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Evidence-based Practices in the Schools for Students with Autism Spectrum Disorders

The National Professional Development Center on Autism Spectrum Disorders (NPDC) and the National Autism Center (NAC) provide extensive information on identified evidence-based intervention practices (EBPs) for children with ASD. In 2010, the NPDC conducted a review of the literature (from 1997-2007) and identified 24 EBPs. The center has just completed an expanded and updated review, which yielded a total of 27 practices. The NAC completed the National Standards Report in 2009 identifying eleven evidence-based practices with adequate student outcome data for use in school settings. Comprehensive behavioral programs were found to be effective and include strategies such as antecedent package, behavioral package, joint attention intervention, modeling, naturalistic teaching strategies, peer training package, schedules and self-management.

Overlap Between Evidence-Based Practices Identified by the National Professional Development Center (NPDC) on ASD and the National Standards Project (NSP)
Evidence-Based Practices Identified by the National Professional Development Center (NPDC) on ASDEstablished Treatments Identified by the National Standards Project (NSP)
Antecedent PackageBehavioral PackageStory-based Intervention PackageModelingNaturalistic Teaching StrategiesPeer Training PackagePivotal Response TreatmentSchedulesSelf-ManagementComprehensive Behavioral Treatment for Young ChildrenJoint Attention Intervention
PromptingX  X     The NPDC on ASD did not review comprehensive treatment models. Components of The Comprehensive Behavioral Treatment of Young Children overlap with many NPOD-identified practices.The NPDC on ASD considers joint attention to be an outcome rather than an intervention. Components of joint attention interventions overlap with many NPDC-identified practices.
Antecedent-Based InterventionX        
Time delayX        
Reinforcement X       
Task analysis X       
Discrete Trial Training X       
Functional Behavior Analysis X       
Functional Communication Training X       
Response Interruption/Redirection X       
Differential Reinforcement X       
Social Narratives  X      
Video Modeling   X     
Naturalistic Interventions    X    
Peer Mediated Intervention     X   
Pivotal Response Training      X  
Visual Supports       X 
Structured Work Systems       X 
Self-Management        X
Parent Implemented InterventionThe NSP did not consider parent-implemented intervention as a category of evidence-based practice. However, 24 of the studies reviews by the NSP under other intervention categories involve parents implementing the intervention.
Social Skills Training GroupsSocial Skills Training Groups (Social Skills Packages) was identified as an emerging practice by the NSP.
Speech Generating DevicesSpeech Generating Devices (Augmentative and Alternative Communication Device) was identified as an emerging practice by the NSP.
Computer Aided Instructioncomputer Aided Instruction (Technology-based Treatment) was identified as the emerging practice by NSP.
Picture Exchange CommunicationPicture Exchange Communication System was identified as an emerging practice by the NSP.
ExtinctionExtinction (Reductive Package) was identified as an emerging practice by the NSP.

Evidence-Based Practices: The STAR Program and Links Curriculum

  • Effective in public school settings
  • Curriculum-based assessments and progress monitoring
  • Strategies (how to teach) & Content (what to teach)
  • Age-appropriate content for all levels
  • Connected to the Common Core and other State Standards
  • Road map to individualize to all learners

The STAR Program (Strategies for Teaching based on Autism Research, Arick, Loos, Falco, Krug, 2004) is a research-validated comprehensive curriculum that includes detailed lesson plans, teaching materials, data systems and a curriculum-based assessment for teaching in the six curricular areas of receptive language, expressive language, spontaneous language, functional routines, academics, and play & social skills. The strategies used in The STAR Program have been shown to be effective with students with autism at the preschool and elementary level.

Links Curriculum (Linking Assessment and Instruction for Independence) is a research-validated comprehensive web-based curriculum to teach upper elementary, secondary and postsecondary students with autism to be independent across school, community and vocational routines. This evidence-based curriculum includes detailed lesson plans, visual sequence strips, data systems and assessment. Links is designed to promote student independence in natural environments. The Links online system utilizes a curriculum-based assessment to individualize routines for every student. The Links school and community lesson plans provide the user with the tools necessary to teach both individual skills and independence in daily routines.

Is your current program implementing all recommended evidence-based practices?

Evidence-based practices as suggested by The National Professional Development Center and National Standards ProjectSTARLinks
Comprehensive Behavioral TreatmentXX
Discrete Trial TrainingXX
Antecedent Package (ABA, positive behavior supports)XX
Behavioral Package (ABA, positive behavior supports, token systems, FBA)XX
Pivotal Response TrainingXn/a
SchedulesXX
Self-management (promoting independence)XX
Task AnalysisXX
Joint Attention TrainingXX
Modeling and ImitationXX
Naturalistic Teaching  StrategiesXX
Functional CommunicationXX
Social Skills TrainingXX
Visual and Environmental SupportsXX
ReinforcementXX
Independent Work SystemsXX
Prompting StrategiesXX
Computer Aided Instructionn/aX

