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 upon which decision-making is based to deliver care and educational services.
Research has also proven that individuals who experience 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 integrate 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 will mention here.
3. The practitioner needs to measure the effectiveness of these practices by setting smart goals for each individual with whom they implement these practices.
4. These practices do not specify for you the type or the goals that can be worked on, but rather depend on your ability to derive the goals for which those practices may be appropriate.

1. Antecedent-based interventions:
Antecedent-based interventions (ABI)

Antecedent-based intervention is considered a form of evidence-based practices through which antecedent-based interventions are used to reduce a 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 onto the floor wanting 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, 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 their daily needs through the skill of requesting: by training him to use the word "I want" or identifying the desired item clearly, such as saying (water) when he wants to get water, as well as training on social skills: shaking hands when meeting people, 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 box of colors. 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 relies on the presence of a teacher and a child (individualized instruction) along with instructional materials and reinforcers. The skill is presented to the child in the form of (trials), and it 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. If an incorrect response is obtained, Khaled is assisted to reach the correct answer by providing full physical assistance by holding Khaled's hand and guiding it toward the correct answer, gradually reducing assistance by touching the elbow, then gesturing, reaching independent responding, noting that in trials where assistance is provided, Khaled will not receive 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 (hand washing, putting on shoes). The learner can become more independent in using the more complex target skill or behavior through task analysis.

Example: Khaled, 3 years old, his mother teaches him the skill of hand washing through sequencing the presentation of the hand-washing skill starting with: 1. The child turns on the water tap 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 off his hands 6. The child turns off the water tap 7. The child dries his hands with a tissue 8. The child throws the tissue into the trash bin.

6. Pivotal response training
Pivotal response training (PRT)

Pivotal response training targets training the child in the domains of language and social interaction through play, in which the child is the one controlling the instructional situation.

Example: While Khaled was in the playroom, he saw his favorite toy "horse" and made a good attempt to request, saying: "horse". 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 only reinforcing if the consequence increases the probability that the learner will perform the skill or behavior in the future.

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

8. Prompting or assistance
Prompting (PP)

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

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

9. Extinction
Extinction (EXT)

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 appears) 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 in obtaining the iPad, and then it will gradually disappear due to the absence of a function and reason for performing this behavior,

and the child can be taught to request in an appropriate way through using 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, communicative, social, motor, 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 opportunity to remember the answer and pronounce it correctly.

11. Visual aids (visual support)
Visual Supports (VS)

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

Example: The specialist trains Fahad in the domain of interactive language to answer conversational questions such as: What do you play in the garden? To help Fahad answer, the specialist displays a picture of a "bicycle". It will be easy for Fahad to remember the correct answer, and the use of pictures fades gradually to build sequential conversation independently.

12. Functional communication training
Functional Communication Training (FCT)

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

Example: Training Mohammed to request using the sentence (I want 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 showing unwanted behaviors when wanting to obtain a specific thing 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 some motor skills or to develop their ability to imitate others (whether motor or vocal imitation).

Example: Fahad's mother wants to train him on self-care skills (such as washing hands and combing hair). His mother will perform the skill in front of him to clarify the correct way of 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 specific behavior.

Example: Youssef, 4 years old, is crying. The specialist observes the reasons that precede 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, wanting to get the specialist's attention.

15. Social stories
Social Narratives (SN)

They are written stories. Social narratives describe social situations to learners by explaining the feelings and thoughts of others, and providing a description of appropriate behavior expectations.

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, monitor and record their behaviors accurately, and reward themselves for appropriate behavior or skill use.

Example: Raed has a problem sitting on the chair and finishing the writing skill within a specific time period (2 minutes). We can help him with self-management through: giving him clear instructions (not standing up from the chair until hearing the alarm sound), and then reinforcing the correct behavior when he adheres to 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 the 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, it is played with him, and when he moves to the slide, for example, moving to it with him and asking him about its color, and stopping asking him about the previous toy) and thus the child is trained by following his motivation during natural activities and also obtaining a natural reinforcer, which is the thing he was asked about.

18. Cognitive behavioral intervention
Cognitive Behavioral Intervention (CBI)

Cognitive behavioral intervention teaches the learner to manage their 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 have high language and cognitive skills) and takes the form of sessions in which a number of goals are set and in which an attempt is made to train the individual to avoid some negative thoughts and artificial scenarios and urge him to think in a different way to solve problems and reinforce those new methods.

The therapist encourages 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, and 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 "blocks", he takes a "blocks" picture from the picture file 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 educating individuals with autism spectrum disorder with their typically developing peers, and relies on guiding and supporting whoever has challenges and difficulties in the educational process through peers to facilitate their perception of the skill and its mastery.

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

21. Exercise
Exercise (ECE)

It can be used to improve the physical fitness of learners. 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 acquiring a goal for the learner.

Example: Reema enjoys using the iPad. The specialist capitalizes on this aspect of Reema through 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 introducing demands or other types of distractors to interrupt an interfering behavior and redirect it to a more appropriate response. It targets reducing repetitive, stereotypical behaviors and self-injury.

Example: When some repetitive problems appear (such as hand 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 takes advantage of weekly social visits to relatives by teaching Mohammed to greet, ask about how they 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 designated space, activity, theme, and roles with peers.

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

27. Scripting
Scripting

Scripting is a visual or auditory cue that supports learners to initiate communication with others.

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

Source:

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

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