Wednesday June 23, 2010 Evidence-Based Practices

1. Wednesday June 23, 2010 Evidence-Based Practices

2. Evidence-Based Practices: What’s the fuss all about?

3. As a consumer - Your doctor suggests surgery to you as the first approach for a non-lie threatening chronic condition. What is your response? Your first grade daughter Marci has been struggling with reading. She doesn’t yet reliably associate letters with sounds. The teacher wants to use a sight word approach due to Marci’s excellent memory. What is your response?

4. Evidence Based Practices What does it mean? It’s been tested and found to be effective Why does it matter? It’s the law It’s the most efficient way to teach Most efficient way to learn Better chance of success

5. Evidence Based Practices (EBP) If there is no evidence, does it mean the practice is ineffective? If the child progresses, isn’t that evidence of effectiveness? What are the risks of using practices that are not evidence based?

6. NPDC Definition of EBP The teaching practice has been tested and found to be effective in: (1)Two randomized or other well-controlled (quasi-experimental design) studies.

7. NPDC Definition of EBP The teaching practice has been tested and found to be effective in: (2) Five single-subject design studies conducted by at least three different researchers

9. Medicine Condition Patient Drug/procedure Dosage How administered Measure of efficacy When to change approaches Education/intervention Content/behavior Student Teaching approach How much time daily Specific procedures Data collection and examination When to change approaches What has to be considered when applying an EBP? Fidelity!

10. Efficacy vs. Effectiveness Efficacy is the systematic evaluation of whether a treatment works Effectiveness is the extent to which the treatment works in natural settings – “real world” applications Clinical utility is the applicability, feasibility, acceptability, and usefulness of the intervention in a specific setting

11. Utility of EBP’s • Some EBP’s may have a strong evidence base but be less useful in educational settings. • Use professional judgement to determine what is most feasible and applicable to your unique context / student.

12. NPDC Tools to Help with EPB Implementation APERS EBP Inventory Briefs and Modules

13. Examples APERS – EBPs in place in the classroom EBP Inventory – Your own learning goals Briefs and Modules – EBPs for individual learning objectives

14. Choosing an evidence-based practice for a student Ask: What is our goal/objective targeting? • Consider the specific IEP goals and related objectives Ask: What are our options? • Look at the domain that the specific goal relates

16. Next, make a decision based on: • The skills being taught • Your professional wisdom • The learner’s learning style • The learner’s temperament • The learner’s interests and motivators • Supports already in place • History of what has and hasn’t worked

17. IEP Application Goal - Communication Goal: Sam will improve expressive communication skills across the school day. Related Objective: When he sees a preferred object, Sam will request a desired item during snack and/or free choice time three times per day for two consecutive weeks.

18. Sam is in an inclusive kindergarten setting. Sam does not like talking to most people and he is difficult to understand. Last year’s IEP efforts to increase his use of speech using differential reinforcement and naturalistic approaches were not successful. Sam is already using pictures for a visual schedule at school. One of Sam’s classmates uses PECS, and Sam is interested in the pictures.

19. How do we decide which EBP to use? Ask: What is the goal targeting? • Expressive Language Ask: What are the options?

21. IEP Application Goals – BEHAVIOR/COMMUNICATION Goal: Rosita will improve communication skills. Related objective: When Rosita shows distress during learning tasks, she will use words, not self injury to request a break or assistance 85% of opportunities over two consecutive weeks.

22. Let’s say we know this… • Through the FBA process, the team determined that Rosita was head banging and self biting during lengthy teaching interactions to end the interaction. • Rosita does have oral language, but tends to not talk very much. • Rosita is interested in print and can read simple words and short sentences. • Rosita enjoys peer interaction more than adult interaction.

23. How do we decide which EBP to use? Ask: What is our objective targeting? • Expressive Language/Pragmatics • Behavior Ask: What are our options?

25. Next, make a decision based on: • Your professional wisdom • The learner’s learning style, temperament, and interests • Supports already in place • History of what has and hasn’t worked

26. Integrating EBP’s • Few practices are ever really used in isolation. • Prompting and reinforcement, for example, are used in almost all of the other practices. • Task analysis, too, is used prior to teaching skills through video modeling, visual supports, etc. • Teams are encouraged, through coaching and mentoring, to explore the overlap of practices.

27. Integrating EBP’s Examples: • Video modeling can be used to teach a self-management system. (model site example : ) • A social narrative can be written to explain the routine of a social skills training group. • A speech generating device may be used by a learner in the context of a peer-mediated intervention.

28. Integrating EBP’s • The understanding required to use practices concurrently, while still being mindful of fidelity of implementation, is an important component in the development of skillful teachers and practitioners.

29. After choosing, then what? ID the EBP Review the Brief & Module ID the data system Develop the teaching plan; inform and train others Gather baseline data Implement plan and data collection system; review daily

30. Don’t tell me I have to keep data! Developing helpful data systems

31. Why is data critical for EBP use? • Collection of performance data tells us: • What should we be teaching? • Is our instruction successful? • Is the student making progress? • Do we need to change the teaching plan? • Is it time to introduce a new skill?

32. The many ways to measure learning • Event recording: frequency counts,%% • Latency recording: time elapsed • Did it happen at all? Yes-no • For chains: number of independent steps • Assessing steps before independence: levels of prompts, precision (for shaping) • Once skills are mastered: thinning reinforcement schedules, generalization to other skills, settings, environs, partners

33. Find a good book for ideas!

34. Assessing progress • Don’t start the new practice until you have baseline data!!! • Assess skill a few times in your current way of teaching first; to determine the baseline rate • Summarize data immediately to make it useful: rates, percents, simple graphs

35. Goal: Child will verbalize to request objects Note the stopping Points! Sherer and Schreibman 2005

36. Goal involving a sequence • When instructed to wash his hands verbally or on picture schedule, Hal will go to bathroom and complete 85% or more of the steps of handwashing independently 90% of requests.

37. Daily Data chart for sequencesHow to summarize? 7 levels; 14% each;

38. Daily Data chart for sequencesHow to summarize? Weights: I=3, MP=2, PP=1, FP=0

39. Take home points • EBPs represent the most effective teaching practices in ed science • Start with these, as written • Pick them carefully, by student age, setting, and content area • Get baseline data before you begin a new practice or implement a change!! • Measure as you go – don’t continue ineffective teaching • Assume students will progress when well taught