Autism Spectrum Disorders and Evidence Based Practices: A Statewide Exploration of Public School Programming

Research Article

Austin J Autism & Relat Disabil. 2016; 2(2): 1018.

Autism Spectrum Disorders and Evidence Based Practices: A Statewide Exploration of Public School Programming

Ferreri SJ1*, Witmer SE1 and Shivers CM2

1Department of Counseling, Educational Psychology and Special Education, Michigan State University, USA

2Department of Human Development, Virginia Tech, USA

*Corresponding author:Ferreri SJ, Department of Counseling, Educational Psychology and Special Education, Michigan State University, 620 Farm Lane, 343A Erickson Hall, East Lansing, Michigan 48824, USA

Received: Febraury 11, 2016; Accepted: March 28, 2016; Published: April 01, 2016


Objective: The purpose of this investigation was to provide a preliminary exploration of (a) Public school programming provided to students with Autism Spectrum Disorder (ASD) across the state of Michigan, (b) The extent to which public school approaches were evidence-based practices (EBP) and (c) How such practices vary by school district.

Method: A systematic sampling process was used to collect information from 194 school professionals from various socioeconomic backgrounds and geographical regions statewide. Educators used an online survey to report on practices they used with a single child with ASD in their classroom.

Results: All teachers report using at least one EBP, and four of the top five most commonly reported practices are empirically supported. However, not all of these practices are used frequently, and their use varies by geographic location.

Conclusions: The infrequent use of EBPs suggests a need for more training for educators. More research is needed into what factors predict the use of EBPs and how to better equip school professionals to work with students with ASD.

Keywords: Autism spectrum disorders; Evidence-based practices; Public school programming


ASD: Autism Spectrum Disorder; IDEA: Individuals with Disabilities Education Ace; NPDC-ASD: National Professional Development Center on Autism Spectrum Disorders; PECS: Picture Exchange Communication System; TEACCH: Treatment and Education of Autistic and Communication related Handicapped Children; REP: Registry of Education Personnel; EBP: Evidence Based-Practices


Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder manifesting in infancy or early childhood and is characterized by

(a) Persistent deficits in social communication, and

(b) The demonstration of restricted, repetitive, and stereotyped patterns of behavior, interests, or activities [1].

Current prevalence estimates are growing; the Center for Disease Control (2014) indicated that 1 out of 68 children in the United States are diagnosed with ASD. This was in stark contrast to prevalence rates of approximately 4 to 5 per 10,000 approximately 25 years ago [2,3]. The prevalence rates of ASD translate to nearly 16,000 students with ASD in Michigan’s public school system [4], representing a large population of students who may need specialized instructional practices. Currently, all children have the right to receive a Free and Appropriate Public Education under the Individuals with Disabilities Education Ace (IDEA), in the least restrictive environment possible. Many public schools now serve as the primary source of intervention for children and adolescents with ASD. Providing services to this growing population of students who have a plethora of unique needs can be challenging for schools, administrators, and teachers [5]. There are many different intervention and treatment approaches available to address the academic, behavioral, communication and social skills needs of individuals on the spectrum [6]. However, intervention effectiveness remained relatively unclear until 2009 when the National Autism Center released the National Standards Project [7]. The NSP expert panel reviewed 775 studies examining treatment and interventions for individuals with ASD; each treatment was then categorized based on the amount of research evidence to support its efficacy. Approaches were classified as

(a) “Established”, meaning the treatment produced beneficial effects and was considered effective,

(b) “Emerging”, meaning a few studies found the treatment to be effective, but more studies are needed,

(c) “Unestablished”, meaning there is little to no evidence regarding the treatments’ effectiveness, or

(d) “Ineffective/harmful”, meaning evidence suggested the intervention was not beneficial or produced negative effects.

The National Professional Development Center on Autism Spectrum Disorders (NPDC-ASD) further defines the Evidence Based-Practices (EBP) as those whose efficacy has been established through peer-reviewed research in scientific journals, meeting one or more of the following benchmarks:

1) Two high-quality randomized or quasi-experimental design studies,

2) Three different investigators or research groups producing at least five high-quality single-subject design studies

3) One high-quality randomized or quasi-experimental group design study and three high quality single subject design studies conducted by at least three different researchers or groups [8].

