Evidence-based Practice Standards Research Articles

Successful treatment of cortical visual impairment in children using anti-amblyopia treatment despite the absence of amblyopia: a case report

BackgroundCortical visual impairment (CVI) is a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways or any potentially co-occurring ocular impairment. Given the limited knowledge on the most effective interventions for visual impairment resulting from CVI, this case report provides valuable insights into an example of successful implementation of anti-amblyopia therapy in a patient with CVI.Case presentationThis case report presents a 5-year-old girl with CVI secondary to hypoxic-ischemic injury, resulting in visual impairment, dyspraxia, and abnormal visual evoked potential testing. The girl did not suffer from amblyopia, there was no evidence of relevant refractive errors or strabismus, so visual pathway damage was the cause of her visual deficit. Nevertheless, the patient underwent anti-amblyopia therapy and showed significant improvement in visual acuity after 12 months of treatment. The improvement, resulting from visual stimulation, was due to a good functional recovery by a better usage of the damaged visual pathways. The therapy included prescribing corrective glasses and implementing secondary occlusion of the better eye for 4 months, which was protracted for another 4 months, leading to further improvements in visual acuity.ConclusionsThe case report shows that addressing even minor refractive errors and implementing anti-amblyopia therapy can significantly improve vision in children with CVI, even without co-existing amblyopia. It also highlights the importance of early intervention and multidisciplinary rehabilitation in children with CVI, focusing on motor and cognitive skills. Additionally, it emphasizes the need for further research to establish evidence-based practice standards for improving vision in children with CVI.

Effects of Arts-Based Pedagogy on Competence Development in Nursing: A Critical Systematic Review.

The integration of arts-based methods into nursing education is a topic of growing interest in nursing practice. While there is an emerging body of research on this subject, evidence on competence development remains vague, largely due to methodological weaknesses. The purpose of this review is to evaluate the effectiveness of arts-based pedagogy in nursing, specifically in terms of students' changes in knowledge, skills, and attitudes. It explores which arts-based approaches to nursing education qualify as evidence-based practice in terms of nursing competence. A systematic critical review of research on arts-based pedagogy in nursing was conducted, identifying 43 relevant studies. These studies were assessed for methodological quality based on the CEC Standards for evidence-based practice, and 13 high-quality comparative studies representing a variety of arts-based approaches were selected. Creative drama was identified as the only evidence-based practice in the field, positively affecting empathy. The findings highlight a research gap in nursing education and emphasize the need for measurement and appraisal tools suitable for the peculiarities of arts-based pedagogy.

Naturalistic Developmental Behavioral Interventions for Developmental Language Disorder.

Naturalistic-developmental-behavioral interventions (NDBIs) are a widely accepted and validated approach for treating language-related symptoms in autism spectrum disorder, including deficits in vocabulary, social skills, and grammar. The purpose of this article is to define the elements naturalistic, developmental, and behavioral as applied to children with developmental language disorder (DLD) and to provide an example of how this type of intervention can be implemented to teach vocabulary and test cross-modal generalization between expressive and receptive modalities. A vocabulary intervention using hybrid NDBI methods (storybook reading and conversational recast interaction) was provided to three participants with DLD using a single-case design. The results indicated that all participants successfully learned receptive and expressive vocabulary targets with extensive cross-modal generalization. However, generalization was limited in some of the participants. This article provided definitions of key elements of NDBI (naturalistic, developmental, and behavioral) including a rationale for extending NDBI procedures to language intervention for children with DLD. In addition, a single-case design demonstrated that NDBI can be implemented in DLD and that broadly defined naturalistic-developmental applied behavior analysis techniques are applicable to language interventions for children with language disorders. Moreover, diverse naturalistic and developmental procedures meet the highest standards for evidence-based practice to treat DLD.

Improving Student Attitudes Toward Autistic Individuals: A Systematic Review.

There is an increasing number of autistic students being educated alongside their neurotypical peers. However, placing a student in the general education setting is not sufficient for meaningful inclusion. Historically, autistic students have had fewer friendships, been less accepted, and experienced stigmatization. Interventions to increase peer attitudes toward autism have emerged as a method for creating more inclusive environments. The purpose of this literature review was to describe the interventions to improve peer attitudes toward autism, review the quality of the research, and determine the effectiveness of interventions. Specifically, this review aimed to answer the following questions: (1) what are participant characteristics and components of interventions designed to improve attitudes toward autistic individuals? (2) What is the methodological quality of interventions designed to improve attitudes toward autistic individuals, as measured by Council for Exceptional Children standards for evidence-based practices in special education (2014) criteria? (3) What is the effectiveness of interventions to improve attitudes toward autistic individuals? A total of 13 studies were located through a systematic search. Included studies were coded for study characteristics, participant characteristics, intervention, and outcomes. Across the studies, there were a total of 2097 participants. All studies included contact (either direct, indirect, or peer-mediation) and most included an education component (k = 10). Findings indicated that interventions are effective at improving attitudes toward autism, but further research is required to determine their overall impact.

