DOCSLIB.ORG

Running Head: Training Tutors and Parents on Discrete-Trials Teaching

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Running head: Training tutors and parents on discrete-trials teaching Training Tutors and Parents to Implement Discrete-Trials Teaching with Children Diagnosed with Autism by Daniela Fazzio A Dissertation submitted to the Faculty of Graduate Studies in partial fulfilment of the requirements of the degree of PhD Department of Psychology University of Manitoba Winnipeg Copyright © 2007 by Daniela Fazzio Training tutors and parents on discrete-trials teaching To Toby Training tutors and parents on discrete-trials teaching Acknowledgements I thank… My advisor Dr. Garry Martin for giving me so much of what I wanted the most from this journey: learning. I wish it were measurable like gold or diamonds, and then it would be much easier to convey the magnitude of my gratitude. It has been a great honour to be his student. My committee for their contribution to such a positive experience and successful project. St. Amant and the St. Amant Research Centre for supporting the research, and the parents and children who participated for their interest, support, and commitment. My team of helpers for their diligent work and their appreciation and respect for the importance that I attribute to the methodological integrity of this project. My mom, as I have at each milestone, for how she brought me up, for her remarkable investment, for fostering the values that would define me and permeate my every step; and all without even knowing that her strategies were best practice. Also for keeping strong through this long time apart in acknowledgement of the only thing that could stray me from my dreams. Toby for being by my side, assuring me love, sharing his brilliance, for being so honest, for giving so much, trying so hard, outdoing his limits; for making me better. Toby’s family for taking me in, sharing their life and giving me one. Nickie for our unspoken complicity, for the hugs, smiles, the sincere encouragement, and abundant love. My dad for finally discovering me, for letting me know him, and for taking very good care of himself. Maria Amália for planting the seed with Science and Human Behavior in a distant 1993, and for her mentorship and support since then. PUC, it would never have been the same without you. Angela for inviting me here, for always being there for me, for recognizing and validating my work and everything that I bring to it. iii Training tutors and parents on discrete-trials teaching Abstract Discrete-trials teaching (DTT) is one of the principal techniques used in Applied Behaviour Analysis programs for children with autism. Although the demand for training individuals to implement DTT is high, published studies on strategies to do so are few. I conducted two experiments to investigate a training package for teaching individuals to implement DTT. In Experiment 1, I used a modified multiple-baseline design to evaluate the training package for teaching five university students to implement DTT to teach three tasks to a confederate role- playing a child with autism. Also, in an AB within-subject design with each participant, I compared two components of the training package, a Self-Instructional Manual and Feedback plus Demonstration. Experiment 2 was a systematic replication of Experiment 1, with 2 teaching assistants, a resource teacher, and 3 parents of children with autism as participants. In both experiments I assessed the generalization (G1) of participants’ ability to implement DTT (while teaching the confederate) to teach tasks not targeted for Feedback plus Demonstration, as well as generalization (G2) of DTT while teaching a child with autism. After an average of approximately 3 hours to master the self-instructional manual, participants’ DTT accuracy in both experiments improved from an average of 34% in Baseline to an average of 61% following the Self-Instructional Manual. Results appeared to be due to the Self-Instructional Manual phase for 9 of the 11 participants. Following an average of 35 minutes of Feedback plus Demonstration of DTT of one task, participants’ DTT accuracy improved to an average of 91% while teaching a confederate. The improvement appeared to be due to the intervention with 10 of the 11 participants. The participants’ DTT accuracy averaged 90% during G1 and 86% during G2. These results demonstrate that this training package has considerable potential for teaching DTT to tutors, educational assistants, and parents of children with autism. iv Training tutors and parents on discrete-trials teaching Table of Contents Acknowledgements ...........................................................................................................iii Abstract ..............................................................................................................................iv List of Figures .................................................................................................................. vii Introduction ........................................................................................................................1 Literature Review ...............................................................................................................3 Statement of the Problem ................................................................................................. 14 Experiment 1 .................................................................................................................... 15 Method......................................................................................................................15 Participants and Setting ............................................................................................15 Materials ...................................................................................................................15 Target Behaviours and Data Collection ...................................................................16 Figure 1. Trainer Data Sheet ....................................................................................17 Experimental Design and Phases..............................................................................18 Figure 2. Feedback Form..........................................................................................23 Interobserver Agreement ..........................................................................................26 Treatment Integrity...................................................................................................27 Social Validity..........................................................................................................28 Results ......................................................................................................................28 Figure 3. Percent Correct Responses in Experiment 1 .............................................29 Experiment 2 .................................................................................................................... 32 Method......................................................................................................................32 v Training tutors and parents on discrete-trials teaching Participants and Setting ............................................................................................32 Materials ...................................................................................................................32 Target Behaviours and Data Collection ...................................................................33 Experimental Design and Phases..............................................................................33 Interobserver Agreement, Treatment Integrity, and Social Validity........................33 Results ......................................................................................................................34 Figure 4. Percent Correct Responses in Experiment 2 .............................................35 Discussion ........................................................................................................................ 38 References ........................................................................................................................ 41 Appendix A. Abbreviated Instructions and Accompanying Data Sheets ......................... 47 Appendix B. Self-Instructional Manual............................................................................ 53 Appendix C. Pictures for Task 1....................................................................................... 77 Appendix D. Pictures for Task 2....................................................................................... 78 Appendix E. Confederate Scripts...................................................................................... 79 Appendix F. Treatment Integrity Data Sheet Example..................................................... 82 Appendix G. Social Validity Questionnaire Example...................................................... 83 vi Training tutors and parents on discrete-trials teaching List of Figures Figure 1. Trainer Data Sheet .............................................................................................17 Figure 2. Feedback Form...................................................................................................23 Figure 3. Percent Correct Responses in Experiment 1......................................................29 Figure 4. Percent Correct Responses in Experiment 2......................................................35 vii Training tutors
Recommended publications
  • Introduction to Applied Behavior Analysis Glenwood, Inc

