Evidence-based Practice
It is important to know the different possible interventions in order to choose the ones that are most effective for an individual. Today, it is easy to get a variety of information online and on social media, but it can sometimes be difficult to distinguish practical information from opinions or assumptions.
The interventions that are covered in this resource are all evidence-based. This section defines the types of interventions and presents guidelines for choosing and implementing evidence-based interventions for learners.
Components of an Evidence-based Practice
Decisions must constantly be made on a daily basis. An evidence-based practice allows you to assess different components of the targeted intervention and collaborate with your team to make informed decisions and achieve the best results. Each of the six components of an evidence-based practice is important to the process of selecting and implementing interventions tailored to the learners.
Here is a description of these components:
Evidence-based intervention
Evidence-based interventions are those that:
- Have been verified by several high-quality scientific studies: Rigorous scientific processes rely on quantitative data, help eliminate sources of bias, and help ensure that the results produced can be attributed to an intervention and not to other unknown factors. This research is published in peer-reviewed journals only when a group of experts in the field has determined its scientific value.
- Are carried out in a precise manner: Evidence-based interventions are effective when used in the same way as in the studies. Using different materials, varying the intensity or frequency of the intervention, or using the intervention for another target behaviour could make it less effective.
- Are conducted for a particular purpose: The intervention is developed with the aim of obtaining positive results on a specific behaviour or problem. It is not supposed to be effective in treating another problem.
- Are carried out with a determined population: To demonstrate that the intervention is effective in treating a particular behaviour, the researcher chooses study subjects who have the characteristics on which one wishes to intervene. It should be noted that these interventions could therefore not be effective with people who are very different from the subjects who participated in the study.
Professional judgment
Professional judgment is based on using clinical expertise and experience to determine the best course of action. To choose and carry out interventions that are perfectly suited to a learner, we must start by studying their unique strengths and needs profile. Next, it is important to note the characteristics of the learner that can influence the effectiveness of an intervention, for example their age, level of cognitive functioning, degree of functional communication, the extent and nature of the difficulties, social adaptation, and all challenging behaviour. Critical thinking is essential in decision-making, because it invites us to examine other explanations or other options.
Family values and preferences
Family participation makes it easier to plan an intervention and respond appropriately to the learner’s needs. If possible, learners themselves should participate in the selection of interventions. Families can provide valuable information about the learner and the strategies that have or have not been successful. They can also take advantage of information about strategies and successes in school and thus help transfer learning to the home. Also, collaborating with families helps professionals understand their cultural values, socio-economic circumstances, socio-emotional factors, and any barriers that could influence preferences and participation.
Data-based decision making
Choosing an intervention is only the beginning of the process of achieving an evidence-based practice. To ensure the effectiveness of an intervention with a learner, data must be collected. In fact, the relevant data allow professionals to verify the effectiveness of an intervention and to select other interventions if necessary.
Team-based approach
Many learners benefit from the services of different professionals. Collaboration between families and professionals facilitates planning coordination and helps prevent the repetition of services or omissions in interventions. Each member of the team brings a unique point of view and set of observations, as well as useful skills for the choice and implementation of interventions. The team approach allows all the members involved to exchange information about what is working and what is not, thus promoting positive results, regardless of the learner’s environment.
Capacity for implementation
For an intervention to be effective, it must be implemented rigorously. In other words, it should be applied consistently and in accordance with a predetermined plan. Professionals sometimes need to undergo training in order to be able to intervene. The team must decide whether a particular intervention is likely to be effective in a specific context, taking into account the personnel, training, resources and other relevant factors.
Evidence-based practice provides guidelines for implementing interventions that are most likely to be effective with learners. It does not dictate which interventions to use or which to avoid, but rather provides leads to help professionals assess what will work best for a learner and collaborate with each other to achieve the best results.
In Case of Disagreement
Even though all team members (parents and professionals) have the same goal, they may have different perspectives on how to achieve it. Here are some tips to encourage collaborative, evidence-based practice:
- Try to better understand the views of others by asking questions.
- Look for similarities, not differences. It is often possible to find common ground.
- Listen carefully to the person who is speaking.
- Use positive language.
- Share facts and examples using non-technical language.
- Remember the objective: the success and well-being of the learner.
Examples
In the following examples, some components of an evidence-based practice are already being followed by different teams, others can be leveraged through concrete actions.
Luke
Luke is 11 years old. Since the start of the school year, his homeroom teacher, Mr. Dixon, has noticed that Luke is having trouble bonding with his new classmates. Mr. Dixon mentioned his concerns with Luke’s parents who share this impression and have noted some repercussions on their family life. Despite the strategies attempted by Mr. Dixon, the situation does not seem to be improving. He then shared his concerns with the members of the school’s Education Support Services team. The team decided that it would be useful to assess Luke using the Comprehensive Assessment for Learning and Independence (CALI) – Functional Skills for Independence, and thereby identify his strengths and challenges.Mr. Dixon and Ms. Richard, the resource teacher, conduct the assessment together. Ms. Richard compiles the results and organizes a meeting with Luke, his parents, Mr. Dixon, Mr. Douglas, the school worker, and Ms. Larson, the school vice principal. Ms. Richard presents the results of the assessment and proposes targeting the skill Integrating a group with similar interests. Given Luke’s age and level of language, she suggests using Behaviour Skills Training (BST) to teach the targeted skill. She explains that this is an evidence-based intervention that would meet the needs of the learner. Luke's parents are thrilled and want to know how to implement the intervention at home. The team designates Ms. Richard to implement the intervention because she has gained some experience with other learners and has already used BST to teach skills.
Think of each component of an evidence-based practice. How are they being used in Luke’s scenario? What steps could the team take to further base their practice on evidence? Click on each element to find out more.
Evidence-based intervention
Positive aspects: The team chose to intervene using Behaviour Skills Training (BST), an evidence-based intervention suggested in this resource. The team could have chosen another intervention, provided it was based on evidence.
Professional judgment
Positive aspects: Ms. Richard takes into account the learner’s age and level of functioning when she suggests the intervention.
Areas for improvement: Ms. Richard could have shared a few examples to demonstrate how effective the intervention was with other learners with a profile similar to that of Luke. She also could have explained the reason behind her recommendation to the team.
Areas for improvement: Ms. Richard could have shared a few examples to demonstrate how effective the intervention was with other learners with a profile similar to that of Luke. She also could have explained the reason behind her recommendation to the team.
Family values and preferences
Positive aspects: Luke and his family were consulted and were present during the meeting. The targeted skill matched their needs.
Data-based decision making
Positive aspects: An assessment was done to determine the learner’s strengths and challenges.
Areas for improvement: The choice of behavioural skills training as an intervention could have been more supported by the data. There is an Intervention Selection Tool that can guide the choice of interventions.
Areas for improvement: The choice of behavioural skills training as an intervention could have been more supported by the data. There is an Intervention Selection Tool that can guide the choice of interventions.
Team-based approach
Positive aspects: Several people are involved and participate in the discussions, including Luke and his family. This approach will allow Luke to progress in various contexts and will ensure the fidelity of the intervention both at home and at school.
Areas for improvement: Ms. Richard seems to make most of the decisions. It would be beneficial to consider the opinions of other team members to ensure that they are comfortable with the decisions.
Areas for improvement: Ms. Richard seems to make most of the decisions. It would be beneficial to consider the opinions of other team members to ensure that they are comfortable with the decisions.
Capacity for implementation
Positive aspects: Ms. Richard has already taken the training and is familiar with the proposed intervention.
Areas for improvement: It remains important to check whether Ms. Richard has enough time to implement the intervention. If Ms. Richard cannot invest the necessary time, it is best to designate another person and provide them with adequate BST training.
Areas for improvement: It remains important to check whether Ms. Richard has enough time to implement the intervention. If Ms. Richard cannot invest the necessary time, it is best to designate another person and provide them with adequate BST training.
Sara
Sara is 15 years old. She is starting to prepare for the transition from high school to the workforce. This year, she will have the chance to do a workplace practicum in her neighbourhood grocery store. To help Sara prepare for this work experience, her team decides to carry out the Comprehensive Assessment for Learning and Independence – Functional Skills for Independence. Unfortunately, the resource teacher, Ms. Carle, has to take leave for 3 weeks and is no longer available to conduct the assessment. The team decides to consult the skills list in the Administration Guide and choose skills that Sarah has difficulty with on a daily basis.A meeting is held with Sara, her parents, Mr. Price (homeroom teacher), Ms. Howard (Sara’s educational assistant), Mr. Jackson (school principal), Ms. Marshall (guidance counsellor), and Mr. Green (community officer and the person responsible for the practicum program). Together, they determine that the skills Following a multi-step instruction and Asking for missing items to complete a task could allow Sara to be more independent and successfully complete her work placement. The whole team agrees with that decision.
The team discusses various possible interventions. Ms. Marshall suggests Behavioural Skills Training (BST), as she is very familiar with that intervention and has already implemented it with other students. The other team members are not familiar with any other strategies, so they decide to choose BST. Ms. Marshall volunteers to implement the intervention, but she has limited time available and will need support from the team. Ms. Howard offers to help, despite her lack of experience.
Think of each component of an evidence-based practice. How are they being used in Sara’s scenario? What steps could the team take to further base their practice on evidence? Click on each element to find out more.
Evidence-based intervention
Positive aspects: The team chose to use Behavioural Skills Training (BST).
Areas for improvement: This is indeed an evidence-based intervention, but the team seems unaware of that. Additionally, it was the only strategy suggested.
Areas for improvement: This is indeed an evidence-based intervention, but the team seems unaware of that. Additionally, it was the only strategy suggested.
Professional judgment
Positive aspects: Ms. Marshall said she was very familiar with the intervention and already has some experience with other learners.
Areas for improvement: Ms. Marshall is unable to justify her recommendation, which seems rather random and not based on data.
Areas for improvement: Ms. Marshall is unable to justify her recommendation, which seems rather random and not based on data.
Family values and preferences
Positive aspects: Sara and her parents were consulted and were present at the meeting. The targeted skills matched their needs.
Data-based decision making
Areas for improvement: The team made decisions and chose the skills to work on in a rather random manner. This may reduce the chances of a successful placement. The team should wait until Ms. Carle returns or find someone else who can carry out Sara’s assessment, as it is essential that the selection of skills be based on data.
Team-based approach
Positive aspects: A number of people are involved and participate in the discussions, including Sara and her family.
Areas for improvement: When a key team member is absent, it is important to determine whether to wait for their return or whether it is better to replace them. In Sara’s case, Ms. Carle was responsible for the assessment – an important step that cannot be overlooked.
Areas for improvement: When a key team member is absent, it is important to determine whether to wait for their return or whether it is better to replace them. In Sara’s case, Ms. Carle was responsible for the assessment – an important step that cannot be overlooked.
Capacity for implementation
Positive aspects: Ms. Marshall has experience and volunteered to implement the strategy. Ms. Howard was available to help.
Areas for improvement: Ms. Howard has no experience or training in implementing the intervention. The team must ensure that adequately trained people are available to implement the intervention. It’s a very important component of evidence-based practice.
Areas for improvement: Ms. Howard has no experience or training in implementing the intervention. The team must ensure that adequately trained people are available to implement the intervention. It’s a very important component of evidence-based practice.
