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| From Efficacy to Effectiveness Studies: Data From Evaluations of Applied Behavior Analysis Programs in Autism and Real-Life Settings |
| Wednesday, November 15, 2017 |
| 8:00 AM–9:50 AM |
| Forum ABC, Niveau 1 |
| Area: AUT/CSS |
| Chair: Melina Rivard (University of Quebec, Montreal) |
| Discussant: Melina Rivard (University of Quebec, Montreal) |
| Abstract: The volume of specialized services offered to children with ASD continues to increase to reflect the constantly increasing prevalence rate of the disorder. Access to early, intensive and individualized intervention services is crucial to prevent crystallization of symptoms and ensure optimal development of children. In real life settings, access to early intervention services and their effectiveness are hindered by three major challenges: 1) waitlists for obtaining diagnostic and services, explained in part due to lack of resources; 2) the variable response of children to treatment; and 3) lack of services regarding the support provided to parents. Service providers are challenged to expose all children (quantity, accessibility and equity) to quality interventions (scientifically proven, as for example, Early Intensive Behavioral Intervention programs). This symposium presents different research projects carried out by our team in order to evaluate alternatives to give access to ABA programs to children with ASD and their families in the best possible conditions and in taking into account the ressources of the public clinical settings. |
| Instruction Level: Intermediate |
| Keyword(s): differential diagnostic, early intervention, parental program, program evaluation |
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| The See Things My Way Assessment Centre: A Pilot Service Model to Eliminate Waitlists |
| (Service Delivery) |
| NADIA ABOUZEID (UQAM), Melina Rivard (University of Quebec, Montreal), Diane Morin (Universite du Quebec a Montreal), Marjorie Morin (Université du Québec à Montréal), Céline Mercier (Université de Montréal) |
| Abstract: To help eliminate current waitlists in Montreal (Canada) for preschool children requiring assessments to confirm the presence of Autism Spectrum Disorder, Global Developmental Delay or Intellectual Disabilities, the See Things my Way Assessment Centre was launched in 2015. The interdisciplinary diagnostic centre aims to offer the highest quality assessments, to support families in accessing and understanding the much needed early intensive behavioural interventions (EIBI). ABA-based recommendations are also provided in the interim. Objective: The Centres implementation is currently being carefully studied to ensure its viability, sustainability and replicability. Method: Instruments: standardized questionnaires, semi-structured interviews, patients records. Participants: 6 staff members and 35 families. Analysis: quantitative (descriptive) and qualitative (thematic analysis). Preliminary results in regards to its implementation (first year of operation), the overall trajectory of services across Montreal as well as parental satisfaction will be discussed. These findings will highlight the utmost importance of obtaining a diagnosis in order to access EIBI as well as the impact of a seamless continuum of services from first signs to intervention on families well-being and quality of life. |
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| Beyond Efficacy Studies: Program Evaluation Perspective on the Global Services Dispensation Around Early Intensive Behavioral Intervention |
| (Service Delivery) |
| CÉLINE MERCIER (Université de Montréal), Melina Rivard (University of Quebec, Montreal), Amélie Terroux (Université du Québec à Montréal) |
| Abstract: Considering that efficacy of early intensive behavioral intervention (EIBI) programs has been well documented in the rigorous experimental framework, the overall objective of this presentation is to show, in a broader program evaluation perspective, the potential contributions of various types of evaluation studies on the implementation and generalization of the EIBI in real life settings. The reported results are part of a large research project on the evaluation of global public services for children with ASD and their familiy (more than 300 participants). Participants were enrolled in different programs offered by a public rehabilitation center in Quebec (French province of Canada). Data and methodological issues on different questions of the project will be presented : 1) the quality of trajectory of services according to 176 parents, the social validity of waitlist intervention and EIBI program for 94 parents and the effectiveness of EIBI programs on different outcomes for 93 children. In conclusion, two issues will be discussed : 1) the importance of the fluidity of the trajectory of services, from the moment of the diagnostic, to the access of EIBI services until the integration in school ;2) the critical place of the families in the overal process, with a premise that more intervention and research should be family-oriented. |
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| CANCELED - ESDM (The Early Start Denver Model): Can Non-intensive Interventions be Effective? |
| (Service Delivery) |
| GISELA REGLI (QcABA Canada) |
| Abstract: The present trend towards naturalistic intensive interventions such as ESDM provides more and more research data displaying their efficacy in controlled environments. However, there is an urgent need for reliable data from non-intensive interventions in real life settings in order to demonstrate their effectiveness in natural environments. We present data from non-intensive ESDM interventions (<25 h/week) collected through indirect assessments. The results point to the importance of 1) intervening earlier and earlier 2) applying behavioral strategies that target developmentally appropriate skills (based on behavioral and developmental research) and 3) supporting non-intensive interventions in real-world settings where intensive intervention is not available. In a second, more theoretical part of the presentation, possible precursors helpful in choosing a non-intensive Naturalistic Developmental Behavioral Intervention (NDBI) such as ESDM are discussed. |
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| Adaptation of Early and Intensive Behavioral Intervention (EIBI) Services for Children With Concurrent Disorders |
| (Service Delivery) |
| ZAKARIA MESTARI (Université du Québec à Montréal), Melina Rivard (University of Quebec, Montreal), Amélie Terroux (Université du Québec à Montréal), Diane Morin (Universite du Quebec a Montreal), Jacques Forget (UQAM) |
| Abstract: Although the majority of children with ASD show significant gains during EIBI program in terms of intellectual functioning, level of development, adaptive behavior and reduction of autistic symptoms, some children still present fewer improvements after the intervention. The current research in ASD and EIBI does not fully understand the factors that could explain this variability. Our previous work highlighted that Challenging Behaviors (CB) could be one of those factors (Rivard et al., 2013, 2015, 2016). With the goal of offering suitable intervention alternatives for children with ASD and comorbidities, we validated a French version of the Developmental Behavior Checklist Under 4 (DBC-U4, preschool age) on 650 children with ASD. By doing so, we want to better understand the CB : their prevalence, their associated factors and their impacts on the prognostic of children as well as their family. The goal of this presentation is twofold: 1) presenting an overview of the validation of the French version of the DBC; 2) providing the results of a three year follow-up of the DBC for a sub-sample of 37 children (24 boys and 13 girls), from all across the province of Qubec, Canada. By analyzing the evolution of CB over time, we want ultimate to suggest an optimal sequences of interventions, adapted for children with heterogeneous profiles. |
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