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The Importance of the Promotion of Evidence-Based Practice as a Reasonable Adjustment in Mainstream Education Settings for Students With Autism Spectrum Disorder

Published online by Cambridge University Press:  16 May 2022

Traci-Ann Garrad*
Affiliation:
University of Notre DameAustralia
Samantha Vlcek
Affiliation:
RMIT University, Australia
Angela Page
Affiliation:
University of Newcastle, Australia
*
*Corresponding author. Email: [email protected]
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Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental condition that can affect a person’s ability to manage the complexities of varied social and environmental situations. This is particularly evident in the dynamic context of a school classroom. To assist students with ASD to navigate the complexities of Australian primary and secondary mainstream classrooms, educators are required to provide ‘reasonable adjustments’ to support learning; that is, to make changes that are practicable and achievable in order for students to access learning on the same basis as their peers. We present an argument that the ‘reasonable adjustments’ made by schools to ensure that students with ASD have equitable learning opportunities should meet a criterion of acceptability where the adjustment is evidence based. The paper also offers a summary of evidence-based pedagogical strategies that have been effective for students with ASD and concludes with a discussion offering evidence-based practices as a solution to meeting legislative requirements for students with disability.

Type
Original Articles
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that can result in individual difficulties with restricted or repetitive behaviours, sensory processing challenges, and social communication impairments (American Psychiatric Association, 2013). The social and environmental context individuals with ASD experience, inclusive of mainstream school classrooms, influences the manifestation of individual difficulties and their associated impact upon the individual (Prizant, Reference Prizant2015). Five key themes have been identified as impacting upon the effective inclusion of students with ASD in mainstream schools (Roberts & Simpson, Reference Roberts and Simpson2016): (a) the challenging behaviours of the student with ASD, (b) the individual’s unique social communication behaviours, (c) educators’ levels of knowledge and understanding of ASD, (d) stakeholders’ attitudes towards inclusion, and (e) stakeholder support networks.

The number of children receiving a diagnosis of ASD is rapidly increasing globally. However, some contention remains regarding the exact prevalence of ASD, given inconsistencies with the way jurisdictions collate and report on statistical data regarding ASD and childhood disability (Chiarotti & Venerosi, Reference Chiarotti and Venerosi2020). In the United States of America (USA), ASD diagnostic prevalence has recently been estimated at 1 in 54 children compared with 1 in 250 in 2000 (Centers for Disease Control and Prevention, 2020). In Australia, for example, prevalence statistics demonstrated a 42.1% rise in childhood diagnosis of ASD from 2012 to 2015, representing 1 in every 150 children (Australian Bureau of Statistics [ABS], 2015). The most common age range concerning diagnosis in Australia is between 5 and 15 years of age, with more than 75% of individuals diagnosed with ASD aged 5–24 years (ABS, 2015). As of 2018, 70% of Australian students with a diagnosis of ASD were enrolled in mainstream primary and secondary schools (Clark et al., Reference Clark, Vinen, Barbaro and Dissanayake2018).

As the number of students with ASD entering mainstream Australian schools has grown (Parliament of Australia, 2016), so too have efforts across the education system to ensure the implementation of evidence-based practice (EBP) to support students’ developmental and academic achievement (Hume et al., Reference Hume, Steinbrenner, Odom, Morin, Nowell, Tomaszewski, Szendrey, McIntyre, Yücesoy-Özkan and Savage2021; National Autism Center [NAC], 2015; Travers et al., Reference Travers, Ayres, Simpson, Crutchfield, Lang, Hancock and Singh2016; Wong et al., Reference Wong, Odom, Hume, Cox, Fettig, Kucharczyk, Brock, Plavnick, Fleury and Schultz2015). Given the increasing prevalence of ASD and the myriad of challenges faced by students with ASD, the use of EBP is an essential component for maximising the likelihood of positive educational and developmental benefits (Travers, Reference Travers2017). Nevertheless, despite this knowledge, students with ASD have continued to underachieve compared with other student populations (ABS, 2015). This has resulted in poor postschool outcomes, with detrimental consequences for the individual and society more generally (ABS, 2015). Therefore, effective inclusion that addresses the academic, social-emotional, and mental health development of children with ASD is not just a legislative, social, and moral responsibility but an economic imperative (Merry, Reference Merry2020).

