The use of evidence-based practices (EBPs) for children with autism spectrum disorders (ASD) has become an important topic. The field of ASD is rapidly growing and changing, and an increased number of people diagnosed with ASD has led to the demand to find effective interventions and treatments (Wong et al., 2014). It is important for these interventions to be researched and tested to determine if they will really be efficacious for individuals with ASD so that parents and practitioners do not waste their time trying ineffective or even harmful practices. Fortunately, several researchers and organizations have explored the effectiveness of various interventions to determine whether they should be considered EBPs for students with ASD. Among them are two organizations, the National Professional Development Center on ASD (NPDC; http://autismpdc.fpg.unc.edu/evidence-based-practices) and National Autism Center (NAC; and http://www.nationalautismcenter.org/national-standards-project/phase-2/), who conducted thorough reviews of the literature to determine the practices that have been proven to be effective for individuals with ASD.
Are There EBPs Specifically
for Academic Areas?
Most of the practices identified as EBPs have been in general areas to improve overall functioning, specifically in behavioral and social areas. No known EBPs for students with ASD have been established in academic content area such as reading, writing, or mathematics. However, teachers and parents can easily implement EBPs into their academic supports.
One of the most important academic areas is writing. Writing is a predictor of academic success and is often the primary way schools assess a student’s knowledge and growth (Graham, Harris, & Hebert, 2011; Graham & Perin, 2007). It is used for various purposes, including explaining, persuading, and relating a personal narrative (National Center for Education Statistics, 2012), and students are expected to use writing as a means to both communicate with others and to demonstrate their knowledge about the content areas (Common Core State Standards Initiative, 2014). Despite its importance, many students with ASD struggle with writing. It is therefore essential for parents and practitioners to help children with ASD improve their writing skills. The remainder of this article will focus on ways to implement EBPs into writing support.
How Can We Utilize EBPs in
Writing Instruction or Support?
There are several EBPs that can be implemented in writing instruction. A selection of these practices that may be relevant to writing, taken from the NPDC (Wong et al., 2014) and NAC, will be described, and suggestions will be provided as to how they may be used to support writing. For information about how to implement other EBPs into writing, see Asaro-Saddler (2015) and Boucher and Oehler (2013).
Antecedent-based interventions – Identifying the factors that are impacting performance and changing them ahead of time by modifying the activity or the environment (Wong, 2014). Boucher and Oehler (2013) suggest preparing students with ASD for writing in a variety of ways, including sensory (e.g. reduce audio or visual distractions), motor (e.g. warming up the muscles in preparation for writing), and organization (e.g. using graphic organizers in the planning process). Preparing the students before presenting the writing task may help them better handle the situation before getting anxious or frustrated.
Modeling – Demonstrating a target behavior to the person learning the new skill, so that person can then imitate the model (NAC, 2015). This is a strategy that teachers often use in their classrooms to help students acquire a new skill. Teachers and parents can actually sit with a child and write in front of him or her, explaining their thought process and why they are doing what they do. Adults should be sure to make overt the processes that they do not normally think about: how to take a thought and turn it into words, how to look for errors to correct, and what to do when they get stuck. Then, parents and teachers can provide the finished piece as a model for the child to follow along with or refer back to when they complete their own work. Modeling can also include video modeling, in which a person (may include the child with ASD himself) is pre-recorded engaging appropriately in the desired behavior (NAC, 2015), and the video is then used as a model to imitate. Parents may consider recording the child successfully engaging in the writing process, and then playing the video again as necessary to begin the process or keep the child going as they work through the task.
Parent-implemented intervention – Parents act as therapist or receive training through a structured parent training program to implement interventions in their home and/or community (NAC, 2015). While there are likely no structured support groups to teach writing to children with ASD, parents can work with schools or local tutoring centers to learn the best-practices in writing instruction. Parents can meet with their child’s teacher to find out how they teach writing in their classroom, and what they can do to implement those practices at home.
Prompting – Any assistance (verbal, gestural, or physical) given to help a learner acquire a new skill (Wong et al., 2014). There are many ways that a parent or practitioner can prompt a writer. Simple verbal prompts might be provided by asking a writer to add another word, or prompting their thinking about what to write next (e.g. “What else can we say about the haunted house?”). Physical prompts can be provided in the form of hand-over hand support if necessary to formulate letters or hold the pencil correctly (Boucher & Oehler, 2013).
