What Are Evidence-Based Practices?

What are "evidence-based practices"?

They are the therapeutic methods and approaches whose effectiveness researchers have proven through scientific research, and through which decision-making for providing care and educational services takes place.

Research has also shown that individuals with autism spectrum disorder benefit from early intervention and appropriate interventions throughout their lives. Learning does not stop at age five; rather, individuals with autism can benefit from therapies that incorporate evidence-based practices, such as behavior analysis techniques and visual supports, to target the skills most relevant to that person's life.

Note:

1. It cannot be expected that all of these practices are applicable to all individuals with autism spectrum disorder.

2. The practitioner needs intensive training on each type of practice we mention here.

3. The practitioner needs to measure the effectiveness of these practices by setting smart goals for each individual with whom these practices are implemented.

4. These practices do not determine for you the type or goals that can be worked on; rather, they depend on your ability to derive goals for which those practices may be suitable.

1. Antecedent-based intervention:

Antecedent-based interventions (ABI)

Antecedent-based intervention is considered a form of evidence-based practice through which antecedent-based interventions are used to reduce specific problem behavior and increase desired behavior by modifying the environment.

Example:

Khaled is a 5-year-old with autism spectrum disorder. Every time he enters the classroom and sees the toys, he throws himself on the floor out of a desire to get the toys. Every morning before Khaled enters the classroom, the specialist places the toys in a high place where Khaled can see them but they are difficult to reach, and tells him that first we will start the learning process and then you can play with the toys.

2. Parent-implemented interventions

Parent implemented interventions (PII)

Parent-implemented interventions consist of practitioners collaborating with parents, who are trained to implement evidence-based practices (EBPs) with their children during daily routines and activities.

Example:

Involving the family in training the child through daily routines, such as training the child to express daily needs through the requesting skill: by training him to use the word "I want" or clearly identifying the desired item, such as saying (water) when wanting to get water; also training in social skills: shaking hands upon meeting individuals, greeting peers.

3. Differential reinforcement

Differential reinforcement

Differential reinforcement is the application of reinforcement in the absence of the problem behavior or upon the occurrence of the alternative behavior, in order to reduce the occurrence of problem behaviors (for example: crying, aggression, self-injury).

Example: Khaled cries when he wants to get the coloring box; every time Khaled stops crying, the behavior of (not crying) will be reinforced,

4. Discrete trial training

Discrete trial training

It is one of the instructional strategies derived from applied behavior analysis. Discrete trial training is based on the presence of a teacher and a child (one-on-one instruction) along with instructional tools and reinforcers. The skill is presented to the child in the form of (trials) and aims to teach a new skill or behavior.

Example: The specialist presents a set of pictures to Khaled and asks Khaled to point to the picture of a (car). Khaled is reinforced every time he provides a correct response. In the event of an incorrect response, Khaled is assisted to reach the correct answer by providing full physical prompting by holding Khaled's hand and guiding it toward the correct answer, and gradually fading the prompting by touching the elbow, then gesturing, up to answering independently—noting that trials in which assistance is provided will not earn Khaled the reinforcer, and the trial will be repeated anew until he is able to perform the skill without needing assistance.

5. Task analysis

task analysis

Task analysis is used to teach the child skills that consist of multiple steps, such as: the skill of (handwashing, putting on shoes). The learner can become more independent using the more complex target skill or behavior through task analysis.

Example: Khaled, 3 years old, is being taught the skill of handwashing by his mother through a sequenced presentation of the handwashing skill starting with: 1. The child turns on the water faucet 2. The child wets his hands with water 3. The child puts soap on his hands 4. The child rubs his hands with soap 5. The child washes the soap from his hands 6. The child turns off the water faucet 7. The child dries his hands with a paper towel 8. The child throws the paper towel into the trash can.

6. Pivotal response training

Pivotal response training (PRT)

Pivotal response training targets training the child in the areas of language and social interaction through play, where the child is in control of the learning situation.

Example: While Khaled was in the playroom, he saw his favorite toy "horse" and made a good attempt to request, saying: "Horse," so the reward will be the "horse" and not something else. You can also use this strategy through planned or spontaneous interactions.

7. Reinforcement

Reinforcement

Reinforcement describes the relationship between the learner's behavior and the consequence that follows the behavior. This relationship is reinforced only if the consequence increases the likelihood that the learner will perform the skill or behavior in the future.

