Part 1 in this series of blogs was about the four functions of behavior and teacher perspectives on behavior. If you missed it, you can access it here in our AC2 blog in Teaching Channel.
Now that we have covered all 27 EBPs identified by the National Professional Development Center (NPDC) for Autism Spectrum Disorder, how do you know which of the 27 to use in addressing a certain skill or behavior with one of your students? Where do you start? Two images were shown in all 28 webinars that we hope are permanently woven into the fabric of your mind because they support your decision making. These are the Matrix of Evidence-Based Practices by Outcome and Age and the E3BP model.
The Matrix is one starting point. If you are targeting a communication goal for your high school student, for example, you could look down the column in the matrix under communication in his age group to see which EBPs have an evidence base. In the clip of the matrix below, we can see that Antecedent-Based Interventions, Extinction, Functional Behavioral Assessment, Functional Communication Training, and Modeling all have research that shows that those EBPs are effective for use with a communication goal for a high school student. However, we cannot just pick one off the list and stop there.
We must also take into consideration the family/student perspectives and the expertise and opinion of the educator. This is what we have been calling our E3BP model and have referred to it in almost every webinar. An EBP is most effective when these three components of research, educator expertise, and student/family perspective are integrated. One reason for this is because “when you’ve met one person with autism, you’ve met one person with autism.” This means that even though Extinction, for example, has evidence behind the EBP that it may work for a high school student working on a communication goal, if the teacher and/or the family members do not agree that it will be effective (based on their knowledge of the student, his environment, and his history), then it will most likely not be. Another EBP with research behind it; that has buy in by the family and the educator, based on her experience, believes will be successful will be more effective. The goal of an effective EBP is the integration of three components.
First shelf tools
My husband has at least 27 different tools in the garage, but he has 5 or 6 “go-to” tools that he uses most often for most tasks: screwdriver (phillips and flathead), hammer, wrench, pliers, and a drill. He calls these tools his first shelf tools. When he opens his toolbox, those are the first tools he sees. This is also true of our toolbox of strategies for use with students with autism. We now have at least 27 different strategies in our toolbox, but there are 5 or 6 “go-to” strategies that should be on our first shelf that are most frequently used for the most outcomes for students at most ages. These would be Reinforcement (with Differential Reinforcement), Prompting, Task Analysis, Modeling, and Visual Supports. Just as my husband often uses his first shelf tools along with all his other tools, our first shelf strategies are often used along with the other 21 evidence-based practices that we covered in the Autism Circuit series. For example, Discrete Trial Teaching (DTT) cannot be implemented with fidelity without Reinforcement, Prompting, and Task Analysis. Remember your first shelf tools.
“She said the F word!” Fidelity
The closer we are to implementing EBPs with a high degree of fidelity, the more effective the strategies will be, and the more progress you will see in your students. There are six dimensions of fidelity.
- Competence – The skill with which the interventionist delivers the EBP
- Adherence – The degree to which the essential components of the EBP are followed
- Exposure – The amount of intervention a learner receives
- Quality – Qualitative aspects of intervention, such as tone of voice
- Student Responsiveness – The degree to which the learner is engaged in the intervention
- Program Differentiation – The degree to which the intervention differs from baseline conditions
The degree of fidelity is critical in determining its efficacy. In the Autism Circuit LiveBinder, there are the NPDC Briefs for all of the EBPs. Every brief contains an implementation checklist like the one included below. Check yourself periodically to see if there are improvements that can be made in one or more of the dimensions of fidelity. Remember that infidelity is like “cheating” on your procedures!