Compare and Contrast

Making Informed Choices

The needs of individuals with autism are unique, complex, and can impact their lives 24/7. There is often much for them to learn, and time is of the essence. So it is crucial to provide treatment that is most likely to be effective. Although much about autism is not yet fully understood, there are strategies that have been proven effective for learners with ASD, and others that have been proven ineffective or harmful. The supports provided can greatly affect each person’s ability to learn and succeed. Many can make great gains with specialized strategies customized for their particular strengths and challenges.

Whether you are a parent or a professional, it is important to know what research says about the many treatment options you may come across. Weighing the conflicting information marketed as autism treatment can be a confusing and overwhelming process. Autism New Jersey is here to help you understand what research suggests about diverse methodologies and how to document that the intervention is beneficial for a particular individual once it has begun.

A Framework for Understanding What Is Evidence-Based

Much treatment information is presented as factual when it may not be. Looking through the filter of science helps us differentiate opinions/testimonials from substantiated data as well as faulty or poorly designed research from well-designed studies. Autism New Jersey uses a simple stoplight analogy to translate the body of empirical autism-specific research.

· Green Light

· Yellow Light

· Red Light

Treatments shown through research to be most effective for individuals with autism

Applied Behavior Analysis (ABA)

The science and practice of ABA includes a variety of evidence-based practices.1,2

· Teaching, maintaining, and generalizing skills

. Activity Schedules

. Backward and Forward Chaining

. Comprehensive Behavioral Treatment for Young Children3

. Differential Observing Response

. Direct Instruction

. Discrete Trial Instruction

. Errorless Learning/Teaching

. Imitation Training

. Incidental Teaching

. Joint Attention Intervention

. Modeling

. Picture Exchange Communication System

. Pivotal Response Treatment

. Precision Teaching/Fluency-Based Instruction

. Prompting

. Reinforcement Schedules and Systems

. Repeated Practice

. Scripting/Script Fading Procedures

. Self-management

. Shaping

. Social Skills Package

. Standard Echoic Training

. Story-based Intervention

. Verbal Behavior/Applied Verbal Behavior

. Video Modeling

· Treating challenging behavior Positive Behavior Support (PBS) is an ABA-based service delivery package that incorporates the following components to understand and treat challenging behavior as well as many of the components listed above to teach functionally-equivalent replacement skills.

. Function-based Intervention

. Functional Behavior Assessment

. Functional Communication Training

. Antecedent-based interventions

. Differential Reinforcement

. Response Interruption and Redirection

1 – National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: Author. 2 –  Association for Science in Autism Treatment 3 – Typical interventions include the use of discrete trial teaching, incidental teaching, errorless learning, behavioral momentum, shaping, modeling and other interventions derived from ABA.

Medications

Risperdal and Abilify  (to treat ASD-related irritability)

 

About Applied Behavior Analysis (ABA)

Hundreds of autism-specific studies have demonstrated the effectiveness of ABA for teaching skills and reducing challenging behavior. While it is effective for other learners as well, it is considered the gold standard in autism intervention. Research also indicates that students in ABA programs make more progress than those in programs combining several different methods.

The goal of ABA is two-fold: to increase useful behaviors that improve quality of life and decrease those that are harmful or interfere with learning or relationships. It is a structured teaching approach that can be implemented in many settings to teach skills from many domains (communication, selfcare, academic, play/leisure, social skills, etc.). It involves understanding patterns of behavior and examining the influence of environmental factors including what happens before and after the behavior. Other key elements are motivation, reinforcement, and task analysis to break complex skills into small steps.

Considerations on the Yellow and Red Light Treatments

Many of the red and yellow light interventions fall into one of two categories:

1. They were created to address an unproven theory about a cause of autism

2. They may be beneficial for individuals with other special needs but don’t address the unique challenges faced by those with autism

Additionally, it is important to differentiate between treatment/therapy and recreation. Some of the activities which are not established as evidence-based practices for autism may be enjoyable to individuals and valuable as reinforcers (opportunities they would like to work for) or leisure activities (hobbies to enjoy). However, they do not qualify as therapeutic treatment unless they directly alleviate the challenges of autism, teach skills, or reduce challenging behavior.

Autism New Jersey understands that any one individual may respond well to an intervention that is not documented as effective for the majority of people with autism. As with any intervention, we recommend collecting and analyzing data regularly to assess progress with the treatment team. Being alert to possible side effects is also important.

Measuring Effectiveness

For ANY strategy that is attempted, data should be regularly analyzed to determine if the intervention is bringing about improvement on a specific goal. Implementation can vary, so even established interventions need to be monitored and adjusted to maximize effectiveness. Progress may be slow, so it’s important to keep records that will guide the team’s decisions and keep everyone informed.

The Road Less Traveled  (Celiberti et al., 2004) is a helpful resource for evaluating any intervention and its implementation for your child/learner.

Title:	Using Bayesian Meta-Analysis to Explore the Components of Early Literacy Interventions
Description:	The What Works Clearinghouse (WWC) released a report that applies two methodological approaches new to the WWC that together aim to improve researchers' understanding of how early literacy interventions may work to improve outcomes for students in grades K-3. First, this report pilots a new taxonomy developed by early literacy experts and intervention developers as part of a larger effort to develop standard nomenclature for the components of literacy interventions. Then, the WWC uses Bayesian meta-analysis—a statistical method to systematically summarize evidence across multiple studies—to estimate the associations between intervention components and intervention impacts. Twenty-nine studies of 25 early literacy interventions that were previously reviewed by the WWC and met the WWC's rigorous research standards were included in the analysis. This method found that the components examined in this synthesis appear to have a limited role in explaining variation in intervention impacts on alphabetics outcomes, including phonics, phonemic awareness, phonological awareness, and letter identification. This method also identified positive associations between intervention impacts on alphabetics outcomes and components related to using student assessment data to drive decisions, including about how to group students for instruction, and components related to non-academic student supports, including efforts to teach social-emotional learning strategies and outreach to parents and families. This report is exploratory because this synthesis cannot conclude that specific components caused improved alphabetics outcomes.
Online Availability:	· Download, view and print the report as a pdf file.    (1.5MB) · Download, view and print the report appendices as a pdf file.    (1.5MB) · View the code and data used in the report    (143KB) Need Help Viewing PDF files? Need Help Viewing Zip files?
Cover Date:	September 2023
Web Release:	September 12, 2023
Print Release:	September 12, 2023
Publication #:	WWC 2023008 General Ordering Information
Center/Program:	WWC
Associated Centers:	NCEE
Authors:	WWC
Type of Product:	Evaluation Report
Keywords:	Early Reading First Literacy Research Methodology
Questions:	For questions about the content of this  Evaluation Report, please contact: Betsy Wolf .