Guide for Judging Treatments & Therapies

…SO many ASD treatments, practices, strategies, information, etc….

How to choose???

Opinions; Opinions; Opinions!!!

Why not just use the therapy / treatment I like best?

Possibility of Harm

Time, money, and energy is NOT directed toward interventions that WILL get the expected outcomes…

…SO many ASD treatments, practices, strategies, information, etc….

How to choose???

TEACH PEOPLE TO BE CRITICAL CONSUMERS!!

Guiding Principle

ALL DECISIONS INFORMED BY….◦THE LAW◦THE RESEARCH◦THE DATA

The LAW…. NCLBRequires experimental studies that are similar to the medical model of research used by scientists. These studies require many steps to prove strong evidence of effectiveness.

◦ Well designed studies that use random samples of the population

◦ Trials must also include a random “control group” for comparison

◦ Valid and reliable outcome measures

◦ Data on long-term outcomes

◦ Trials in more than one site of implementation

Science, Pseudoscience or Anti-science

Science :◦ Does not take assertions or observations at face value◦ Seeks proof. ◦ Differentiates opinions, beliefs, and speculations from demonstrated

facts.

Pseudoscience:◦ Tries to lend credibility to beliefs, speculations, and untested

assumptions by making them appear scientific.◦ Instead of objective measurements from well-controlled experiments,

offer testimonials, anecdotes, and unverified personal reports to back up their claims.

Antiscience:◦ The outright rejection of the scientific method as a means of

producing valid and useful knowledge. Adapted from asatonline.org (2011)

Pseudoscientific Therapies: Some Warning Signs

1. High "success" rates are claimed. 2. Rapid effects are promised. 3. The therapy is said to be effective for many symptoms or disorders. 4. The "theory" behind the therapy contradicts objective knowledge (and

sometimes, common sense). 5. The therapy is said to be easy to administer, requiring little training or

expertise. 6. Other, proven treatments are said to be unnecessary, inferior, or harmful. 7. Promoters of the therapy are working outside their area of expertise. 8. Promoters benefit financially or otherwise from adoption of the therapy. 9. Testimonials, anecdotes, or personal accounts are offered in support of claims

about the therapy's effectiveness, but little or no objective evidence is provided.

10. Catchy, emotionally appealing slogans are used in marketing the therapy. 11. Belief and faith are said to be necessary for the therapy to "work." 12. Promoters resist objective evaluation and scrutiny of the therapy by others. 13. Negative findings from scientific studies are ignored or dismissed. 14. Critics and scientific investigators are often met with hostility, and are

accused of persecuting the promoters, being "close-minded," or having some ulterior motive for "debunking" the therapy.

Retrieved from asatonline.org (2011)

CONGRESSIONAL FINDINGS

“…the implementation of this chapter (33 : IDEA) has been impeded by low expectations, and an insufficient focus on applying replicable research on proven methods of teaching and learning for children with disabilities.”

Understanding Federal Law

U.S. Code (U.S.C.)50 Titles

Title 20: Education78 Chapters

Chapter 33: IDEA — IV SubchaptersSubchapter I: General Provisions

82 Sections -- denoted as §§ 1400: Findings / Purpose

What ARE Evidence-Based Practices?

Practices that have empirical support

Practices that show effectiveness through documented improved measurable outcomes (DATA) that result in improved functioning.

NOT:◦ “I’ve seen this work” OR “I heard this works”◦ It works because I WANT it to work (Placebo)

Natural Growth & Maturity◦ Would this change have occurred anyway as the student grows and

matures?

Other Interacting Interventions◦ During the time of treatment, interventions currently in place are not

generally stopped to try the new one, and often other interventions are added during the time of treatment so it is difficult to determine what intervention is causing the change.

Expectations of Improvement◦ Expectations have a POWERFUL impact on outcomes.◦ The more invested we are in the treatment (i.e. emotionally,

financially, in terms of time, etc.), the more expectations we have for outcomes.

◦ Possible reasons this occurs: More attention to small changes More investment into the student generally (e.g. time interacting with

the student)

Placebo Effects—Points to Consider

What ARE the EBPs for Students with

ASD?

The National Professional Development Center on ASD (NPDC)

The National Professional Development Center on Autism Spectrum Disorders is a multi-university center to promote the use of evidence-based practice for children and adolescents with autism spectrum disorders.

http://autismpdc.fpg.unc.edu/content/briefs

• EBP Briefs: Step by Step Implementation Guides

EBPs by Age Level & Skill Addressed

The National Autism Center launched the project in 2005 with an expert panel. The culmination of this rigorous multi-year project is the National Standards Report, the most comprehensive analysis available about treatments for children and adolescents with ASD. The National Standards Report will serve as a single, authoritative source of guidance for parents, caregivers, educators, and service providers as they make informed treatment decisions.

National Standards Project

• Overview Manual• Educators

Manual

National Autism Center -- National Standards Project: http://www.nationalautismcenter.org/nsp/dissemination.php

NSP – NPDC Comparison Chart

OCALI Online Modules

http://www.autisminternetmodules.org/

http://media.mindinstitute.org/education/ADEPT/Module1Menu.html

The Association for Science in Autism Treatment

ASAT is a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of people with autism. Since autism was first identified, there has been a long history of failed treatments and fads, levied on vulnerable individuals as well as on their families. Since ASAT was established in 1998, it has been our goal to work toward adopting higher standards of accountability for the care, education and treatment of all individuals with autism.

http://www.asatonline.org/intervention/treatments_desc.htm

Additional Resources for EBPs in ASD Classroom / Building Tools:

◦ USAPT (Universal Supports Assessment & Planning Tool)-- Building Tool: http://www.gvsu.edu/autismcenter/usapt-online-326.htm

◦ Georgia State University’s EIC-ASD (Enhancing Instructional Contexts for Students with ASD)—Classroom Tool: http://education.gsu.edu/autism/index.htm

Texas Statewide Leadership for Autism Training: http://www.txautism.net/manual.html

Questions to Ask to Judge Treatments, Therapies, &

Strategies against the EBP Standard

Concerns/Issues? Skill Acquisition?◦ Behavioral?◦ Communication?◦ Social?◦ Academic?

Will this treatment, therapy, strategy, etc. address these issues?

Why are you seeking a new treatment, therapy, strategy?

http://autismpdc.fpg.unc.edu/content/briefs

Does the treatment align with EBPs?

Does the treatment align with practices with no / limited research support?

http://www.asatonline.org/intervention/treatments_desc.htm

What research is available that supports the use of this intervention? Does this research have strong research design with control groups?

Who has performed the research? Has it been published in peer reviewed journals? (GET COPIES)

Are the outcomes supported by data (get the information) or anecdotal stories or testimony from individuals, not based on scientific method?

What specific changes / improvements are expected and how are they measured? (Does is “WORK”?)

What are the qualifications of the person(s) implementing this intervention? (e.g. degree / certificate; training requirements)

What are the potential side effects?

Additional Questions to Ask…

NOW… YOU DECIDE…..