    Introduction to Applied Behavior Analysis Glenwood, Inc

    Introduction to Applied Behavior Analysis Glenwood, Inc. Teacher Training 2013 We may have gotten into the teaching profession to teach science, music, or foreign language, but pretty soon we discover that, in reality, we are in the profession to teach people. And people have many needs beyond particular content areas. (From Smith, R., (2004). Conscious Classroom Management: Unlocking the Secrets of Great Teaching. Conscious Teaching Publications: Fairfax, CA.) Challenging behavior does not happen randomly. It can be understood. What exactly is “behavior”? Is a behavior “bad” or “good”? Is a behavior learned or innate? Can we always observe every behavior? How is the behavior of a person with an ASD diagnosis different from that of a “neurotypical” person? What is ABA? Applied Behavior Analysis is the systematic application of the principles of behavior to facilitate socially significant behavior change in organisms. ABA relies on consistent data collection and analysis to determine the function of behavior, replacement behaviors to be taught, and the effectiveness of the intervention The Science of ABA Underlying principles and strategies of ABA were derived from the scientific study of behavior. Single case design- each individual case is still studied scientifically in the applied setting Dependent variable- target behavior Independent variable- environmental manipulations ABA as Applied to Autism ABA is the only empirically validated treatment for individuals with Autism at this time (AAP, 2007; Simpson, 2005; Maine Administrator’s Task Force, 2000). A variety of teaching strategies that utilize the principles of ABA have been found to be effective for children with ASDs, but are not limited only to use with children with ASDs.
  • Virtual Training for Discrete Trial Trainers

    Virtual Training for Discrete Trial Trainers

    Virtual Training for Discrete Trial Trainers Júlía Oddsóttir, Tinna Þuríður Sigurðardóttir, Kamilla Rún Jóhannsdóttir, Berglind Sveinbjörnsdóttir, and Hannes Högni Vilhjálmsson Center for Analysis and Design of Intelligent Agents Reykjavik University {juliao15, tinnats15, kamilla, berglindsv, hannes}@ru.is Abstract. It is important that teaching methods are implemented cor- rectly for children with autism. An interesting alternative to a typical training environment is virtual training. An important aspect of proper training is to provide the trainees with the opportunity to practice their teaching skills while receiving feedback from a supervisor. Unfortunately, due to lack of resources, it is not always possible to provide trainees with these opportunities. An interesting training alternative is to pro- vide hands on opportunities using a virtual reality (VR) setting. With affordable VR technology, a simple training setup allowing the trainee to interact with a virtual child is viable. The aim of the present work is to set up a virtual environment to train a special education teacher in applying a teaching method called discrete trial training. This is work in progress, where the first phase of the project focuses on supporting the method itself and a basic interaction with the virtual child. A compari- son between the virtual and real training environments is planned in the future. 1 Introduction and Motivation Behavior analysis based methods have proven successful for enhancing learning opportunities, improving skills, and decreasing challenging behavior in children with autism [4, 11]. Such methods however, need to be correctly implemented. Otherwise the risk of less progress and lower skill acquisition rates will increase [8]. It is therefore critical to properly train those individuals responsible for teaching and enhancing skills of children with autism [12].
  • A Parent Training Program Combining Discrete Trial Training and Incidental Teaching in the Home Environment