The approximate economic cost for supporting the needs of individuals with ASD in Australia has been estimated at $9.7 billion per annum (Synergies Economic Consulting, 2011). These costs result from the impact of ASD on the individual, such as reduced or limited lifetime productivity, and the costs incurred through health care and social services, including government income benefits. Additionally, poor educational attainment has been linked with poor postschool outcomes, such as high unemployment rates for people with disability in Australia (Children with Disability Australia, 2015) and particularly for those with ASD. Almost one third (31.6%) of Australian adults diagnosed with ASD are unemployed (ABS, 2015). This rate is 3 times higher than for individuals with other disabilities (10.0%) and nearly 6 times higher than for individuals without a disability (5.3%; ABS, 2015). As such, ensuring that students with ASD receive an equitable education through the provision of reasonable adjustments aligned with their specific strengths and needs is a critical factor in supporting better educational outcomes and, in turn, more significant economic activity in the later years of their lives.

To prepare the current cohort of Australian students for employment and lifestyle opportunities beyond their formal schooling years, it is imperative to evaluate the factors that affect positive educational outcomes. Research into the specific features impacting upon positive educational attainment outcomes for students with ASD includes the attributes of the individual, the quality of instructional approaches, as well as the appropriateness of curriculum and assessment adjustments (Cumming et al., Reference Cumming, Dickson and Webster2013; Keen et al., Reference Keen, Webster and Ridley2016; Lawson & Shields, Reference Lawson and Shields2014).

Barriers for Students With ASD in Educational Settings

To meet the needs of students with autism, teachers must possess knowledge of the disorder itself and the unique challenges students face. In an international exploration of the barriers to the inclusion and effective education of students with ASD, teachers reported concerns in their ability to provide efficacious autism-specific adaptations, as well as a lack of autism-specific staff training (Roberts & Simpson, Reference Roberts and Simpson2016). These concerns caused a shared frustration for students, parents, and teachers. Students expressed their belief that teachers required higher levels of understanding to support specific and unique individual ASD traits and profiles that impacted on successful education outcomes at the classroom level. For example, students cited the management of environmental factors that can increase students’ stress and anxiety levels, such as noise levels and changes in routine. In addition to these environmental challenges, curricular factors, such as academic demands, and developmental factors, such as co-morbid mental health issues, increased emotional sensitivity, executive functioning deficits, social communication difficulties, and stereotypic behaviours (Roberts & Webster, Reference Roberts and Webster2022), also created significant barriers to inclusion and learning in mainstream educational contexts. In a large-scale Australian study (Saggers et al., Reference Saggers, Klug, Harper-Hill, Ashburner, Costley, Clark, Bruck, Trembath, Webster and Carrington2016), students with autism noted they experienced a marked degree of challenge with social-emotional regulation and management, executive functioning skills, and fine motor skills, and sensory issues had a notable impact on them at school.

Social communication behaviours, general communication skills, and language development can be significantly delayed in students with ASD, presenting several challenges in the classroom. An estimated 30% of children with ASD may never acquire functional speech (Noens & van Berckelaer-Onnes, Reference Noens and van Berckelaer-Onnes2005; Tager-Flusberg & Kasari, Reference Tager-Flusberg and Kasari2013). Other children may develop echolalic speech or they may demonstrate impairments in the pragmatic aspects of language (Boutot et al., Reference Boutot, Hall, Wheeler, Mayton and Carter2017). Children with ASD demonstrate a focus on specific words or phrases in isolation of the situation or context in which they are being used. The lack of identification of the contextual details often negatively impacts an individual’s comprehension of the meaning of a message, resulting in miscommunication.

