PICO Presentation BY AMY FOX RN COHP 450

PICO Presentation BY: AMY FOX RN COHP 450

Do Children with autism ages 0 -5 who are receiving behavioral intervention therapy have improved speech and language skills compared to those who have not received any intervention?

Research Search Words Ø Autism Ø Behavioral Interventions Ø Applied Behavioral Interventions(ABA) Therapy Ø Speech and Language Development Search Engines Ø Research Articles found using FLITE library database through Ferris State University Results of search Ø Two articles found related to my PICO question topic

References Speckley, M. , Boyd, R. (2009). Efficacy of Applied Behavioral Intervention in Preschool Children with improving Cognitive Language, and Adaptive Behavior: A Systematic Review and Meta-analysis. The Journal of Pediatrics, 154(3), 338 -344. doi: 10. 1016/j. peds/. Watson, L. R. , Baranek, G. T. , Roberts, J. E. , David, F. J. , & Perryman, T. Y. (2010). Behavioral and Physiological Responses to Child- Directed Speech as Predictors of Communication Outcomes in Children with Autism Spectrum Disorders. Journal of Speech, Language and Hearing Research, 53(4), 1052 -1064, doi: 10. 1044/1092 - 4388.

Rationale Articles chosen based on topic Limited resources Chose 2 different types of interventions

Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis Theory Applied behavioral analysis (ABA) therapy would show improvements in speech and language in children with Autism Spectrum Disorder (ASD) Type of Study Quantitative study needed for metaanalysis Design Ø systematic reviews Ø Randomized control trials Ø Quantitative data

Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis (Continued) Methods Ø Search Study Ø Multiple studies meeting criteria Findings Ø Inadequate Ø More evidence research needed

Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders Theory to determine if communication skills improve with Child-Directed Speech therapy in Autistic Children 12 months after initial therapy Type of Study Ø Longitudinal Study Design All boy study with reevaluation 12 months after therapy initiated

Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders (continued) Methods Ø Search Study Ø Multiple studies screened to meet criteria Findings Ø Inadequate Ø More evidence research needed

Ethical Considerations Study 1 Too much ABA therapy Too little or no therapies at all No access of Inability to receive ABA therapy Study 2 Developmental improvement result of Child-Directed Speech Therapy or Normal Developmental Milestones

Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis Strengths Quality Ø Specific Target Group Ø Inadequate Evidence Ø Children ages 18 months 6 years Ø Ø All have Autism Spectrum Disorder or Pervasive Development Disorder Broader outcomes needed for adequate evidence that ABA could be beneficial Credibility Scholarly Journal

Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders. Strengths Ø Specific all boy target group Ø <24 months of age at entry Ø Re-evaluation 12 months after receiving therapy Quality Ø Limited study due to small sample size Credibility Ø Scholarly journal Ø Peer reviewed

Relevant To Practice Communication Ø Ø Ø Scholarly journals Medical conferences Power point presentations Individual and Professional level Ø Parents and families of Autistic Children Ø Teachers Ø All Medical Professionals ImplicationsØ Early Intervention is Recommended for nonverbal Autistic Children however not enough research is implicated in the studies presented in this presentation

Barriers to Autism Care Ø Policy- not indicated Ø Resources- not everyone has access to specialized therapies Ø Values- Early intervention recommended

Additional PICO QUESTIONS Do children with autism ages 0 -5 who are receiving behavioral intervention therapy have improved gross and fine motor skills that children who are not receiving any therapy? Do children with autism ages 0 -5 who are receiving behavioral intervention therapy have improved social skills than children who are not receiving any therapy?

Conclusion Study 1 Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis Ø Meta-analysis did NOT show an improvement in speech and language Study 2 Behavioral and Physiological Responses to Child-Directed Speech as Predictors of Communication Outcomes in Children With Autism Spectrum Disorders. Ø Evidence suggests improvement in improved communication 12 months after initial therapy began