relates to developing effective training systems for paraeducators who support students with ASD.

Iterative Development of Caregiver-Implemented Behavioral Intervention via Telehealth: A Focus on Feasibility

Purpose:Applied behavior analysis (ABA) interventions are considered an evidence-based practice for individuals with autism spectrum disorder. With the recent COVID-19 pandemic, behavior analytic professionals quickly pivoted ABA therapy to the telehealth modality to ensure continuity of services. In particular, this modality has been reported to be particularly effective for caregiver training. As the world transitions from the pandemic, sustainability of the telehealth modality is now in question, with consumer perceptions regarding the feasibility of telehealth identified as crucial to long-term adoption.Method:The article presents two studies conducted over 2 years within a larger host study. Therefore, the goal of the current study was to develop an acceptable and feasible telehealth model by focusing on three aspects of behavioral intervention via telehealth: (a) usability and feasibility of the program as rated by caregivers and coaches, (b) effect of the program on caregiver stress, and (c) choice of telehealth dosage.Results:Results from Study 1 indicate the telehealth modality was usable and feasible for the caregivers and trainers but that they had difficulty scheduling sessions into their daily schedule. Results from Study 1 also suggest that caregiver-led intervention via telehealth led to increased caregiver sense of competency including increased sense of efficacy and satisfaction. Results from Study 2 indicate that caregivers prefer limited or focused services via telehealth as compared to more comprehensive services.Conclusion:Overall, these findings confirm previous research identifying the telehealth modality as feasible but highlight the need to account for impact of the dosage on caregivers.

Increasing Social Participation Using a Shared-Reading Peer-Mediated Intervention in Students with Autism

Peer-mediated interventions (PMIs) have been established as an evidence-based practice for individuals with autism spectrum disorder (ASD), yet few studies of this intervention have included students with ASD considered to be significantly impacted by the disorder. In the present study, a shared-reading PMI employing a three-step strategy including visual supports and token reinforcement was used to increase social interactions between four first and second grade participants with autism spectrum disorders (ASD) requiring substantial and very substantial support and 12 second grade participants with typical development (TD). A reversal design (ABAB) was used with sessions held twice a week over 2 months to measure social participation of participants during baseline and intervention phases. During intervention sessions, participants with ASD and TD were taught to stay, read, and talk with their buddies about a story. Visual analysis of graphical data and percent of all nonoverlapping data (PAND) effect size estimates indicated that all four participants with ASD increased social participation with typical peers over baseline measures, with two of the four participants with ASD increasing social participation to levels commensurate or surpassing that of participants with TD; however, two participants with ASD did not follow the expected reversal pattern. Additionally, three of four participants with ASD showed modest increases in initiations to peers. These results provide information about the use of PMI with participants with ASD requiring substantial and very substantial support, and the practicality of this intervention holds promise for sustainable use of PMI with this population in public-school settings.

Functional Communication Training: The Strength of Evidence Across Disabilities

Functional communication training (FCT) is a commonly used, often recommended intervention that involves teaching a functionally equivalent communicative response to replace challenging behavior. The purpose of this literature review was to evaluate the strength of the evidence for the use of FCT. A systematic review of the literature resulted in the identification of 215 single-case-design articles that evaluated the efficacy of FCT to reduce challenging behavior for individuals diagnosed with a disability. FCT resulted in a decrease in challenging behavior for 135 participants. The reviewers rated FCT as an evidence-based practice for individuals with autism, intellectual disability, other health impairments, and multiple disabilities based on What Works Clearinghouse standards. Overall, the extant literature indicates FCT consistently results in the reduction of challenging behavior in children with disabilities. Implications for practice and directions for future research are discussed.

Evaluating Exercise as Evidence-Based Practice for Individuals with Autism Spectrum Disorder.

The purpose of this study was to conduct a systematic review of the literature to evaluate empirical support for the use of exercise as an evidence-based practice (EBP) for individuals with autism spectrum disorder (ASD), aged 1-21 years, using the Adapted Physical Activity Taxonomy (APAT) (1). A systematic review of research, published within the past 10 years and accessible in SPORTDiscus, ProQuest Nursing, Science Direct, ERIC, Ovid MEDLINE, and PsychINFO databases, was conducted following seven inclusion criteria. An initial 169 articles were identified of which 23 articles were found that met the inclusion criteria including implementation of an exercise intervention for participants diagnosed with ASD and utilization of an experimental/quasi experimental, correlational, single-subject, or qualitative research design. These 23 articles were evaluated using the APAT to determine the quality of the research and the strength of the recommendation in establishing exercise as an EBP. Of the 23 articles evaluated, 17 employed an experimental/quasi experimental design, 1 article employed a correlational design, and 5 articles employed a single-subject design. Only one article (2) was found to meet the minimum overall quality indicator of moderate (i.e., Level 2) when evaluated on the APAT. In total, 13 of the 23 articles (57%) had method sections evaluated as weak, and 17 of the 23 articles (74%) had results sections evaluated as weak. From the findings of this systematic review, and in accordance with the Every Student Succeeds Act of 2015 (3) definition of an EBP, it appears that exercise can be considered an EBP for school-aged children with ASD. However, this recommendation is based solely on moderate evidence from one well-designed and well-implemented experimental study; therefore, generalization is still pending further similar findings. Recommendations for future research are offered.

