The National Autism Center’s National Standards Report Addressing the Need for Evidence-Based Practice Guidelines for Autism Spectrum Disorders

Purpose Identify the level of research support currently available Help understand how to integrate critical information in making treatment decisions Identify the limitations of existing treatment research

The Research 775 research studies were reviewed Individuals with ASD under age 22 Published in peer reviewed journals prior to Fall 2007 Treatments could be implemented in school systems Biomedical interventions excluded Studies needed to have empirical data Limited to research studies published in English

Scientific Merit Rating Scale Developed to ensure that the results of the studies were reliable Five Dimensions: Research design Dependent variable Independent variable Participant ascertainment Generalization Five point scale

Treatment Effects Ratings Criteria were developed to determine if treatment had: Beneficial treatment effect Unknown treatment effect Ineffective treatment effect Adverse treatment effect

Strength of Evidence Classification System Established- Sufficient evidence that these treatments produce beneficial effects for individuals with ASD Emerging- one or more studies shows beneficial treatment effects, but additional high quality studies are needed Unestablished- little or no evidence about treatment effectiveness Ineffective/Harmful- Sufficient evidence exists to show treatment is ineffective or harmful

Outcomes 11 Established Treatments 22 Emerging Treatments 5 Unestablished Treatments

Outcomes Two thirds of the established treatments were developed from behavioral literature Less than 10% of the Established Treatments came from theory of mind perspective The pattern of findings suggests that treatments from the behavioral literature have the strongest research support

Established Treatments Antecedent Package Behavior Package Comprehensive Behavioral Treatment for Young Children Joint Attention Training Modeling

Established Treatments Naturalistic Teaching Strategies Peer Training Package Pivotal Response Treatment Schedules Self-management Story-based Intervention Package

Emerging Treatments Augmentative & Alternative Communication Device Cognitive Behavioral Intervention Package Developmental Relationship-based Treatment Exercise Exposure Package Imitation-based Interaction Initiation Training Language Training (Production) Language Training ( Production & Understanding) Massage/Touch Therapy Multi-component Package

Emerging Treatments Music Therapy Peer-mediated Instructional Arrangement Picture Exchange Communication System Reductive Package Scripting Sign Instruction Social Communication Intervention Social Skills Package Structured Teaching Technology-based Treatment Theory of Mind Training

Unestablished Treatments Academic Interventions Auditory Integration Training Facilitated Communication Gluten-and Casein-Free Diet Sensory Integrative Package Effectiveness is unknown, due to lack of research

Ineffective/Harmful Treatments No treatments identified based on the research Research generally stops, once it is shown that the treatment is harmful or does not work

Treatment Selection Established Treatments Give serious consideration These treatments will not universally produce favorable outcomes for all individuals with ASD Emerging Treatments Don’t begin with these treatments Give serious consideration, if established treatments are not appropriate

Treatment Selection National Standards Report did not address level of intensity needed for effectiveness In interim, follow recommendation of National Research Council for children less than 8 years old

To obtain a copy of the report go to: http://www. nationalautismcenter