The NPDC-ASD currently recognizes 27 evidence-based practices for individuals with ASD [9]. Though evidence-based practices are mandated in schools by No Child Left Behind [10], current research shows that many of the practices used for students with ASD are not established. A similar study conducted in Georgia [11] found that the top five strategies used by public school teachers – including Gentle Teaching, sensory integration, cognitive behavioral modification, assistive technology, and Social Stories – did not qualify as evidencebased. Similarly, a study in California found that less than one-third of practices used by the preschool teachers surveyed had any evidence of efficacy for children with ASD [12]. Though Michigan has issued a statewide plan for individuals with ASD, the usage rate of evidencebased practices in Michigan public schools are not yet known. When studying practices for students with ASD, it is important to acknowledge that various school-level factors may influence educator decisions. In a qualitative study of teacher beliefs when working with students with ASD, [13] found that the availability of personnel and resources were related to teacher beliefs, indicating that school funding or measures of economic status may impact practices. Additionally, some researchers [14,15] have pointed out the potential differences in rural vs. urban schools, suggesting that factors related to geographic setting may also play a role in the experience of students with ASD and their teachers. Finally, [11] survey of strategies used with students with ASD showed differences based on grade level, indicating that teachers may change their practices based on student age.

Current Study

Research shows that evidence-based practices have significant benefits for individuals with ASD [16]; and such practices are required by law [10]. However, there are many factors that influence the use of EBPs in schools, including the varying abilities and symptoms of individuals with ASD, limited ASD-specific training for teachers in public schools, and the large number of available treatment options, paired with limited large-scale reports on the effectiveness of such interventions. The current study aimed to quantify the classroom practices used by teachers who work with children with ASD. By understanding what strategies are most frequently used with students with ASD, as well as the school-level factors that relate to the usage of said strategies, policy makers and educators can better identify the gaps in teacher training and improve school-based service delivery for individuals with ASD. To our knowledge, this kind of study has only been conducted in one other state [11]. The present study used a statewide survey in Michigan to address the following research questions:

1) Are the services provided to students with ASD in Michigan similar to those that have been identified as evidence-based practices?

2) What specific programs and instructional strategies are most commonly used?

3) How frequently are the most common programs and strategies used?

4) What school factors (e.g. location, SES, grade level) are related to the use of evidence-based practices?



