Opening the “Black-Box:” Describing Usual Care Practice for Youths

The goals of this symposium are to (a) present new data characterizing assessment and treatment practices in “usual care,” community-based services for children and adolescents with Autism Spectrum Disorders (ASD), and Disruptive Behavior Disorders (DBP), and (b) to discuss how such data can improve efforts to integrate evidence-based practices into usual care.

There is speculation about how divergent usual care intervention, psychotherapy and diagnostic procedures may be from evidence-based practice, but there is very limited empirical data characterizing community providers' actual practices. Rich data on existing service provision provides essential contextual data on which to build and tailor implementation efforts. Strengths and weakness of different methods used to characterize practice, including case record review, therapist self-report and observational coding, will be discussed. Each of the presenters will present data characterizing usual care practice, and comment on how descriptive data has informed, or can potentially inform efforts to improve care.

The linked papers include:

1) Natacha Akshoomoff, Ph.D. presenting data on assessment practices for 200 children ages 2-6 referred for evaluation of ASD; data were collected using case record review in a community center.

2) Aubyn Stahmer, Ph.D. presenting teacher self-report and observational data on community intervention for children with ASD.

3) Ann Garland, Ph.D., presenting data on community-based out-patient psychotherapy delivered to 219 children ages 4-13 with DBP, collected through video-tape data on over 900 therapy sessions.

4) Lauren Brookman-Frazee, Ph.D., presenting observational data on the psychotherapeutic strategies observed with parents in usual care treatment of children with DBP.