A Systematic and Quality Review of Augmentative and Alternative Communication Interventions that use Core Vocabulary

AbstractCore vocabulary is defined as “lexical items that are accepted as being central and indispensable to language use” (Bell, 2012, p. 1). Use of core vocabulary is common amongst professionals who teach augmentative and alternative communication (AAC) to individuals with disabilities. Although the use of AAC is often classified as an evidence-based practice (EBP) (Steinbrenner et al., 2020; Wong et al., Journal of Autism and Developmental Disorders, 45(7), 1951–1966, 2015) an analysis of the relevant intervention procedures as well as the vocabulary used is often missing from syntheses of the literature. Therefore, a systematic review was conducted to determine the quality and strength of the evidence for AAC interventions that use core vocabulary. A systematic database search and a subsequent screening process resulted in a total of 10 peer-reviewed studies that involved an AAC intervention that used core vocabulary. Each study’s outcomes were then categorized as positive, mixed, or negative and a quality review was performed using the Council for Exceptional Children’s (CEC) standards for evidence-based practices (Cook et al., Teaching Exceptional Children, 46(6), 206-212, 2015a; Remedial and Special Education, 36, 220-234, 2015b). Overall, the results suggest a lack of strong evidence in favor of AAC interventions that use core vocabulary. The results are discussed in the context of general suggestions for vocabulary selection and teaching practices for AAC systems.

A Systematic Review of Second Step Social-Emotional Skills Program in Middle Schools

In this systematic review, we evaluated the quality and rigor of the current evidence base for the Second Step social-emotional learning program in middle schools. Eleven studies were coded using the Council for Exceptional Children Standards for Evidence-Based Practices in Special Education with an 80% weighted criterion. We determined five studies met the weighted 80% criteria and one study demonstrated a positive effect as defined by Council for Exceptional Children. The other four studies demonstrated neutral/mixed results, and we therefore classified Second Step for middle schools in the mixed evidence category. We discuss the strengths of evaluated studies and future directions for research.

Assessment of strategy instruction and self-regulation in reading comprehension: A review of the literature

Strategy instruction is a common instructional method for teaching academic skills, particularly reading comprehension, and it is commonly combined with self-regulation components (e.g., goal setting, self-monitoring). Previous meta-analyses and reviews have examined the effectiveness of strategy instruction on reading comprehension, but have not examined how reading comprehension is assessed, an area of need considering that reading comprehension assessments are not created equal. In this systematic review, sixteen articles were examined to determine the methods for assessing reading comprehension, self-regulation, reading motivation/attitudes, and social validity. In addition, the Council for Exceptional Children’s Standards for Evidence-Based Practices in Special Education were applied to all included studies. Limitations and recommendation for future researchers are presented and disussed.

Comparing and Contrasting Quality Frameworks Using Research on High-Probability Requests With Young Children

The purpose of this study was to compare and contrast frameworks for evaluating methodological rigor in single case research. Specifically, research on high-probability requests to increase compliance in young children was evaluated. Ten studies were identified and were coded using 4 frameworks. These frameworks were the Council for Exceptional Children Standards for Evidence-based Practices, What Works Clearinghouse, Risk of Bias Assessment for Single Subject Experimental Designs, and Single Case Analysis and Review Framework. Significant differences were found across frameworks, both in the rating of rigor and the study effects. Implications for determining high-quality research and effective practices are discussed.

Around the EQUATOR with clinician-scientists transdisciplinary aging research (Clin-STAR) principles: Implementation science challenges and opportunities.

The Institute of Medicine and the National Institute on Aging increasingly understand that knowledge alone is necessary but insufficient to improve healthcare outcomes. Adapting the behaviors of clinicians, patients, and stakeholders to new standards of evidence-based clinical practice is often significantly delayed. In response, over the past twenty years, Implementation Science has developed as the study of methods and strategies that facilitate the uptake of evidence-based practice into regular use by practitioners and policymakers. One important advance in Implementation Science research was the development of Standards for Reporting Implementation Studies (StaRI), which provided a 27-item checklist for researchers to consistently report essential elements of the implementation and intervention strategies. Using StaRI as a framework, this review discusses specific Implementation Science challenges for research with older adults, provides solutions for those obstacles, and opportunities to improve the value of this evolving approach to reduce the knowledge translation losses that exist between published research and clinical practice.