Teachers have reported significant challenges in addressing students’ language and communication needs with ASD in mainstream education. For example, in comparison with typical teacher–student interactions, teachers frequently need to ensure that their instructions in the class are clear and unambiguous to minimise confusion for students with ASD (Roberts & Simpson, Reference Roberts and Simpson2016). In addition, for students with ASD who require the support of augmentative and alternative communication systems, Biklen and Burke (Reference Biklen and Burke2006) reported that students with ASD experienced high frustration levels because of a lack of teacher understanding of support technology and its use. That is, teachers did not consider the level of concentration, effort, and time it takes a student to indicate their desire to talk or failed to recognise when the student was ready to talk. This often resulted in students not being given the time or the opportunity to communicate with the teacher or participate in class discussions in a meaningful way.

The Importance of EBP in the Education of Students With ASD

Sulek et al. (Reference Sulek, Trembath, Paynter and Keen2021) define EBP as ‘a decision-making process whereby users integrate the best available research, with clinical or professional experience, while considering client characteristics’ (p. 480). However, despite a large body of international literature addressing EBP in the education of students with disability (Burns & Ysseldyke, Reference Burns and Ysseldyke2009 [USA]; Carter et al., Reference Carter, Stephenson and Strnadova2011 [Australia]; Cook & Odom, Reference Cook and Odom2013 [USA]; Hess et al., Reference Hess, Morrier, Helfin and Ivey2008 [(USA]), the adoption and maintenance of empirically supported practices by teachers concerning students with ASD has remained sporadic. Instead, teachers often have an ad hoc approach to strategy choices in addressing the individual needs of students with disability that has included both EBP and non-scientifically supported interventions (Odom et al., Reference Odom, Hume, Boyd and Stabel2012). This approach has led to criticism of teachers as their practice selections are not necessarily evidence based and, more importantly, some practices lacking scientific evidence used in the classroom have even been reported to be detrimental to the developmental needs of students with ASD (Travers et al., Reference Travers, Ayres, Simpson, Crutchfield, Lang, Hancock and Singh2016). However, if teachers are to avoid using unsupported practices to meet the needs of their students with ASD, they need to possess knowledge about ASD itself and the practices found to be efficacious in successfully engaging with and supporting the specific needs of this student population.

A fundamental aspect of EBP in the education of students with disability broadly, and ASD specifically, is the cyclical nature of the assessment, selection, implementation, and evaluation of an EBP for meeting a student’s specific strengths and needs. As in the personalised learning and support model (Sharma & Salend, Reference Sharma and Salend2018), educators must first assess the specific strengths and needs of the student to identify their entry skills and the supports they require moving forward. Next, as part of the selection of teaching strategies, educators must plan relevant short-term and long-term goals for the student and then plan and implement appropriate adjustments (i.e., EBP) to support goal achievement. Next, teachers must integrate the adjustments into their teaching and the learning process throughout implementation. Finally, teachers must regularly and consistently evaluate the effectiveness of the adjustments for meeting the student’s goals and make modifications to adjustments and programs as necessary (Sharma & Salend, Reference Sharma and Salend2018). This information connects back with the first step of the cycle, where the teacher should once again assess the student’s needs and prepare to support continued growth and development.

Australian Education Policy and Legislation for Students With Disability

The education system in Australia is underpinned by the rights and responsibilities outlined in the United Nations Convention on the Rights of the Child (United Nations [UN], 1989). As a signatory, Australia addresses these rights through the provision of public education as per Article 28, which states that all children have the right to an education (UN, 1989). Accessibility to the school of choice for students with disability is informed by the Convention on the Rights of Persons With Disabilities (UN, 2006) Article 24 (the right to inclusive education). In Australia, these conventions are explicitly addressed through two key legislative documents: the Disability Discrimination Act (DDA; Australian Government, 1992) and the Disability Standards for Education 2005 (DSE; Commonwealth of Australia [COA], 2006). These guiding documents work to ensure students with disability can access and participate in education on the same basis as students without disability. Through the provision of systems and school-level supports, it is teachers who have the primary responsibility for enacting inclusive educational practice in the classroom.

Australian teachers’ importance in the implementation of inclusive education practices is acknowledged. Internationally, in Article 24 of the Convention on the Rights of Persons With Disabilities (UN, 2006), it is stipulated that signatory parties should employ well-trained teachers to address the educational needs of students with disability. According to the convention, member state parties are also required to ensure that all teachers are well trained in the appropriate teaching methods for students with disability and that preservice teaching institutions should be encouraged and incentivised to provide quality inclusive education training (UN, 2006).

