Tag Archive for 'effective treatment'

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US ED resource on restraint and seclusion

The US Department of Education (ED) published Restraint and Seclusion: Resource Document today. After the extensive discussions the last few years about abuses of management procedures (see , especially those used with children and youths with Emotional and Behavioral Disorders, ED contracted with an agency to create this document that provides guidelines for the appropriate use of restraints and seclusion.

The foundation of any discussion about the use of restraint and seclusion is that every effort should be made to structure environments and provide supports so that restraint and seclusion are unnecessary. As many reports have documented, the use of restraint and seclusion can, in some cases, have very serious consequences, including, most tragically, death. There is no evidence that using restraint or seclusion is effective in reducing the occurrence of the problem behaviors that frequently precipitate the use of such techniques.

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Toilet training Webinar

My colleague, Annie McLaughlin, who is the Outreach Supervisor for the Virginia Institute of Autism (VIA), will be hosting a Webinar on toilet training 15 May 2012. Annie—who completed teacher education work at the University of Virginia’s Curry School and Ph.D. studies at the University of Washington and has doctoral-level certification from the Behavior Analyst Certification Board—told me that the focus won’t be on rapid toilet training a la Azrin and Foxx, but more on a data-based, schedule training that increases the likelihood that the individual will learn that the toilet is the stimulus for voiding.

Dr. Annie McLaughlin will lead an online, interactive parenting workshop on toilet training individuals of all ages with Autism Spectrum Disorders and other related disabilities. Learn how to recognize if your child is ready for toilet training, design a toilet training plan for your child, and learn practical tips for overcoming common problems. Cost $65. Limit space. After registering, participants will receive instructions on how to view the online lecture and live chat.

Registration for the Webinar is available on the Web as is a contact for additional information. Here’s a link to an antique post about toilet training

First Step supported by WWC

The US What Works Clearinghouse (WWC) reviewed research about First Step to Success, an early intervention program for K-3 children who are at risk of developing antisocial behavior, and identified it as having positive effects on ratings of student behavior and potentially positive effects on ratings of emotions, social skills, and academic outcomes. The WWC based its review on two studies by the developers of First Step, Hill Walker and colleagues—alert readers of EBD Blog will recognize one of them (see “First Step Takes Off“).

What Works—which some folks have taken to calling “what doesn’t work,” because they say it rarely identifies practices that are effective—gave the research undergirding First Step a strong review:

The WWC review of interventions for Children Classified as Having an Emotional Disturbance addresses student outcomes in seven domains: external behavior, emotional/internal behavior, social outcomes, reading achievement/ literacy, math achievement, school attendance, and other academic performance. The two studies that contribute to the effectiveness rating in this report cover five domains: external behavior, emotional/internal behavior, social outcomes, reading achievement/literacy, and other academic performance. The findings below present the authors’ estimates and WWC-calculated estimates of the size and statistical significance of the effects of First Step to Success on children classified as having an emotional disturbance….

Two studies reported findings in the external behavior domain.

Walker et al. (1998) found, and the WWC confirmed, four positive and statistically significant differences between treatment and comparison groups on academic engaged time, the Child Behavior Checklist–Teacher Report Forms (CBCL-TRF) Aggression Subscale, the Early Screening Project (ESP) Adaptive Behavior Subscale, and the ESP Maladaptive Behavior Subscale.

Walker et al. (2009) found, and the WWC confirmed, four positive and statistically significant differences between treatment and comparison groups on academic engaged time, the Social Skills Rating System (SSRS) Problem Behavior Subscale for Parents, the SSRS Problem Behavior Subscale for Teachers, and the SSBD Maladaptive Behavior Index. Although the overall design of the Walker et al. (2009) study meets evidence standards, there was high attrition on one outcome: the SSRS Problem Behavior Subscale for Parents outcome. The authors established equivalence for the analytic sample for this outcome; thus, this finding meets evidence standards with reservations.

The mean effect size from the four outcomes in Walker et al. (1998) and the mean effect size from the four out- comes in Walker et al. (2009) were both statistically significant. Thus, for the external behavior domain, two studies with strong designs showed statistically significant positive effects. This results in an intervention rating of positive effects for the domain, with a small extent of evidence.

Walker, H. M., Kavanagh, K., Stiller, B., Golly, A., Severson, H., & Feil, E. (1998). First Step to Success. An early intervention approach for preventing school antisocial behavior. Journal of Emotional and Behavioral Disorders, 6, 66–80.

Walker, H. M., Seeley, J. R., Small, J., Severson, H. H, Graham, B. A., Feil, E. G., . . . Forness, S. R. (2009). A randomized controlled trial of the First Step to Success early intervention: Demonstration of program efficacy outcomes in a diverse, urban school district. Journal of Emotional and Behavioral Disorders, 17, 197–212.

Webinar on FBA and positive behavior support plans


Tim Lewis

If you and your colleagues need to obtain a good foundation on the use of functional behavioral assessment and positive behavior support plans, there is an opportunity coming to satisfy that need.Tim Lewis will present another Webinar under the auspices of the Council for Exceptional Children (CEC), and this one is entitled “Designing Individual Student Positive Behavior Support Plans Through Functional Behavioral Assessment.” It is scheduled for Tuesday 25 October 2011 from 4:00 to 5:00 PM (Eastern Time, US).

Professor Lewis is among the leaders in the area of Emotional and Behavioral Disorders and positive behavior interventions and supports (PBIS). He co-edits the journal Behavioral Disorders and co-directs major projects on PBIS. Follow this link to learn more about the event and how to register for it; it is the third in a series of Webinars on the topic of PBIS that Professor Lewis is providing via CEC. (I don’t have a financial interest in them; I’m just shilling for them for free here.)

