News and Knowledge

Note to readers: In each issue of The OARacle, we provide a helpful resource on a topic of interest within the autism community. This month’s article by Shahla Alai-Rosales, Ph.D., BCBA discusses how autism intervention research is put into practice. Special thanks to Dr. Alai-Rosales for her contribution.

The field of autism intervention research is vast and each child with autism has unique skills, interests and needs. While we have learned a great deal in recent years about how to best support and teach children with autism, there is still much that we do not know. Fortunately, steady streams of new intervention strategies are available in journals. Published evaluations of effective strategies allow us to improve the lives of people with autism. Accessing and applying this research base, however, can sometimes be challenging. The purpose of this resource article is to provide parents with an overview of four important questions that they should pose when turning to the intervention research. Of course, it is ideal for parents to work in collaboration with a professional familiar with the intervention research in the area of interest and for parents and professionals to work together especially when applying new intervention procedures for an individual child. A more detailed version of much of the information included here can be found in “Life Journey through Autism: A Parents Guide to Research,” available on OAR’s Web site.

1. What outcomes are important for my child?

Probably the first and foremost priority is to have a clear idea of your child’s needs and the desired goals, or outcomes, for your child. This is typically accomplished through formal and informal assessments that survey a child’s achievements and strengths and pinpoint areas where deficits exist. For a child with autism, assessments occur across many skill areas and domains and involve a team of people who know, or get to know, the child in different contexts and have a vested stake in his or her wellbeing. Once information is gathered, what the child needs to learn should be clear and a plan to achieve the desired outcomes can be developed with his or her treatment team. The plan should include ways of objectively measuring the child’s progress across time, relevant environments and interventions. There are existing curricula available to teach many of the skills needed by children with autism, and these serve us well. Nevertheless, the field of behavior analysis continues to advance. To incorporate new advances into your child’s intervention program, you will need to turn to the intervention literature.

2. How can I find research that might be useful in reaching my child’s goals?

You may find preliminary information through a variety of sources: other parents, the popular media, workshops, conferences, books and Web sites. Once a particular strategy is identified, you will want to get more information and find the original sources, if possible. To do this you can conduct online searches. Several databases are available. For example, medical and psychological information is available through the Scirus Web site, a Science and Technology News Service and educational information is available through the Education Resources Information Center (ERIC) Web site. As you look through the different options, you may consider several factors. First, is the research published in a “peer reviewed” journal? That is, have reputable scientists reviewed the quality and ethics of the research and found it to be acceptable? Second, is the original source readily available to you on the Internet, through your local library or through a location service? Finally, once you locate the actual journal article, is it in a format that is understandable to you, and do the findings of the study actually relate to your child’s needs?

The best way to determine if the study may be useful to your needs is to first look at the abstract. The abstract provides a summary of the research goals, the people who participated in the study, the procedures used to teach the child, a description of how effective the procedures were, and a summary of the findings and why they are important. An intervention may be worth considering if:

• The outcomes are similar to what your child needs at this point in time;
• The children who participated in the study are similar to your child in terms of age, diagnosis and their prerequisite skills; and
• You find the procedures acceptable and feasible.

If, from reading the abstract, it seems the study is appropriate, then your next step is read the entire study and, as mentioned before, consult with a professional.

3. How can I apply the research to help my child?

After reading the entire study, your next task is to study the “Methods” section. In this section there will be detailed information about the participants, how the researchers taught the children who participated in the study (this is usually referred to as the procedures or intervention), how they measured success (usually the information that is displayed on the graphs), and the research design (how the researchers created the conditions to show that the procedures produced the change and not something else).

If you plan to use the intervention, first consult your treatment team. A professional will be able to discuss the pros and cons of the treatment and speak with you about how the new treatment could affect ongoing interventions and therapies.

If you decide to move forward with the new treatment, it may be helpful to prepare a checklist or script of the procedures and then to practice them with one of the treatment professionals who knows your child well and can imitate how they might respond. This will allow you to better understand the details of the teaching procedure and determine if you need more information. If you find that you need more specifics, you can usually find contact information for the authors included as a footnote at the beginning or end of the article. Sometimes the authors will refer to published manuals or books that contain additional information about the teaching procedures.

4. Is it working?

Within the methods section, you will read about the measurement system the researchers used to evaluate the effects of the intervention. The section on measurement should provide you and your treatment team with operational definitions that describe what the child does and how you can count instances of the favorable behavior. To be sure that the intervention is effective, these measures should be collected before you start the intervention (the baseline), during the intervention, and after you have stopped teaching (to insure that the outcomes are durable). The important thing is that you are responsive to the data: graphing will help you do this. The research study will give you some samples of how to set up the graphs. By looking at the graphs you and the team will be able to make rapid decisions as to whether the intervention is effective or not. If you see effects quickly, continue — if not, change.

Although this may seem challenging, it is well worth the effort. Advances in the field are exciting, but their application requires extra effort on the part of parents and professionals. Fortunately, parents of children with autism are known for their dedicated efforts in overcoming far more significant challenges. In that vein, adapting a promising intervention to your child’s treatment regimen will be a welcome challenge.

References

Alberto, P. A., & Troutman, A. C. (1990). Applied Behavior Analysis for Teachers. New York: Merrill.

Baer, D.M. (1996). Evaluating autism treatment programs: A special case of program evaluation. Kansas Autism Society.

Green, G. (1996). Evaluating claims about treatment for autism. In Maurice, Green, & Luce, Behavioral Interventions for Young Children with Autism. Austin: Pro-ed.

Wolery, M. (1996). Monitoring child progress, Chapter 17. In McLean, M., Bailey, D.B., & Wolery, M., Assessing Infants and Preschoolers with Special Needs. Prentice Hall: New Jersey.

Wolery, M. & Garfinkle, A.N. (2002). Measures in Intervention Research with Young Children Who Have Autism. Journal of Autism and Developmental Disorders, 32, 463-478

Shahla Alai-Rosales, Ph.D., BCBA is a member of OAR’s Scientific Council and an Assistant Professor in the Department of Behavior Analysis at the University of North Texas. She teaches graduate level courses on autism intervention, applied research methods in autism, legal and ethical issues in behavior analysis, and positive parenting. Dr. Alai-Rosales is also the Director of the North Texas Autism Project, a service learning program that partners with community providers and that offers parent training (the TALK program) and sibling support (the SMILE program). She has provided evidence-based interventions to children with autism and their families for over 20 years.