EBIs for Students with Autism

Rather than re-invent the wheel and post a bunch of different specific interventions for assisting students with autism, below I have provided a link to Lindgren & Doobay’s (2011) “Evidence-Based Interventions for Autism Spectrum Disorders.” This resource also refers to The National Professional Development Center on Autism Spectrum Disorder (http://autismpdc.fpg.unc.edu/), which also has a page on best practices that may be valuable.

This vast resource (24 pages) includes information on:

  • Defining ASD
  • Assessing ASD
  • Interventions: Promising, Limited, and Not Recommended
  • References

 

Significant evidence suggests that Applied Behavior Analysis (ABA) is effective for students with autism, specifically including Discrete Trial Training, Functional Communication Training, Pivotal Response Training, and Antecedent Based Interventions.

Other effective interventions are early intensive interventions, social skills training, cognitive-behavioral therapy, and medication (depending on symptoms, not a cure). Communication Devices (Augmentative/Alternative) and Picture-Exchange Communication Systems also have a plethora of evidence supporting these systems of communication, along with visual supports, modeling, and computer-aided instruction.

Some promising interventions include play therapy, developmental relationship-based treatment, and supportive therapy (e.g. music, pet, massage therapy). Interventions with limited support include sensory integration, auditory integration therapy, specific diets, and facilitated communication.

Sensory integration in particular surprised me as a limited intervention, given its widespread use, and it was considered complementary and without objective findings, though it may be helpful as a way to calm or reinforce the child’s desired behaviors.  Since the publishing of this resource, this debate has continued. Lang et al. (2012) found that “the current evidence-base does not support the use of SIT in the education and treatment of children with autism spectrum disorders” (p. 1004), though Case-Smith and Schaaf (2013) offered a rebuttal, and one randomized-control trial, albeit small (N=17 with autism, 15 in control), showed significantly positive impact of SIT on a Goal Attainment Scaling outcome measure (Schaaf et al., 2014). This study concluded that “this study provides evidence that this intervention may be a useful adjunct to a comprehensive intervention program for individuals with ASD who have functional and behavioral challenges related to difficulty processing and integrating of sensory information” (Schaaf et al., 2014, p. 1504). Overall, this intervention is widespread, but for now is considered too controversial for its own post on this site.

Interventions that are NOT recommended include holding therapy, secretin, and chelation for neurotoxicity.

A link to this document is here:

http://www.uihealthcare.org/uploadedfiles/uihealthcare/content/services/center_for_disabilities_and_development/ucedd/dhs%20autism%20interventions%206-10-11.pdf 

OR (as links tend to change over time):

http://www.interventionsunlimited.com/editoruploads/files/Iowa%20DHS%20Autism%20Interventions%206-10-11.pdf

 

References:

Case-Smith, J., & Schaaf, R. (2013). Response to systematic review of sensory integration therapy for autism spectrum disorders. Retrieved from http://www.aota.org/-/media/Corporate/Files/Practice/Children/Response-to-Research-in-Autism.ashx.

Lang, R., O’Reilly, M., Healy, O., Rispoli, M., Lydon, H., Streusand, W., … & Didden, R. (2012). Sensory integration therapy for autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders,6(3), 1004-1018.

Lindgren, S., & Doobay, A. (2011). Evidence-based interventions for autism spectrum disorders. The University of Iowa.

Schaaf, R. C., Benevides, T., Mailloux, Z., Faller, P., Hunt, J., van Hooydonk, E., … & Kelly, D. (2014). An intervention for sensory difficulties in children with autism: A randomized trial. Journal of Autism and Developmental Disorders, 44(7), 1493-1506. Retrieved from http://link.springer.com/article/10.1007%2Fs10803-013-1983-8/fulltext.html.