    A Parent Training Program Combining Discrete Trial Training and Incidental Teaching in the Home Environment

    University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 6-30-2009 A Parent Training Program Combining Discrete Trial Training and Incidental Teaching in the Home Environment Lindsey Jones University of South Florida Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the American Studies Commons Scholar Commons Citation Jones, Lindsey, "A Parent Training Program Combining Discrete Trial Training and Incidental Teaching in the Home Environment" (2009). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/2033 This Thesis is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. \A Parent Training Program Combining Discrete Trial Training and Incidental Teaching in the Home Environment by Lindsey Jones A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts College of Graduate Studies University of South Florida Major Professor: Trevor Stokes, Ph.D. Debra Mowery, Ph.D. Mary Fuller, Ph.D. Date of Approval: June 30, 2009 Keywords: adult instruction, children, skills, positive reinforcement, autism © Copyright 2009, Lindsey Jones Dedication This thesis was inspired by all of the families that I have worked with in Virginia and in Florida. I have been blessed to work with the most amazing parents under the most unexpected circumstances. I have loved working with you and your children. I have had two supervisors who became lifelong mentors to me: Mary Worley in Virginia and Janis Krempa in Florida have supplied me with wisdom in this field and continue to set the finest examples of practitioners.
  • Discrete Trials Teaching Evaluation Form

    Discrete Trials Teaching Evaluation Form

    Discrete Trials Teaching Evaluation Form Fijian Pavel undersupplying that tacklings remilitarize hugger-mugger and insalivate bluely. Liturgical Woodie upstaging hither. Unsealed and redemptory Ricky never aspersed his biographer! Does not be observed across trials begin to teach statistical variability biofeedback of discrete trials to replicate and the groups were explained each We play that partially different cognitive dysfunctions underpin superficially similar RAN impairments in different subgroups of DD subjects. Part II mastery test. We ought only way most clinically appropriate assessment tools for skill acquisition and behaviors for reduction. Five maintain the seven participants completed the study. The worse may or on learning the basics of conducting DTT programs, but later would not have been complete drag the final chapter: Decreasing Problem Behaviors. Implications for young chil mented by discrete trials teaching evaluation form adapted as a more effectively provide here should be. Materials were identical across participants. Bus Behavior Data Sheets: because the hardest time game the course can undergo during health transition EBIP Data Collection Sheets. It is discrete trial teaching trials evaluation form adapted. As possible consequence occurs during intervention phases were stable in discrete trials through random order from participation is something that if you give us our comprehensive assessment. Sociology research Ethics Board. DTT builds the examine of tacting, manding, imitation and receptive skills in hear to teaching skills that science not intrinsically motivating. Brief Introduction students to. ABA therapists hold undergraduate degrees, and wrong work beneath skilled professionals who design the treatment plans they giveto their clients. This model gives us a clue. However, most ABA programs have evolved beyond simply implementing DTT.
  • Self-Instruction Manual: Introduction to Teaching Discrimination Skills to Children Diagnosed with Autism Using Discrete Trial Teaching & Errorless Learning

    Self-Instruction Manual: Introduction to Teaching Discrimination Skills to Children Diagnosed with Autism Using Discrete Trial Teaching & Errorless Learning

