Evidence-Based Practices and Students With Autism …

1 The past several years have been witness to a variety of educa-tion reform and reorganization efforts, including for studentswith disabilities. Prominent among these restructuring effortshave been initiatives that require educators to adopt practicesthat are supported by research. Noteworthy examples of thistrend include the No Child Left Behind Act of 2001 and othercalls for use of effective practice methods by educators andothers who are connected with Students with disabilities. Al-though this is a daunting challenge for any group of Students ,the process of identifying and consistently and correctly usingeffective practice methods has been especially demanding forprofessionals who work with children and youth with autismspectrum disorders. This article discusses issues and factors thatrelate to identifying and using effective Practices with studentswith Autism -related disorders. Recommended effective practicemethods are also into law in January 2002, the No Child Left Be-hind Act of 2001 (NCLB) is an ambitious congressionalattempt to ensure that all children have a fair, equal, andsignificant opportunity to obtain a high-quality education, andreach, at a minimum, proficiency on challenging state aca-demic achievement standards and state academic assessments (NCLB, 2002).

2 Included in the noteworthy, standards-basedNCLB enactment is the expectation that all Students , includ-ing those with disabilities, will demonstrate annual yearlyprogress (AYP) and perform at a proficient level on stateacademic assessment tests. The means, suitability, and even thesensibility for accomplishing these lofty goals are under intensedebate (Albrecht & Joles, 2003; Allbritten, Mainzer, & Zieg-ler, 2004;Center on Educational Policy, 2003). Algozzine(2003), for example, observed that federal control is being ex-erted through discretionary and other incentives to state andlocal education agencies, even though the federal gov-ernment has no designated power to manage education. Yet,independent of these debates, there is general agreement thatimproving Students performance and outcomes is an impor-tant and necessary endeavor. Moreover, increasingly there is aperception that improved student outcomes will be most likelyto occur within a restructured education system (Egnor, 2003;Robelen, 2002).

3 Education restructuring includes teachers willingness andability to adopt and properly use effective-practice materialsand strategies (Lerman, Vorndran, & Addison, 2004). Indeed,a salient element of NCLB relates to using effective educationpractices developed from scientifically based research (SBR).Such Practices are defined as those that have met rigorous peerreview and other standards and that, when consistently and re-liably applied with fidelity, have a history of yielding positiveresults (Simpson, LaCava, & Graner, 2004).The call for effective and scientifically supported methodsfor use with Students with disabilities extends beyond NCLBand other legislative and policy statements (Odom et al.,2005). This appeal has been particularly trumpeted within thefield of Autism spectrum disorders (ASD; National ResearchCouncil, 2001). Demands and pleas for adoption of effectivepractices for children and youth with Autism and related dis-abilities are connected, at least in part, to the significantly in-creased prevalence of ASD (American Psychiatric Association,2000) and a longstanding tradition and legacy of accepting,condoning, and even promoting methods and strategies thatlack efficacy and proven utility (Gresham, Beebe-Frankenberger,& MacMillan, 1999; Simpson, 2004).

4 This article addressesseveral issues connected to identifying and using scientificallysupported and effective-practice methods with Students withASD. Effective Practices for Students with ASD are Interventions and Treatments for Students with ASD Notwithstanding noteworthy advancements in treating andunderstanding individuals with ASD, Autism -related disabili-ties remain largely inexplicable (Frith, 2003). Thus, in spite ofcrucial and meaningful gains in information about ASD andFOCUS ON Autism AND OTHER DEVELOPMENTAL DISABILITIESVOLUME 20, NUMBER 3, FALL 2005 PAGES 140 149 Evidence-Based Practices andStudents with Autism SpectrumDisordersRichard L. SimpsonVOLUME 20, NUMBER 3, FALL 2005141procedures and intervention strategies that benefit individualswith ASD, persons with Autism -related disorders remain anenigmatic group. Highly unique and idiosyncratic character-istics associated with ASD, manifestation of irregular and oc-casionally even advanced skills that accompany diagnoses ofautism, and a remarkably increased prevalence of ASD (Amer-ican Psychiatric Association, 2000; Autism Society of America,2005) are only a few of the factors that have fueled significantdebate about which treatment and intervention choices aremost apt to lead to favorable outcomes (Prizant & Rubin,1999).

5 Furthermore, related to its perceived distinctiveness andinimitability and because Autism is considered to be a life-long,permanent disability, Autism -related disabilities have attracteda number of highly controversial treatments and interventionstrategies (Bettelheim, 1967; Biklen & Schubert, 1991; Sill-man, 1995). In this context, controversialis a reference to un-validated methods and strategies for which there is little in theway of scientific support and efficacy, especially when extraor-dinary and incomparable results are promised (Simpson &Myles, 1998).Effective and Scientifically ValidInterventions and Treatments for Students with ASDP ersons associated with children and youth with Autism andautism-related disorders are not exclusive in their struggle tosort between effective and ineffective interventions and treat-ments and to identify the salient components of an effectiveprogram. Indeed, no area of disability has managed to escapethe difficulties associated with controversial and unsupportedtreatments and interventions (American Speech-Language-Hearing Association, 2004).