Visual Supports

Visual Supports are often considered one of the most important interventions for students with autism. For a primer on what Visual Supports are, types of supports and when they are helpful, examples, and advice for what to do when challenging behaviors occur, Autism Speaks has a brief handout available at:

https://www.autismspeaks.org/docs/sciencedocs/atn/visual_supports.pdf

The Indiana Resource Center for Autism, https://www.iidc.indiana.edu/IRCA, includes articles and recommendations, discussions, programs, examples of visual supports, and much more, and could be considered a great starting point for researching about interventions for autism. In particular, their Visual Supports page (https://www.iidc.indiana.edu/pages/visualsupports) includes a variety of examples of visual supports that could be used for students with autism. A wide variety of evidence suggests that video supports are especially helpful for students with autism (e.g. with transitions, Dettmer, Simpson, Myles, & Ganz, 2000) and this is a common recommendation. This page  has examples of all kinds of visual supports, including schedules, emotions, work systems, calendar icons for holidays/events, and much more, already made and available for viewing or, in some cases, download.

 

Reference:

Dettmer, S., Simpson, R. L., Myles, B. S., & Ganz, J. B. (2000). The use of visual supports to facilitate transitions of students with autism. Focus on Autism and Other Developmental Disabilities, 15(3), 163-169.

 

Autism Certification Center

The Autism Certification Center, https://autismcertificationcenter.org/, is a valuable resource for learning about Autism, particularly if you are a resident of Ohio, as all resources are free. Otherwise, only the first video “Many Faces of Autism,” described below, is free.

The other videos are titled “Toddler and Preschool Age,” “School Age,” and “Transition Age.” Each of those video programs are approximately 10.5 hours long, but for a new parent or someone who is newly interacting with a student with autism, the time investment is minimal compared to its importance. You can also receive professional development certificates following completion. I personally completed the Many Faces of Autism section and found it engaging and applicable to my future work, and believe that almost anyone who has not had a lot of experience with this population would gain value from these resources.

“Many Faces of Autism

A free course that will introduce you to characteristics of autism spectrum disorder (ASD) and dispel common misconceptions through the experiences and perspectives of individuals on the autism spectrum. Whether you are a parent, grandparent, neighbor, co-worker, teacher, bus driver, or librarian, you will find valuable insights and information in this 90-minute course.

Estimated Time to Complete Course: 1.5 Clock Hours” via https://autismcertificationcenter.org/ 

Autism and Vaccines

Facts for Parents About Vaccine Safety from the American Academy of Pediatrics:

http://www2.aap.org/advocacy/releases/autismparentfacts.htm

This link gives background on autism and mitochondrial disease, as well as the importance of vaccines and their lack of a link to autism.

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Do vaccines cause autism?

Short answer: NO.

Long answer: NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO.

Longer answer and resources:

http://www.cdc.gov/vaccinesafety/concerns/autism.html <— Center for Disease Control resource, with the headings “There is no link between vaccines and autism” and “Vaccine ingredients do not cause autism.”

http://www.thearc.org/document.doc?id=3665 <— Document from The Arc (an organization for individuals with intellectual and developmental disabilities) with facts about childhood vaccines, the types of vaccines, their safety, and the reasons why it is crucial to vaccinate your children. Namely, “Deciding not to immunize a child puts that child and others who come in contact with him or her at risk of contracting a disease that could be dangerous or even deadly” (TheArc).

 

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Video Modeling

Video Modeling can be a highly effective intervention for students with autism or other students that may have difficulty acquiring the social skills required for success in the classroom. This intervention involves using videos to show a correct example of the desired behavior, based on Bandura’s theory of social learning. Video self-modeling can also be used, in which the video is created using the student themselves as the actor.

Steps:

  1. Select a skill to be modeled and subsequently learned.
  2. Find an adequate example, or create one, of the desired skill.
  3. Play the video and explain the skill to the student.
  4. Replay or further instruct as needed.

An example of a video that could be used in a video modeling intervention is:

A full intervention brief for this common intervention is available at the Missouri EBI network:

http://ebi.missouri.edu/wp-content/uploads/2013/04/Modeling-Brief-EBI-Network.pdf