At the national level, Australian teachers are required to meet the needs of students with disability within the scope of their professional role and responsibilities, as outlined in the Australian Professional Standards for Teachers (Australian Institute for Teaching and School Leadership, 2011). Most notably, articulated in Standard 1.6 relating to professional knowledge, graduate teachers are required to ‘demonstrate a broad knowledge of the legislative requirements and the teaching strategies needed to support participation and learning of students with disability’ (p. 11). In addition, proficient teachers are expected to design curriculum programs and support the participation and learning of students with disability (Australian Institute for Teaching and School Leadership, 2011). This includes implementing supportive, differentiated practices and, significantly, EBP.

At the classroom level, it is teachers who play the primary role in the inclusion and education of students with disability in Australian schools, including students with ASD. However, the use of EBP to meet the needs of students with disability in Australian schools is inconsistent (Garrad et al., Reference Garrad, Rayner, Pedersen and Cuskelly2021; Sulek et al., Reference Sulek, Trembath, Paynter and Keen2021); this is detrimental for the education of students with a range of disabilities, including ASD. Furthermore, the education of students with disability will be compromised if schools and teachers continue to underutilise their time and resources on interventions that are known to be effective (Education and Employment References Committee, 2016, p. 67).

Reasonable Adjustments in the Australian Legislation and Mandates

The articulation of Australia’s commitment to inclusive education for students with disability is profiled within the DSE (COA, 2006). The DSE clarifies the responsibilities of education providers within the DDA (Australian Government, 1992) and outlines that an education provider is required to make any decisions about admission, enrolment or participation on the basis that reasonable adjustments will be made where necessary so that the student with disability is treated on the same basis as a student without the disability. However, a provider is required only to make a reasonable adjustment. An adjustment is not mandatory if it would cause unjustifiable hardship to the provider.

What constitutes a reasonable adjustment is not explicitly stated; however, the DSE defines an adjustment as reasonable if it balances the interests of all affected parties (COA, 2006). The use of EBP is not mandated in Australian schools, but it is conceivable that the term reasonable adjustments should be aligned with practices that have a quantifiable research benefit to meet the specific needs of the intended recipient. Further, it appears relevant to consider the use of pseudoscientific or unsupported practices as not meeting the reasonable adjustment expectation as mandated.

The 2020 Review of the Disability Standards for Education 2005 (Australian Government Department of Education, Skills and Employment [DESE], 2021) was undertaken to clarify educational providers’ responsibilities under the DDA and to ensure that students with disability were able to appropriately access and participate in education on the same basis as others. The report made 13 recommendations to improve existing practices and processes. Improvement in upskilling professional staff and improving standards were given priority, although EBP is only explicitly mentioned concerning calls for educators to have ‘clearer guidance and opportunities to practice the design and implementation of evidence-based adjustments’ (p. 37).

While specific reference to the term EBP is inconsistent in Australian legislation, the intent of the Nationally Consistent Collection of Data on School Students with Disability (NCCD) clearly stipulates the expectation of reasonable adjustments for students with disability aligned with the DDA and DSE, including EBP (Education Council, 2020). The NCCD is an annual data collation expectation of all Australian schools. Within the reporting requirements, school leaders must identify the level of adjustment provided to students with disability at school. The four adjustment levels include support provided within quality differentiated teaching practice, supplementary adjustments, substantial adjustments, and extensive adjustments. Within quality differentiated teaching practice, students with disability are provided explicit adjustments consistent with expected differentiated teaching practice. Supplementary adjustments include adapted and additional curricular, instructional, or environmental modifications that occur some of the time. Substantial adjustments are regular adaptations made to multiple areas of a student’s education, such as modifications to the curriculum, instruction, and/or environment. Students who require adjustments to most areas of their educational participation and achievement most of the time are provided extensive adjustments (Education Council, 2020).

