Resources for Implementation of Evidence-Based Practice
by Kate Fiske, Ph.D., BCBA-D
Though many parents and professionals recognize the importance of implementing evidence-based practices for children with autism, they may struggle with identifying resources that offer practical strategies for implementing these practices. The National Professional Development Center (NPDC) on Autism Spectrum Disorders (ASD) has compiled a series of briefs on 24 evidence-based practice approaches for individuals with autism, including: antecedent-based interventions, differential reinforcement, discrete trial training, extinction, functional behavior assessment, peer-mediated instruction, pivotal response training, Picture Exchange Communication System (PECS), Pivotal Response Training (PRT), prompting, self-management, task analysis, video modeling and others. The briefs for these practices can be found at the following address: http://autismpdc.fpg.unc.edu/content/briefs
The NPDC‘s briefs are well-organized and user-friendly, with a ―package‖ of PDF files available for each approach. Each package includes a summary of the evidence base for the practice, an overview of the approach, a detailed description of the steps required for implementation, and a checklist of necessary implementation steps. Additionally, several briefs include related data sheet templates and sample data sheets pre-filled with fictitious data to illustrate their use.
One of the strengths of the compilation of briefs is the heavy emphasis on the assessment and treatment of problem behavior. Several briefs—functional assessment, extinction, differential reinforcement, functional communication training, and antecedent-based interventions—describe best practices for identifying the function of a behavior, and designing and implementing a function-based treatment for the behavior. For many professionals and parents, the area of functional assessment will be one of the most helpful, especially given the frequent necessity for implementing functional behavioral assessment in response to problem behavior in home and school settings. The step-by-step instructions for conducting a functional assessment and implementing function-based treatment—accompanied by a very helpful checklist to ensure that all steps are completed—will be valuable to any professional conducting the assessment, or to any parent who wishes to ensure that a functional assessment and treatment are implemented appropriately. Importantly, the authors point out that some treatment practices, such as extinction, can be very effective but should only be used in conjunction with other strategies, such as functional communication training and other antecedent-based strategies. Such cautionary statements are invaluable when professionals are using these briefs as references for designing an effective behavioral intervention.
The NPDC should also be praised for its emphasis on the importance of data collection for all procedures included in their briefs list, as is evidenced most obviously by their inclusion of data sheet templates in many briefs. The group repeatedly states that baseline data should be collected on a skill or problem behavior prior to the implementation of an evidence-based practice, and then monitored over time to ensure that appropriate changes in behavior are observed. Furthermore, the group attends nicely to considering setting and context when implementing interventions. For example, one brief on ―parent intervention‖ cautions the professional to be aware of family environment when designing interventions for the home. Additionally, when considering best practices for peer involvement in intervention, the authors establish different steps to intervention based on the educational level of the students (early childhood, middle school, high school) to help professionals adapt to the developmental needs of these age groups. These sensitivities are highly important when treating individuals with autism, but may be often overlooked by professionals.
In addition to these briefs, the NPDC has also begun to compile a list of Autism Internet Modules, hosted by the Ohio Center for Autism and Low Incidence (OCALI) at http://autismpdc.fpg.unc.edu/content/autism-internet-modules-aim. These modules can be accessed after setting up a free account with OCALI, and include topics related to the evidence-based practices reviewed in the briefs (e.g., PECS, PRT), but also extend to topics such as the assessment and diagnosis of autism. The modules include written text as well as pictures and video related to each topic. Many modules included on this website are listed as ―coming soon,‖ so this site will likely be a growing resource in years to come.
Frequently, the briefs listed on the NPDC site are stamped with the word ―draft,‖ indicating that the briefs are a work in progress. These documents will undoubtedly change over time, and may be added to as further evidence is found for current and future treatments. One also hopes that the NPDC will expand upon current topics by offering an elaborated description of variations of the procedures addressed. For example, in describing methods by which to identify student preferences, only one example of a reinforcer sampling is offered (Mason & Egel, 1995). Other assessments (e.g., DeLeon & Iwata, 1996; Fisher et al., 1992) offer valuable information about a student‘s preferences and may be beneficial to include in the brief. Synthesizing different bodies of research that describe variations of similar evidence-based practices (e.g., preference assessments, discrete trial instruction) is a challenge, but ultimately will be beneficial for consumers.
In sum, the NPDC has created an approachable resource for consumers that provides clear descriptions of frequently used evidence-based practices. Particularly helpful for professionals working in public schools, the implementation steps and checklists for each practice will be an excellent resource for those wishing to implement practices with integrity. Additionally, several briefs offer a concise summary of broad topics (e.g., PECS) that can be used as a handy reference to supplement other program materials and guides. The continued development of the briefs and modules will be a wonderful resource by which professionals and parents can identify best practices, as well as the steps required to implement them.
DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of a multiple-stimulus presentation format for assessing reinforcer preferences. Journal of Applied Behavior Analysis, 29, 519-533.
Fisher, W., Piazza, C. C., Bowman, L. G., Hagopian, L. P., Owens, J. C., & Slevin, I. (1992). A comparison of two approaches for identifying reinforcers for persons with severe and profound disabilities. Journal of Applied Behavior Analysis, 25, 491–498.
Mason, S. A., & Egel, A. L. (1995). What does Amy like? Using a mini-reinforcer assessment to increase student participation in instructional activities. Teaching Exceptional Children, 28, 42-45.