What do educators need to know about EBPs for children with autism?
Page 2: Evidence-Based Practices
For Your Information
Two federal laws—the Every Student Succeeds Act (ESSA) and the Individuals with Disabilities Education Act (IDEA ’04)—mandate that educators use, to the greatest extent possible, evidence-based academic and behavioral practices and programs.
Every Student Succeeds Act
Federal school reform legislation originally enacted in 1965 that aimed to increase school accountability for student learning, offer more choices for parents and students, create greater flexibility for schools in the use of funds, and emphasize early-reading intervention. This act now mandates the use of academic and behavioral evidence-based practices. When this act was reauthorized in 2001, it was referred to as the No Child Left Behind Act (NCLB). The Every Student Succeeds Act (ESSA) reauthorized the Elementary and Secondary Education Act in 2015. For more information about ESSA, click here.
Individuals with Disabilities Education Act (IDEA ’04)
Name given in 1990 to the Education for All Handicapped Children Act (EHA) and used for all reauthorizations of the law that guarantees students with disabilities the right to a free appropriate education in the least restrictive environment.
To improve the outcomes of children with ASD, educators should implement evidence-based practices (EBPs), strategies that have been shown to be effective in teaching appropriate behaviors and skills and decreasing inappropriate behaviors for a given population. There are evidence-based practices to improve academic and behavior outcomes for all students. However, this module will focus on strategies that have been shown to be effective in teaching appropriate behaviors and skills and decreasing inappropriate behaviors for students with ASD. The National Professional Development Center (NPDC) on Autism Spectrum Disorder has identified 27 evidence-based practices for improving outcomes for students with ASD.
evidence-based practices (EBPs)
Strategies proven to be effective for the majority of students through experimental research studies or large-scale research field studies.
|Antecedent-based intervention||Arrangement of events or circumstances that precede the occurrence of an interfering behavior and designed to lead to the reduction of the behavior.|
|Cognitive behavioral intervention||Instruction on management or control of cognitive processes that lead to changes in overt behavior.|
|Differential reinforcement of alternative, incompatible, or other behavior||Provision of positive/desirable consequences for behaviors or their absence that reduce the occurrence of an undesirable behavior. Reinforcement provided: a) when the learner is engaging in a specific desired behavior other than the inappropriate behavior (DRA), b) when the learner is engaging in a behavior that is physically impossible to do while exhibiting the inappropriate behavior (DRI), or c) when the learner is not engaging in the interfering behavior (DRO).|
|Discrete trial teaching||Instructional process usually involving one teacher/service provider and one student/client and designed to teach appropriate behavior or skills. Instruction usually involves massed trials. Each trial consists of the teacher’s instruction/presentation, the child’s response, a carefully planned consequence, and a pause prior to presenting the next instruction.|
|Exercise||Increase in physical exertion as a means of reducing problem behaviors or increasing appropriate behavior.|
|Extinction||Withdrawal or removal of reinforcers of interfering behavior in order to reduce the occurrence of that behavior. Although sometimes used as a single intervention practice, extinction often occurs in combination with functional behavior assessment, functional communication training, and differential reinforcement.|
|Functional behavior assessment (FBA)||Systematic collection of information about an interfering behavior designed to identify functional contingencies that support the behavior. FBA consists of describing the interfering or problem behavior, identifying antecedent or consequent events that control the behavior, developing a hypothesis of the function of the behavior, and/or testing the hypothesis.|
|Functional communication training||Replacement of interfering behavior that has a communication function with more appropriate communication that accomplishes the same function. Functional communication training usually includes FBA, differential reinforcement of alternative behavior, and/ or extinction.|
|Modeling||Demonstration of a desired target behavior that results in imitation of the behavior by the learner and that leads to the acquisition of the imitated behavior. This EBP is often combined with other strategies such as prompting and reinforcement.|
|Naturalistic intervention||Intervention strategies that occur within the typical setting/activities/routines in which the learner participates. Teachers/service providers establish the learner’s interest in a learning event through arrangement of the setting/activity/routine, provide necessary support for the learner to engage in the targeted behavior, elaborate on the behavior when it occurs, and/or arrange natural consequences for the targeted behavior or skills.|
|Parent-implemented intervention||Parents provide individualized intervention to their child to improve/increase a wide variety of skills and/or to reduce interfering behaviors. Parents learn to deliver interventions in their home and/or community through a structured parent training program.|
|Peer-mediated instruction and intervention||Typically developing peers interact with and/or help children and youth with ASD to acquire new behavior, communication, and social skills by increasing social and learning opportunities within natural environments. Teachers/service providers systematically teach peers strategies for engaging children and youth with ASD in positive and extended social interactions in both teacher-directed and learner-initiated activities.|
|Picture Exchange Communication System (PECS)||Learners are initially taught to give a picture of a desired item to a communicative partner in exchange for the desired item. PECS consists of six phases which are: (1) “how” to communicate, (2) distance and persistence, (3) picture discrimination, (4) sentence structure, (5) responsive requesting, and (6) commenting.|
|Pivotal response training||Pivotal learning variables (i .e., motivation, responding to multiple cues, self-management, and self-initiations) guide intervention practices that are implemented in settings that build on learner interests and initiative.|
|Prompting||Verbal, gestural, or physical assistance given to learners to assist them in acquiring or engaging in a targeted behavior or skill. Prompts are generally given by an adult or peer before or as a learner attempts to use a skill.|
|Reinforcement||An event, activity, or other circumstance occurring after a learner engages in a desired behavior that leads to the increased occurrence of the behavior in the future.|
|Response interruption/ redirection||Introduction of a prompt, comment, or other distracters when an interfering behavior is occurring that is designed to divert the learner’s attention away from the interfering behavior and results in its reduction.|
|Scripting||A verbal and/or written description about a specific skill or situation that serves as a model for the learner. Scripts are usually practiced repeatedly before the skill is used in the actual situation|
|Self-management||Instruction focusing on learners discriminating between appropriate and inappropriate behaviors, accurately monitoring and recording their own behaviors, and rewarding themselves for behaving appropriately.|
|Social narratives||Narratives that describe social situations in some detail by highlighting relevant cues and offering examples of appropriate responding. Social narratives are individualized according to learner needs and typically are quite short, perhaps including pictures or other visual aids.|
|Social skills training||Group or individual instruction designed to teach learners with autism spectrum disorders (ASD) ways to appropriately interact with peers, adults, and other individuals. Most social skill meetings include instruction on basic concepts, role-playing or practice, and feedback to help learners with ASD acquire and practice communication, play, or social skills to promote positive interactions with peers.|
|Structured play group||Small group activities characterized by their occurrences in a defined area and with a defined activity, the specific selection of typically developing peers to be in the group, a clear delineation of theme and roles by adult leading, prompting, or scaffolding as needed to support students’ performance related to the goals of the activity.|
|Task analysis||A process in which an activity or behavior is divided into small, manageable steps in order to assess and teach the skill. Other practices, such as reinforcement, video modeling, or time delay, are often used to facilitate acquisition of the smaller steps.|
|Technology-aided instruction and intervention (TAII)||Instruction or interventions in which technology (e.g., tablet, computer, computer program, online activity) is used to increase or maintain functional skills and behaviors.|
|Time delay||In a setting or activity in which a learner should engage in a behavior or skill, a brief delay occurs between the opportunity to use the skill and any additional instructions or prompts. The purpose of the time delay is to allow the learner to respond without having to receive a prompt and thus focuses on fading the use of prompts during instructional activities .|
|Video modeling||A visual model of the targeted behavior or skill (typically in the behavior, communication, play, or social domains), provided via video recording and display equipment to assist learning in or engaging in a desired behavior or skill .|
|Visual support||Any visual display that supports the learner engaging in a desired behavior or skills independent of prompts. Examples of visual supports include pictures, written words, objects within the environment, arrangement of the environment or visual boundaries, schedules, maps, labels, organization systems, and timelines.|
Adapted from Wong, Odom, Hume, Cox, Fettig, Kucharczyk, Brock, Plavnick, Fleury & Schultz, 2014. Retrieved from https://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/imce/documents/table7_working_definition_ebp.pdf
Click here to download and save a PDF version of the list.
With so many EBPs from which to choose, how can educators or practitioners determine which of them to use with a specific child? The four steps outlined below can help educators and practitioners make a more informed decision when they select an EBP.
The target behavior is the behavior the teacher wants to change. This should be a discrete behavior that is directly observable, measurable, and clearly defined. The definition of the behavior should:
- Describe the behavior in an observable manner
- Describe the behavior in measurable terms (i.e., instances of the behavior can be counted or timed)
- Identify the setting in which the behavior occurs
Note the difference in the definitions below.
- Ambiguous and subjective definition: Michelle violates other’s personal space.
- Clear and observable definition: When talking to someone, Michelle stands within a foot of that person.
Defining behavior in this manner allows multiple professionals to observe and collect objective data on the behavior. If multiple professionals gather data using the second definition of Michelle’s behavior, they are more likely to collect data on the same behavior rather than on their subjective opinion of personal space violation.
To learn more about how to clearly define a student’s behavior so that when it occurs it can be reliably identified, measured, or counted, visit the following IRIS Case Study:
Baseline data refers to the level (i.e., frequency, duration) at which a behavior occurs before a strategy or intervention is implemented. These data should be gathered for at least four days or until a pattern of behavior is evident. By comparing these data to data collected after the strategy has been implemented, educators can determine whether it is effective for the student.
To learn more about collecting observational data on a child or student’s behavior, visit the following IRIS Case Study:
Once the target behavior has been identified and baseline data collected, the goal needs to be indicated in a child’s individualized education program (IEP) or individualized family service plan (IFSP). The goal should include information about:
individualized education program (IEP)
A written plan used to delineate an individual student’s current level of development and his or her learning goals, as well as to specify any accommodations, modifications, and related services that a student might need to attend school and maximize his or her learning.
individualized family service plan (IFSP)
A written document used to record and guide the early intervention process for young children with disabilities and their families; designed to reflect individual concerns, priorities, and available resources.
- When or where the behavior will be performed
- What behavior should be displayed
- Specific, measurable criterion for mastery
Note the difference in the goals below.
- Poorly written goal: Michelle will respect other’s personal space.
- Observable goal: When talking to friends or school personnel, Michelle will stand a minimum of 1½ feet from them at least 90% of the time.
The next step in this process is to determine which EBPs can address the target behavior. With those in mind, educators can select an EBP that is likely to be effective for a student. The IFSP or IEP team should consider the following when they choose an EBP:
- The characteristics of the child and her or his family (e.g., the child’s strengths and challenges, what strategies have or have not worked in the past)
- The student’s goal (i.e., what the student is expected to achieve and in what learning domain)
- The expertise and experience of the teacher in successfully implementing specific EBPs
- The availability of resources (e.g., equipment, personnel) necessary to implement a given EBP
When they select a practice to implement with a child or student, educators and practitioners should understand that:
- When selecting a target behavior and EBP, it is important to collaborate with parents. A behavior that is problematic at school is also often problematic at home. When parents and teachers implement the same EBP, the probability that the strategy will be effective across multiple settings increases.
- Just because a practice is deemed evidence-based does not guarantee that it will be effective for every student.
- Information about treating and even curing autism is abundantly available on the Internet, but many of these practices are unproven, and are sometimes even harmful. For this reason, educators and practitioners should rely on trustworthy sources to identify evidence-based practices.
Visit the National Professional Development Center on Autism Spectrum Disorder for more information about the:
- Process used to identify EBPs
- 27 evidence-based practices for students with ASD
Once an EBP has been selected and implemented with a child, the educator or practitioner needs to collect data on the behavior to evaluate how the EBP is working for the individual student. It is also important to determine whether the EBP was implemented with fidelity (i.e., implemented as the developer intended), especially if the EBP was not effective for the student. Kara Hume and Ilene Schwartz discuss selecting an EBP, implementing a practice with fidelity, and evaluating whether an EBP is effective for a student.
Kara Hume, PhD
Frank Porter Graham Child Development Institute
University of North Carolina-Chapel Hill
Selecting an EBP
Implementing with Fidelity
Ilene Schwartz, PhD
Professor, Special Education
Director, Haring Center for Research
and Training in Inclusive Education
University of Washington
Evaluating the Effectiveness
Transcript: Kara Hume, PhD
The first step to think about when selecting EBPs for students is to determine what skill or behavior you would most like to target. In the module, there’s a table that lists EBPs that have been proven to help strengthen those outcome areas, so using that table is a great place to start. From the list of the 27 EBPs, determine which EBPs best match that skill area or target area. Once you have some ideas of what EBPs might be most beneficial then really start to think about the students. What do you know about the students? How old are they? What evidence-based practices or any practices have already been used with that student? What does that student typically respond to that can help you determine a starting point?
And then think about what do you know about the staff. What type of expertise does the staff have? What type of training has the staff already received that might be beneficial in learning or implementing an additional evidence-based practice?
And then the last thing to consider is what resources do you have. What’s available that can help you facilitate the implementation of that evidence-based practice?
