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| Judging Evidence of Treatment Efficacy in Scientific Literature on Low Incidence Populations |
| Tuesday, August 14, 2007 |
| 8:00 AM–9:20 AM |
| L2 Room 3 |
| Area: TPC; Domain: Applied Behavior Analysis |
| Chair: Howard Goldstein (Florida State University) |
| Discussant: Cameron J. Camp (Myers Research Institute) |
| CE Instructor: Howard Goldstein, Ph.D. |
| Abstract: Information clearinghouses, professional organizations, and government agencies have developed criteria to identify Evidence-Based Practices. Three presenters will discuss applications of those criteria. Goldstein will discuss why different stakeholders (i.e., interventionists, client-consumers, policy makers, and scientists) propose different evaluation criteria and why single subject design research has been largely ignored. He will introduce a set of criteria that have general applicability to group and single-subject experimental designs and illustrate its application to47 articles investigating social skills interventions for preschoolers with autism. Results will be summarized using a Consumer Reports format. Dr. Green will focus on the development of the National Autism Centers rating scheme used to develop evidence-based guidelines for behavioral interventions for autism. Application is illustrated using research on "Applied Verbal Behavior" techniques. Dr. Bourgeois will discuss the application of a set of guidelines to evaluate evidence for behavioral treatments for adult neurogenic disorders (i.e., dementia, traumatic brain injury, aphasia). She will discuss shortcomings of current evaluation systems and propose an alternative that will more adequately reflect the empirical support for interventions in the area of dementia in particular. Dr. Camp will offer perspectives on the state of intervention research on low incidence populations in his role as discussant. |
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| Application of a Consumer Reports Evaluation of Social Skills Interventions in Autism. |
| HOWARD GOLDSTEIN (Florida State University) |
| Abstract: A variety of information clearinghouses, professional organizations, and government agencies have developed criteria to judge Evidence-Based Practices (EBP). It is important to consider why different stakeholders might select different evaluation criteria and perhaps why there has been a tendency to ignore single subject experimental design research. How perspectives are expected to differ among interventionists, client-consumers, policy makers, and scientists will be discussed. The presentation will introduce a set of criteria that have general applicability to experimental research. These criteria can be used to judge empirical support associated with various intervention strategies used with different populations. A set of 14 criteria were developed to evaluate single-subject and group experimental designs according to: (a) Experimental design characteristics, (b) Measurement and reliability, (c) Evaluation of treatment effects, and (d) External validity dimensions. A good deal of literature has reported interventions targeting social and communication skills in preschoolers with autism. Use of this EBP system will be illustrated through an examination of 47 articles investigating social skills interventions in this population. Results of this review will be summarized and tables using a Consumer Reports format will illustrate the adequacy of the studies across the dimensions rated. Applicability to various stakeholder groups will be discussed. |
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| Promoting Inclusion of Behavior Analytic Research in Evidence-Based Guidelines for Autism Intervention. |
| GINA GREEN (San Diego State University) |
| Abstract: Many protocols for developing evidence-based practice guidelines exclude evidence from behavior analytic studies. To date, the few guidelines that have incorporated such evidence have been based on evaluations of only limited aspects of single-case studies, or have included only studies that met formulaic criteria regarding design. Most neglected the essential components of measurement and clear demonstration of functional relations. This paper describes a comprehensive method for evaluating single-case studies that is consistent with behavior analytic research methods as defined by Sidman (1960) and Johnston and Pennypacker (1993) as well as contemporary research on autism treatment. The strength of the evidence produced by each study is inferred from quantitative ratings of each of the following components: design, measurement of the dependent variable, measurement of the independent variable, participant ascertainment, treatment effect, and generality of treatment effect. This rating scheme has been proposed for use in the National Autism Center’s project to develop evidence-based guidelines for behavioral and educational interventions for autism. Application of the rating scheme is illustrated using research on "Applied Verbal Behavior" techniques. Possibilities for using the rating scheme to improve behavior analytic research and to promote wider acceptance of behavior analytic research methods are discussed. |
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| Evaluating Evidence for Behavioral Treatments of Individuals with Neurological Impairments. |
| MICHELLE S. BOURGEOIS (Florida State University) |
| Abstract: The application of a set of guidelines to evaluate evidence for behavioral treatments for adult neurogenic disorders (i.e., dementia, traumatic brain injury (TBI), aphasia) will be presented. In 2001, an ad hoc committee of the Academy of Neurologic Communication Disorders and Sciences proposed to develop evidence-based practice guidelines for the management of communication disorders in individuals with neurological impairments individuals. To date, comprehensive reviews of the treatment literature in the areas of aphasia, dementia, dysarthria, and traumatic brain injury have been published in the Journal of Medical Speech Language Pathology. The paucity of randomized control trials studies with these clinical populations, and the rejection of single-subject studies as unable to index treatment efficacy (Robey and Schultz, 1998), are the reasons why the endorsement of most of the current treatment approaches for these populations are limited. The shortcomings of current evaluations systems will be outlined and an alternative approach that will more adequately reflect the empirical support for interventions in the area of dementia in particular will be offered. |
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