Beyond reporting requirements, the NCCD provides a national funding and resourcing program to support Australian schools and educators to meet the needs of students with disability (Education Council, 2020). The NCCD portal provides educational resources for educators at all levels, from preservice teachers to leading teachers, to ensure all legislative mandates are met. Within the professional development resources, educators are supported to understand their roles under the DSE and guided to select reasonable adjustments aligned with the needs of their students with disability throughout the school year. The data collation process then facilitates the calculation of equitable funding to each educational jurisdiction based on the level of adjustment provided to students with disability. Through the NCCD process, schools and educators are provided with appropriate tools to support the education of students with disability (Education Council, 2020). These appropriate tools should be based on efficacious practices and strategies as the foundation for an EBP model approach.

EBPs in the Education of Students With ASD

EBP Models

Selecting applicable and appropriate practices to meet the needs of students with ASD is not necessarily a prescriptive undertaking. To begin to contextualise the challenges faced by teachers in identifying and selecting EBP from the research literature, an explanation of EBP models is required. Odom et al. (Reference Odom, Hume, Boyd and Stabel2012) classified EBP intervention approaches for children with ASD into three types: the comprehensive treatment model (CTM), eclectic, and technical eclectic. CTM is an approach that uses a defined range of individual EBPs around a central framework, such as programs based on applied behaviour analysis (ABA) techniques commonly employed in early intervention (Tonge et al., Reference Tonge, Bull, Brereton and Wilson2014). Primarily, the practices prescribed within CTM employ ongoing, replicable interventions to consistently improve targeted core challenges, barriers, and behaviours (Odom et al., Reference Odom, Boyd, Hall and Hume2010). Although ABA is not the only underpinning model used in early intervention, it is one of the most well-known approaches for determining interventions to be used with children with ASD and is supported by several research studies (Felzer-Kim & Hauk, Reference Felzer-Kim and Hauck2020; Grigorenko et al., Reference Grigorenko, Torres, Lebedeva and Bondar2018; Vietze & Lax, Reference Vietze and Lax2020). Although ABA has a long history of evidence-based efficacy (see Dillenburger, Reference Dillenburger2011, for an overview), it has also come under criticism for being a narrow approach to meeting the needs of children with ASD (Gorycki et al., Reference Gorycki, Ruppel and Zane2020).

It should be noted that ABA is not a specific intervention, nor is it treated that way within this article. There is a distinct difference between formal ABA-based programs and those programs developed by educators that are based on ABA principles, the first being more rigid and didactic, the second offering a more flexible approach based on individual needs. ABA is the data- and research-based application of behavioural principles to socially relevant behaviour (Cooper et al., Reference Cooper, Heron and Heward2019). The data-driven nature of the approach requires the collection of baseline data and, most importantly, ongoing data collection to monitor intervention effectiveness to allow for adjustments where necessary.

ABA has application in developing interventions for individuals with a range of disability and additional needs. Because of the pervasive nature of ASD that can result in dramatic impairments in communication and social behaviour, along with restricted and repetitive behaviour, the primary goals of ABA interventions have typically focused on improving communication and social behaviours of individuals with ASD, as well as reducing the occurrence of restricted and repetitive behaviours (Tiura et al., Reference Tiura, Kim, Detmers and Baldi2017). Programs based on an ABA approach are highly prescriptive with predetermined criteria regarding the correctness of the behavioural response. As an example, valuable communications by a child may be overlooked under such a regime if they are deemed to be displaying off-task behaviours (Roberts, Reference Roberts2003). This criticism suggests that social or individual values can influence the perception of such didactic approaches and that such values may impact the decision to adopt or cease using a particular approach. However, the CTM is not the only approach available: eclecticism is a more flexible way of working with students with ASD.

The eclectic approach is used when individual strategies are chosen on an ad hoc basis rather than using those predefined by a framework (as occurs with CTM). The practice of eclecticism is primarily through using a range of interventions that an educator judges will meet the specific needs of their student with ASD and may include interventions that have only anecdotal evidence of efficacy (Odom et al., Reference Odom, Hume, Boyd and Stabel2012). Academics and educators advocate for eclecticism due to flexibility arising from the use of a single EBP and combinations of EBPs. However, this system has also attracted criticism due to the incorporation of practices by teachers that are socially promoted and validated rather than scientifically validated, some of which have been suggested to be detrimental to the development of children with ASD (McDonald et al., Reference McDonald, Pace, Blue and Schwartz2012; Metz et al., Reference Metz, Mulick, Butter, Foxx and Mulick2016).