Example: Reinforcement is used in an intentional manner and through an organized reinforcement schedule, such as the specialist asking the learner: What is your name? and the learner answers: Fahad, and is then reinforced for the correct response,

8. Prompting or assistance

Prompting (PP)

Prompting or assistance is an effective practice for increasing the success and generalization of target skills or behaviors for learners, and reduces their chances of error.

Example: When training a child to point to a picture of a car when presented with a group of pictures, full physical prompting will be provided initially after asking him: Show me where the car is? by (holding the child's hand and helping him reach the correct response), and then progressing to partial physical prompting (touching the elbow), then gesturing, which aims to reach the outcome independently.

9. Extinction (EXT)

Extinction

Extinction is a behavioral principle that can be used to reduce or eliminate problem behavior by withholding the consequences (the event that follows the behavior when it occurs) that maintain it and increase its rate of occurrence.

Example: Every time Fahad screams to get the iPad, the screaming behavior will be ignored. Consequently, over time, the (screaming) behavior will lose its function of getting the iPad and will then gradually disappear due to the absence of a function and reason for performing this behavior,

and the child can be taught to request appropriately through the use of the differential reinforcement method (reinforcing the absence of the behavior or training him on an alternative behavior of requesting with the words: I want iPad).

10. Time delay

Time Delay (TD)

The time delay method can be used to increase academic, communication, social, practical, and play skills by delaying the duration between the stimulus and the response.

Example: If you are training the child to answer the question: What is your name? when asking the question to the child, wait a little before providing assistance to him; give him more of an opportunity to remember the answer and pronounce it correctly.

11. Visual aids (visual supports)

Visual Supports (VS)

They are tools that help the learner process and understand information more easily and quickly, such as pictures.

Example: The specialist trains Fahad in the area of interactive language to answer conversational questions such as: What do you play in the park? To help Fahad answer, the specialist presents a picture of a "bicycle"; it will be easy for Fahad to remember the correct answer, and the use of pictures is gradually faded to build a sequential dialogue independently.

12. Functional communication training

Functional Communication Training (FCT)

Functional communication training can be used to replace problem behavior with more appropriate and effective communicative behavior.

Example: Training Mohammed to request using the sentence (I want a biscuit), whether through spoken language, using cards, or any other form of language. Accordingly, Mohammed will learn the correct way to express his needs instead of resorting to displaying undesirable behaviors when wanting to get something specific or communicate what he feels to others.

13. Modeling

Modeling (MD)

The modeling method can be used to train the child on how to perform certain motor skills or to develop his ability to imitate others (whether motor or vocal imitation).

Example: Fahad's mother wants to train him in self-care skills (such as washing hands and combing hair); his mother will perform the skill in front of him to demonstrate the correct way to do the task, and then ask him to perform the task.

14. Functional behavior assessment

Functional Behavior Assessment (FBA)

Functional behavior assessment is used to explain the reasons behind the occurrence of a particular behavior.

Example: Youssef, who is 4 years old, is crying. The specialist observes the reasons preceding the crying behavior to determine the function of the behavior. The specialist noticed that Youssef's crying occurs when she is occupied away from Youssef playing with another child, out of a desire to gain the specialist's attention.

15. Social narratives

Social Narratives (SN)

They are written stories; social narratives describe social situations to learners by explaining the feelings and thoughts of others, and describing expectations for appropriate behavior.

Example: Fahad is trained on the daily routine by presenting a social story describing the stages of the day starting from (waking up from sleep, going to the bathroom, brushing teeth, getting dressed, riding the bus, going to school).

16. Self-management

Self-management

Self-management teaches learners to distinguish between appropriate and inappropriate behavior, accurately monitor and record their behaviors, and reward themselves for appropriate behavior or skill use.

Example: Raed has a problem sitting in the chair and finishing the writing skill within a specified time period (2 minutes). We can help him with self-management by: giving him clear instructions (not getting up from the chair until hearing the alarm sound), and then reinforcing the correct behavior when he adheres to the instructions.

17. Naturalistic intervention

(Naturalistic Intervention (NI

Naturalistic intervention relies on applying the principles of applied behavior analysis during the daily routine of activities and the learner's activities in order to increase the target behavior or reduce interfering behavior.

