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Wednesday June 23, 2010 Evidence-Based Practices. Evidence-Based Practices:. What’s the fuss all about?. As a consumer -. Your doctor suggests surgery to you as the first approach for a non-lie threatening chronic condition. What is your response?

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slide1

Wednesday June 23, 2010

Evidence-Based Practices

evidence based practices

Evidence-Based Practices:

What’s the fuss all about?

as a consumer
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?

evidence based practices4
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

evidence based practices ebp
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?

npdc definition of ebp
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.

npdc definition of ebp7
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

what has to be considered when applying an ebp fidelity
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!
efficacy vs effectiveness
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

utility of ebp s
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.
npdc tools to help with epb implementation
NPDC Tools to Help with EPB Implementation

APERS

EBP Inventory

Briefs and Modules

examples
Examples

APERS – EBPs in place in the classroom

EBP Inventory – Your own learning goals

Briefs and Modules – EBPs for individual learning objectives

choosing an evidence based practice for a student
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
slide16

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
iep application goal communication
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.

slide18

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.

how do we decide which ebp to use
How do we decide which EBP to use?

Ask: What is the goal targeting?

  • Expressive Language

Ask: What are the options?

iep application goals behavior communication
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.

slide22

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.
how do we decide which ebp to use23
How do we decide which EBP to use?

Ask: What is our objective targeting?

  • Expressive Language/Pragmatics
  • Behavior

Ask: What are our options?

slide25

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
integrating ebp s
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.
integrating ebp s27
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.
integrating ebp s28
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.
after choosing then what
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

don t tell me i have to keep data

Don’t tell me I have to keep data!

Developing helpful data systems

why is data critical for ebp use
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?
the many ways to measure learning
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
assessing progress
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
slide35

Goal:

Child will verbalize

to request

objects

Note the stopping

Points!

Sherer and Schreibman 2005

goal involving a sequence
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.
take home points
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