Socially validated practices refer to interventions or strategies that have socially accepted goals, procedures, and outcomes as evaluated by the individuals who receive, implement, or oversee these interventions in practice (Callahan et al., Reference Callahan, Henson and Cowan2008). An example of such an approach is facilitated communication (FC). Developed in Melbourne, Australia, FC enjoyed considerable international popularity during the 1980s and 1990s. FC involves stabilising an individual’s hand or arm by a facilitator to support that individual in typing out words and sentences on a keyboard, letter pad, or similar communication device (Biklen, Reference Biklen1990). Proponents of FC proclaimed that the intervention elicited communication from individuals with a range of physical and developmental disabilities, such as cerebral palsy and ASD, where expressive speech production had been impeded (Jacobson et al., Reference Jacobson, Mulick and Schwartz1995). Despite these claims, by the mid-1990s, FC had been widely discredited through a large number of independent, well-controlled studies (n = 19), none of which had succeeded in replicating or validating the intervention (see Gorman, Reference Gorman1998). However, subsequent research by Paynter et al. (Reference Paynter, Ferguson, Fordyce, Joosten, Paku, Stephens, Trembath and Keen2017), investigating the use of a range of supported and unsupported practices by early intervention educators with children with ASD in Queensland, Australia, found that educators reported using FC more often than EBP, such as discrete trial training, social narratives, speech-generating devices, and other alternative and augmentative communication devices. Although the use of FC remains relatively low overall, it is an example of the persistent nature of socially validated practices in the face of contrary evidence and despite the promotion of current efficacious practices or EBP. According to Odom et al. (Reference Odom, Boyd, Hall and Hume2010), one reason for using socially validated, rather than scientifically validated, practices is the rapid development of strategies that are promoted to meet the needs of an ever-growing number of children with ASD. This has led to the adoption of new strategies in practice before their effectiveness is evaluated in the academic literature. Thus, social validation often precedes scientific validation, limiting the effectiveness of adjustments provided to students with ASD.

There is considerable debate over which model should dominate and guide intervention and EBP selection for children with ASD. For example, Dillenburger (Reference Dillenburger2011) questioned the need for continued exploration and implementation of practices beyond formal ABA programs and programs developed by educators based upon ABA techniques. The essential premise of the argument is that given the lengthy empirical history of ABA, there is already a proven approach that can be employed with individuals with ASD across a range of settings. Although it has been acknowledged that ABA approaches have resulted in significant developmental outcomes for some children, these approaches have not demonstrated the same degree of success for all children with ASD (Eikeseth, Reference Eikeseth2009). The reported disparity in outcomes has led to reviews of the research literature to determine if a specific intervention or strategy could be the most efficient for most children with ASD (Kasari, Reference Kasari2002). As no single approach or intervention had a sufficiently strong evidence base to support such a claim, the consensus view of policymakers and experts in several countries was that the use of a range of interventions is appropriate, thus providing support for the eclectic approach (Parsons et al., Reference Parsons, Guldberg, MacLeod, Jones, Prunty and Balfe2009). Nevertheless, as discussed previously, the eclectic approach to meeting the needs of children with ASD does not guarantee that the adjustments employed will necessarily be empirically supported nor meet the specific needs of the individual for whom they have been implemented.