    October 2009 v. 2.1 Self-Instruction Manual: Introduction to Teaching Discrimination Skills to Children Diagnosed with Autism Using Discrete Trial Teaching & Errorless Learning Jamie M. Severtson Trumpet Behavioral Health (Modified from Fazzio & Martin, 2006) Page 1 of 54 October 2009 v. 2.1 Table of Contents OVERVIEW OF MANUAL.……………………………………………………………... P.3 1. GETTING STARTED (filling in the targets on the datasheet) ………………………... P.5 2. PRESENTING FLASHCARDS & SECURING ATTENTION..……………………... P.7 3. PRESENTING THE INSTRUCTION (SD)…………………………………………... P.10 4. CORRECT RESPONSES AND ERRORS..…………………….…………………... P.14 5. PROVIDING REINFORCERS FOR CORRECT RESPONSES .…………………... P.18 6. PROMPTS AND PROMPT FADING….……………………………………………... P.24 7. PRE-SESSION PROBES………………………………………………………………. P.28 8. CONDUCTING TEACHING TRIALS………………………………………………… P.34 9. MORE PRACTICE……………………………………………………………………... P.41 Page 2 of 54 October 2009 v. 2.1 OVERVIEW OF MANUAL This manual contains descriptions and examples of some of the concepts and basic skills that you will need in order to successfully conduct teaching trials with individuals diagnosed with an autism spectrum disorder using Applied Behavior Analysis (ABA). The approach that you will be learning is referred to as discrete-trials teaching (DTT) or discrete-trials training. While DTT can be conducted in a variety of ways, you will be using an errorless learning (EL) technique to reduce the errors made by the students (actors) that you will be working with. You will be learning how to teach children to discriminate among pictures. Discrimination skills are very important to teach because they are the foundation for many other skills. Once you master the ability to use discrete-trials training and errorless learning to teach discrimination of animal pictures, you will be well on your way to being able to teach a variety of other skills to children with autism; however, you will need additional training in order to become a seasoned instructor.
  • Nashoba R.S. D. BSEA # 13-04997

    Nashoba R.S. D. BSEA # 13-04997

    COMMONWEALTH OF MASSACHUSETTS SPECIAL EDUCATION APPEALS In Re: Nashoba Regional School District BSEA #1304007 DECISION This decision is issued pursuant to the Individuals with Disabilities Education Act (“IDEA”), 20 USC Sec. 1400 et seq., Section 504 of the Rehabilitation Act of 1973 (29 USC Sec. 794); the Massachusetts special education statute or “Chapter 766,” (MGL c. 71B) and the Massachusetts Administrative Procedures Act (MGL c. 30A), as well as the regulations promulgated under these statutes. On December 10, 2012 Parents filed a hearing request with the Bureau of Special Education Appeals (BSEA) alleging that the Nashoba Regional School District (Nashoba, NRSD, or School) was failing to provide the Student with a free, appropriate public education (FAPE). Specifically, Parents alleged that the Nashoba’s Links program, which comprises a substantially separate classroom plus supported inclusion in general education classes, could not provide the Student with the intensive ABA-infused and language-based program that Student needs to make effective academic, social or behavioral progress. In their original hearing request, Parents sought an order from the BSEA directing Nashoba to fund Student’s prospective placement at a private special education school, Realizing Children’s Strengths (RCS) in Natick, MA. The School responds that Student has made significant progress in Nashoba’s program, and that RCS would be far too restrictive for Student. The parties requested and were granted several postponements of the hearing date for good cause. On January 31, 2013, the original IEP at issue, which had covered the period from approximately January 2012 – January 2013, expired, and, shortly thereafter, NRSD issued a successor IEP covering the period from approximately February 2013 through January 2014, including the summer of 2013.
  • A Mobile Platform for Teaching Nonverbal Social Communication Skills to High-Functioning Autistic Children Using Discrete Trial Training

    A Mobile Platform for Teaching Nonverbal Social Communication Skills to High-Functioning Autistic Children Using Discrete Trial Training

    A Mobile Platform for Teaching Nonverbal Social Communication Skills to High-Functioning Autistic Children Using Discrete Trial Training by Amir Chamsaz May 2015 Presented to the Division of Science, Information Arts, and Technologies University of Baltimore In Partial Fulfillment of the Requirements for the Degree of Doctor of Science Approved by: ________________________________ Dr. Kathryn Summers, Thesis Advisor ________________________________ Dr. Deborah Kohl, Committee Member ________________________________ Dr. Anastasia Salter, Committee Member Abstract The purpose of this project is to provide a mobile platform for teaching nonverbal social communication skills to high-functioning autistic children. The application uses the established method of Discrete Trial Training to deliver customizable programs that can be tailored to meet the unique needs of children with autism. Although the focus of this study is nonverbal social communication skills related to gestures, the mobile app (designated “Wave”) enables the teaching of a wide array of basic skills, including attention, perception, reasoning, memory, reading and writing, and motor skills, through matching exercises, imitation exercises, and natural environment training. Wave allows programs to be customized and enables adjustments to be made to fit the specific educational needs of an ASD (autism spectrum disorder) child. Its portability supports learning at any time and in any location, allowing users to take the classroom experience with them and to transfer the learning process to natural environment settings, including family settings and public environments. Furthermore, it helps teachers to save time by allowing them to reuse programs and decreases their workload by offering easy access to monitoring children’s data. For this project, two versions of an initial interactive prototype (one for iPhone and one for iPad) were created using Axure in order to test the mobile delivery method.
  • Discussion Guide for Autism in Love

