ASA's 36th National Conference on Autism Spectrum Disorders (July 13-16, 2005)

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Thursday, July 14, 2005: 3:30 PM-5:00 PM
East Blrm
#1620- Finding the Truth: Evaluating Different Kinds of Evidence to Create Best Practices
Educators and parents are faced with designing best practice programs in the absence of needed empirical studies of many specific treatment issues. We will examine how programs can be designed relying upon empirical studies on autism treatment, as well as conceptualizations supported by developmental, neurobiological, medical and policy research.

Presenter:Bryna Siegel, University of California, San Francisco, Professor, Child & Adolescent Psychiatry - Dr. Bryna Siegel’s is Professor of Psychiatry and Director of the Autism Clinic at the University of California, San Francisco. She is author of the PDDST-II (2004) for early autism screening, Helping Children with Autism Learn (2003) and The World of the Autistic Child (1996) and developer of the JumpStart autism parent training model.
 
Educators and parents are faced with having to make decisions about treatment program design in the face of little of the empirical outcome studies they might ideally like. This session will begin with a brief review of difficulties in doing valid treatment outcome research in autism including issues around study designs such as problems in measuring responder characteristics, meaningful generalization of measured treatment outcomes, contamination from collateral treatments, and interpreting the meaning of change due to development alone. Other factors known to influence treatment outcomes such a treatment fidelity, parent training, and definition of intensity of treatment will be considered.

The main focus of the session, however, will be on evaluating tiers of evidence. While it is well-recognized that the randomized clinical trial (RCT) is the gold standard in clinical treatment outcome research, there are almost no such studies of autism treatment. Instead, educators as well as parents must rely on quasi-experimental studies (such as Lovaas's original 1987 work on DTT) but may lack expertise in understanding how experimental design features matter in considering the relevance of results of quasi-experimental studies or other designs such as single case studies or clinical reports. The goal of the presentation will be for the participant to better understand how, in the absence of much empirical data, an educator or parent can rely on developmental theory, behavioral theory, and neurobiological studies to extrapolated about what may constitute justifiable treatments. As providers of autism treatment, we need to rely on different kinds of evidence, but also need to understand whether treatments are supported by sound theoretical foundations, if not empirically-demonstrated effectiveness.

Increasingly, autism treatment is a ‘marketplace' with stakeholders ‘vending' specific treatments in which they have an economic investment. Often there is neither behavioral or biological science backing assertions behind treatment efficacy. This presentation will aim to create a more informed ‘consumer' of these services and provide criteria and strategies for evaluating new treatments as they occur.

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