A third approach that can aid in avoiding or minimising ineffective intervention choices has been labelled technical eclecticism. The technical eclectic approach provides teachers with a choice of individual practices restricted to a pool of EBP. Technical eclecticism is the process by which professionals, including teachers, combine the flexibility of intervention choice with the utilisation of interventions based on positive research support (Odom et al., Reference Odom, Hume, Boyd and Stabel2012). The technical eclectic approach is not restricted to methods arising only from ABA research but rather sees end users selecting a range of practices and interventions based on the solid foundation of replicable, evidence-based research (Callahan et al., Reference Callahan, Henson and Cowan2008; Fixsen et al., Reference Fixsen, Blase, Metz and van Dyke2013; Wood et al., Reference Wood, McLeod, Klebanoff and Brookman-Frazee2015). Technical eclecticism supports a student-centric approach; that is, the selection of an EBP is based on individual student needs (Australian Advisory Board on Autism Spectrum Disorders, 2010; Knight et al., Reference Knight, Huber, Kuntz, Carter and Juarez2019). To appropriately implement a technical eclectic approach, teachers are required to engage with the research literature and acquire the skills to adequately assess the validity of that research and its relevance to meeting the specific needs of a student with ASD. The technical eclectic approach aligns most closely with the goals outlined in the 2020 Review of the Disability Standards for Education 2005 of good practice supporting students with disabilities (DESE, 2021). Most prominently, effective implementation of EBP ensures students receive reasonable adjustments aligned with their specific strengths and needs to achieve education on the same basis as other students.

In considering the mandate for ‘reasonable adjustments’ and the need for Australian educators to adjust their practice and pedagogical approaches to support the individual needs of students with disability, the technical eclectic approach to EBP selection and use is required. However, determining the effectiveness of an intervention when reviewing research literature can be complicated by the fact that studies encompassing interventions with children with ASD often involve single or limited numbers of participants (Odom et al., Reference Odom, Hume, Boyd and Stabel2012). This limited representation base can lead educators to dismiss potentially useful and effective interventions or approaches due to their perception that the goals and outcomes of any particular study are too narrow or fail to reflect the needs of their students with ASD (Dingfelder & Mandell, Reference Dingfelder and Mandell2011). One approach to negating the unwitting engagement of unsupported practices over established EBP is identifying and promoting EBP through literature reviews and the creation of EBP compendiums.

EBP Compendiums as Technical Eclectic Choice Guidance for Educators

Identifying strategies that research demonstrates work, particularly for children and youth with ASD, to aid educators in selecting EBP is not new. Heflin and Simpson (Reference Heflin and Simpson1998) reviewed several treatment options available at that time, noting the necessity of such literature reviews, given the increase in intervention strategies and perceived controversy over participant outcome claims. As it is, research professionals who engage with the research literature are in a position to provide these overviews and recommendations rather than end users, such as educators and teachers. In response to this need, Simpson (Reference Simpson2005) published a widely accessible book for individuals working with children and youth with ASD that evaluated common ASD interventions of the period. The interventions reviewed by the authors were then classified into four categories: (a) scientifically based practices, (b) promising practices, (c) limited supporting information for the practice, and (d) not recommended. Scientifically based practices were defined as ‘[those practices] … that have significant and convincing empirical efficacy and support’ (p. 9). A promising practice was one that had documented levels of ‘efficacy and utility with individuals with ASD, even though the intervention requires additional scientific support to be considered a scientifically based method’ (p. 9). Interventions categorised as having limited supporting information were practices for which there was little information about their use with individuals with ASD or had minimal research support. Interventions that were not recommended were reported to have been subjected to rigorous research methods that demonstrated either detrimental effects or outcomes for children or lacked effective results. This was an important inclusion, given that there was a clear identification of methods to be avoided that provided balanced guidance for decision-makers. Despite the availability of such a compendium of identified EBP, researchers have continued to report erratic uptake of EBP when working with individuals with ASD (Carter et al., Reference Carter, Stephenson and Strnadova2011; Hess et al., Reference Hess, Morrier, Helfin and Ivey2008).

More recently, the NAC and the National Professional Development Center on Autism Spectrum Disorder worked independently to identify and promote the most efficacious interventions for children with ASD in community settings (Hume et al., Reference Hume, Steinbrenner, Odom, Morin, Nowell, Tomaszewski, Szendrey, McIntyre, Yücesoy-Özkan and Savage2021; NAC, 2015). The impetus for these reviews arose from the need to support professionals, parents, educators, and those who work with children with ASD to identify and select EBPs. The EBP literature reviews undertaken by the NAC and National Professional Development Center on Autism Spectrum Disorder were important steps towards meeting this need, with a specific focus on individuals with ASD. The reports themselves align with the technical eclectic approach where they list all current EBPs that have and can be used to address the specific needs of individuals with ASD rather than focusing only on CTMs or packaged programs. Although there is no explicit promotion of the technical eclectic approach within either report, these reviews assist educators in identifying and implementing appropriate EBP for their students with ASD rather than scientifically unsupported therapies.