Research Validation of the STAR Program

The Oregon Statewide Outcome Study: In 1999 the Oregon Department of Education began the funding of an on-going long-term outcome study designed to monitor the progress of students with autism. The Autism Outcome Study enrolled over 122 children in public pre-school and school-age programs over a five year period. These programs included rural, suburban and urban schools. The project staff provided training in The STAR Program and a separate team of researchers conducted assessments of the students to monitor their progress. The students made significant progress in all areas of instruction. In particular students made significant progress in the areas of expressive language, receptive language, social interaction skills, academics and independence on functional routines. (Arick, Young, Falco, Loos, Krug, Gense, & Johnson, 2003; Arick, Young, Falco, Loos, Krug, Gense and Johnson 2004). Ninety-one percent of the students made progress in the expressive language area. The average expressive language age gain for the first cohort of students was of 33 months of gain in the 52 month time period (Arick, et.al, 2004). The project has continued to evaluate student progress and has found results consistent with those obtained in the initial Autism Outcome Study (Arick, Willis, Nakada, 2011). Read Article

The Autism Instructional Methods Study (AIMS.): The Aims project was a comprehensive study of effective educational practices in a large urban school district. The STAR Program, and training in the curriculum, composed the core elements for a three-year study involving thirty-four K-3 classrooms for students with autism. This study was a randomized control trial funded by the National Institute of Health (NIH) and the Institute of Education Sciences (IES). The study was conducted by the University of Pennsylvania’s Center for Autism Research and the Children’s Hospital of Philadelphia. Students in The STAR Program showed significantly greater gains than the experimental group when program fidelity was obtained (Mandell, 2010, 2011, 2014).

Measuring Outcome in Early Intervention Program for Toddlers with Autism Spectrum Disorder: Results of this study found that students who were provided early intervention using The STAR Program made significant progress over a two year period of time. The study also found that the STAR Student Learning Profile correlated highly with other standardized measures and provided additional useful information about student skills learned (Bacon, Dufek, Schreibman, Stahmer, Pierce and Courchesne 2014). ). Click here to read the full research article

Evidence Basis for the Links Curriculum

The Links Curriculum integrates recommendations for best practices from research on effective instruction for secondary students with developmental disabilities including autism.

Themes of Instruction

(National Research Council, 2001: Snell & Brown, 2006; Wehmeyer, 1998)

  • Independence
  • Self-Determination
  • Functional and Generalizable Skills

Content of Instruction

(National Research Council, 2001; Snell & Brown, 2006)

  • School and Community Routines
  • Responding to Language
  • Communicating with Others
  • Functional Academics
  • Engaging in Diverse Activities
  • Social Skills

Instructional Methods

(National Autism Center, 2009; National Professional Development Center, 2010; Snell & Brown, 2006)

  • Principles of Applied Behavior Analysis
  • Discrete Trial Training
  • Task Analysis (i.e. Functional Routines)
  • Visual and Environmental Supports
  • Antecedent-Based Strategies
  • Positive Behavior Strategies and Supports
  • Self-Management Techniques
  • Augmentative Communication Systems
  • Modeling/Imitation Strategies
  • Joint Attention
  • Student Schedules
  • Reinforcement
  • Structured Work Systems
  • Peer Mediated Instruction
  • Prompting Strategies

Links combines assessment and the instructional processes listed in the table above by using online and print materials in both school and community settings to increase student independence. It has been suggested that this combined approach is the most appropriate method for implementing evidence-based curriculum for students with ASD and other developmental disabilities (Kavale & Forness, 1999). Emphasizing skill generalization to enhance independence is also considered a critical component in the development of an appropriate curriculum for this population of students (National Research Council, 2001) and is interwoven throughout the Links Curriculum. Links capitalizes on students' strengths, interests, and abilities and individualizes the assessment and instructional process in natural environments.


Research Validation of the Links Curriculum

Links Assessment System

A major field test was conducted in the state of Oregon during 1999-2000 to determine the reliability and validity of the measurement system that is utilized in the Links Curriculum. Thirty school districts, 133 instructors, and 478 students with moderate to severe disabilities participated in the study (Arick, Nave, & Hoffman, 2000). Extensive reliability and validity studies were conducted. Test-retest and inter-observer reliability were found to be high. Assessment validity correlated with the Vineland Adaptive Behavior Scales. It was found to measure independence levels in students with significant disabilities including students with autism. Further information can be found in the implementation guide.

Links Instructional System

A study was implemented by a group of instructors residing in several areas of the U.S. A pre-post single subject design was utilized. At the conclusion of the study, an analysis of the pre-post results was conducted. Data from the study indicated that 90% of the students improved across all routines selected. This indicates that 90% of the students made progress on their selected routines. Further information on this study can be found in the implementation guide. Learn more from the Links Manual.

References

National Autism Center (2009). National Standards Project findings and conclusions: Addressing the need for evidence-based practice guidelines for Autism Spectrum Disorders. Randolph, MA: National Autism Center.

Wong, C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S., Schultz, T. R. (2013). Evidence-based practices for children, youth, and young adults with Autism Spectrum Disorder. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group.