Charlene Chamberlain, PhD, R.SLP
Terri Duncan, MSLP, R.SLP
www.childrensautism.ca
Evidence-Based
Practice
http://barryprizant.com/files/asq15_evidencebased_practice_fall_2011.pdf
 Evidence-based practice in
psychology (EBPP) is the integration
of the best available research, with
clinical expertise, in the context of
patient (family) characteristics,
culture, and preferences (APA,
2005).
Heterogeneity of the ASD population
 Changing diagnostic criteria
 Huge number of ‘sub-topics’
 Procedural fidelity in treatment packages
 Active Ingredients in treatment
 Measuring change
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2003 – Wetherby & Woods – pilot study
observing parent-implemented coaching
2006 – Wetherby & Woods – preliminary data
with 2 yr olds with ASD, and a 3 yr old
comparison group.
2014 – Wetherby et al., Randomized Control
Trial (RCT) of the model with 82 toddlers
randomly assigned to the individual
treatment condition or a group treatment
condition
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A word about the web…
Peer reviewed journals (general vs. specific)
◦ General:
Pediatrics
Canadian Journal of Psychiatry
Topics in Early Childhood
Journal of Child Psychology and Psychiatry
Journal of the American Academy of Child and Adolescent
Psychiatry
 Etc...
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◦ Specific:
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Autism
Journal of Autism and Developmental Disorders (JADD)
Research in Autism Spectrum Disorder
Autism Research
Journal of Sleep Research
◦ Halifax research centre:
http://autism.medicine.dal.ca/research/publications.ht
m (http://link.springer.com/article/10.1007/s10803014-2138-2)
◦ Edmonton research centre:
◦ https://sites.google.com/a/ualberta.ca/autismresearchc
entre/home
◦ Autism Speaks RESEARCH link (www.autismspeaks.org)
◦ UC Davis MIND institute:
http://www.ucdmc.ucdavis.edu/mindinstitute/
 Distinguished Lecturer Series (**Connie Kasari – engagement
research, Wendy Stone – Early detection to early intervention
research, Helen Tager-Flusberg – language and
communication research, Stephen Scherer-Genetics, Temple
Grandin, etc…)
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Review of the development of NDBI, theories, common
features, and research support
 Examples include: PRT, Early Start Denver, SCERTS, JASPER, Milieu
Teaching, etc...
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Increase in NDBIs grew as a response to limitations in
Discrete Trial Training (DTT)
 Lack of spontaneity, failure to generalize, escape/avoidance
behaviours, prompt dependence
 Explains confusion between ABA & DTT
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Common features = individualized goals, 3 part
contingency, manualization, measurement of progress, child
initiation, fidelity, progress measures, environmental
arrangement, natural methods to motivate, prompts and
fading, modeling & imitation
NDBIs are a “new generation” of early intervention models
and are efficacious treatments
New framework to categorize models
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Systematic Review of the literature of treatments
for under 3 years old
◦ Peer-reviewed articles published up to Dec 2013
◦ No statistical analysis of the data in the articles
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Key findings: 10 Summary Statements
1. Current best practice should include a combination of
developmental and behavioural approaches, as early as
possible
2. Current best practice should include active involvement of
families and/or caregivers
3. Interventions should improve functioning in both core
and associated features of ASD (i.e., social
communication, regulation, and adaptive behaviours)
4. Interventions should include consideration of
social/cultural, economic, family dynamics, and supports
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Key findings: 10 Summary Statements
5. Intervention research should include socially and
culturally diverse populations to evaluate familial factors
that affect participation in services
6. Future research should include high quality research
methods and meaningful outcome measurements
7. Research is needed to determine the “active ingredients”
of treatments
8. Adopting a common set of research-validated core
measures of ASD symptoms for < 3 yrs old
9. Future research needs to examine biological and
behavioural heterogeneity of RTI (response to
intervention)
10. Interventions need to consider medical disorders and
refer to appropriate health care providers
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Question: What moderates the association between JA and
language development? TD vs ASD? type of JA (RJA, CA, IJA,
SJE, CJE)? or other participants factors?
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Methods: Included: 71 datasets, 605 effects sizes, 1,859
participants with ASD, 1,835 TD participants, correlation stats
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Results: 1. Significant differences between ASD and TD
(higher association between JA and language), 2. Only RJA
had sufficient effect sizes to compute, 3. Most moderator
factor were not significant
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Implications: 1. Need to be clear about type of JA, 2. RJA
may have a biological origin, 3. Other types of JA need to be
investigated, 4. “Engagement states” must be defined
measured as well, 5. All of these can/will impact our services
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Question: Does language or social skills explain reversals
in ASD and TD?
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Participants: 15 ASD children matched on language to 18
typical toddlers, ADOS, CDI, Vineland, Mullen (pre & post)
 Methods: 30 minute mother-child play sessions, half
coded for JA (joint attention), every 4 months for 2 years
 Results: Few reversals were noted in both groups overall,
ASD: 3%, TD:1% (significant difference), TD stopped mid
study: ASD continued to reverse; JA significantly different, in
duration and frequency, Both early language and JA predicted
pronoun reversals in ASD
 Implications: Consider assessing and targeting JA and
general language skills (vocab), rather than pronouns directly
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A simplified diagnostic observational assessment of autism
spectrum disorder in early childhood. Autism Research, 2016,
9: 443-449
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Brief Report: Joint Attention and Information Processing in
Children with Higher Functioning Autism Spectrum Disorders
pp 1-6, Journal of Autism and Developmental Disorders. 09
April 2016
Exploring “the Autisms” at a cognitive level. Autism Research,
2016, (online release)
Reasoning on the Autism Spectrum: A Dual Process Theory
Account. Journal of Autism and Developmental Disorders June
2016, Volume 46, 6, pp 2115-2125

Screening for co-occurring conditions in adults with autism
spectrum disorders using the Strengths and Difficulties
Questionnaire: A pilot study. Autism Research, 2016, (online
release)
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The Need for an Ecological Approach to Parental Stress in
Autism Spectrum Disorders: The Combined Role of Individual
and Environmental Factors. Journal of Autism and
Developmental Disorders. June 2016, Volume 46, Issue 6, pp
1895-1905