Dr. Chris’ Autism Journal

It seems like every week I am reading an article about another school district struggling to keep up with the expenses of educating children with autism and how instead of adding resources, they keep getting taken away!

In South Carolina, $1.4 million were taken away from the already struggling programs.  This means that children might not get the needed treatment that they need, such as ABA.  More than $700,000 is being dedicated to serving the children with autism, which will cover ABA for only 30 students.  It seems to me that solutions must be found which can spread the limited amounts of money further, how can schools serve more children with the same amount of money while still providing the quality treatment that is needed?

It is time for researchers to start thinking about solutions for schools, there is a large amount of data supporting ABA and some other approaches as well.  However, I would like to see studies looking at how to develop ABA treatments further so as to be able to serve more children, perhaps in small group instruction, or utilizing technology, or simplifying procedures for less expensive staff to implement, or other creative solutions to deal with this critical issue in our education system.

In addition, I would like to see more funding and grants for school programs and more education for school staff to more effectively educate children with autism spectrum disorders.  This could be done easily through online learning programs or local conferences for educators.  In addition, more funding and research is needed for how to effectively and efficiently educate school staff so that they are empowered and motivated.

The other important thing that is needed for school systems is training and accountability for student outcome.  Researchers should consider designing assessments that are feasible and easy for schools to implement, and standards should be set for what exactly schools are expected to measure and report.  While some school districts require teachers to use standardized measures of assessment, these measures are often not appropriate or informative for measuring the progress of children with autism spectrum disorders.  If measurements are required, they should be scientifically validated for the autism population.  In addition, managable and efficient tools need to be developed and available to teachers to make data collection accurate and consistent.

Some states are taking measures to address these important issues, such as California and the Blue Ribbon Commission.  I recently served on the task force for education for this group, and was pleased to see that I am not alone in these concerns and that there are initiatives out there that are working toward solutions.  I will post updates on this Commission as they are available.  Please post other initiatives or solutions that you think are helpful! 

There is certainly no shortage of interventions for autism.  However, not all treatment options have evidence to support them, and it is important for parents and professionals to look at the research behind various treatment options before choosing a program for their child.  This will put more pressure on those who develop new interventions to base their products on existing research and to continue doing research on their products. 

The National Research Council recommends early, intensive intervention for children with autism consisting of 25 hours of structured learning for each child.  The difficulty for parents and professionals is choosing how to fill these hours of intervention for their child.  Today, many efforts are taking place to help educate and evaluate treatment programs, but these efforts still lack the funding and the awareness to make them happen sooner rather than later.

One of the biggest problems in evaluating treatment approaches is that there is very little research comparing one approach to another or looking at combinations of interventions that might be effective.  In reality, professionals typically choose a variety of treatment approaches (e.g. Discrete Trial Training + Floortime + PECS) and make their choices based on what they think might be the best fit for the child’s individual needs.  Researchers need to make this type of study a priority or come to a consensus on how to evaluate treatment programs. 

Another obstacle is that people on the child’s treatment team may have very different philosophical ideas about treatment making it really tough to figure out what is best for the child.  Ultimately, the child’s needs are best served by the team coming to an agreement, so that the child has some consistency across treatment settings.

The ultimate way to determine if the child is getting appropriate treatment is to measure the child’s progress with each new approach that is implemented.  Even less data-driven approaches must provide ways to assess how the child is doing.  Objective measurements are best and you are more likely to get reliabilty among team members.  

The National Standards Project is one of the best strategies for dealing with this issue - I talked about this in a previous post and am very excited about their initiative.

The Center for Evidence-Based Practices: Young Children with Challenging Behavior, which is funded by the Department of Education aims to raise awareness and implementation of positive, evidence-based practices and to build an enhanced and more accessible database to support those practices.  Their mission is not specific to autism, nor should it be, but has a huge impact on the autism community if they are able to achieve the goals that they state.

They are currently conducting research to address this mission:

Research Program Emphases

• Longitudinal, multi-site study to investigate the developmental patterns, preventive factors, and predictive variables related to young children’s challenging behavior.
  
• Effective services and interventions for young children with challenging behavior and their families
  
• Administrative operations and systems variables
  
• Personnel preparation and utilization of evidence-based practice