    Discussion Guide for Autism in Love

    DISCUSSION GUIDE Table of Contents Using this Guide 1 From the Filmmakers 2 The Film 3-4 Background on the Subjects 5 Background Information What Is Love? 6 What is Autism? 6 Symptoms and Diagnoses 7 Causes 7 Treatment 8-9 Pioneers 10 Definitions 11 Controversies and Disagreements 12 Adults with Autism 13 Topics and Issues Relevant to Autism in Love 14 Sparking Discussion 14 Suggestions for Action 15 Resources 15-16 Credits 17 DISCUSSION GUIDE AUTISM IN LOVE Using This Guide Indie Lens Pop-Up is a neighborhood series that brings people together for film screenings and community-driven conversations. Featuring documentaries seen on PBS's Independent Lens, Indie Lens Pop-Up draws local residents, leaders and organizations together to discuss what matters most, from newsworthy topics, to family and relationships. Make friends, share stories, and join the conversation. Can't attend in person? Find Independent Lens on Facebook for information on our online Pop-Up events. This discussion guide is designed as a tool to facilitate dialogue, and deepen understanding of the complex topics in the film Autism in Love. It is also an invitation to not only sit back and enjoy the show, but to step up and take action. This guide provides important context on the issues raised in the film, and can serve as a springboard for further research. It raises thought-provoking questions to encourage viewers to think more deeply and spark conversations with one another. We present suggestions for areas to explore in panel discussions, in the classroom, in communities, and online. We also include valuable resources and connections to organizations on the ground that are fighting to make a difference.
  • A Behavior Analytic Approach to Addressing Sensory Behavior

    A Behavior Analytic Approach to Addressing Sensory Behavior

    7/30/2015 A Behavior Analytic Approach to Addressing Sensory Behavior August 6, 2015 National Autism Conference Amy McGinnis Stango, M.S., OTR/L, M.S., BCBA amycginnis.com Purpose of Today’s Workshop • The primary purpose of today’s workshop is not to debate sensory integration theory or practices, but instead to describe how behavior analysis can be used to overcome “sensory challenges” across a wide variety of learners. 1 7/30/2015 Applied Behavior Analysis (ABA)is a science that is: • Applied • Behavioral • Analytic • Technological • Conceptually systematic • Effective • Possesses generality (Baer, Wolfe & Risley, 1963) Verbal Behavior Self Help Motor & Perceptual (Language) (Eating, Dressing, Skills Toileting, etc.) Academics Play / Leisure Skills ABA in Early Childhood Social Interaction Minimizing Problem Independent Work Behavior Skills 2 7/30/2015 What ABA is Not • A specific strategy, approach, or program (i.e. discrete trial training, token economies, etc.) • An intervention for a specific population (i.e. children with autism) • A way to change who people are (i.e. “turning them into robots”) (Newman, 2005) Philosophy of ABA • Behavior can be learned. • Behavior is either strengthened or weakened by the consequences. • We can predict and control behavior when discover the variables governing a particular behavior. (Donohue & Ferguson, 2001) 3 7/30/2015 The Benefits of a Behavioral Approach • Strong evidence base • Procedures for teaching a variety of occupations & performance skills • Yields measurable results • Prevent and
  • DTT) to Improve the Non-Verbal Communication Skills in Children with Autism Spectrum Disorder (ASD

    DTT) to Improve the Non-Verbal Communication Skills in Children with Autism Spectrum Disorder (ASD

    INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol.33, No.3, 2018 Developing a Proposed Training Program Based on Discrete Trial Training (DTT) to Improve the Non-verbal Communication Skills in Children with Autism Spectrum Disorder (ASD) Mohammed Akram Hamdan, Faculty of Education and Arts, Department of Special Education, University of Tabuk, K.S.A. Abstract The present study aimed to develop a proposed training program based on DTT to improve the nonverbal communication skills in children with ASD. To achieve the objective of the study, the author developed a scale of non-verbal communication skills consisted of (20 items) measures attention and eye contact, imitation and using the signal, understanding the facial expressions and tones of voice. The author also developed a DTT program by reviewing the previous literature. The study sample consisted of (26) children with ASD aged (6-11) years, were chosen deliberately and divided randomly into two groups: an experimental group consisted of (13) children, and a control group consisted of (13) children. The results showed a statistically significant difference at the level of significance (0.005) between the performance of the experimental and the control groups on the non-verbal communication skills scale in favor of the experimental group. On the other hand, the results indicated that there are no differences in the experimental group between post-test and following up phases. Keywords: training program, discrete trial training (DTT), non-verbal communication skills, children with ASD. 579 INTERNATIONAL JOURNAL OF SPECIAL EDUCATION Vol.33, No.3, 2018 Introduction Autism spectrum disorder is a complex neurological and developmental disorder that causes lifelong difficulties (the national autistic society, 2012).
  • Autism: an Analysis of Research, Practice, and Policies