If you want to implement the Picture Exchange Communication System and you have staff that’s been trained, do you have some materials—a computer, a printer, software—that can allow you to easily make materials that you need to implement that evidence-based practice? So following those steps can really help you choose what evidence-based practice is best for an individual student.
Transcript: Kara Hume, PhD
The first step is to ensure that the intervention is actually being implemented with fidelity. Often we’re quick to say, “Oh, that didn’t work. You know, I tried video modeling, but it didn’t work for the student.” But we really haven’t implemented video modeling the way it was designed and the way that we know that it actually works. So what I would recommend is first finding the fidelity checklist for each of the evidence-based practices. That can help you as a teacher to monitor how the intervention is being implemented. Our first instinct shouldn’t necessarily be, “Oh, we need to do this more,” or “We shouldn’t do this at all,” but first make sure that the intervention that we are implementing is of high quality or high fidelity. Then, next, if we know that we’re implementing it in the way in which it is designed then to allow for a little bit of time for the evidence-based practice to impact the behavior. Especially if it’s a behavior that’s been part of a student’s repertoire for a long time, it may take a bit of time to see the impact of that evidence-based practice.
If it’s being implemented with fidelity over a period of time and the data are indicating that there’s no change then consider selecting another evidence-based practice or adding additional evidence-based practices to support that behavior change and consider the match between the evidence-based practice and the student and the evidence-based practice and the staff. Sometimes we have a mismatch there. It’s not the right practice for the student or the staff.
And when we’re considering intensive intervention, we also want to think about we may not need more intensive but we often need more consistent intervention. For example, we might only be using the Picture Exchange Communication System during snack time, and we may not see behavior change, and so we might think, “Oh, that’s not effective.” But really we need to think about implementing that system across settings: So not just at snack time but at nap time and at circle time and out on the field trip. Or across people: So not just with the speech-language pathologist, but with the paraprofessionals, with the teacher, with the family. Or across items: We’re not only using PECS to request for food but we’re using it to request the items that we need in our math activity. So I would think about implementing evidence-based practices more consistently, rather than necessarily more intensive.
Transcript: Ilene Schwartz, PhD
One of the things that we do with every student with whom we’re working who has autism is that we’re taking data on every instructional practice that we use. For example, if I’m working with a child to teach them how to make initiations to peers on the playground, and I have a practice that I’m using to do that, I need to take data on whether or not the child is actually increasing the number of independent initiations that they make towards students. If not, then I have to say, regardless of the data that exists on that practice, it’s not working at this time in this setting under these conditions with that child. And so then I have to, as the instructor, come back and say, well, how do I need to change my instruction?
If a student is not learning what we want them to learn then that means we’re not providing the instruction in the way it needs to be provided. We need to back up as the instructional team and say do we need to break the instruction down into smaller steps? Do we need to provide more instruction? Do we need to use a different reinforcer? Do we need to provide more supports, or is it the wrong time to be teaching this particular skill? Are there some prerequisites skills that we need to learn? Is there a lack of motivation to learn this skill? When the child-performance data are not showing that the child is learning, that is the prompt for the instructional team that they need to change their behavior.
To learn more about identifying and selecting an EBP, implementing it with fidelity, and evaluating its effectiveness for a given child or student, visit the following IRIS Modules:
For Your Information
Are the EBPs for students with autism also high-leverage practices?
High-leverage practices (HLPs) are practices often used by teachers that have been shown to increase student performance. HLPs that can be used with students with ASD include small-group instruction, functional behavior assessments, peer-assisted strategies, and organized and supportive learning environments. Listen as Kara Hume discusses some of these HLPs and the overlap with EBPs for students with autism (time: 0:58).
Kara Hume, PhD
Research Scientist, Frank Porter Graham
Child Development Institute
University of North Carolina-Chapel Hill
Transcript: Kara Hume, PhD
There are some areas of overlap between the high-leverage practices and these evidence-based practices. The field is not completely decided on what the high-leverage practices are for special educators, but draft documents have indicated that understanding and using functional behavior assessment, FBAs, is key, and that’s also an evidence-based practice. Peer-mediated strategies is both an HLP and an EBP. Another area that could potentially overlap is around the use of building supportive learning environments, and you could likely make a parallel between building these supporting learning environments and all of the interventions that fall under that antecedent-based intervention, or the ABI, in those evidenced-based practices, which is about building an environment that helps to prevent challenging behavior and enhance skills before challenging behavior occurs.