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Saturday, July 22, 2017

EBP - Part 1

EBP stands for Evidence-Based Practices. The National Professional Development Center on Autism Research  has identified 27 Evidence-Based Practices which have been shown through scientific research to be effective for students on the Autism Spectrum. By law, teaching practices must be based on evidence of effectiveness. So Evidence Based Practices, or "EBPs," are important in maintaining the fidelity of our practice as Speech-Language Pathologists. 



But no need to be intimidated by the technical names - most of these are things we do everyday! Check out how many we are ALREADY using:

1. Antecedent Based Intervention (ABI): An arrangement of events preceding an interfering behavior to prevent or reduce the occurrence. So you know that kindergartener who just can't help but touch ALL of your materials? You make sure he's seated out of arms reach right? Or those temptations are out of sight. Well that's ABI. See? You've been using it all along!

2. Cognitive Behavior Intervention (CBI): Instruction on cognitive processes leading to changes in behavior. If you've ever used Michelle Garcia Winner's Social Thinking curriculum, then you've used CBI. Helping students be aware of their own thoughts and behaviors, and how they effect the thoughts and behaviors of those around them, is the foundation of any good pragmatics program.

3. Differential Reinforcement of Alternative, Incompatible, or Other Behavior (DRA/I/O): Consequences provided for desired behaviors that reduce the occurrence of interfering behaviors. In other words. . . Positive Reinforcement. As SLPs we know how powerful this can be. Ignore the things you can ignore, and reinforce the heck out of the behaviors you want to increase. Punch cards, mini-boxes, and hand stamps have worked great for me this year for reinforcing positive behaviors in speech. 

4. Discrete Trial Teaching (DDT): Instructional process of repeated trials, consisting of instruction, response, and consequence. Articulation drills anyone? Or targeting and tracking comprehension of directions, Wh-quesions, or specific grammar forms perhaps? I fully support a play based approach to learning but believe DTT definitely has its place. 



5. Exercise (ECE): Antecedent based physical exertion to reduce interfering behaviors or increase appropriate behaviors. Making an exuberant student your "helper" in order to get him up and moving just kinda seems intuitive doesn't it? Holding open the door, handing out materials, and removing visual icons from our felt board are all activities which have worked for me. 

6. Extinction (EXT): Removal of existing reinforcement in order to reduce an interfering behavior. Ok, full disclosure. I'm all about positive reinforcement but for a behavior which CANNOT be ignored I have been known to remove punch cards for the remainder of the session or withhold hand stamps (gasp!) A few minutes away from a reinforcing activity is another behavior management tool I keep in my back pocket when necessary. 

7. Functional Behavior Analysis (FBA): Systematic protocol designed to identify contingencies that maintain an interfering behavior. In my district true FBAs are performed by a behaviorist, but we can help by observing and taking note of what happens immediately before a behavior in order to understand the function it is trying to communicate (e.g., attention, obtaining a desired item, protesting, escape).

8. Functional Communication Training (FCT): Replacement of an interfering behavior with communication that accomplishes the same function. Helping a child make this connection might be the most gratifying experience for an SLP. I mean this is what it's all about! Especially with our little ones, I think we can safely say FCT is our JAM! 

9. Modeling (MD): Demonstration of a desired behavior that results in acquisition through learned imitationAnother one we use MANY times a day. And I'm not just talking giving an example before an activity. As SLPs we understand how powerful peer modeling can be. This is one of the benefits of mixed therapy groups. One child's area of difficulty may be another's strength, creating opportunities for them to learn from each other. 




10. Naturalistic Intervention (NI): Intervention strategies that occur with the learner's typical settings and routines. In other words . . . Push-In. Another EBP we SLPs utilize on a regular basis. 

11. Parent-Implemented Intervention (PII): Parent delivered intervention learned through a structured parent training program. The Hanen model for early intervention is an excellent example of this. Based on the idea that young children learn best through everyday routines and interactions with caregivers, Hanen-certified SLPs train parents in language facilitation techniques they can implement at home. 

12. Peer-Mediated Instruction (PMI): Typically developing peers are taught strategies that increase social learning opportunities in natural environments. Working with typical peers to increase awareness and understanding of individuals with autism and other disabilities is the first step in PMI. From there, strategies such as initiation and persistence can be taught to increase opportunities for our students to interact meaningfully with their peers. 

13. Picture Exchange Communication System (PECS): Systematic 6 phase teaching the exchange of pictures between communicative partners. Loads of evidence for this one when implemented correctly. 

14. Pivotal Response Training (PRT): Pivotal learning variables guide intervention implemented in settings that build on learner interests and initiative. A fancy way of saying, "follow the child's lead." If you work with the 0-5 population, you've no doubt used this powerful EBP. 



15. Prompting (PP): Verbal, Gestural, or physical assistance that support skill acquisition.  Prompting (and prompt fading) is how we as SLPs target goals and systematically move our students toward the ultimate goal of independence. Yep we've got this one down too.   

So I'd say as SLPs our EBP game is strong! And that's just the beginning. Stay tuned for part 2 where I'll get into more EBPs (and more ways we rock!) 

How do you incorporate EBPs into your therapy? Leave me a message in the comments section. I'd love to hear from you!


Stay fired up!



4 comments:

  1. Most excellent post! Can't wait for part two!

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  2. How do we subscribe? I'd like to read part 2 when you finish it.

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  3. Right now you can follow me on BlogLovin'. I'll also post on FB & Instagram when Part 2 is complete. Keep an eye out this week!

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