Tag Archive for 'intervention'

Addressing bullying via PBIS

Published on 7 October 2011 in Acting out, Administration, Behavior management, Bullying, News, Professsional development, The press and Treatment. 0 Comments Tags: , , , , , , , , .


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.)

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Denny Reid in C’ville!

Published on 6 September 2011 in Autism, Behavior management, News, Professsional development and The press. 0 Comments Tags: , , , , , , , , , .

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.

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ASAT newsletter pending

Published on 27 July 2011 in Administration, Autism, Families, Professsional development, Research, The press and Treatment. 1 Comment Tags: , , , , , , , .

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.”

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Research participation opportunities

Published on 13 July 2011 in Assessment, Autism, Families, News, Research and Treatment. 0 Comments Tags: , , , , , , , , , , .

In an accompanying PDF I have listed studies that are currently seeking children (both female and male) with Emotional of Behavioral Disorders (especially autism spectrum disorders) as participants (some include adults, as well) that are registered with ClinicalTrials.gov, a service of the US National Institutes of Health (NIH). The studies have diverse purposes: They may be observing different events (whether overt behavior or neurochemical activity) or they may be testing different therapies (ranging from behavioral to medical methods). Many are sponsored at least in part by the NIH, but some have funding from universities or even private industries. Because of its affiliation with NIH, ClincialTrials.gov is more likely to represent medically oriented studies and studies that use rigorous scientific methods (i.e., randomized clinical trials or RCTs), but this is not exclusively the case. Readers should examine the studies carefully.

The list is not exhaustive (I used “autism” in the search, so there are many more studies that could be located by using other terms), and I’ve provided only some of the data about each study in the table, but you can learn a fair bit about individual studies. For example, one can learn about study number NCT00198107 that is entitled “Evaluating the Effectiveness of Aripiprazole and D-Cycloserine to Treat Symptoms Associated With Autism.” It focuses on individuals with Autistic Disorders and examines an intervention (in this case, comparing drugs called Aripiprazole D-cycloserine to placebo in a randomized design with double-blind (Subject, Caregiver, Investigator, Outcomes Assessor) | Primary Purpose: procedures. The study began 1-Sep-05 and will end 1-Sep-11 (making it odd that it is still listed as open, no?).

To locate additional information about a particular study, copy the NCT ID number, go to ClinicalTrials.gov, and enter that number into the search box. Download the PDF here (10 pages).

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Cog mod for PTSD

Published on 6 July 2011 in Acting in, Acting out, Mental health, News, Research, The press and Treatment. 1 Comment Tags: , , , , , , , , , , .

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

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New review of early intervention in Autism from Pediatrics

Published on 20 April 2011 in Autism, News, Research, The press and Treatment. 0 Comments Tags: , , , , , , .

Zachary Warren and colleagues from Vanderbilt University published a review of 34 studies of early intervention efforts with children who have Autism in Pediatrics in April of 2011. The authors interpret their results as providing tempered supported for the the early intervention methods often described as “UCLA,” “Lovaas–based,” “EIBI,” or the “Early Start Denver Model.” Here is the abstract.

A Systematic Review of Early Intensive Intervention for Autism Spectrum Disorders
by
Zachary Warren, Melissa L. McPheeters, Nila Sathe, Jennifer H. Foss-Feig, Allison Glasser and Jeremy Veenstra-VanderWeele

CONTEXT: Early intensive behavioral and developmental interventions for young children with autism spectrum disorders (ASDs) may enhance developmental outcomes.

OBJECTIVE: To systematically review evidence regarding such interventions for children aged 12 and younger with ASDs.

METHODS: We searched Medline, PsycINFO, and ERIC (Education Resources Information Center) from 2000 to May 2010. Two reviewers independently assessed studies against predetermined inclusion/ exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of evidence ratings using predetermined criteria.

RESULTS: Thirty-four unique studies met inclusion criteria. Seventeen studies were case series; 2 were randomized controlled trials. We rated 1 study as good quality, 10 as fair quality, and 23 as poor quality. The strength of the evidence overall ranged from insufficient to low. Studies of University of California Los Angeles/Lovaas–based interventions and variants reported clinically significant gains in language and cognitive skills in some children, as did 1 randomized controlled trial of an early intensive developmental intervention approach (the Early Start Denver Model). Specific parent-training approaches yielded gains in short-term language function and some challenging behaviors. Data suggest that subgroups of children displayed more prominent gains across studies, but participant characteristics associated with greater gains are not well understood.

CONCLUSIONS: Studies of Lovaas-based approaches and early intensive behavioral intervention variants and the Early Start Denver Model resulted in some improvements in cognitive performance, language skills, and adaptive behavior skills in some young children with ASDs, although the literature is limited by methodologic concerns.

Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-VaderWeele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127, e1303–e1311. Published online Apr 4, 2011; DOI: 10.1542/peds.2011-0426

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Secretin still does not help

Published on 19 April 2011 in Autism, News, Research, The press and Treatment. 0 Comments Tags: , , , , .

Shanthi Krishnaswami and colleagues examined the research about the effects of using secretin as a theraputic agent for the treatment of Autism. They found that there were none of the seven randomized controlled trials showed beneficial effects and, therefore, concluded that secretin does not merit consideration as a therapy. Their finding, which employs rigorous methods, is consistent with earlier analyses that examined more preliminary research and which I have reported previously (as far back as the 1990s).