Emergency Department Initiative to Improve Sepsis Core Measure Compliance: A Hospital Network Approach.

The topic of sepsis has been realized among the last 20 years. A majority of patients with sepsis enter the health system through the emergency department, and health professionals need to provide evidence-based care. Within the health system, interdepartmental teams were formed with the purpose to set a system-wide standard to meet the evidence-based practice standards for sepsis. Participants were recruited from every department that was involved with the care delivery of emergency department patients with sepsis. The team developed a team charter to state the group objectives. A gap analysis was completed to set group priorities. The first priority was to develop a system-wide sepsis alert process. The Operational Excellence coach conducted direct observations and interviews at each system facility and then a sepsis alert plan was developed. Two hospitals volunteered to pilot the sepsis alert within their emergency departments, and education was completed at each hospital. Informatics nurses developed electronic medical record workflow and outcome elements to help the team with the process. The pilot process showed an increase in compliance for core measures and laid the groundwork for each hospital to develop an individualized process.

Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies.

How a community responds to behavioral health emergencies is both a public health issue and social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments (EDs), boarding for hours or days while waiting for treatment. Such crises also account for a quarter of police shootings and >2 million jail bookings per year. Racism and implicit bias magnify these problems for people of color. Growing support for reform provides an unprecedented opportunity for meaningful change, but solutions to this complex issue will require comprehensive systemic approaches. As communities grapple with behavioral health emergencies, the question is not just whether law enforcement should respond to behavioral health emergencies but how to reduce unnecessary law enforcement contact and, if law enforcement is responding, when, how, and with what support. This policy article reviews best practices for law enforcement crisis responses, outlines the components of a comprehensive continuum-of-crisis care model that provides alternatives to law enforcement involvement and ED use, and offers strategies for collaboration and alignment between law enforcement and clinicians toward common goals. Finally, policy considerations regarding stakeholder engagement, financing, data management, legal statutes, and health equity are presented to assist communities interested in taking steps to build these needed solutions.

A Systematic Review of Interventions for Multilingual Preschoolers With Speech and Language Difficulties.

Purpose There is a shortage of information on evidence-based interventions for supporting young multilingual children. The purpose of this review was to identify interventions that have been evaluated with preschool-age multilingual children with a speech and/or language disorder or who are at risk of poor speech, language, literacy, and/or educational outcomes. Method This review considered speech, language, and early literacy interventions evaluated with preschool-age multilingual children with a speech and/or language disorder or who have been identified as being at risk of language difficulties (PROSPERO ID: 165892). The following electronic databases were searched: EBSCO (CINAHL Plus, ERIC, PsycINFO, Medline, Education) and Linguistics, Language, and Behavior Abstracts. Data were extracted describing article, participant, methodological, and intervention variables, and effect sizes. The Council for Exceptional Children's (CEC) standards for evidence-based practice were used to examine the quality of studies. Results Fifty-six relevant studies were identified in 52 articles and these studies described 4,551 participants who had speech sound disorder (six articles), developmental language disorder (11 articles), or were considered to be at risk (36 articles). The interventions targeted speech production (seven studies), language (45 studies), and early literacy (11 studies) skills. Most studies reported positive effects. Only 15 studies met all quality indicators specified by the CEC (2014) and these described 18 interventions targeting language and literacy skills. The only intervention with sufficient evidence to be considered an evidence-based practice was Nuestros Niños [Our Children] for children's early literacy and phonological awareness skills. Conclusions A number of high-quality studies exist that describe speech, language and/or literacy interventions for preschool-age multilingual children with a speech and/or language disorder, or who have been identified as being at risk of language difficulties. However, there remains limited evidence for specific interventions as to their ability to inform evidence-based practices. Supplemental Material https://doi.org/10.23641/asha.16632649.