Training Teachers in Evidence-Based Practice for Individuals With Autism Spectrum Disorder

In this review, the authors include 23 studies where researchers experimentally evaluated training for teachers of students with Autism Spectrum Disorder (ASD). Authors summarized qualitative information on study and participant characteristics. Next, variables related to teacher practice and student learning targets were categorized based on Odom, Collet-Klingenberg, Rogers, and Hatton’s list of evidence-based practices (EBPs) for individuals with ASD. Training components were also categorized based on instructional format (i.e., self-instruction, individual, group). Finally, application of standards (What Works Clearinghouse [WWC]) facilitated the evaluation of each study’s rigor. Findings suggest that research has most frequently focused on individually training teachers in the use of behavioral interventions to improve students’ communication. From the evaluation of design quality, only 2 of the 23 studies met WWC quality indicators for single-case or group-design standards. A discussion of the findings, limitations to the review, and recommendations for practitioners and future research on teacher training conclude the study results.

Evidence-based practice for individuals or groups: let's make a difference.

The aim of applying science into practice is to deliver high-quality health care. Thinking about teaching the necessary accompanying skills, a distinction can be made between using evidence for individual patient care and using scientific knowledge for the development of protocols or guidelines for groups of patients or professionals. In this paper, these two ways of applying science into practice are being considered. We plea for explicating the differences between the individual patient and a group of patients or professionals when applying scientific knowledge in the decision-making process. The acknowledgment of these differences facilitates the teaching of the accompanying competences and different CanMEDS roles.

Parents served by assertive community treatment: Parenting needs, services, and attitudes.

Assertive Community Treatment (ACT) is an evidence-based practice for individuals with severe mental illness. Although at least half of all people with severe mental illness are parents, little is known about their experiences as parents and as recipients of mental health interventions like ACT. The purpose of the current study was to examine the experiences of parent consumers served by ACT. Seventeen parents being served by ACT teams were interviewed about parenting, parenting needs, severe mental illness, satisfaction with ACT services, and suggestions for improved parent-focused treatment services. All parents identified at least one positive aspect of parenting and most parents (77%) also identified negative aspects of parenting. Loss of custody emerged as a significant parenting problem, with most parents (88%) experiencing custody loss at least once. Parents expressed interest in numerous parent-focused services, including family therapy, parenting skills, communication skills training, resources for children, and peer support groups. Most participants with adult children (88%) reported having no unmet parent-related needs and high satisfaction (4.63 of 5) with ACT services, whereas parents with young children (78%) reported having several unmet parenting needs and relatively lower satisfaction (3.78 out of 5) with ACT services. The ACT treatment model may not be adequately serving parents of young, dependent children. Findings suggest the need for more attention and focus on parent consumers, including identification of parental status and improved parent-related treatment services and support.

Parents Served by Assertive Community Treatment: Prevalence, Treatment Services, and Provider Attitudes

Assertive Community Treatment (ACT) is an evidence-based practice for individuals with severe mental illness. Although studies estimate at least half of all people with severe mental illness are parents, little is known about ACT policies and services for consumers who are parents. ACT providers from 67 teams completed a survey assessing policies for identifying parent consumers of ACT, estimated prevalence of parent consumers, available treatment services, and attitudes about parent consumers. Participants estimated that 18% of ACT consumers are parents. However, less than half of participants (47.8%) reported formally asking about parental status during intake and only 22.4% reported providing programs or services designed for parent consumers. Most participants (about 80%) reported negative or mixed attitudes about parenting with severe mental illness. Findings suggest the need for more attention and focus on parent consumers, including the formal identification of consumers' parental status and availability of parent-related treatment services.

VR closure rates for two vocational models.

The Individual Placement and Support (IPS) model of supported employment is an evidence-based practice for individuals with psychiatric disabilities. To be financially viable, IPS programs require funding from the state-federal vocational rehabilitation (VR) system. However, some observers have questioned the compatibility of IPS and the VR system. Using a randomized controlled trial comparing IPS to a well-established vocational program called the Diversified Placement Approach (DPA), we examined rates of VR sponsorship and successful VR closures. We also describe the establishment of an active collaboration between a psychiatric rehabilitation agency and the state VR system to facilitate rapid VR sponsorship for IPS clients. Both IPS and DPA achieved a 44% rate of VR Status 26 closure when considering all clients entering the study. IPS and DPA averaged similar amount of time to achieve VR sponsorship. Time from vocational program entry to Status 26 was 51 days longer on average for IPS. Even though several IPS principles seem to run counter to VR practices, such as zero exclusion and rapid job search, we found IPS closure rates comparable to those for DPA, a vocational model that screens for readiness, provides prevocational preparation, and extensively uses agency-run businesses.