Sample development: Michigan does not provide a statewide dataset of individual students with ASD receiving special education services. Therefore, we chose to create our sample from a dataset containing names and school districts of special education personnel: the Registry of Education Personnel (REP), provided by the Michigan Center for Educational Performance and Information. By combining the REP dataset with information on the number of students with ASD served in each intermediate and local school district, we sought to select more professionals from districts with a greater number of students with ASD, and fewer professionals where there were fewer students with ASD. Based on interactions with parents and educators, we knew that many students with ASD were provided special education services by individuals without specific training in ASD. Therefore, we included the following categories of special educators in our sample: “Autistic Impaired” (AI teachers), “Teacher Consultant: Autistic Impaired” (AI consultants), “Mildly Cognitively Impaired,” “Moderately Cognitively Impaired,” “Severely Cognitively Impaired,” “Emotionally Impaired,” “Learning Disabled,” Hearing Impaired,” “Visually Impaired,” “Physically Impaired or Otherwise Health Impaired,” “Severely Multiply Impaired,” “Preprimary Impaired,” “Speech/Language Impaired,” “Resource Room,” and “Physical Education for the Handicapped.” Although the majority of our sample were categorized as AI teachers and AI consultants, we selected additional special education professionals from the remaining categories within districts where the number of AI teachers and AI consultants were proportionally lower than expected considering the number of students with ASD in those districts. That is, every nth teacher was selected based on the list of other special education professionals until the intended sample size was reached. Before completing the survey, we notified all potential participants that in order to participate, they needed to currently serve a student with ASD who was currently enrolled in kindergarten through 12th grade within a public school. The initial list of 1,000 special education professionals was alphabetized and split into two 500-person matched sets (i.e. the first educator alphabetically was assigned to the first sample set, the second person was assigned to the second set, the third person to the first set, etc.) The first set was designated the “primary” sample and the second was the “secondary” sample. Contact information for each person in the two datasets was sought through school district websites, and each member of the primary sample was e-mailed a short description of the study and a link to the online survey. If there was no contact information given for a member of the primary sample, another special educator from the same school district was contacted. If a member of the primary sample indicated they did not work with any students with ASD, they were asked to provide the name and contact information of a special education professional in the same building or school district who did work with students with ASD. In this way, we ensured that each participant could report about students with ASD with whom they worked. If a member of the primary sample did not respond to the survey request after one month and two reminders from the research team, we contacted the matched educator from the secondary sample. At the end of the survey, special educator participants were asked to provide contact information for special education consultants, general educators, and paraprofessionals that also worked with the student who they chose to report about as part of the survey. These individuals were then also asked to complete the survey. To obtain information about the students with ASD, we asked each responding educator to select one student with ASD with whom they currently worked who was: a) enrolled in a public school in grades K-12 and b) had a last name that began with the letter closest in the alphabet to the last name of the responding special education professional. This systematic approach ensured that respondents were not biased in their reporting in terms of selecting students who were the most or least challenging. Additionally, to prevent inclusion of multiple sets of data on the same student with ASD from multiple educators within the analysis, we chose to report data from one educator for each student. In some cases, substantial missing data were evident from special educators, therefore we selected out a different school professional’s responses about a given student with ASD. Our preference order for respondents’ roles was special educator, special education consultant, general educator, and finally paraprofessional. Specifically, if a special educator responded about a student with ASD, we used that respondent’s data. If a special educator did not fully respond, we used the special education consultant who reported about the given student. If neither a special educator nor a special education consultant fully responded, we used the responses from the general educator or paraprofessional associated with the target student. To summarize, in order to be included in the current analysis, the responding individuals had to be

(a) Identified through the sampling process described above,

(b) A school professional who reported currently serving one or more students with ASD enrolled in a public school as a kindergarten through 12th grade student, and

(c) The individual had to provided the most complete information on the selected student among the various school professionals who completed the survey for a given student with ASD.

Survey completion: All respondents completed the survey online using a link sent from the researchers. The questionnaire took approximately 20 minutes to complete, and respondents were offered $15 for their participation. Survey completion took place over a period of one academic year.


Demographics: General background information was gathered about the school districts, school professionals, and students with ASD, including county median household income (categorized as low, medium, or high), geographic region within the state of Michigan (Tri-county Area, Southwestern lower peninsula, Southeastern lower peninsula, thumb and central lower peninsula, and upper and Northern lower peninsula), educational role (special educator, general educator, paraprofessional, or consultant), student diagnosis, student grade, student race/ethnicity, and student free or reducedprice lunch.

Practices used for students with ASD: To ensure inquiries to school professionals about interventions, strategies, techniques, and approaches were maximally inclusive, a comprehensive review of empirical literature on educational services and interventions provided to students with ASD was conducted. The final list included 65 different approaches, including those with and without empirical support. Respondents indicated whether or not they used the given approach with the student with ASD, as well as how many hours per week they utilized each strategy with that particular student. Because the present study was developed before the NSP report [7] was published, the list of strategies included in the survey does not directly align with the language used to categorize interventions according to the NSP report. Therefore, to determine the level of empirical support for each of the included strategies, two independent reviewers with doctoral degrees, and extensive knowledge in ASD analyzed the approaches against both the NSP and the NPDC-ASD classifications [7,8].


Respondents: Our final sample included 194 education professionals, which represents 26% of the intended sample. The majority of the respondents (82%) were special educators; 11% were special education consultants, 4% were paraprofessionals, 1% were general educators, and the remaining 2% did not report their affiliation Table 1.