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Finding the “Best” in Best Practices

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by Jim Ball, EdD, BCBA-D
Autism Asperger’s Digest
| March/April 2011

The world of teaching and education changes dramatically as your child transitions into the public school system. Gone are the days of family-focused programs, along with other changes we explored in the last article. Today we move on to another area of change: how your child will be educated, i.e., what methodology the school uses and how this relates to “best practices.” Let’s be clear right from the start: “pedagogy” – how your child will be taught – is, by law, a decision that rests with your school district. Yes, the school has to operate within the guidelines of federal legislation, but how they do that can vary greatly from school to school. Therefore, it is critical that you – the child’s parent, guardian, or advocate – stay abreast of best teaching practices for a child on the autism spectrum. You are a vital partner in the discussion of your child’s education and by knowing the options available, you can help steer teachers and school administration in the right direction.

Evidence-Based Instruction
The idea of “scientifically-based research” practice was first introduced in the No Child Left Behind Act of 2001, and echoed in the 2004 revision of the Individuals with Disabilities Education Improvement Act (IDEIA). In general, “best practice” refers to strategies that have been proven to be effective and more importantly, produce the best positive outcomes for students with an Autism Spectrum Disorder. An important distinction that is often glossed over is the difference between scientifically-based strategies and evidence-based strategies. In a nutshell, “research based” involves only scientific studies as a measure of efficacy; “evidence based” involves both scientific and clinical experience. When it comes to best practices in autism, the clinical experience can be a huge component in knowing what works – or doesn’t – with spectrum kids.

In 2009 theNationalAutismCenterreleased a comprehensive, 258 page report, “Evidence-Based Practice and Autism in the Schools.” In their report they acknowledged that evidence-based practices are not just “strategies” that have been researched, but also include:

  • Educational decisions based on outcome data
  • Family involvement and input from the student (when able)
  • The ability of the school to implement the program

Unfortunately for parents and educators everywhere, there is not a great deal of research directly targeting school-aged children with ASD. But of the research available, key points arise that are relevant to this discussion:

  • The program has to be individual to the student and the family. There is no “cookie cutter approach” when educating students with ASD.
  • Family involvement is a must.
  • Instruction has to be systematic. There has to be a cohesive approach that takes into account the individual student’s strengths and challenges.
  • A very structured environment that is consistent and predictable is favored.
  • Analyzing behavior for function, and programming to teach alternate skill development are key elements for success.

IDEIA is quickly moving toward authorizing school districts to only use those strategies that are evidence based. This is unfortunate for our group of students, given the lack of methodologies that have been scientifically researched via randomized controlled trials (the gold standard of scientific research methods).

The National Autism Center’s report outlined eleven “Established Treatments” that have been thoroughly researched and had sufficient evidence for them to confidently state they are effective. (Find the full report at www.nationalautismcenter.org.) The one methodology most researched and considered to be the most effective for students with ASD is Applied Behavior Analysis (ABA). However, there are many other methods that have some research behind them:

  • Picture Exchange Communication System (PECS)
  • Social Stories™
  • Pivotal Response Training
  • Video Modeling
  • TEACCH
  • Structured Teaching
  • Peer-Mediated Intervention

It is very disheartening that we do not have more research on best practices for educating individuals with ASD. Professionals who have worked with this population appreciate the need for more “treatment” guided research that encompass those therapies that we know have validity, but have very little research behind them. These include treatments in the areas of speech and language, visual strategies, and occupational therapy. While there may be prolific “case studies” that support the use of these and other therapies, this does not help bridge the gap between clinical recognition of effectiveness versus mainstream scientific backing.

Do understand that the strategies considered “Established Treatments” are by far the most effective. They have been proven over time and are successful across a broad range of children with ASD. The sad piece of this educational dilemma is that a new strategy or program touting “cure” or “recovery” sprouts up almost weekly, and can be quite attention getting. This can take a parent or educator’s focus away from the limited and precious time we have to make meaningful impact with these kids. Therefore, keeping a diligent eye on evidence-based strategies and how they can be incorporated into the child’s program is vital. It will keep the school district accountable over the long haul, and provide the greatest chance for the child to achieve success.

Making it Work, Day to Day
Talking about best practices is great, but it’s direct action within the day-to-day operations of a classroom and a school that bring success. The consensus is that decisions concerning evidence-based instruction should follow a process similar to the Individual Education Plan (IEP). The IEP drives the goals and objectives and defines what will be taught to a student. This document is based on the results of formal assessment and observation of the child, and is created by a team that includes educators, administration, and the child’s parents. Both the child’s strengths and challenges are evaluated and strategies are selected that align with the child’s learning style. Should this not also be the way we select and implement evidence-based practices? It makes total sense.

However, this is not always the case. In many instances, the school has “an autism program” already established and the child is “fit” into the program, whether or not that program meets the student’s needs or learning style. When families are involved in promoting the use of evidence-based practices, and are knowledgeable about what best practices are “best” for their child, a “blended” program can be achieved – one that highlights the child’s strengths and remediates the child’s challenges.

How can parents accomplish this goal?

  • Get to know how your child learns. This will help you choose the most effective teaching techniques.
  • Get to know your school district and what they offer. Visit classes and see how instruction is delivered.
  • Ask the tough questions. Ask what evidence-based strategies are being used in classes where your child could be educated. Ask how the school defines evidence-based, and upon what research they based their decisions.
  • Keep good records of instructional methods used with your child. Make sure all decisions are data driven, rather than being subjective determinations. If you’re not happy with the way something is reported, ask where the information came from and how the data was collected. If an evaluation tool was used, ask for it by name, and for the research behind it.

Parents and educators share a common goal: to improve the learning opportunity for spectrum kids through using evidence-based instruction. This must be an ongoing, collaborative process, accomplished not by one individual or because of a singular report or methodology, but through an interdisciplinary approach that takes into consideration the individual child. It must be flexible and evolve as the child learns and grows. Collaboration and teamwork is paramount, and is essential to any best practice program.

BIO
Dr. Jim Ball has been working in the field of autism for 20+ years helping children, teens, and adults with ASD. Learn more about Jim’s consulting services company at www.jbautismconsulting.com.

Copyright © Autism Asperger’s Digest. 2011. All Rights Reserved.Distribution via print means prohibited without written permission of publisher.


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