The health insurance system and psychoanalytic psychotherapy in Japan: the association with evidence-based practice

Since 1958, the Japanese public health insurance system has covered psychoanalytic psychotherapy. Although it is called ‘standard-type psychoanalytic therapy’, it is essentially psychoanalytic psychotherapy or psychodynamic psychotherapy performed face-to-face once a week. Japan has two psychoanalytical organisations: the Japan Psychoanalytic Society (JPS) and the Japan Psychoanalytical Association (JPA), both established in 1955. Until they separated in 1980, they were one organisation that worked together to secure government approval for medical insurance coverage of psychoanalytic psychotherapy and contributed to training psychiatrists and clinical psychologists in psychoanalytic psychotherapy. Currently, less than 1% of psychiatrists and clinical psychologists in the country have undergone JPA or JPS training. Psychoanalytic psychotherapy provision nationally is difficult because psychoanalytic psychotherapists are concentrated in urban centres. Recent global trends have prompted the demand for evidence-based practice (EBP). To date, the effectiveness of psychoanalytic psychotherapy has not been demonstrated in Japan. Therefore, it is not recognised as an EBP within national measures for public mental health. However, psychoanalytic psychotherapy is essentially an ‘experience-based practice’, even though it is fundamentally different from EBP. Nevertheless, to sustain psychoanalytic psychotherapy as a viable psychotherapy in Japan, it would need to meet EBP standards.

Development of the counselor wellness competencies

ABSTRACT Foundational to counseling, wellness and counselors’ attention to the integration of wellness-related counseling assessments and interventions are preventative and unique to the profession. This manuscript presents the process of delineating counselor wellness competencies based on evidence-based research, professional ethics, and educational and practice standards. Nine specific competencies of counselor, professional and client-centered wellness are discussed.

In the preparation and administration of intravenous medicines, what are the best practice standards that healthcare professionals need to follow to ensure patient safety? Protocol for a systematic review.

Introduction: Intravenous therapy and medicines (IVTM) are the most common invasive interventions in use in healthcare. Prescribed IVTM play an essential role in the treatment of illness, management of chronic conditions and in maintaining health and wellbeing. The intravenous (IV) route is the administration of concentrated medications (diluted or undiluted) directly into peripherally or centrally inserted vascular access devices. Medication safety is a key priority and best practice standards are required to guide the safe preparation and administration of IVTM. Methods: We will conduct a systematic review of the literature pertaining to the preparation and administration of intravenous therapy and medicines. Our search will include studies concerned with the preparation and/or administration of IVTM via peripheral or central vascular access devices. We will be guided by the preferred reporting items for systematic review and meta-analysis (PRISMA) in this review. Literature will include all trial designs, national/international guidelines, and expert consensus opinion made available in English from 2009 to present day. Conclusions: We will synthesise the evidence concerning safe and effective preparation and administration of intravenous therapy and medicines to inform the development of a national guideline for healthcare professionals in Ireland. The availability of up-to-date, contemporaneous evidence-based practice standards will ensure quality and safety for service-users. Registration: This study has been submitted to PROSPERO and we are awaiting confirmation of registration.

Gregory Research Beliefs Scale: Preliminary confirmatory factor analysis of convergent construct validity

ABSTRACT Purpose: A number of factors underscore the importance of validly measuring social work students’ beliefs regarding research and social work practice. The Gregory Research Beliefs Scale (GRBS) purports to measure social work students’ beliefs about the general value of research for social work practice. The purpose of the present study was to preliminarily determine the convergent validity of the GRBS. Method: A confirmatory factor analysis was used to examine the convergent validity of the GRBS relative to the Evidence-Based Practice Process Assessment Scale (EBPPAS) Attitude subscale. Results: Based on observed scale correlations, latent variable correlations, an anticipated statistically significant X 2 difference in models, and various modification indices all aligning with a priori theoretical expectations, the convergent validity of the GRBS was preliminarily supported. Discussion: The present study, in conjunction with prior research, will ultimately translate to social work education that embodies CSWE standards for evidence-based practice.

A Meta-Analysis of Video Modeling Interventions to Enhance Job Skills of Autistic Adolescents and Adults.

