scholarly journals Changing Developmental Trajectories of Toddlers With Autism Spectrum Disorder: Strategies for Bridging Research to Community Practice

2018 ◽  
Vol 61 (11) ◽  
pp. 2615-2628 ◽  
Author(s):  
Amy M. Wetherby ◽  
Juliann Woods ◽  
Whitney Guthrie ◽  
Abigail Delehanty ◽  
Jennifer A. Brown ◽  
...  

PurposeThe need for community-viable, evidence-based intervention strategies for toddlers with autism spectrum disorder (ASD) is a national priority. The purpose of this research forum article is to identify gaps in intervention research and needs in community practice for toddlers with ASD, incorporate published findings from a randomized controlled trial (RCT) of the Early Social Interaction (ESI) model (Wetherby et al., 2014) to illustrate community-based intervention, report new findings on child active engagement from the ESI RCT, and offer solutions to bridge the research-to-community practice gap.MethodResearch findings were reviewed to identify gaps in the evidence base for toddlers with ASD. Published and new findings from the multisite ESI RCT compared the effects of two different ESI conditions for 82 toddlers with ASD to teach parents how to support active engagement in natural environments.ResultsThe RCT of the ESI model was the only parent-implemented intervention that reported differential treatment effects on standardized measures of child outcomes, including social communication, developmental level, and adaptive behavior. A new measure of active engagement in the natural environment was found to be sensitive to change in 3 months for young toddlers with ASD and to predict outcomes on the standardized measures of child outcomes. Strategies for utilizing the Autism Navigator collection of web-based courses and tools using extensive video footage for families and professional development are offered for scaling up in community settings to change developmental trajectories of toddlers with ASD.ConclusionsCurrent health care and education systems are challenged to provide intervention of adequate intensity for toddlers with ASD. The use of innovative technology can increase acceleration of access to evidence-based early intervention for toddlers with ASD that addresses health disparities, enables immediate response as soon as ASD is suspected, and rapidly bridges the research-to-practice gap.Presentation Videohttps://doi.org/10.23641/asha.7297817

Autism ◽  
2021 ◽  
pp. 136236132110331
Author(s):  
Weiwen Zeng ◽  
Sandy Magaña ◽  
Kristina Lopez ◽  
Yue Xu ◽  
J Marisol Marroquín

This study examined maintenance of treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder using a behavior maintenance framework. In a two-site randomized waitlist-control study, we compared differences in parent and child outcomes across three timepoints using linear mixed models to determine whether outcomes observed at 4 months after baseline (Time 2) were maintained for an additional 4-month period (Time 3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results showed that at Time 3, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. Site-specific treatment differences were found in outcomes such as parent-reported empowerment and child social communication impairments. Findings suggest that the intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation. Lay abstract Background: We conducted a follow-up investigation of a two-site randomized controlled trial in the United States. We examined whether the treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder were maintained over time. Methods: Using linear mixed models, we compared differences in parent and child outcomes across three timepoints: baseline, 4 months after baseline (Time 2), and 8 months after baseline (T3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder. Results: After intervention at both Time 2 and Time 3 in both sites, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. We also found that there were treatment differences across the two study sites in several outcomes. Implications: The intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation.


Autism ◽  
2020 ◽  
Vol 24 (7) ◽  
pp. 1713-1725 ◽  
Author(s):  
Melanie Pellecchia ◽  
Rinad S Beidas ◽  
Gwendolyn Lawson ◽  
Nathaniel J Williams ◽  
Max Seidman ◽  
...  

