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Top Autism Treatments

In a recent About: Autism Spectrum Disorders posting, the top 10 treatment approaches for autism were listed along with helpful links for each of these approaches.  The top 10 were determined by popularity, research, and most effective overall.

The top 10 listed were:100_0152.JPG

1) Applied Behavior Analysis (ABA)

2) Speech Therapy

3) Occupational Therapy

4) Social Skills TherapyB and Trish.jpg

5) Physical Therapy

6) Play Therapy

7) Behavior Therapy/Positive Behavior Support

8) Developmental TherapiesEl 1.jpg

9) Visually-based Therapies

10) Biomedical Therapies

I would like to see a similar list, in order, of those that are the most research-based and have evidence of effectiveness with the largest number of children with autism.  Organizations such as the National Autism Center are dedicated to coming up with good ways to make these kinds of lists and to develop rankings for treatment approaches which will be based on research and effectiveness for ASD.  This project is called the National Standards Project and the expert panel and conceptual reviewers include a prestigious group of autism researchers including several of our TeachTown science advisory board members including Dr. Ilene Schwartz, Dr. William Frea, and Dr. Aubyn Stahmer.

J computer.jpgI would also like to see more studies on technology and which programs are effective and which ones are not.  It won’t be long before Computer-Assisted Instruction is added to the list above, I just hope that developers, and perhaps more importantly, university researchers continue to conduct the necessary research to keep improving these programs.

**Please see comments from the author of the ABOUT blog, she makes some excellent comments and I completely agree with her!**

Evidence-Based Practices

B & E.JPGThere 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. 

Manya & E.JPGThe 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.classhands.gif

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.

dmbtest.gifThe 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 BehavioB & E 2.JPGr, 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

The National Standards Project

I’m currently attending the AEN conference in San Jose, CA. The primary focus of the project is on a “National Standards Project” which will focus on the urgent need for universally accepted standards that promote evidence-based treatment approaches for autism.

This is exciting stuff! I’ll follow-up in the next week with additional information. Here’s some information pulled from the National Autism Center web site:

The National Standards Project is an unprecedented effort to produce a set of peer reviewed standards for evidence-based education and behavioral intervention for children with autism. The standards will also give policy-makers the tools they need to ensure that effective, scientifically sound treatment programs receive crucial funding.

The technical manual will be the basis for the development of additional materials targeted for specific audiences and uses. Projects presently scheduled include:

1) A handbook for families providing criteria for selecting evidence-based services.

2) A handbook for public school systems outling specific evidence-based program components, procedures, and implementation strategies.

3) Published recommendations for physicians on how to counsel families to identify effective services for their children with autism.

4) Professional training in how to implement the national standards.

5) Practical web-based material to help families and practitioners learn about the standards and their implementation.

Participants in the project include nationally recognized experts.

The need for standards is well established in the field. In 2001 the National Research Council (NRC) assembled a multi-disciplinary subcommittee to integrate the scientific, theoretical, and policy literature pertaining to the education and treatment of children with autism and to disseminate a preliminary set of recommendations. Although the NRC Report summarized the components of evidence-based approaches to education, it did not provide details explicit enough for standards implementation. An National Institute of Health (NIH) sponsored Autism Summit in 2003 further confirmed the need for standards.

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