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ECI Guest Blog: Evidence Based Practices

Chrystal Jansz Rieken, M.A., BCBA
Clinical Services Supervisor
Burkhart Center for Autism Research and Education

March 27, 2014

Today we’re going to talk about a popular term you’ve probably heard or read when researching different therapies or interventions, especially when it comes early intervention. Evidence-based practice is a term used frequently by practitioners and clinicians, and everyone will tell you it’s what you need to be doing, using, or implementing, but what does it really mean? We’re going to answer this from two perspectives, and highlight why both matter to you.

From a research and scientific perspective, an evidence- based practice (e.g., intervention)

• has been shown to produce the outcomes it was intended to and as a direct result of that intervention, and not something else.
• has been shared in peer-reviewed platforms (e.g., scientific journals), including a description of the intervention and treatment outcomes.

The peer-review process is important and acts like an independent quality control system for treatment publications. This means that when a researcher or clinician wants to publish their results, a group of experts from that field reviews the submission’s methods, claims, and outcomes with scrutiny.

As the consumer, you need to be aware of whether a treatment or intervention has been peer-reviewed. Sometimes there will be claims of a treatment being effective, and even show effectiveness data, but those published claims lack peer review. This is a big red flag. Click here to view some examples of so-called therapies that may actually be harmful.

When considering an intervention, ask yourself: does this treatment have outcome studies published in a peer-reviewed journal?

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Now, let’s switch gears and look at evidence-based practice from a different view. Practitioners are sometimes called single-case researchers because every client they work with is its own experiment. This doesn’t mean that the practitioner is going to try the latest fad treatment with the client! In fact, it means just the opposite.

The practitioner should be applying a method for which there is proven, peer-reviewed evidence to support its implementation. Each intervention should be specific to one client (e.g., a young child with autism) for a particular issue (e.g., teaching choice making).

The practitioner also has the responsibility to collect his or her own effectiveness data for that client. In order for the practitioner to show evidence that the selected intervention is effective for that client, they should:

• take baseline data (i.e., before the treatment starts) on the particular issue
• continue to record data on the very same issue once the intervention is applied
• control for other potential sources of influence (e.g., a secondary and third treatment starting at the same time)

Clear and measurable treatment goals, along with baseline data, allow the practitioner and consumer to decide if the intervention is working. They can compare progress (e.g., data) to the baseline levels before treatment, as well as determine whether progress is approximating, or moving closer towards, the treatment goals.

When applying an intervention ask yourself: is data collection frequent and ongoing, and am I able to review progress data regularly?

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Further reading for caregivers, family members, educators, and practitioners to learn more about wading through interventions and how to determine what’s evidence-based, and what’s not:

• Association for Science in Autism Treatment
• What Works Clearinghouse
• Evidence Based Practice and Autism in the Schools (report)
• American Speech-Language-Hearing Association

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