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05/16/2012

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The first thing that has to be done regarding this issue of what constitutes evidence-based" is to agree upon what outcomes are most important. It is much easier to put together a good body of tightly designed research when you are looking at a very narrow range of outcomes in the short term and are able to control for all other variables. An example would be teaching a child a particular skill. A tight body of research is much more difficult to produce when looking at more long-term, global outcomes. For example, does a particular school intervention now lead to the child being better prepared for the workforce in 10 years? Lead to more friendships in high school? Be more independent in adulthood? I would argue that these global outcomes are what we should strive for with our children, and that we need to be careful that 1)the short term goals we set toward these long term outcomes are appropriate and 2)we do not "game" the research to demonstrate tight studies that in fact are missing the point in terms of the long term outcomes we desire for the special needs population. Perhaps we need different standards for "evidence based" depending on whether we are looking at short term, skill-based outcomes (a large body of tightly controlled studies would be appropriate) versus long-term, quality of life outcomes (since tight studies are nearly impossible to produce for these outcomes, interventions should be based more on best practices, family preferences, availability of resources and clinical judgment).

I agree with the above comment by Laura. Also, there are many emerging interventions that come from a research base, but haven't been in existence long enough for significant research on the intervention itself. Things that come to mind are the relationship based/developmental interventions that have origins from the child development/developmental psychology fields, which themselves do have extensive research.

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