Reinforcement – An event, activity, or other circumstance occurring after a learner engages in a desired behavior that leads to the increased occurrence of the behavior in the future (Wong et al., 2014). Parents and teachers can use reinforcement in various ways to support writing. Depending on the needs of the student, reinforcement can occur as a preferred activity or tangible item provided after an essay is completed or after a single letter or word is written. Some students might like to use technology, another EBP for children with ASD (Wong et al. 2014); therefore, allowing the child to type instead of writing with a pencil might be reinforcing for those who like keyboarding. For others, being allowed to draw a picture once the story is completed might be rewarding.
Task analysis – Breaking a skill into smaller, more manageable tasks to teach one at a time (Wong et al., 2014). Writing is a complex task that requires a person to plan, draft, revise and edit in order to produce a complete piece. Sometimes the process can be overwhelming and writers will shut down because of the demands of the task. A parent or teacher can task analyze a writing assignment to help the writer be more successful. For example, writing the letter “T” can be broken down into the following eight steps: locate the top left part of the space; place your pencil there; draw a line (about the size of your eraser) to the right; take your pencil off the page; locate the center of the line you drew; place your pencil there; draw a line straight down until you reach the bottom of the space; and take your pencil off the page. If combining reinforcement with task analysis, you can reinforce at the completion of each step, or when the entire letter is written, depending on the needs of the child. Task analyses can be conducted for more complex writing tasks as well. If the child has to write a biography about a famous sports star, for instance, the parents can help by breaking down the task: picking a star one day, researching their topic another day, completing a graphic organizer the next day, transferring their notes to an essay the next day, revising it for content the next day, and finally editing it on the last day.
A Few Things to Keep in Mind
It is important to remember that each person, with ASD or without, is different. Although these EBPs have been identified as effective for a majority of students with ASD, they may not work for every learner. Therefore, parents and practitioners must be sure to review each practice and consider the specific strengths, needs, and interests of their own children/students before implementing a practice. As indicated earlier, practices may be combined (e.g. task analysis with reinforcement) to see if there are increased benefits. In addition, parents and practitioners may need to try an intervention several times before it starts to demonstrate effectiveness; therefore, they should be patient and not give up prematurely. Be sure to monitor the effects of the intervention, however, and withdraw it if it does not seem efficacious over time.
Although there are no evidence-based practices specifically for writing instruction, parents, teachers and other practitioners can integrate general EBPs into their writing instruction and support. The suggestions offered in this article may help lead to improvements in the written products of students with ASD.
Kristie Asaro-Saddler, PhD is Assistant Professor of Special Education at the University at Albany. For more information, please contact Dr. Asaro-Saddler at email@example.com.
Asaro-Saddler, K. (2015). Evidence-based practices and writing instruction for children with autism spectrum disorders. Preventing School Failure. DOI:10.1080/1045988X.2014.981793
Boucher, C., & Oehler, K. (2013). I hate to write! Tips for helping students with autism spectrum and related disorders increase achievement, meet academic standards, and become happy, successful writers. Shawnee Mission, KS: AAPC Publishing.
Common Core State Standards Initiative. (2014). Key shifts in English Language Arts. Retrieved October, 2014 from http://www.corestandards.org/other-resources/key-shifts-in-english-language-arts/
Graham, S., Harris, K. R., & Hebert, M. (2011). It is more than just the message: Presentation effects in scoring writing. Focus on Exceptional Children, 44, 1-12.
Graham, S. & Perin, D. (2007). Writing next: Effective strategies to improve writing of adolescents in middle and high schools – A report to Carnegie Corporation of New York. Washington, D.C: Alliance for Excellent Education.
National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Randolph, MA: Author.
National Center for Education Statistics (2012). The Nation’s Report Card: Writing 2011. Institute of Education Sciences, U.S. Department of Education, Washington, D.C.
Wong, C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S., … Schultz, T. R. (2014). Evidence-based practices for children, youth, and young adults with Autism Spectrum Disorder. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group.