A Systematic Review of Secretin for Children With Autism Spectrum Disorders
by
Shanthi Krishnaswami, Melissa L. McPheeters and Jeremy Veenstra-VanderWeele

CONTEXT: As many as 1 in every 110 children in the United States has an autism spectrum disorder (ASD). Secretin is 1 of many medical treatments studied for treating the symptoms of ASDs, but there is currently no consensus regarding which interventions are most effective.

OBJECTIVE: To systematically review evidence regarding the use of secretin in children with ASDs who are aged 12 years and younger.

METHODS: We searched the Medline, PsycINFO, and ERIC (Education Resources Information Center) databases from 2000 to May 2010 and reference lists of included articles. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes and assigned overall quality and strength-of-evidence ratings on the basis of predetermined criteria.

RESULTS: Evidence from 7 randomized controlled trials supports a lack of effectiveness of secretin for the treatment of ASD symptoms including language and communication impairment, symptom severity, and cognitive and social skill deficits. No studies have resulted in significantly greater improvements in measures of language, cognition, or autistic symptoms when compared with placebo; study authors who reported improvement over time did so equally for both the intervention and placebo groups.

CONCLUSIONS: Secretin has been studied extensively in multiple randomized controlled trials, and there is clear evidence that it lacks benefit. The studies of secretin included in this review uniformly point to a lack of significant impact of secretin in the treatment of ASD symptoms. Given the high strength of evidence for a lack of effectiveness, secretin as a treatment approach for ASDs warrants no further study.

Krishnaswami, S., McPHeeters, M. L., & Veenstra-VanderWeele, J. (2011). A systematic review of secretin for children with autism spectrum disorders. Pediatrics, 127, 1322-1325. DOI 10.1542/peds.2011-0428

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Autism awareness

Published on 2 April 2011 in Autism, News and Treatment. 1 Comment Tags: , , .

World Autism Awareness Day is upon us. Check on it!

While you’re thinking about the topic, learn a lot by watching Fred Volkmar’s presentation about interventions for Autism: “Treatments for Autism: Overview of Model Programs.”


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ASAT newsletter’s available

Published on 8 February 2011 in Autism, Families, News, Research, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , .

For those readers interested in Autism who do not already subscribe to the newsletter of the Association for Science in Autism (ASAT), I have a nourishing treat: The latest issue of Science in Autism Treatment (SIAT) is now available. You can learn about ASAT and SIAT by going to the ASAT homepage and scouting about the many valuable resources there, including learning about and subscribing to the SIAT newsletter. Subscribe and you won’t have to depend on my flaky reminder system to let you know when one arrives in my mailbox!

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Follow up of Fast Track

Published on 7 February 2011 in Acting out, News, Prevention, Research, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , , .

These are the lead researchers in the Conduct Problems Prevention Research Group with their current universities (over the years, some have changed affiliations):

The Conduct Problems Prevention Research Group, a team of composed of seven of the most eminent US scholars studying the development of childhood behavior disorders, published another in its series of papers tracking the outcomes of the children it has been following in a long-term study about preventing acting out disorders. In this longer-term follow-up analysis, the team found that the effects were still present for the children who showed the most risk of having behavior disorders in the first place.

This project and these folks are the big time. The work has been conducted very carefully and cannot be represented as an example of over-hyped findings.
Continue reading ‘Follow up of Fast Track’

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WWC on Lovaas model

Published on 24 August 2010 in Autism, News, Research and Treatment. 0 Comments Tags: , , , , , , , , , .

The US Department of Education’s What Works Clearinghouse (WWC) released the results of its review of the model for teaching children with Autism that is based on the work of the late Ivar Lovaas on 24 August 2010. The WWC report is based on two of the many studies of the Lovaas method—often called “Applied Behavior Analysis”—and reports positive results for cognitive outcomes.
Continue reading ‘WWC on Lovaas model’

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ABAI on restraint and seclusion

Published on 5 August 2010 in Acting out, Behavior management, News, Policy, The press and Treatment. 0 Comments Tags: , , , , , , , , , , , , .

Based on the work of a task force composed of highly qualified individuals, the Association for Behavior Analysis International (ABAI) has issued position statement about the use of restraint and seclusion in treatment. Members of the task force, which was appointed by the executive board, include Jon S. Bailey, Michael F. Dorsey, Louis P. Hagopian, Gregory P. Hanley, David B. Lennox, Mary M. Riordan, Scott Spreat, and Timothy R. Vollmer (chair).

The Association for Behavior Analysis International (ABAI) and its members strongly oppose the inappropriate and/or unnecessary use of seclusion, restraint, or other intrusive interventions. Although many persons with severe behavior problems can be effectively treated without the use of any restrictive interventions, restraint may be necessary on some rare occasions with meticulous clinical oversight and controls. In addition, a carefully planned and monitored use of timeout from reinforcement can be acceptable under restricted circumstances. Seclusion is sometimes necessary or needed, but behavior analysts would support only the most highly monitored and ethical practices associated with such use, to be detailed below.

In the “below,” the document goes on to present in detail the a set of guiding principles and specific recommendations about the use of seclusion and restraint. Read the statement, “ABAI Statement on Restraint and Seculsion” from the ABAI Website.

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