Updated Review of Evidence-Based Practices for Children and Youth with Autism Spectrum Disorders

Background:

Evidence-based intervention practices (EBPs) for children with ASD are the basis on which effective programs are built. In their previous review and analysis of the literature from 1997-2007, the National Professional Development Center on ASD (NPDC) identified 24 practices that met the evidentiary criteria they had established. The research on focused intervention practices has accelerated in recent years, requiring an ongoing process for updating and communicating the most current scientific knowledge about practices to practitioners and families.

 Objectives:

The purpose of this poster session is to describe the process that NPDC followed in identifying EBPs for children and youth with ASD and the results of the updates reviews of the literature.

 Methods:

Using five databases (EBSCO, EMBASE, Medline, ISI, Sociological Abstracts) and a range of descriptors (e.g., autism, Asperger, intervention), the initial search generated 23,000 articles published between 1990 and 2011. After screening to ensure articles employed an experimental, quasi-experimental or single case design that tested and intervention with children and youth having ASD, the number of articles was reduced to 1,085. Criteria for determining methodological acceptability of individual were developed. One hundred forty reviewers completed training, met inter-rater agreement criteria, and evaluated the acceptability of the article methodology. Articles identified as acceptable were sorted using categories for practices established by the previous NPDC review and the National Standards Project. A final determination was then made about whether a practice meets the level of evidence necessary to be classified as an EBP using the following criteria: (a) two high quality experimental or quasi-experimental design studies, or (b) five single case design studies conducted by three different research groups and involving a total of 20 participants across studies, or (c) there is combination of research designs, which must include at least one high quality experimental/quasi-experimental design and three high quality single case designs.

 Results:

To date, reviewers have completed evaluations of 935 reviewed articles (86%) with the rest of the review being completed in the next month. Five hundred eleven articles (59 group design studies, 452 single case design studies) have been accepted as providing scientific evidence.  Content analyses of procedures produced 31 different practices that appear in the table below.

 Conclusions:

The focused intervention literature for children with ASD has been activity and high quality. The revised literature search and analysis by staff of the NPDC has identified practices that will provide a solid, empirical basis on which to design programs for children with ASD.

 Table 1. Evidence-based Practices

 

Antecedent-based interventions	Functional behavior assessment	Picture exchange communication system	Social skills groups
Cognitive behavioral intervention	Functional communication training	Pivotal response training	Speech generating devices
Computer-aided instruction	Imitation-based interaction	Prompting	Structured work systems
Developmental relationship-based treatment	Massage/touch therapy	Reinforcement	Task analysis
Differential reinforcement	Modeling	Response interruption/redirection	Time delay
Discrete trial teaching	Naturalistic intervention	Scripting	Video modeling
Exercise	Parent-implemented intervention	Self-management	Visual supports
Extinction	Peer-mediated instruction and intervention	Social narratives