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Using a Data-based Decision Making Model for Addressing Non-Evidence Based Interventions

Updated: Apr 19

When it comes to intervention with our clients or students it is always our goal to have them learn and grow and ultimately have a better quality of life. At times, a family member may be implementing interventions outside of the school day. Even after consideration, parents or other service providers may want to implement an intervention that has not been deemed to be evidence-based. Under these circumstances, although it may be difficult, one must stay objective and listen and remember to advocate for your client. Be available to assist the family, meet with other providers or colleagues while adhering to your ethical guidelines.

Federal law requires students with disabilities to receive the support services that are necessary to allow them to benefit from their education.  Over the years, some interventions that may be considered "support services" may actually be pseudoscientific or antiscientific interventions, such as facilitated communication (Le Mars Community School District, 1992). 

If you learn that a parent or colleague is planning to implement an unsubstantiated treatment, you may decide to inform the parent or colleague that this intervention should not be used due to the lack of scientific support of the efficacy of the intervention. This may not be the most effective the way to approach this situation. A quick response often fails to consider the perspective or interests of others and may not lead to the outcome you are hoping to achieve which is an open exchange of dialogue regarding intervention and understanding of possible side effects or dangers for your client/student.

As a professional, it is important to develop or identify guidelines to help facilitate the decision-making process (Heflin & Simpson, 1998). These guidelinescan be helpful to the whole treatment team. I have created a data-based decision making model that can be implemented with parents and other professionals when an intervention is being implemented that is not supported by evidence. The model allows for consistent assessment and review of the intervention outcomes and allows for data-based decisions to be made. This should lead to informed decision making and thereby be in the best interest of the student/client. The use of the model does not imply that we are in agreement with the use of the intervention. 

The model includes the following components assuming collaboration with parents:

  • Initial Informational Meeting  During this meeting you will learn about the intervention and the expected treatment outcomes. It is possible that the parent/s may not know what the expected outcomes are and this is an opportunity to be sure that there are expected outcomes so that they can be tracked and measured.

  • Conduct your own Research:  Prior to meeting you should conduct some research on the intervention. You should do this again after the meeting to determine the efficacy of the intervention in the literature. Be sure it is clear to everyone on the team what behavior the parents are expecting changes in with the intervention at this stage. 

  • Remember the Ethics of Do No Harm:  We should never implement or be a part of any intervention that does harm. If the intervention has been shown to be harmful, initiate a discussion about the previous outcomes and communicate that the present decision-making model will not be applicable and terminate involvement consistent with ethical guidelines. For example, practitioners consulting with a parent who intends to treat their child to Miracle Mineral Solution, which has been linked to serious injury and death (Connett, 2015), should not pursue this proposed decision making model.  

  • Deciding about Implementation:  Meet with the parents again and discuss your findings and their plans related to the intervention.  The parents will decide if they will move forward with the intervention.  

  • Details and Outcomes:  If the parents decide to move forward with the intervention, clarify and operationalize the expected outcomes.  What behavior will you be recording?  What are the expected changes in the behavior?  What is the timeframe for the expected behavior change? 

  • Set up the Data Collection System:  Set up your data collection systems and record baseline, as needed, for new (unlearned) behavior that you may begin recording.  For behavior already being recorded, make phase change lines on existing graphs noting the addition of the intervention.  Criterion should be set for behavior change based on the expected outcomes and timeline, which will allow for clear data-based decision making in the future.  

  • Prepare for Effects of Intervention:  Be sure to prepare for side effects or direct effects of the intervention, such as an initial increase in a particular behavior.  Expect temporary changes in behavior (e.g., diet may cause a temporary change in the student's behavior) or possibly, long-term effects of intervention. 

  • Ongoing evaluation and Revisions:  Review data daily and meet with parents weekly to review the effects and expected outcomes.  Take note of any changes in target behavior and other behavior, or anticipated or unanticipated side effects.  

  • Modification or termination:  Data should be reviewed and expected outcomes discussed. At this point a discussion should be held to either continue, terminate or make modifications to the intervention and outcome data systems.

  • The goal of the data-based decision making model is that if an intervention is not showing the expected outcomes or possibly even showing negative outcomes (e.g., increase in self-injurious behavior, decrease in verbal initiations), the parents will agree to stop the intervention based on pre-agreed criteria and a review of the data. 

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