scholarly journals Service use by youth with autism within a system-driven implementation of evidence-based practices in children’s mental health services

Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2094-2103
Author(s):  
Nicole A Stadnick ◽  
Anna S Lau ◽  
Kelsey S Dickson ◽  
Keri Pesanti ◽  
Debbie Innes-Gomberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Health Services ◽  
Service Use ◽  
Public Mental Health ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Mental Health Systems ◽  
Evidence Based Practices

Public mental health systems play an important role in caring for youth with autism spectrum disorder. Like other dually diagnosed populations, youth with autism spectrum disorder may receive services in the context of evidence-based practice implementation efforts within public mental health systems. Little is known about service use patterns within the context of system-driven implementations efforts for this population. This case–control study examined mental health service patterns of 2537 youth with autism spectrum disorder compared to 2537 matched peers receiving care in the Los Angeles County Department of Mental Health, the largest public mental health department in the United States, within the context of a system-driven implementation of multiple evidence-based practices. Although not the primary target of this implementation effort, youth with autism spectrum disorder were served when they met criteria for the services based on their presenting mental health symptoms. Comparative analyses using administrative claims data were conducted to examine differences in mental health utilization patterns and clinical characteristics. Findings revealed significant differences in the volume and duration of mental health services as well as differences in the service type and evidence-based practice delivered between youth with and without autism spectrum disorder. Results provide direction targeting implementation efforts for youth with autism spectrum disorder within a public mental health system care reform.

Evidence-Based Practices for Music Instruction and Assessment for PreK–12 Students with Autism Spectrum Disorder

2019 ◽  
pp. 788-826
Author(s):  
Robyn Swanson
Keyword(s):  
Autism Spectrum Disorder ◽  
Special Education ◽  
Students With Disabilities ◽  
Universal Design For Learning ◽  
Autism Spectrum ◽  
Music Educators ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Students With Autism

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).

Teaching Social Scripts to Improve Social Communication for Students With Autism Spectrum Disorder

2021 ◽  
pp. 004005992110220
Author(s):  
Gretchen Scheibel ◽  
Zijie Ma ◽  
Jason C. Travers
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Communication ◽  
Challenging Behaviors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Academic Difficulties ◽  
Evidence Based Practices ◽  
Social Scripts ◽  
Students With Autism

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.

Characterizing therapist delivery of evidence-based intervention strategies in publicly funded mental health services for children with autism spectrum disorder: Differentiating practice patterns in usual care and AIM HI delivery

Autism ◽  
2021 ◽  
pp. 136236132110016
Author(s):  
Eliana Hurwich-Reiss ◽  
Colby Chlebowski ◽  
Teresa Lind ◽  
Kassandra Martinez ◽  
Karin M Best ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Usual Care ◽  
Teaching Strategies ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Intervention Strategies ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Active Teaching

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.

scholarly journals Renaming schizophrenia: 5 × 5

2018 ◽  
Vol 28 (03) ◽  
pp. 254-257 ◽  
Author(s):  
Sinan Guloksuz ◽  
Jim van Os
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Well Being ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Long Run ◽  
The Social ◽  
Technical Features ◽  
In The Beginning

AbstractThere had been a long way to go before we felt comfortable about even discussing the issues revolving around the concept of ‘schizophrenia’, let alone reckoning on mere semantic revision. In this editorial, we aim to extend our discussion on the reasons behind the slow death of the concept of ‘schizophrenia’ and the benefits of changing the name and embracing a spectrum approach with an umbrella psychosis spectrum disorder (PSD) category (similar to autism spectrum disorder) that goes further than a mere semantic revision. We attempted to cover the topic of the renaming by providing five most pertinent points categorised under five domains: reasons, signals, challenges, promises and steps for the change. Admittedly, even a modest revision, such as classifying all psychotic disorder categories under an umbrella category of PSD, and abolishing the term schizophrenia requires careful deliberation and some effort in the beginning, but the revision is well worth the effort considering the benefits in the long run. Renaming a particular form of mental suffering should be accompanied by a broader debate of the entire diagnosis-evidence-based-practice (EBP)-symptom-reduction model as the normative factor driving the content and organisation of mental health services that may be detached from patients’ needs and reality, overlooks the trans-syndromal structure of mental difficulties, appraises the significance of the technical features over the relational and ritual components of care, and underestimates the lack of EBP group-to-individual generalisability. Individuals may make great strides in attaining well-being by accommodating to living with mental vulnerabilities through building resilience in the social and existential domains. Changing the name and the concept of ‘schizophrenia’, which goes beyond a mere semantic revision, may become the first step that allows catalysation of the process of modernising psychiatric science and services worldwide.