    Autism: an Analysis of Research, Practice, and Policies

    Autism: An Analysis of Research, Practice, and Policies By Savannah Dysard 1 May (Spring 2016) SIT: Global Health and Development Policy Advisor: Dr. Astrid Stuckelberger Academic Director: Dr. Alexandre Lambert The George Washington University International Affairs, Global Public Health 2 Abstract This study serves to explore the history and innovations of autism and the programs available to people with Autism Spectrum Disorder (ASD). The purpose of this paper is to exploit the lack of attention autism has received worldwide and to display the need for better diagnostic, educational, and treatment programs. A description of the disease, current definitions and typologies, and past stigmatization will be discussed. Additionally, this study will highlight various speculations presented by researchers over the past twenty years. As epigenetics are a new innovation in the world of health, environmental epigenetics will be discussed as possible contributing factors to ASD. Case studies and information about the effects autism has on parents, families, and societies are included. The latter portion of this study will analyze systems and programs in Switzerland and the United States. Programs implemented in India, Spain, and Africa will be discussed as well. Governments must address autism as a priority by working to decrease stigmatization, increase education and training for physicians, enhance diagnostic centers, and drastically reshape education programs for children with autism. Abbreviations ASD: Autism Spectrum Disorder USPSTF: US Preventative Services Task Force AAP: American Academy of Pediatrics IEP: Independent Education Program TEACHH: Teaching, Expanding, Appreciating, Collaborating and Cooperating, Holistic CSHCN: Children with Specific Health Care Needs 3 SESI: Specialized Education Services Incorporated NSP: National Standards Project ADA: Americans with Disabilities Act IDEA: Individuals with Disabilities Education Act DTT: Discrete Trial Training Table of Contents Abstract 2 Abbreviations 3 1.
  • Autism: Proven & Unproven Therapies

    Autism: Proven & Unproven Therapies

    AUTISM SPECTRUM DISORDER: EVIDENCE BASED TREATMENTS Michelle M. Macias, MD, FAAP Ashley Belt, M.Ed., BCBA Developmental-Behavioral Pediatrics Board Certified Behavior Analyst Medical University of South Carolina Lowcountry Autism Foundation DISCLOSURES ▸ In the past 12 months, we have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in this CME activity. ▸ Dr. Macias does intend to discuss an unapproved/investigative use of a commercial product/device in the presentation, which will be disclosed at the time of discussion. Learning Objectives ▸ Relate the current scientific support for educational, behavioral, and medical intervention strategies for youth with autism spectrum disorder. Treatment Objectives ▸ Primary treatments are developmental and behavioral therapies. ▸ Decide what you are treating! . Core ASD Symptoms? ‣ Social Reciprocity ‣ Repetitive and restrictive behaviors (“RRB”) . Coexisting Conditions? ‣ Challenging/disruptive behaviors ‣ Affective Disorders ‣ Sleep disturbances ‣ Seizure disorders ‣ Others (GI, feeding problems) What do we mean by “Evidence”? ▸ Factors to look for in a study: ▸ Hierarchy of evidence ‣ Homogeneous case definition ‣ Randomized, double blind ‣ Consistent dosing of product with placebo controlled consistent content prospective trial ‣ Valid outcome measure ‣ Cohort studies ‣ Appropriate sample size ‣ Case control studies ‣ Placebo group ‣ Case series ‣ Double blind ‣ Retrospective data analysis ‣ Anecdotal report Grade BMJ, 2004 ▸ Positive expectancy ▸ Participation affects caregiver behavior ‣ Therapeutic impact of research participation ‣ Parents looking for positive responses to a new treatment may be engaging their children in more activities to determine response ‣ Sandler (2010) – Placebo as treatment for ADHD Some Reviews that Grade the Evidence for Therapies for ASD: ▸ Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD).