The importance of being evidence-based.

Not necessarily earnest though.

Many years ago, when I was studying my Special Ed course, I remember having a very brief discussion with one of my lecturers in regards to “harmful” treatments. We were discussing the fact that there are some promising interventions out there (in regards to Autism interventions) however there just wasn’t as much research to support these treatments as there is in regards to behavioural interventions.

Don’t get me wrong, I am definitely all in favour of behavioural based treatments. There is a long history and evidence base of behavioural interventions being highly effective in many different aspects. However I was just interested to see what the deal was with other interventions, and how could we really discount something, if it hadn’t been tested yet (another relevant blog post coming soon – I’m a Scientist!)

Her response was quite informative and I really learned something about science and research. In my mind, I was only considering ‘harmful’ interventions to be the ones that cause physical harm e.g. Students being rolled up into blankets and then suffocating. However she explained that ‘harmful’ interventions also could be interventions that were taking the time, money and place of proven interventions, and providing ineffective treatments, wasting the time and money that could have been spent on effective, evidenced-based treatments.

It was like a light switch. It made sense to me, and explained to me why some ABA providers were perhaps extremely vocal and adamant about the effectiveness of ABA.

I have been doing this for many, many years, and I am still learning to this day. By continuing my study towards becoming a BCBA, I am actually linking things together and things are falling into place even more. But this particular conversation has always stood out in my mind, and I take it with me in my work.

I wanted families to understand the importance of evidence-based treatments. And understand their rights and the types of questions they should ask when engaging with a service provider e.g. What are our goals? When do you review our goals? What measurement tools do you use to check the effectiveness of what you are doing?

I can completely empathise with families wanting to try anything and everything. And a lot of families have friends who may have tried different interventions, and have anecdotal reports about its effectiveness. I imagine I would be in the same boat as families, and want to try everything, and do everything in my power to help my children. Personally, I just want to be able to support families, and share with them the information I have learned over my time in this field, and hopefully provide them with good information.

I was always happy to be a consultant for families who had recently received a diagnosis, because I wanted to share with them the importance of evidence-based interventions, and the types of questions they should be asking service providers, and how if you aren’t happy with a service, you can move on to a different service (particularly if you are paying for a service).

I feel this type of information will be even more relevant in the future once the National Disability Insurance Scheme comes into play, and hope families can utilise the tools available to help them make informed decisions.

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The importance of being evidence-based.

I’m always ready for Summer!

Thinking back to some of the different things I have done over the years, I have been pretty lucky to be able to have a lot of fun in my work – particularly in sessions!

One thing I love to do, particularly on extremely hot, Australian Summer days, is do sessions outside, preferably near water. And one of my favourite things to use, are water balloons!

I don’t think I have used these since I was a kid. And even then, I don’t remember using them that often. But I was in Woolworths one day, walking past the party items, and thought “That would be an awesome idea!”

It was.

I cannot think of one child who did not want to give water balloons a go. I have one who was a little scared, but he was interested and watched me (hiding behind the wall, with his hands covering his ears) as I filled up water balloons and then proceeded to pop them all over his garden (I clearly had a great time!)

They have been an invaluable asset to my little reinforcer kit. And they surpassed their original use as a nice reinforcer for a hot day, to being a part of many different programs I was teaching.

Initially, I used water balloons as reinforcement e.g. “First we have to get all our tokens, then we can do water balloons outside!”

The I started realising there was a whole lot more we could be doing with water balloons.

I introduced waiting to three brothers who all wanted water balloons at once, but there was only one tap to fill it up!

I used it to teach accepting and tolerating change, at a very, very basic level i.e. I would say “What colour balloon do you want?” and whatever he would answer, I would say “Hmmm, nah, what about this colour instead?” and he would happily take it because at that point in time, he didn’t care about the controlling the colour, he just wanted a water balloon!

I used it to teach a brother and sister to follow more complex instructions e.g. “I want you to pop the balloon next to the small, green plant in the garden.”

It is great for even discrimination tasks – colours, attributes (big/little, full/empty, wet/dry).

And of course, requesting/manding! Getting signs/gestures/picture/vocalisations/mands for water balloons is always an exciting thing, especially with kids who are just beginning to learn to request, and then you get the added bonus of fun water balloons once the balloon has been requested for 🙂

Of course, there are a few rules discussed before the use of water balloons. I always check with the parents that it is an OK thing to use with their kids. And then the rule for the kids is once a balloon is popped, pick up all the pieces and put it in the bin, and then you can get a new one.

So even though we have had a mild winter here in Australia, I suggest stocking up on water balloons, because if you are anywhere near me, I’m going to buy out all the local supplies 😉

Resources

Water Balloon Pump

I’m always ready for Summer!

Can you name the 7 dwarves?

I am pretty sure I can’t.

I can, however, name the five key components of an effective literacy program.

To be fair, I should probably know both of those, because they both could be relevant in my work. Although I think knowing Thomas the Tank Engine and his friends names would be more relevant … I haven’t come across a kid who loved Snow White and the Seven Dwarves yet.

Anyway, I want to provide a little overview of yet another area I am passionate about. Literacy. This is at the front of my mind because I delivered some fantastic Literacy workshops this week in regional NSW.

I have worked with hundreds of children over the years who are struggling with their reading, and have used very specific programs, that are underpinned by scientific research, to ensure their success, and it is that scientific research I will be discussing today.

Three independent inquiries into the components needed in an effective literacy program were conducted between the 2000 and 2006, in Australia (The National Inquiry into the Teaching of Literacy), The US (The National Reading Panel), and the UK (The Rose Report). Each of these independent reviews looked at all the research on teaching reading available and gathered information about what the research indicated worked. They all found that the same key five components that need to be present for a reading program to be effective. Those five key components are:

  1. Phonemic awareness – oral manipulation of sounds/words e.g. rhyming, syllables, oral blending & segmenting, breaking words into the smallest units of sound (phonemes)
  2. Phonics – linking the letter sounds to their written form e.g. knowing that when we see the letter “m” it makes the sound /mmmmmm/
  3. Fluency – the ability to read quickly and accurately
  4. Comprehension – the ability to understand what you are reading
  5. Vocabulary – understanding the meaning of the words you are reading

These five components, along with explicit and systematic instruction in phonics skills, as well as opportunity to practice these component skills in reading real text, will help to provide the best intervention for teaching students to read.

I find it is (relatively) easy to teach kids the foundational skills needed to be able to decode sounds and blend words and provide repeated practice so they remember them!

However teaching them how to remember what they have read, understand what they have read and make sense of it, is quite difficult. Looking back at the five key components, there is a kind of progression, moving down the list in regards to the skills. You need to be able to read accurately before you can read fluently, and once you start to read fluently, you can then spend more time and energy understanding what you are reading (comprehension), and trying to make sense of what you are reading, which ultimately, is the goal of reading.

It isn’t easy. Teaching students to read fluently to help with comprehending what they are reading, and then teaching students how to understand what they are reading, and increasing their vocabulary to help with comprehension, takes a lot of practice and repetition. There are a lot of different things you can do to help students learn different strategies to make sense of what they are reading. Reading aloud to students, or having them read aloud to you, and asking questions to check for meaning is one of the easiest ways to do this.

There are also Direct Instruction programs that teach comprehension explicitly. I have used theses programs with a few students over the years, and they are highly effective, teaching specific skills and giving students strategies to take meaning from what they are reading.

There is a whole lot more I can talk about on this topic, but I will probably make individual blog posts on those down the track. So I’ll leave you with the things I find are really helpful when teaching students who are struggling to read:

  • a clear progression of teaching individual phonic sounds and skills,
  • building on previously learned/mastered skills,
  • explicit teaching of reading strategies, and
  • opportunities to practice those skills in a supported situation while asking questions to check for meaning and understanding i.e. having them read aloud to practice.

Resources

Direct Instruction Reading – Douglas Carnine

National Institute for Direct Instruction

MultiLit – Making Up Lost Time in Literacy

National Inquiry into the Teaching of Literacy

National Reading Panel

The Rose Report

Can you name the 7 dwarves?