scholarly journals Emergent life events in the delivery of a caregiver-mediated evidence-based intervention for children with autism spectrum disorder in publicly funded mental health services

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1286-1299
Author(s):  
Teresa Lind ◽  
Anna S Lau ◽  
Christopher Gomez ◽  
Adriana Rodriguez ◽  
Karen Guan ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Life Events ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Health Intervention ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Mental Health Intervention ◽  
Therapy Sessions

Mental health clinicians often report significant challenges when delivering evidence-based interventions in community settings, particularly when unexpected client stressors (or emergent life events) interfere with the therapy process. The current study sought to extend the study of emergent life events to children with autism spectrum disorder by examining the occurrence and impact of emergent life events in the context of a collaborative, caregiver-mediated intervention for reducing challenging behaviors in children with autism spectrum disorder, An Individualized Mental Health Intervention for ASD (AIM HI). Participants included 38 child–clinician dyads enrolled in a community effectiveness trial of An Individualized Mental Health Intervention for ASD. Video recordings of 100 therapy sessions were coded for caregiver-reported emergent life events and clinician adherence to the Individualized Mental Health Intervention for ASD protocol. Results indicated that mild to severe emergent life events were reported in 36% of sessions, and were reported for 58% of children at some point during treatment. Greater number of child comorbid diagnoses and less clinician experience were both significantly associated with a higher number of caregiver-reported emergent life events. There was no significant link between emergent life events and clinician adherence to the Individualized Mental Health Intervention for ASD protocol. Findings offer implications for evidence-based intervention implementation, particularly the importance of incorporating clinician training in addressing complex presentations and crises in the context of evidence-based interventions. Lay abstract Mental health clinicians often report significant challenges when delivering evidence-based interventions (EBI) in community settings, particularly when unexpected client stressors (or emergent life events; ELEs) interfere with the therapy process. The current study sought to extend the study of ELEs to children with Autism Spectrum Disorder (ASD) by examining the occurrence and impact of ELEs in the context of a collaborative, caregiver-mediated intervention for reducing challenging behaviors in children with ASD. This intervention was An Individualized Mental Health Intervention for children with ASD (referred to as AIM HI). Participants included 38 clinicians and child clients who were enrolled in a community effectiveness trial of AIM HI. Video recordings of 100 therapy sessions were coded for caregiver-reported ELEs and also how well clinicians adhered to the AIM HI protocol. Results indicated that mild to severe ELEs were reported in 36% of therapy sessions, and were reported for 58% of children at some point during the intervention. Children who had a greater number of diagnoses (in addition to the autism diagnosis) tended to have more ELEs. In addition, clinicians with less years of experience tended to have sessions with more ELEs. There was no significant link between ELEs and how well clinicians adhered to the AIM HI protocol. Findings offer implications for the implementation of EBI, particularly the importance of incorporating clinician training in addressing complex presentations and crises in the context of EBIs.

scholarly journals Does implementing a new intervention disrupt use of existing evidence-based autism interventions?

Autism ◽  
2020 ◽  
Vol 24 (7) ◽  
pp. 1713-1725 ◽  
Author(s):  
Melanie Pellecchia ◽  
Rinad S Beidas ◽  
Gwendolyn Lawson ◽  
Nathaniel J Williams ◽  
Max Seidman ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Child Outcomes ◽  
Qualitative Interviews ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Computer Assisted ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
School Year ◽  
One To One

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.

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