Autistic transition-aged youth and young adults face many societal barriers to competitive integrated employment (CIE). Existing evidence-based practices (EBPs) for autistic individuals, such as video modeling (VM), may be a viable on-the-job training method to enhance employment experiences and outcomes for this population. The purpose of this meta-analysis was to synthesize VM studies to teach job skills for autistic individuals. We applied the Council for Exceptional Children's (CEC) Standards for Evidence-Based Practices in Special Education to evaluate the methodological rigor of included studies using a weighted coding scheme. We further evaluated methodologically sound studies by calculating an omnibus Tau-U effect size. Twenty articles met our inclusion criteria, and 11 of those studies were classified as methodologically sound according to the CEC's criteria. Results indicate that VM is an EBP to improve job skills of autistic individuals. The overall effect size for methodologically sound studies was strong (0.91), but most studies occurred in contrived or school-based employment settings rather than CIE settings in the local labor market. Employers, transition professionals, and related service providers can consider VM a viable method to teach job skills to autistic employees. However, additional research conducted in CIE settings is needed to better understand the effects of VM in contexts where autistic employees earn regular wages. Why was this study done?: Autistic adolescents and adults often experience barriers obtaining employment in their local communities. They may also benefit from on-the-job supports for successful employment. Video modeling is one intervention technique that has been used to teach a variety of skills to autistic individuals. Video modeling involves creating short video clips that show the person how to do specific skills or tasks. We wanted to learn about how video modeling has been used to teach job skills to autistic employees.What was the purpose of this study?: The purpose of this study was to evaluate the quality of research studies that used video modeling to teach job skills to autistic employees. Understanding how video modeling interventions can be used in employment settings may help autistic employees have more positive work experiences.What did the researchers do?: The researchers analyzed the video modeling research studies with autistic participants aged 14 years or older. We evaluated the quality of each study, type of employment setting, type of job skill, and how much the job skills improved. We used a criteria established by a professional organization, the Council for Exceptional Children, to evaluate the quality of the research studies.What were the results of the study?: We analyzed 20 research studies and found that video modeling was an overall effective intervention to teach job skills to autistic adolescents and adults. However, most of the studies focused on general job tasks rather than employment-related social skills. In addition, most of the studies were conducted in employment settings where the autistic employees did not earn regular wages, such as school settings or internships. We encourage future researchers to study how video modeling can be used to promote competitive integrated employment in community settings.What do these findings add to what was already known?: Prior research studies have used video modeling to teach skills such as academic, play, and social skills to autistic children and youth. This study showed us that video modeling is an effective intervention to teach job skills to autistic adolescents and adults.What are the potential weaknesses of the study?: There are disagreements about how to evaluate the quality of research studies in the field of special education. We used a popular criterion by the Council for Exceptional Children organization, but our results may be different from other researchers. We also did not find a large number of studies, so some of our findings should be considered with caution.How will these findings help autistic adults now or in the future?: These findings demonstrate that video modeling is an effective on-the-job training method for autistic employees. Autistic adults can use video modeling at work to learn new job skills. Employers, job coaches, and secondary transition professionals could use brief videos to support autistic employees.

Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the UK

BackgroundFundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals.MethodsUsing a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice.Results/conclusionsOur comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.

Partnership Through Integration: Perianesthesia Policy Standardization

PurposeTo develop system-wide perianesthesia policies, through partnerships, across 11 acute care hospitals and 1 ambulatory surgery center. DesignA partnership culture was created and maintained throughout the development and integration of multiple site-based policies into system policies. MethodsPolicies were built using evidence-based practice and professional organizational standards with an emphasis on quality, safety, and standardization of patient care. Early and ongoing partnerships with key stakeholders were maintained in order to effectively develop the policies. FindingsMore than 50 independent policies across 11 acute care hospitals and 1 ambulatory surgery center were integrated and updated into 4 main perianesthesia nursing policies. ConclusionsFlexibility and partnership with key stakeholders throughout the policy process was instrumental for early detection of barriers and the successful development of perianesthesia nursing policies.

Changing Culture Around Serious Illness: The VA Life-Sustaining Treatment Decisions Initiative

Discussing and documenting goals of care and life-sustaining treatment decisions with seriously ill patients is a widely endorsed practice by healthcare and professional organizations. In 2018, The Veterans Health Administration (VA) initiated a new national policy to standardize such practices, the Life Sustaining Treatment Decisions Initiative (LSTDI), which included a coordinated set of evidence-based strategies and practice standards for conducting, documenting, and supporting high-quality goals of care conversations (GoCCs); staff training to enhance skills in conducting, documenting, and supporting GoCCs; standardized, durable electronic health record tools for documenting patients’ goals and preferences; and monitoring and information technology tools to support implementation and improvement. In this symposium, we will describe the first 20 months of implementing the LSTDI across the VA, the largest integrated healthcare system in the US. The first paper will focus on the factors associated with documentation of a GoCC and treatment preferences. The second paper will present findings describing facilitators and barriers to implementing the LSTDI and identifying factors that promote high rates of LSTDI documentation. The third paper examines patient level outcomes associated with a documented goal of comfort care, specifically the odds of receipt of hospice/palliative care, hospitalization, or ICU admission. This symposium will provide attendees with important information regarding a wide range of individual and system strategies to enhance the care of seriously ill older adults by engaging patients with serious illness in GoCCs and documenting their preferences for treatment in durable, easily accessible notes and orders.