This study examines how the introduction of TeachTown:Basics, a computer-assisted intervention for students with autism spectrum disorder, influenced teachers’ use of other evidence-based practices. In a randomized controlled trial that enrolled 73 teachers nested within 58 schools, we used three-level hierarchical linear models to evaluate changes in teachers’ use of evidence-based practices across the school year for those who received TeachTown:Basics versus those assigned to control. Both groups received training and implementation support to deliver three well-established evidence-based practices for autism spectrum disorder. Qualitative interviews were conducted with 25 teachers who used TeachTown:Basics to better understand their experience. Compared with teachers in the control group, teachers in the TeachTown:Basics group reported significantly less growth over the 9-month period in their use of evidence-based practices that require one-to-one instruction ( ps < 0.05), but no difference in their reported use of evidence-based practices that do not involve one-to-one instruction ( p = 0.637). Qualitative interviews indicated that teachers viewed TeachTown:Basics as an effective substitute for one-to-one instruction because it was less burdensome, despite the lack of support for TeachTown:Basics’ effectiveness. Before introducing new practices, education leaders should carefully consider both evidence of effectiveness and the potential impact on the use of other evidence-based practices. Lay abstract Interventions for children with autism spectrum disorder are complex and often are not implemented successfully within schools. When new practices are introduced in schools, they often are layered on top of existing practices, with little attention paid to how introducing new practices affects the use of existing practices. This study evaluated how introducing a computer-assisted intervention, called TeachTown:Basics, affected the use of other evidence-based practices in autism support classrooms. We compared how often teachers reported using a set of evidence-based practices in classrooms that either had access to TeachTown:Basics or did not have the program. We found that teachers who had access to the computer-assisted intervention reported using the other evidence-based practices less often as the school year progressed. Teachers also reported that they liked the computer-assisted intervention, found it easy to use, and that it helped overcome challenges to implementing other evidence-based practices. This is important because the computer-assisted intervention did not improve child outcomes in a previous study and indicates that teachers may use interventions that are appealing and easier to implement, even when they do not have evidence to support their effectiveness. These findings support the idea of interventions’ complexity and how well the intervention fits within the classroom affect how teachers use it and highlight the need to develop school-based interventions that both appeal to the practitioner and improve child outcomes.


Author(s):  
Robin L. Gabriels ◽  
Julia Barnes

There are well-documented gaps between evidence-based interventions (EBIs) developed and tested in controlled research settings and those delivered in routine, community-based care. The field of implementation science has developed in response to identified gaps to study methods to promote the uptake and sustainment of EBIs in community care. Community mental health (MH) services play an important role in caring for individuals with autism spectrum disorder (ASD) across the lifespan who have co-occurring psychiatric conditions. This chapter summarizes over a decade of community-engaged research aimed to (a) characterize MH services for children with ASD, including the training needs of therapists and clinical needs of children with ASD receiving care; (b) develop the AIM HI (An Individualized Mental Health Intervention for ASD) intervention, a package of well-established, evidence-based behavioral strategies designed to reduce challenging behaviors in children served in MH service settings; (c) test the impact of training therapists to deliver AIM HI on child outcomes; (d) identify potential influences on implementation; and (e) test the impact of different implementation strategies to enhance therapist delivery of AIM HI. The chapter includes directions for future research including applying the AIM HI development model to older individuals with ASD and other community service systems and integrating implementation science approaches earlier in the pipeline of research-to-practice translation.


Author(s):  
Robyn Swanson

This chapter addresses the use of evidence-based practices (EBPs) by special education practitioners in instruction and assessment while providing music educators guidance toward implementing these practices in instruction and assessment for students with autism spectrum disorder (ASD) within universal design for learning (UDL) inclusive classrooms. Included are behavioral characteristics of students with ASD that music educators need be cognizant of in inclusive settings; federal education laws and policies that have provided students with disabilities rights to a quality education; and selected special education EBP and accommodations deemed as viable interventions for teaching and assessing PreK-12 standards-based music curriculum for students with ASD. Music educators may determine the PreK-12 music assessments aligned to appropriate EBP and accommodations for students with ASD are beneficial resources when designing and implementing curriculum, instruction, and assessment linked to the 2014 National Core Arts (Music) Standards (NCAS) with supporting Model Cornerstone Assessments (MCAs).


2021 ◽  
pp. 004005992110220
Author(s):  
Gretchen Scheibel ◽  
Zijie Ma ◽  
Jason C. Travers

Students with Autism Spectrum Disorder are likely to demonstrate social impairments that contribute to challenging behaviors and academic difficulties. As a result, the task of improving social communication skills is a critical component to any educational program for this population. Scripting provides an evidence-based and versatile option for improving social communication, yielding valuable results while requiring limited time and resource preparation from educators. In this article, we present step by step guidance to support practitioners in using scripting interventions. Considerations are discussed for adapting this intervention to meet the needs of students across the autism spectrum and links to resources for strengthening implementation and including other evidence-based practices.