Example: In this intervention, the learner's motivation in the natural environment is relied upon, such as: teaching the child to name toys or colors while playing and moving between toys in the outdoor playground (when the child goes to the swing, he is asked: What is this? and when he says: swing, he is played with on it; and when he moves to the slide, for example, one moves to it with him and asks him about its color, and stops asking him about the previous toy). In this way, the child is trained by following his motivation during natural activities and also receiving a natural reinforcer, which is the item that was asked about.

18. Cognitive behavioral intervention

Cognitive Behavioral Intervention (CBI)

Cognitive behavioral intervention teaches the learner to regulate his thoughts and emotions, and recognize when negative thoughts and emotions escalate. The strategy is used to change the learner's thinking and behavior in the right direction.

Example:

This type of intervention may be with high-functioning individuals (who possess high language and cognitive skills) and takes the form of sessions in which a number of goals are set, attempting to train the individual to avoid certain negative thoughts and simulated scenarios, and urging him to think in a different way to solve problems and reinforcing those new ways.

The therapist works on encouraging the therapist

19. Communication system

The Picture Exchange Communication System (PECS)(R)

The Picture Exchange Communication System (PECS) is used to teach individuals effective communication using expressive cards. The PECS system consists of 6 levels. We need to add the stages here

Example: Mohammed, a 7-year-old with autism spectrum disorder, is trained to request to express his needs and desires using pictures. Every time Mohammed wants to get the "blocks," he takes a picture of "blocks" from the picture binder and gives the picture to the teacher, and the blocks are provided immediately to play with.

20. Peer-mediated instruction and intervention

Peer-mediated Instruction and Intervention (PMII)

It involves teaching individuals with autism spectrum disorder alongside their typically developing peers, and is based on guiding and supporting those who have challenges and difficulties in the educational process through peers to facilitate their comprehension and mastery of the skill.

Example: Training Saad in social play by involving his classmates in playing with him in games that involve: turn-taking, searching, and exploring.

21. Exercise

Exercise (ECE)

It can be used to improve learners' physical fitness. In addition, physical exercise can be used to increase desired behaviors (time on task, correct responding) and reduce inappropriate behaviors (aggression, self-injury).

22. Technology-aided instruction and intervention

Technology-aided Instruction and Intervention (TAII)

Technology-aided instruction and intervention refers to instruction or intervention in which technology represents the central feature that supports achieving a goal for the learner.

Example: Reema enjoys using the iPad. The specialist capitalizes on this aspect of Reema by teaching academic skills (letters and numbers) using educational applications or video clips.

23. Response interruption and redirection (RIR)

Response Interruption and Redirection

It is an intervention that involves presenting demands or other types of distractors to interrupt an interfering behavior and redirect it to a more appropriate response. It targets reducing repetitive, stereotypical, and self-injurious behaviors.

Example:

When some repetitive problems appear (such as flapping) whose behavioral function may be (self-stimulation or what is known as automatic reinforcement), the procedure is to stop the behavior (response interruption) and give him a toy to occupy his hands with (redirection).

24. Social skills training

Social Skills Training (SST)

Refers to any adult-directed instruction where social skills are targeted for improvement.

Example: Mohammed's mother utilizes weekly social visits to relatives to teach Mohammed to say hello, ask how people are doing, and interact with others.

25. Video modeling

Video Modeling (VD)

Using video clips to teach a skill helps process information more easily and quickly.

Example: Khaled loves drawing very much. The specialist shows him video clips to teach drawing a (car), and Khaled imitates the drawing correctly.

26. Structured play groups

Structured Play Groups

Structured play groups are small group activities with a defined space, activity, theme, and roles with peers.

Example: The teacher trains learners on colors by going to the playground and placing a group of primary colors on the ground (red, yellow, green) and asking learners to jump on the requested color correctly.

27. Scripting

Scripting is a visual or auditory cue that supports learners in initiating communication with others.

Example:

Teaching children with autism spectrum disorder social interaction by prompting them through providing a text model that they follow (Hello, how are you?) when meeting a friend in the classroom.

Source:

.https://autismpdc.fpg.unc.edu/evidence-based-practices

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Originally published in Arabic. This English version was produced with AI-assisted translation; the Arabic original remains the reference.