On this page
Introduction
National Academy of Pediatrics
California Best Practices
New York State Guidelines
Main Autism Task Force
Colorado Manual for Working with Children with Autism Spectrum Disorders
Draft New Zealand Evidence-Based Guideline for Autism Spectrum Disorders
American Academy of Pediatrics 2007 report
Links
Introduction
Many state and federal groups have studied the issue of what is documented to be best practice for identifying and treating (mostly young) children with autism. Here are some documents and links to some of these.
National Academy of Pediatrics
Also sometimes called the National Research Council Report. This is a major report and has a lot of influence--but it is not legally binding! It is by a government advisory group, but it isn't the law. That said, anyone who recommends less than this report suggests needs to be prepared to defend that based on the individual needs of your child. This report reviews many of the methodologies (like ABA, Floortime, etc.). They also have come to some conclusions about identification and treatment. They recommend
" active engagement in intensive instructional programming for a minimum of the equivalent of a full school day, 5 days (at least 25 hours) a week, with full year programming varied according to the child's choronological age and developmental level"
This "25 hour" recommendation is somewhat controversial. It appears to be based on a study by Scheinkopf and Siegel that some have raised concerns about.
Key points-- minimum of 25 hours/week and full year. At least where I am, this appears to be more of a maximum. It pays to request reasons if you are offered less than this. Ask the IEP team to defend a "low bid" with "peer reviewed" literature.
If this whole book is daunting, here are the "conclusions and recommendations"
Also,
consider starting with one of the
other best practice guides--the California one summarizes a lot and
makes some clear recommendations. The NY guide (especially on the
website) gives brief recommendations with grades to how well supported
the recommendations are.
California Best Practices
This is a good
starting place, even if you aren't in California.
There
are a lot of descriptions of diagnostic and therapy methods. There
aren't as many strong recommendations on therapies as in other sources
though.
New York State Guidelines
This
links to the website. There is also a book--it is free to residents
of NY state, and inexpensive to everyone else. The website is
good in that it reviews the literature and grades the results. They
tell you how many studies they looked at and how many they threw out as
not strong scientifically. The recommendations are clear.
The "evidence ratings" are:
Evidence Ratings: [A] = Strong [B] = Moderate [C] = Limited [D1] =
Opinion/No evidence meeting criteria [D2] = Literature not reviewed
You do have to navigate around the website to find the
information. Here is a recommendation from chapter IV, Behavioral
and Educational Approaches:
"It is recommended that intensive behavioral programs include as a
minimum approximately 20 hours per week of individualized behavioral
intervention using applied behavioral analysis techniques (not
including time spent by parents). [A] "
The [A] is the "evidence rating". Again, many would argue that
there really isn't firm evidence for 20 hours (as opposed to 30 or 40)
per week.
Main Autism Task Force
The report is here.
This is from the MADSEC website.
Like the California guide, this gives a lot of descriptions and is a
good place to start. Like the NY guide, this gives some
evaluations of methodologies have a proven effectiveness in the
peer-reviewed literature. .
Colorado Manual for Working with Children with Autism Spectrum Disorders
The
report is here.
This is another good starting place. This has a brief
introduction to autism, Colorado and federal resources and
interventions.
Draft New Zealand Evidence-Based Guideline for Autism Spectrum Disorders
The
report is here.
This is a draft and from New Zealand, so it isn't going to carry much
weight in the US. However, it is a great resource for a summary
of various studies. In a manner similar to the NY state
guidelins, they state is something is "expert opinion" or evidence
based. If there is evidence, they rate the "Level of Evidence" by
according to 3 criteria.
| Level of Evidence |
|
| Strong study where all or
most of the validity criteria are met |
+ |
| Study where not all of
the criteria are met but the results of the study are not likely to be
affected |
~ or Ø |
| Weak study were very few
of the validity criteria are met and there is a high risk of bias |
x |
If you want to start looking up important studies yourself, this is a good starting place. They give citations to a lot of studies.
Management of Children With Autism Spectrum Disorders
The report is here.
This is report from the American Academy of Pediatrics. It covers
multiple subjects, not just ABA. The section on ABA starts on
page 4. There are some good quotes to use in support of
insurance, such as:
"The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings. Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups."