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| Evidence-Based Practice: Identifying Treatments that Work |
| Monday, August 13, 2007 |
| 2:00 PM–2:50 PM |
| L4 Room 1 |
| Area: CBM; Domain: Theory |
| Chair: Susan Wilczynski (National Autism Center/May Institute) |
| Discussant: Susan Wilczynski (National Autism Center/May Institute) |
| Abstract: Increasingly, the field of psychology recognizes the urgent need for high quality research to guide practice decisions. This trend is probably most apparent in the Evidence-based Practice (EVP) movement. EVP involves the integration of research-supported treatments with clinical judgment and patient values. Ironically, behavior analysts, who have long fought for research and data to drive treatment services, have been silent in this important discussion that is shaping the field. Hopefully, the formation of the EVP special interest group in the Association for Behavior Analysis in 2006 will spur behavior analysts to join in the discussion of EVP. The current presentation is intended to describe the best available information in EVP in three areas of practice: autism, enuresis, and ADHD. The results of the National Standards Project (NSP), the most up-to-date and comprehensive review of educational and behavioral literature regarding treatment of individuals with Autism Spectrum Disorders, will be reviewed. The next presentation will explore behavioral approaches to enuresis with an emphasis on what underlies the functional aspects of these procedures. Finally, methodological considerations of EVP will be considered, with ADHD serving as an exemplar of why a continued discussion on determining what constitutes EVP is necessary. |
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| The National Standards Project: Evidence-Based Practice in Autism. |
| SUSAN WILCZYNSKI (National Autism Center/May Institute) |
| Abstract: The National Standards Project is an unprecedented effort to provide validated national standards for evidence-based education and behavioral intervention for children and adolescents with Autism Spectrum Disorders. Specifically, parents, educators, service providers, and policy-makers need access to a resource that identifies the strength and quality of research supporting comprehensive programs, designed to produce multiple skill domains simultaneously, and focused interventions to address a defining feature of the disorder or an associated characteristic. Using a methodology that is consistent with that used to produce evidence-based medicine guidelines, experts from across the United States have actively participating in the National Standards Project and developed criteria for evaluating the extent to which interventions commonly used in schools and treatment programs are well-supported by research. The results of the National Standards Project will be announced in the spring of 2007 in the United States and the purpose of this presentation is to share the results with the international community. Separate data will be presented on the basis of (a) the name of the intervention provided he author, (b) the category of intervention in which it falls (e.g., academic, higher cognitive functions, problem behaviors, stereotypy, etc.), and (c) age. |
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| Making Sense out of Behavioral Approaches to Primary Nocturnal Enuresis. |
| WILLIAM J. WARZAK (University of Nebraska Medical Center), Karen I. Dittmer-McMahon (Children's Hospital of Omaha, NE) |
| Abstract: There have been many interventions for primary nocturnal enuresis (PNE), including pharmaceutical and behavioral approaches. In general, behavioral approaches have enjoyed the most widespread success. The most common element in behavioral intervention is the moisture alarm, of which there is a wide variety. However, the alarm is not necessarily the correct intervention for all children who wet the bed. This presentation will discuss differential features of children with PNE that should be considered when evaluating children for moisture alarms. In addition, the functional properties of moisture alarms will be discussed in an effort to clarify how these alarms work in patients for whom they are appropriate. |
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| The Evolution of Research Methodology in ADHD. |
| NANCY A. NEEF (The Ohio State University) |
| Abstract: The What Works Clearinghouse (WWC) has established standards for evaluating the strength of evidence of effectiveness of interventions. According to these standards, studies that provide the strongest evidence are randomized controlled trials and regression discontinuity studies. Ironically, No Child Left Behind -- although suggesting a focus on the individual-- has similarly promoted randomized group designs as the “gold standard.” This represents a departure from the focus on individuals that has led to major discoveries since the beginnings of science. The historical context for these methodological approaches will be traced, with research on interventions for ADHD as recent examples of how the methodological standards currently being advocated can impede progress. This will be illustrated by contrasting the questions, conclusions, limitations, and implications of the MTA study (randomized group design) with those of studies that have used within subject design |
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