PICO Presentation By: amy fox rn Cohp 450

Do Children with autism ages 0-5 who are receiving behavioral intervention therapy have improved speech and language skills compared to those who have not received any intervention?

Research Search Words Search Engines Results of search Autism Behavioral Interventions Applied Behavioral Interventions(ABA) Therapy Speech and Language Development Research Articles found using FLITE library database through Ferris State University Two articles found related to my PICO question topic

References Speckley, M., Boyd, R. (2009). Efficacy of Applied Behavioral Intervention in Preschool Children with improving Cognitive Language, and Adaptive Behavior: A Systematic Review and Meta-analysis. The Journal of Pediatrics, 154(3), 338-344. doi:10.1016/j.peds/. Watson, L.R., Baranek, G.T., Roberts, J.E., David, F.J., & Perryman, T.Y.(2010). Behavioral and Physiological Responses to Child- Directed Speech as Predictors of Communication Outcomes in Children with Autism Spectrum Disorders. Journal of Speech, Language and Hearing Research, 53(4), 1052-1064, doi:10.1044/1092- 4388.

Rationale Articles chosen based on topic Limited resources Chose 2 different types of interventions

Randomized control trials Quantitative data Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis Theory Type of Study Design Applied behavioral analysis (ABA) therapy would show improvements in speech and language in children with Autism Spectrum Disorder (ASD) Quantitative study needed for meta- analysis systematic reviews Randomized control trials Quantitative data

Multiple studies meeting criteria Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis (Continued) Methods Findings Search Study Multiple studies meeting criteria Inadequate evidence More research needed

Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders Theory Type of Study Design to determine if communication skills improve with Child- Directed Speech therapy in Autistic Children 12 months after initial therapy Longitudinal Study All boy study with re- evaluation 12 months after therapy initiated

Multiple studies screened to meet criteria Inadequate evidence Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders (continued) Methods Findings Search Study Multiple studies screened to meet criteria Inadequate evidence More research needed

Ethical Considerations Study 1 Too much ABA therapy Too little or no therapies at all No access of Inability to receive ABA therapy Study 2 Developmental improvement result of Child-Directed Speech Therapy or Normal Developmental Milestones

Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis Strengths Quality Credibility Specific Target Group Children ages 18months- 6years All have Autism Spectrum Disorder or Pervasive Development Disorder Inadequate Evidence Broader outcomes needed for adequate evidence that ABA could be beneficial Scholarly Journal

Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders. Strengths Quality Credibility Specific all boy target group <24 months of age at entry Re-evaluation 12 months after receiving therapy Limited study due to small sample size Scholarly journal Peer reviewed

Relevant To Practice Communication Scholarly journals Medical conferences Power point presentations Individual and Professional level Parents and families of Autistic Children Teachers All Medical Professionals Implications- Early Intervention is Recommended for nonverbal Autistic Children however not enough research is implicated in the studies presented in this presentation

Barriers to Autism Care Policy- not indicated Resources- not everyone has access to specialized therapies Values- Early intervention recommended

Additional PICO QUESTIONS Do children with autism ages 0-5 who are receiving behavioral intervention therapy have improved gross and fine motor skills that children who are not receiving any therapy? Do children with autism ages 0-5 who are receiving behavioral intervention therapy have improved social skills than children who are not receiving any therapy?

Conclusion Study 1 Study 2 Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis Meta-analysis did NOT show an improvement in speech and language Study 2 Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders. Evidence suggests improvement in improved communication 12 months after initial therapy began