While the technical eclectic approach has limitations, it is relevant to consider how it could support Australian educators in implementing adjustments more consistently with a proven evidence basis. A compendium of current EBPs has the potential to support the actualisation of recommendations within the 2020 Review of the Disability Standards for Education 2005 regarding the review and expansion of current exemplars of practice and the development of information for education providers (DESE, 2021). A compendium that included each EBP’s research basis, target demographic, implementation and analysis procedures, and anticipated outcomes has the potential to support educators to utilise evidence-based adjustments for students with ASD, fulfilling legislative obligations within the DDA (Australian Government, 1992) and DSE (COA, 2006), as well as supporting NCCD mandates applicable to all Australian schools (Education Council, 2020). Therefore, adoption of the technical eclectic approach in Australia offers an initial step towards guiding educators through evaluating student strengths and needs to select, implement, and analyse EBP to support the educational opportunities and outcomes of students with ASD.

Summary

Throughout this article the authors have worked to clearly identify the importance of EBP in working with students with ASD. Further, this information is likely to support the use of EBP for students with a range of other disabilities or educational needs. The importance of EBP is evident in the literature discussed within this paper. The benefits include standardised practices proven to be effective in their outcomes for students with ASD and that EBP provides certainty and confidence for educators in their choices of intervention. A further benefit of using EBP is that it assists educators to meet the legislated obligations of education service providers in Australia as stipulated by the DDA and DSE and recommended by the DESE in the review of the DSE. We also argue for the necessity to implement EBP approaches as a fundamental obligation for ensuring students with ASD are provided reasonable adjustments. We maintain that the use of non-evidence-based adjustments fails to meet the standard of ‘reasonable’ and reduces the likelihood educators are appropriately meeting their legislated obligations. The necessity for aligning practices with EBP is that students with disability are potentially placed at risk when non-evidence-based practices are adopted. In such cases, the risk of harm will not just affect these individuals during their educational matriculation but likely impact upon their longer-term educational opportunities and economic participation.

Promotion of Identified EBP to Meet the Needs of Students With ASD in Australian Schools

Through this paper, the authors aimed to provide a rationale that strongly recommends the promotion of EBP to meet the needs of students with ASD in Australian classrooms. With the increased prevalence of students with ASD in mainstream classroom settings, effective inclusion in mainstream schools requires educators to meet students’ individual needs, such as challenging behaviours and unique social communication behaviours (Roberts & Simpson, Reference Roberts and Simpson2016). These issues are best addressed using EBP to ensure a successful social and academic experience for students with ASD in mainstream classrooms. The extensive body of literature supporting EBP for students with ASD shows that these practices work, yet there is national inconsistency in the message that EBP is ‘best practice’. We suggest, therefore, that there is an imperative for the promotion of current identified EBP and an urgency for an alignment of these approaches as being reasonable adjustments in the education of students with disability, including those with a diagnosis of ASD, in Australia. Finally, we wish to not only articulate the relevance of our argument for the promotion of EBP in Australian schools but also advocate its applicability on the international stage. The road to a full participatory, inclusive education locally has been fraught with challenges, as school systems struggle with the complexities of managing intrinsic student factors, resources, and teacher attitudes (Garrad et al., Reference Garrad, Rayner and Pedersen2019; Stephenson et al., Reference Stephenson, Browne, Carter, Clark, Costley, Martin, Williams, Bruck, Davies and Sweller2021). Globally, these barriers are consistent (Sharma & Vlcek, Reference Sharma, Vlcek, Goldan, Lambrecht and Loreman2021), and the issues that students with disability face in accessing an equitable education are the same (Young et al., Reference Young, McNamara and Coughlan2017). It is hoped that by raising the profile of the efficacy of EBP, its potential can be realised and, as a result, all reasonable adjustments will be firmly grounded in EBP for children and youth with ASD.

Footnotes

This manuscript was accepted under the Editorship of Michael Arthur-Kelly.

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