6 Yet, no area of disability has ex-perienced this problem to the same degree as those within theautism field. Parents and professionals connected to childrenand youth with ASD have been singularly and exceptionallyprominent in their willingness to consider and advocate use ofunproven and controversial interventions and treatments, in-cluding strategies and methodologies that supposedly lead toattainment of skills, knowledge, and progress that are well be-yond those characteristically found with established effective-practice methods (Heflin & Simpson, 2002; Volkmar, Cook,& Pomeroy, 1999a). That some of these methods are pro-moted to result in rapid, all encompassing, and dramatic im-provements, or to actually restore an individual with anautism-related disability to normalcy, has been appeal and lure of overvalued and unvalidated inter-ventions and treatments are both explicable and arguably evenlogical. Consider and identify with the parents of children withautism: These individuals are confronted with raising childrenwho have been identified with a life-long pernicious disabilityfor which there is neither a clear explanation nor a universallyaccepted course of treatment.

7 When confronted with oppor-tunities and options that purport to lead to significantly im-proved outcomes, even if the techniques that are beingconsidered lack scientific validation, it is understandable thatmany parents, as well as numerous professionals who workwith these children and youth, are willing to consider and evenforcefully advocate for approaches that promise improved out-comes or to restore an individual to normal functioning. Kalb(2005) poignantly makes this point in a Newsweek feature ar-ticle on Autism , commenting on one family s search for treat-ments: Since their sons were diagnosed [ with Autism ], bothat age 2, Barry and Dana Craven have tried a dizzying array oftherapies: neurofeedback, music therapy, swimming with dol-phins, social-skills therapy, gluten-free diets, vitamins, anti-anxiety pills and steroids (p. 45).In spite of the comprehensible reasons for the current in-tervention and treatment dilemma, it is nonetheless painfullyevident that unrestricted use of and reliance on untested meth-ods, especially those that promise extraordinary results, havebeen detrimental to the ASD field.

8 Gullible and uncritical ac-ceptance of interventions and treatments that promise phe-nomenal results and acceptance of unvalidated methods andstrategies that capriciously and naively supplant proven strate-gies have undermined wide-reaching identification, correctimplementation, and prudent evaluation of methods that bodebest for children and that may be the prerequisite foundationfor effective programs for Students with ASD. In short, de-pendence on and uncritical use of miracle cures and unprovenmethods have encouraged unhealthy, unrealistic, and improb-able expectations and have, in all too many cases, retarded theprogress of Students with apparent solution to this dilemma is to identify anduse scientific methods and Evidence-Based Practices (Shavelson& Towne, 2002). This clear-cut and evident answer is appeal-ing and has obvious value. Yet its implementation is fraughtwith Herculean challenges. Regarding using a science-orientedstrategy for identifying and adopting Evidence-Based methods,Odom and his colleagues sagely observed that the devil is inthe details (Odom et al.)

9 , 2005, p. 137). To be sure, thereare significant difficulties and a lack of consensus regardinghow best to identify, use and evaluate scientifically valid andeffective Practices ( Department of Education, 2003).NCLB has prominently and aggressively supported the useof SBR in selecting educational Practices . Mentioned morethan 100 times in NCLB, SBR is defined as research that in-volves the application of rigorous, systematic, and objectiveprocedures to obtain reliable and valid knowledge relevant toeducation activities and programs (NCLB, 2002). Accord-ingly, NCLB has identified effective SBR Practices as those thathave met thorough and particular standards and that have re-liably yielded positive results when applied in the approvedmanner. Rigorous peer review policies and strategies are thepreferred means for testing and confirming that Practices areFOCUS ON Autism AND OTHER DEVELOPMENTAL DISABILITIES142scientifically based .

10 More specifically, scientifically based prac-tices include products and materials validated by means of re-search designs that use random samples and control andexperimental groups. This model of research is considered byNCLB to be the gold standard. For a variety of sound rea-sons, however, randomized control group designs are infre-quently used in research involving children and youth withautism-related disorders. This narrow interpretation of what isscientifically valid has broad and significant implications re-lated to endorsing intervention and treatment Practices forchildren and youth with (2003) attempted to explain NCLB s narrow inter-pretation of SBR by citing the Department of Educa-tion s Questions and Answers on No Child Left Behind: DoingWhat Works, a guidance tool for parents and educators:To say that an instructional program or practice is grounded inscientifically based research means there is reliable evidence thatthe program or practice works.