Review of the Research to Identify the Most Effective Models of Practice in Early Intervention for Children with Autism Spectrum Disorders


Appendix D: Research strategy and scientific merit rating scale



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Appendix D: Research strategy and scientific merit rating scale


Literature Review Methods and Literature Search and Retrieval Process

Databases


The following search terms were used to retrieve references from four databases:

MEDLINE, PsycINFO, Cochrane Central (randomized controlled trials) and Education Resources Information Center (ERIC), Hand-searches of reference lists were also performed to identify additional studies.



Search terms

Database

Medline (1966-April 2011)

PsychInfo (1872-April 2011)

Cochrane Central (April 2011)

ERIC (-April 2011)

Autism terms

Exp. child development disorders, pervasive

asperger.tw

kanner.tw


Exp. pervasive developmental disorders/ or exp. autism/ or exp. Asperger’s syndrome

asperger.tw

kanner.tw


Exp. child development disorders, pervasive

asperger.tw




Pervasive developmental disorders/ or Asperger’s syndrome/ or autism

asperger.tw

kanner.tw


Study

design


Randomized controlled trial.pt

controlled clinical trial.pt

random.tw

control.tw

intervention.tw

Exp. between groups/ or clinical trials

Random.tw

Control$.tw


Randomized controlled trial.pt

controlled clinical trial.pt

random.tw

control.tw

intervention.tw





Treatment

Early intervention

therapeutics

treatment outcome


Exp. school based intervention/ or exp. group intervention/ or exp. family intervention/ or exp. early intervention

Exp. treatment

(treatments or therapy or interventions).tw





Exp. outcomes of treatment

Exp. intervention/ or early intervention

Therapy

Special education



(treatment or therapy or intervention).tw

Limits

Exp, animals/ not humans.sh

‘all infant birth to 23 months’) or ‘preschool child (2 to 5 years)’ or ‘child (6 to 12 years)’

Year: 2005-2011


Childhood

Year: 2005–2011



Exp, animals/ not humans.sh

‘all infant birth to 23 months’) or ‘preschool child (2 to 5 years)’ or ‘child

(6 to 12 years)’

10. Year: 2005–2011



Childhood education or grade 1 or grade 2 or kindergarten

Year: 2005–2011


Total (duplicates removed)


225

398

166

107

NB. Text words (tw) were extended using the symbol ‘$’

Article selection process


Abstracts of articles identified through the electronic database searches were examined to determine whether studies met the following key criteria:


published original research

children aged between 0–7 years with ASD (autism, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), Asperger syndrome)

studies with 10 participants or more

any study design except single subject designs with less than 10 participants

children experiencing educational interventions, not biomedical or psychodynamic interventions,
Two reviewers evaluated each abstract for inclusion or exclusion.

Searches of bibliographies, internet and grey literature sources identified a further seven research articles including six reviews.


Data abstraction process


Three reviewers assessed the full text of each included article. The staff members and clinical experts who conducted this review jointly developed the evidence tables from the abstracted data. The type of data abstracted included: study design, descriptions of the study populations (for applicability), description of the intervention, appropriateness of comparison groups and outcome data.

Assessing methodological quality of individual studies

We used the Scientific Merit Rating Scale as described in the National Standards Report (ref) which examines five critical dimensions of experimental rigour:


research design

measurement of the dependent variable

measurement of the independent variable or procedural fidelity

participant ascertainment

generalisation of results.
For each of the five dimensions of scientific merit, a score between zero and five (0–5) was assigned with 0 representing a poor score and 5 representing a strong score. The dimension scores were combined to yield a composite score that was rounded to the nearest whole number; this was called the SMRS score. The formula for combining these dimensions is as follows: Research Design (0.30) + Dependent Variable (0.25) + Participant Ascertainment (0.20) + Procedural Integrity (0.15) + Generalization (0.10).

SMRS scores of 3, 4, or 5 indicate that sufficient scientific rigor has been applied.

SMRS scores of 2 provide initial evidence about treatment effects. However, more rigorous research must be conducted to confirm these same effects would likely occur when more rigorous procedures are applied to other individuals with ASD.

SMRS scores of 0 or 1 indicate that insufficient scientific rigor has been applied to the population of individuals with ASD.

Results

Literature review

Of 896 references identified through electronic database searches, 107 references met inclusion criteria. Seventeen of the included references were in the National Autism Center Standards Report (2009) and had already been assessed for quality using the SMRS system. The remainder underwent quality assessment using the SMRS system (Appendix E). Fourteen of the references were systematic reviews which represent the highest level of evidence.




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