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Page 1

Authors representing

The Australian Autism Research Collaboration

now The Australian Society for Autism Research (ASFAR)

Margot Prior
The University of Melbourne

Jacqueline M. A. Roberts
Griffith University

Sylvia Rodger
The University of Queensland

Katrina Williams

with assistance from

Susan Dodd

Dr Greta Ridley

Rebecca Sutherland


This report was funded by the Australian Government
Department of Families, Housing, Community Services and

Indigenous Affairs (FaHCSIA).

Page 2


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

This review was prepared for the Australian Government Department of Families,
Housing, Community Services and Indigenous Affairs (FaHCSIA), by Professor Margot
Prior, Professor Jacqueline Roberts, Professor Sylvia Rodger and Professor Katrina
Williams on behalf of the Australian Autism Research Collaboration (AARC), with
assistance from Dr Greta Ridle y, Rebecca Sutherland and Susan Dodd.

This review is a follow up and extension of Roberts J. M. A. and Prior M. A, Review of the
Research to Identify the Most Effective Models of Practice in Early Intervention for Children with
Autism Spectrum Disorders, (2006) Australian Government Department of Health and Ageing.

The authors would like to acknowledge the contribution of the advisory group for this review: Dr

Natalie Silove, Professor Valsamma Eapen, Dr Angelika Anderson and Mrs Judy Brewer Fischer.

We would also like to thank the organisations across Australia for completing surveys and

providing information: Australian Advisory Board on Autism Spectrum Disorders (AAB), Autism

Advisors, Parenting Research Centre (PRC), Speech Pathology Australia (SPA), Occupational

Therapy Australia, Australian Psychological Society and The Royal Australian College of

Physicians, Division of Paediatrics and Child Health.

The Commonwealth of Australia accepts no responsibility for the accuracy or completeness of

any material contained in this report. Additionally, the Commonwealth disclaims all liability to any

person in respect of anything, and the consequences of anything, done or omitted to be done by

any such person in reliance, whether wholly or partially, upon any information contained in this


Any views and recommendations of third parties contained in this report do not necessarily reflect

the views of the Commonwealth, or indicate a commitment to a particular course of action.

Suggested Format for Citation
Prior, M., Roberts, J. M.A., Rodger, S., Williams, K. & Sutherland, R. (2011). A review of the
research to identify the most effective models of practice in early intervention of children with
autism spectrum disorders. Australian Government Department of Families, Housing, Community
Services and Indigenous Affairs, Australia.

Page 85


The initial requirement that providers form a multidisciplinary collaboration, in line with

recommended principles of good practice, was relaxed in 2010 because of the difficulty this

presented to families in remote/ rural areas of Australia. Feedback suggests this change has

not been helpful and re-confirms the importance of a multidisciplinary approach. Therefore

we recommend that the requirement for providers to be multidisciplinary be restated with

possible exceptions for isolated families in remote rural areas on a case by case basis

Particular questions have been raised concerning physiotherapy, and music therapy.

Physiotherapy does not have an evidence base for autism. A special case may be made for

individuals with Rett’s Disorder requiring physiotherapy. Music Therapy has some evidence

to suggest it may be effective as a component of a program only (see page 43). We support

the latter only if it is part of an eligible multi-disciplinary EI approach.


and expertise in autism, along with provision of ongoing training

The lack of experience and expertise among some service providers is a recurrent theme in

stakeholder feedback. In line with principles of good practice, staff personnel delivering the

programs need to have demonstrated substantial experience and expertise in autism, plus

engagement in ongoing training and support/supervision. Changes in staff skill and

experience profile subsequent to approval are to be reported on in the revised monitoring and

evaluation process.

Employment of non-qualified staff was also noted as a stakeholder concern.

6. Revisions pertaining to evaluating provider applications

6(a) Decision making on provider panel approvals

Submitted applications must conform to published guidelines, and must clearly demonstrate

how conformity to guidelines will be shown throughout the intervention, and how this will be


Criteria need to be clear for panel provider applicants that intervention must have valid

scientific evidence (Type 1 and/or Type 2) and must meet principles of good practice

indicating that this treatment will make a difference to autism in cognitive, adaptive, social,

behavioural, and communicative development etc., as listed in modified current sections in

FaHCSIA application document and seen in 5, above, in this section.

Full details of all providers regarding the status, professional experience, and competence in

the autism field required. (Note that both the intervention program and the provider(s) have to

be scrutinised.)

Full details of the program offered including all personnel, all components of intervention,

time frame, setting, fees/charges, multidisciplinary input, and details of adherence to clinical

guidelines should be provided.

We recommend that independent senior consultants with expertise and experience in autism

should work with FaHCSIA to provide advice on unclear or doubtful applications.

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6(b) We recommend changes to the application form as follows:

Revision of criteria relating to the goals of intervention is required. We recommend stating the

required goals of “documented gains in development in social, communicative, cognitive,

adaptive, play, self-care areas, and in improvement in problem behaviour areas”.

Providers should incorporate information on what measures will be used to demonstrate

change within and across those core domains, and how improvement will be measured and

quantified for individual children.

6(c) Provision of consistent advice to potential service providers seeking to join the


Consistent responses are important for potential providers seeking information, to draw

attention to the methods and rationale leading to approval standards for stakeholders who

contact the department.

In problematic or unclear cases, the submission could be referred to experts for advice on

treatment effectiveness.

7. Roles of Autism Advisors

An expanded role for Autism Advisors including service brokerage and case management

assistance for families was a dominant theme in the feedback data.

This could involve further guidance for some families to help them to complete paperwork

and to assist them to best utilise their funding allocations.

8. A system of ongoing monitoring and evaluation of services

Stakeholder feedback has indicated a need for more supervision and ongoing monitoring and

evaluation of service providers, suggesting strongly that there need to be processes in place

to ensure that services are being delivered as originally proposed.

Many respondents considered that once treatment has been funded, there is not sufficient

follow up surveillance to ensure that interventions are proceeding as proposed, that approved

provider staff have remained consistently engaged, that the program is multidisciplinary, and

that the progress of the children in the domains specified for attention have been assessed to

monitor improvements.

We recommend ongoing monitoring and reporting from providers covering the above noted

principles, along with submission of regular reports to FaHCSIA. This could be monitored in

vivo by a person on the ground, or via a questionnaire, or parent survey focused on the

assessment of change in the domains targeted for improved adjustment.

We recommend the monitoring and follow-up of provider programs to ensure fidelity of

treatment and to check any changes to staff or programs from the original granting of eligible

provider status.

Applications to include reference to research evidence, direct evidence of intent to cover

measurable outcomes, direct evidence of relevance to ASD and application of principles

of good practice in ASD EI.

Page 169


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