Perceived Evidence and Use of Autism Intervention Strategies in Early Intervention Providers

2019 ◽  
Author(s):  
Jessica Paynter ◽  
Sarah Luskin-Saxby ◽  
Deb Keen ◽  
Kathryn Fordyce ◽  
Grace Frost ◽  
...  

Background. Continued use of practices not supported by empirical evidence is an ongoing challenge in the field of autism spectrum disorder (ASD). Knowledge and individual attitudes to evidence-based practice, as well as accuracy of categorization of practices on their evidence base, have been linked to practice selection in allied health professionals. This study aimed to extend this research to early intervention staff, and investigated perceived evidence base of practices, and links to intended future use, along with individual attitudes and sources of information accessed.Method. Participants included 86 early intervention staff who completed an online survey. They rated the evidence base of six ASD intervention practices (three unsupported by research, three empirically supported), along with current and intended future use of these, as well as attitudes to research and to evidence-based practice. Results. At a group level, participants reported using, and intending to use in future, the empirically supported practices more than unsupported practices, and generally accurately reported a higher evidence base for the empirically supported practices. However, a number of individual participants showed inaccuracy in ratings varying by practice. Perceived evidence was linked to greater intention to use practices in the future, while few links to individual attitudes were found. Conclusions. Our findings point to the influence of perceived evidence on intended use of practices. Perceived evidence may be impacted by lack of awareness and/or misinformation regarding the evidence base of practices. The need for accurate information about both empirically supported and unsupported practices, as well as strategies to seek and evaluate information are highlighted. Limitations of the self-report methodology, and future research directions including broader clinical decision-making processes are overviewed.

Author(s):  
Alaine E Reschke-Hernández

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.


Author(s):  
Lissette M. Saavedra ◽  
Antonio A. Morgan-Lopez ◽  
Anna C. Yaros ◽  
Alex Buben ◽  
James V. Trudeau

Evidence-based practice is often encouraged in most service delivery settings, yet a substantial body of research indicates that service providers often show resistance or limited adherence to such practices. Resistance to the uptake of evidence-based treatments and programs is well-documented in several fields, including nursing, dentistry, counseling, and other mental health services. This research brief discusses the reasons behind provider resistance, with a contextual focus on mental health service provision in school settings. Recommendations are to attend to resistance in the preplanning proposal stage, during early implementation training stages, and in cases in which insufficient adherence or low fidelity related to resistance leads to implementation failure. Directions for future research include not only attending to resistance but also moving toward client-centered approaches grounded in the evidence base.


People with autism spectrum disorder (ASD) are often diagnosed, and treated for, co-occurring mental health disorders. Co-occurring problems are, in fact, a primary reason for referral and treatment-seeking. Research on comorbidity and its management in youth and adults with ASD has expanded at a rapid rate over the last decade. This is the first comprehensive volume on the topic of co-occurring psychiatric conditions and symptoms in ASD. In this Handbook, internationally recognized clinical scientists synthesize the research on assessment and evidence-based treatment for a broad range of conditions as they present in ASD, from childhood through adulthood. In addition to coverage of formal diagnoses that frequently present in ASD (e.g., mood and anxiety disorders), common behavioural concerns (e.g., psychosexual and sleep problems) are also addressed. Each chapter summarizes the condition or disorder as it presents in ASD, and presents the extant research on its prevalence, developmental course, etiology, and assessment and diagnosis in the context of ASD. Each chapter also includes a summary of evidence-based treatment approaches or current best practices for intervention, as well as a case example to demonstrate application. Chapters are also included to synthesize broader issues related to co-occurring psychiatric conditions in ASD, including a historical overview and conceptual framework for co-occurring conditions in ASD, crisis management, and psychopharmacology. In sum, this handbook is comprehensive compilation of the current evidence-base and recommendations for future research to inform clinical practice related to co-occurring psychiatric conditions and symptoms in ASD.


CNS Spectrums ◽  
2004 ◽  
Vol 9 (12) ◽  
pp. 905-912 ◽  
Author(s):  
Aaron B. Murray-Swank ◽  
Lisa Dixon

AbstractFamily psychoeducation programs have emerged as a strongly supported evidence-based practice in the treatment of schizophrenia and bipolar disorder. Over 30 randomized clinical trials demonstrated that psychoeducation programs reduce relapse, improve symptomatic recovery, and enhance psychosocial and family outcomes. Recent work supports family psychoeducation strategies for other disorders, including major depression, obsessive-compulsive disorder, and borderline personality disorder. This review summarizes the research evidence supporting prominent models of family psychoeducation. Professional and peer-led family education programs are also reviewed and differentiated from family psychoeducation. Directions for future research studies to enhance the evidence base and inform treatment recommendations are proposed. Finally, strategies for implementation of family psychoeducation in routine clinical practice are discussed.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


Author(s):  
C. Richard Spates ◽  
Sophie Rubin

In this chapter we review the empirical foundation for Eye Movement Desensitization and Reproessing Therapy (EMDR) for posttraumatic stress disorder. We present a brief description of the therapy, critically review recent primary and meta-analytic investigations concerning its efficacy and effectiveness, offer a summary of recent primary investigations that addressed the mechanism of action for EMDR, and based on this overall review, we suggest limitations with recommendations for future research. Recent empirical investigations of the efficacy of EMDR have improved along a number of important dimensions, and these along with the few completed effectiveness trials, position this therapy among evidence-based frontline interventions for PTSD. What is less thoroughly researched, and thus less well understood, are putative models of its theoretical mechanism of action. In addition to continuing specific improvements in research concerning efficacy and effectiveness, we recommend more and higher quality empirical studies of its mechanism of action.


2007 ◽  
Vol 15 (3) ◽  
pp. 508-511 ◽  
Author(s):  
Cristina Mamédio da Costa Santos ◽  
Cibele Andrucioli de Mattos Pimenta ◽  
Moacyr Roberto Cuce Nobre

Evidence based practice is the use of the best scientific evidence to support the clinical decision making. The identification of the best evidence requires the construction of an appropriate research question and review of the literature. This article describes the use of the PICO strategy for the construction of the research question and bibliographical search.


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