Autism ◽  
2021 ◽  
pp. 136236132110016
Author(s):  
Eliana Hurwich-Reiss ◽  
Colby Chlebowski ◽  
Teresa Lind ◽  
Kassandra Martinez ◽  
Karin M Best ◽  
...  

This study identified patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder within publicly funded mental health services and compared patterns for therapists delivering usual care to those trained in AIM HI (“An Individualized Mental Health Intervention for ASD”). Data were drawn from a randomized community effectiveness trial and included a subsample of 159 therapists (86% female) providing outpatient or school-based psychotherapy. Therapist strategies were measured via observational coding of psychotherapy session recordings. Exploratory factor analysis used to examine patterns of strategy delivery showed that among therapists in the usual care condition, strategies loaded onto the single factor, General Strategies, whereas for therapists in the AIM HI training condition, strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies. Among usual care therapists, General Strategies were associated with an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were associated with reductions in child behavior problems over 18 months. Results support the effectiveness of training therapists in evidence-based interventions to increase the specificity of strategies delivered to children with autism spectrum disorder served in publicly funded mental health settings. Findings also support the use of active teaching strategies in reducing challenging behaviors. Lay abstract This study was conducted to identify patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder receiving publicly funded mental health services and compare strategy use for therapists delivering usual care to those trained to deliver AIM HI (“An Individualized Mental Health Intervention for ASD”), an intervention designed to reduce challenging behaviors in children with autism spectrum disorder. For therapists trained in AIM HI, intervention strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies, while strategies used by usual care therapists grouped onto a broader single factor, General Strategies. Among usual care therapists, General Strategies were related to an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were related with reductions in child behavior problems over 18 months. Findings support the use of active teaching strategies in reducing challenging behaviors in children with autism spectrum disorder and provide support for the effectiveness of training therapists in evidence-based interventions to promote the delivery of targeted, specific intervention strategies to children with autism spectrum disorder in mental health services.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ludger Tebartz van Elst ◽  
Thomas Fangmeier ◽  
Ulrich Max Schaller ◽  
Oliver Hennig ◽  
Meinhard Kieser ◽  
...  

Abstract Background Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition with a prevalence rate above 1%, characterized by deficits in social communication and interaction; restrictive, repetitive patterns of behavior, interests, or activities; and a preference for sameness and routines. The majority of adult ASD patients suffer from comorbid conditions such as depression and anxiety. Therapy options for adult ASD patients are lacking, with presently no available evidence-based interventions in Germany. Recently, two interventions to improve social responsiveness have been published. FASTER (“Freiburger Asperger-Spezifische Therapie für ERwachsene” = Freiburg Asperger-specific therapy for adults) is a manualized group psychotherapy program including three modules on psychoeducation, stress regulation management, and non-verbal and verbal social communication training with videotaped tasks. SCOTT&EVA (“Social Cognition Training Tool”, and its enhancement “Emotionen Verstehen und Ausdruecken” = understanding and expressing emotions) is a computer-based training program to enhance social cognition including video and audio material of emotional expressions and complex real-life social situations. Initial studies for both programs have shown good feasibility and efficacy. Methods Three hundred sixty adult participants with an autism spectrum disorder (ASD) will take part in a randomized controlled three-armed multi-center trial to prove the efficacy of manualized group psychotherapy and a manualized computer-based training program. Both interventions will be compared with a treatment as usual (TAU) group, aiming to establish evidence-based psychotherapy approaches for adult individuals with ASD. The primary outcome is evaluated by parents, spouses, or others who have sufficient insight into the respective participant’s social communication and interaction, and will be measured with the Social Responsiveness Scale. First, each of both interventions will be compared to TAU. If at least one of the differences is significant, both interventions will be compared against each other. The primary outcome will be measured at baseline (T0) and 4 months after baseline (T1). Discussion The trial is the first to validate psychiatric therapeutic and training interventions for adult ASD patients in Germany. A trial is needed because the prevalence of ASD in adulthood without intellectual disability is high, and no evidence-based intervention can be offered in Germany. Trial registration German Clinical Trial Register DRKS00017817. Registered on 20 April 2020.


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