Evidence-Based Practices In Autism Research Articles

Practitioner Adherence and Competence in MEYA, a Free Online Self-Instruction Program in Modular Psychotherapy and Counseling for Children's Autism-Related Clinical Needs.

The quality of care in public schools and other community settings for school-aged youths on the autism spectrum is variable and often not evidence-based. Training practitioners in these settings to deliver evidence-based practices (EBPs) may improve the quality of care. We developed a free internet-based training and clinical guidance system synthesizing multiple EBPs for youth on the autism spectrum addressing a range of mental health needs and autism-related behaviors, entitled Modular EBPs for Youth on the Autism Spectrum (MEYA; meya.ucla.edu). A multiple baseline study was conducted with seven practitioners recruited from mental health practice settings across the United States who were providing services to children on the autism spectrum (aged 6 to 17years). Practitioners were randomly assigned to undergo baseline conditions of 2 to 8weeks. Once online training in MEYA commenced, practitioners engaged in algorithm-guided self-instruction in EBPs for autism. Participants video-recorded sessions. Independent coders used the MEYA Fidelity Scale (MEYA-FS) to rate adherence and competence in EBPs for autism. Practitioners also completed measures pertaining to implementation outcomes and parents rated youth outcomes on personalized target behaviors. Five of seven practitioners increased their adherence to MEYA practices (i.e., MEYA-FS scores) following MEYA training. Findings for competence were similar, though somewhat less robust. Practitioners generally viewed MEYA as feasible, understandable, and acceptable. Most youth outcomes improved during MEYA. A randomized, controlled trial of MEYA would be helpful in characterizing its effectiveness for supporting practitioner EBP implementation and youth outcomes in school and community service settings.

Mindfulness-Based Stress Reduction in the Treatment of Adults with Autism Spectrum Disorder: a Systematic Review of Interventional Studies

AbstractAdults with autism spectrum disorder (ASD) have a lower quality of life (QoL) than neurotypical adults and a higher risk of psychiatric comorbidities. We reviewed the effectiveness of mindfulness-based stress reduction (MBSR) in the treatment of adults with ASD. Data were collected from 6 eligible interventional studies (4 adequate quality, 2 weak quality; 245 total participants). The study quality and certainty of findings were assessed using Evaluative Method for Determining Evidence-Based Practices in Autism and GRADE framework. MBSR was effective in all outcomes: ASD symptoms (n = 4, low certainty), QoL (n = 5, low certainty), symptoms of anxiety and depression (n = 4, low and moderate certainty, respectively). MBSR shows promise for improving QoL, reducing ASD symptoms and alleviating psychiatric comorbidities in adults with ASD.

Supplemental Material for Strengthening Capacity for Implementation of Evidence-Based Practices for Autism in Schools: The Roles of Implementation Climate, School Leadership, and Fidelity

Supplemental Material for Strengthening Capacity for Implementation of Evidence-Based Practices for Autism in Schools: The Roles of Implementation Climate, School Leadership, and Fidelity

Reading Instruction for Children with Autism Spectrum Disorders: A Systematic Review and Quality Analysis

This study reviews the literature on reading instruction consistent with the recommendations of the National Reading Panel (NRP; National Institute of Child Health and Human Development, 2000) for children with autism spectrum disorder, using the Evaluative Method for Determining Evidence-Based Practices in Autism to assess research quality (Reichow, Volkmar, & Cicchetti, 2008). A search of the literature published between 2009 and 2017 identified 10,779 relevant records, of which 19 met inclusion criteria. Studies reported gains in phonics, reading accuracy, reading fluency, and/or reading comprehension skills; however, few were of adequate or strong quality. Instruction that incorporated multiple Big Five elements from the NRP was associated with gains in reading accuracy and comprehension as well as relatively high quality ratings. Clinical implications and priorities for future research are discussed.

Organizational culture and climate profiles: relationships with fidelity to three evidence-based practices for autism in elementary schools

BackgroundImplementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit implementation theory and strategy development to the extent that individual dimensions of culture and climate interact, mutually reinforce or counteract one another, or exhibit non-linear relationships. This study tests whether empirically identifiable culture and climate profiles emerge in a sample of organizations and examines how these profiles relate to EBP fidelity and work attitudes that support EBP sustainment, focusing on three EBPs for youth with autism delivered in schools as an example.MethodsThe study included 65 elementary schools in the U.S. that implemented three EBPs—discrete trial training, pivotal response training, and visual schedules—for youth with autism. Organizational culture and climate and work attitudes were assessed using the Organizational Social Context measure at the beginning of the school year. Observations of EBP fidelity occurred mid school-year. We used bias-adjusted stepwise latent profile modeling to (1) identify subpopulations of schools that share similar culture and climate profiles, and (2) test for mean differences across profiles in observed EBP fidelity and teacher and staff work attitudes.ResultsControlling for region, four profiles best characterized the organizational cultures and climates of schools. Teachers and staff in schools with a comprehensive profile (high proficiency culture, positive climate) exhibited higher fidelity to two of three EBPs (d’s = .95 to 1.64) and reported superior work attitudes (d’s = .71 to 1.93) than teachers and staff in all other schools. Teachers and staff in supportive schools (low rigidity culture, positive climate) had better work attitudes, but not better fidelity, than those in schools with indifferent (low culture/climate, elevated stress) and constrained (high rigidity and resistance, high stress) profiles.ConclusionsOrganizational culture and climate profiles are a strong predictor of EBP fidelity and work attitudes that support EBP sustainment, highlighting the importance of an organization’s overarching social context when developing implementation theory and strategies. Strategies that foster a comprehensive profile may improve EBP implementation.

Development of the Evaluative Method for Evaluating and Determining Evidence-Based Practices in Autism

Although research in autism has grown more sophisticated, the gap between research knowledge and applicability of research in real world settings has grown. There have been a number of different reviews of evidence-based practices of treatments for young children with autism. Reviews which have critically evaluated the empirical evidence have not found any treatments that can be considered evidence-based. Reasons for this shortcoming are explored, and a new method for the evaluation of empirical evidence is provided. Future uses of this evaluative method are provided as well as a discussion of how this tool might aid in narrowing the research to practice gap.

Social Validation of Evidence-Based Practices in Autism by Parents, Teachers, and Administrators

Relatively little attention has been devoted to the social validation of potentially effective autism interventions. Thus, it is often difficult to identify and implement evidence-based practices, and programming is often inadequate. The authors identified autism intervention components with reported effectiveness for school settings. The results of a social validation survey completed by parents, teachers, and administrators indicate strong, consistent support for program components falling within five functional areas: (a) individualized programming, (b) data collection, (c) the use of empirically-based strategies, (d) active collaboration, and (e) a focus on long-term outcomes. These socially validated interventions can be used to evaluate existing autism curricula and develop training for professionals, parents, and students in order to improve public school autism programs.