Advocating for Evidence Based Practices in ASD

Advocating for Evidence Based Practices in Autism Spectrum Disorder

Our UCSD Autism Research Seminar this morning featured Connie Wong PhD, first author on the report Evidence Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorders.  It’s free to download at: http://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/2014-EBP-Report.pdf

This is the most recent review done by principle investigator Sam Odem, PhD, whose reviews have in the past been friendly to developmentally oriented practitioners in the sense that they recognized that no single treatment is appropriate for all children with autism spectrum disorders.  The work here was exhaustive, screening over 30,000 titles, then reading over 3000 abstracts, then carefully studying over 1000 papers, looking for quasi-experimental, experimental, and single case study support for focused interventions (in this review they were not looking at comprehensive programs).

Bottom line as it stands for developmental approaches: because the study was limited to papers published during or before 2011, the more recent studies supporting developmental and mixed developmental-behavoral approaches were not included and so these did not rise to the level of evidence needed to be included in the final list.

As our colleague Marilee Burgeson pointed out, the concern is that such lists are often used to exclude support for approaches not on them despite the more recent evidence.  Moreover, Connie seemed to indicate that the tremendous work and cost of the study may make it difficult to do another revision with updated research.

Medical ‘fact’ changes constantly – it has been often said that the half-life of medical knowledge is about five years.  That is, half of what we know is wrong, and in five years we will know what half, but at any given time we don’t yet know what will be considered ‘wrong’ later.  So this report, based largely on papers that are more than 5 years old, demands that we use what we have learned since then to update our knowledge.

So when we advocate for families to be able to choose among the entire range of evidence based practices, we can take the lead from this report and its process and show how current research might support inclusion on this list in 2015.  That current research is listed in Diane Cullinane’s most recent annotated bibliograpy on www.circlestretch.com.

Author
Joshua Feder, M.D. Dr. Feder's Blog

You Might Also Enjoy...

How Effective is Atomoxetine in Children and Adolescents?

Since its FDA approval in 2002, Atomoxetine (brand name Strattera) has become a second or third line option (after stimulants and sometimes after central alpha agonists) for ADHD in both children and adults. Does it work? Listen and find out!

Discussing Stimulant Treatment with Parents

ADHD is one of the most treatable conditions in psychiatry if patients adhere to medication regimens. So, why are parents so resistant to stimulant medications and how can we approach these misconceptions?

Treating Children of Divorce

Each year in the US, there are about 1.04 million divorces, affecting about 800,000 children. How can we navigate the complexities of treating a child with divorce?