Addressing bullying via PBIS


Tim Lewis

Do you want to learn how to do something about bullying in schools? Here’s a way to get started.

Under the auspices of the Council for Exceptional Children (CEC), Tim Lewis will present an online seminar (“Webinar”) entitled “Addressing Bullying Behavior Through Schoolwide Positive Behavior Supports” on Thursday 20 October 2011 from 4:00 to 5:00 PM (Eastern Time, US). Professor Lewis, who teaches and conducts research at the University of Missouri, has a wealth of experience and expertise in the area of Emotional and Behavioral Disorders and positive behavior interventions and supports (PBIS), so this an excellent opportunity to get a good grounding in how to use the features of PBIS to help a school manage bullying problems. Follow this link to learn more about the event and how to register for it; it is one in a series of Webinars on the topic of PBIS that Professor Lewis is providing via CEC. (I don’t have a financial interest in them.)

Denny Reid in C’ville!

Dennis Reid, a renowned researcher and clinician who for more than 35 years has worked with individuals who have Autism, will speak on 22 September 2011 on “Evidence-Based Strategies for Promoting Enjoyment among People with Autism” in Charlottesville (VA, US). The talk by Mr. Reid, which is free and open to the public (but registration is required), is part of the Virginia Institute of Autism (VIA) Autism Speaker Series and is sponsored by VIA and the University of Virginia Children’s Hospital. It is scheduled for 5:30-6:30 at St. Anne’s-Belfield Greenway Rise Campus, Randolph Hall Auditorium. To register, go to VIA’s Web site viaschool.org or call (434) 923-8252.

For those who are unfamiliar with Mr. Reid’s research, he has an extensive record of work in behavior analysis, having published repeatedly in the Journal of Applied Behavior Analysis. He’s based at the Carolina Behavior Analysis and Support Center in Mogantown (NC, US) which, oddly, doesn’t seem to have a Web site.

ASAT newsletter pending

Do you want to know more about evidence-based interventions for Autism? Are you weary of wading through a lot of over-hyped-and-not-well-tested methods hoping to find one gem? Do you come back to EBD Blog because you pine for trustworthy news about Autism?

There is an alternative, another source: The Association for Science in Autism Treatment has a regular newsletter and a new one is about to be released. If readers hustle their bustles, they can register in time to receive the next issue which includes (according to a mailer I received)

  • A feature article in which Dr. Thomas Zane discusses the adoption of Fad Treatments in Autism.
  • Four research article summaries (ranging from treatment comparisons to prevalence of adults with autism).
  • Spotlight on a new organization Advancing Futures for Adults with Autism.
  • Two Clinical Corners (Food Selectivity and Help with the Dentist).
  • Consumer Corner (Review of Transition Resources for Adolescents and Adults with Autism).
  • An in-depth group interview about fostering positive portrayals of science-based treatment in the media.

…and for the rest, you’re just going to have to read to find out!

Here’s a link to register for the newsletter: http://www.asatonline.org/signup. I encourage folks to do.

And, if you ever forget how to find ASAT, you don’t have to poke around looking for this message. Just check over there in the siderail. You’ll find it listed in the “Web Resources.”

Cog mod for PTSD

In the Journal of Behavior Therapy and Experimental Psychiatry, Joanna Kowalik and colleagues reported that their review of studies on the use of cognitivie behavioral therapy for treating posttraumatic stress disorder (PTSD) revealed that cog-mod appears effective in changing raters’ responses on some of the widely used scales of the Child Behavior Checklist. However, the results of their literature review are not as powerful as one might hope, given the small number of studies and substantial variability in the studies themselves.

Abstract

Background and objectives There is no clear gold standard treatment for childhood posttraumatic stress disorder (PTSD). An annotated bibliography and meta-analysis were used to examine the efficacy of cognitive behavioral therapy (CBT) in the treatment of pediatric PTSD as measured by outcome data from the Child Behavior Checklist (CBCL).

Method A literature search produced 21 studies; of these, 10 utilized the CBCL but only eight were both 1) randomized; and 2) reported pre- and post-intervention scores.

Results The annotated bibliography revealed efficacy in general of CBT for pediatric PTSD. Using four indices of the CBCL, the meta-analysis identified statistically significant effect sizes for three of the four scales: Total Problems (TP; ?.327; p = .003), Internalizing (INT; ?.314; p = .001), and Externalizing (EXT; ?.192; p = .040). The results for TP and INT were reliable as indicated by the fail-safe N and rank correlation tests. The effect size for the Total Competence (TCOMP; ?.054; p = .620) index did not reach statistical significance.

Limitations Limitations included methodological inconsistencies across studies and lack of a randomized control group design, yielding few studies for meta-analysis.

Conclusions The efficacy of CBT in the treatment of pediatric PTSD was supported by the annotated bibliography and meta-analysis, contributing to best practices data. CBT addressed internalizing signs and symptoms (as measured by the CBCL) such as anxiety and depression more robustly than it did externalizing symptoms such as aggression and rule-breaking behavior, consistent with its purpose as a therapeutic intervention.

Because they are integrating so few studies it is very difficult to have a sensitive meta-analysis in this case. However, that Professor Kowalik and her collaborators found differences at all is encouraging. I hope they’ll continue to follow this literature. Also, I hope researchers will be using other measures of outcomes and that those other measures will be examined in future integrative literature reviews, too.

Kowalik, J., Weller, J., Venter, J., & Drachman, D. (2011). Cognitive behavioral therapy for the treatment of pediatric posttraumatic stress disorder: A review and meta-analysis. Journal of Behavior Therapy and Experimental Psychiatry, 42, 405-413. doi:10.1016/j.jbtep.2011.02.002

Counselling explained. You can find counselling services in your local private hospital in Nottingham, UK.