Statewide Interagency Collaboration to Support Evidence-based Practice Scale Up: The California Autism Professional Training and Information Network (CAPTAIN)

Exploring Organizational Differences in Perceptions of Implementation Climate and Leadership in Schools: A Mixed Methods Study of Autism EBP Implementation

Public programs have been charged with implementation of evidence-based practices (EBPs) to improve outcomes for children with autism. However, research indicates that scale-up of EBPs poses challenges. This study identifies perceived variables linked to effective statewide scale-up of EBPs in special education by exploring implementation climate and leadership across special education organization types (e.g., schools, districts, and regional consortiums). A simultaneous QUAL + QUAN mixed methods design was employed with the primary function of convergence and triangulation. Data included focus groups with 30 special educators and a statewide survey completed by 656 school personnel. In general, perceptions of implementation climate and leadership are weak in special education organizations with strengths at regional levels focused on special education and increased challenges at the school and district levels. Implications for practice and future research are identified.

Practice-driven research for statewide scale up: Implementation outcomes of the California Autism Professional Training and Information Network

Scaling up the use of evidence-based practice (EBP) for autism across service sectors and regions has presented a considerable challenge indicating a clear need for continued development. The California Autism Professional Training and Information Network (CAPTAIN) integrates implementation drivers into specific procedures and methodology as an implementation strategy to support statewide scale up. The current study was designed to evaluate the impact of CAPTAIN on provider-level outcomes including attitude toward, and knowledge, fidelity and use of autism EBPs, and overall classroom quality. Overall, results indicated variability across measures, with some significant differences between CAPTAIN-trained and non-CAPTAIN-trained providers. CAPTAIN-trained providers reported more openness to EBP. Significantly more CAPTAIN-trained direct service providers reported collecting fidelity of implementation data (χ2(2, N = 1515) = 10.95, p = 0.004), collecting student data (χ2(2, N = 1509) = 14.19, p = 0.001), and reported using their primary EBP with “most or all students” (χ2(2, N = 1514) = 11.41, p = 0.003) than providers not trained by CAPTAIN. In summary, these preliminary findings show promise for the efficacy of the CAPTAIN model to increase dissemination and implementation of EBP at the classroom level.

Lay abstract

Supporting use of evidence-based practice in public service programs for autistic individuals is critical. The California Autism Professional Training and Information Network (CAPTAIN) brings together best practices from intervention and implementation research to support scale up of autism services. The current study was designed to evaluate the impact of CAPTAIN on provider-level outcomes including attitude toward, knowledge, fidelity, and use of autism EBPs and overall classroom quality. Overall, results indicated variability across measures, with some significant differences between CAPTAIN-trained and non-CAPTAIN-trained providers. These preliminary findings show promise for the efficacy of the CAPTAIN model to increase dissemination and implementation of EBP at the classroom level.

Producing Child-Centered Interventions: Social Network Factors Related to the Quality of Professional Development for Teachers of Autistic Students

Autistic students benefit from child-centered goals that align with evidence-based practices (EBPs) that meet their individualized needs, however, most teachers are not trained in how to implement autism-specific EBPs. The challenges do not lie with teachers alone. Professional development (PD) providers, such as district or regional autism experts who train and coach teachers on how to implement autism-specific EBPs, face barriers accessing the needed supports to conduct high-quality PD and lack experience with individualizing their methods for training and coaching teachers. When PD providers have networks of professional support, they can potentially gain access to resources to provide successful individualized coaching for teachers. No research has measured the impact of the social networks of PD providers on their performance as coaches in classrooms for teachers of autistic students. To test the hypothesis that social network resources can impact the performance of PD providers who coach teachers how to use EBPs for their autistic students, we conducted social network analysis with PD providers. Findings suggest that network factors were associated with the self-reported performance for PD providers. PD providers who have more people in their networks who were autism EBP experts, as well as more people in their networks who supported them with how to individualize their PD efforts to specific teachers or districts, had higher performance as teacher coaches. We discuss future research about how to support network development for PD providers and policy implications.

A systematic review of school-based social skills interventions and observed social outcomes for students with autism spectrum disorder in inclusive settings

LAY ABSTRACT

Most social skills interventions for students with autism spectrum disorder have been conducted in clinic-based settings. While students with autism spectrum disorder are able to acquire new skills, the generalization of these skills to authentic social environments, like school, is more difficult. To address this issue, there is an increase in research examining the implementation of social skills interventions for students with autism spectrum disorder who are educated in inclusive school settings. This review included 18 research studies that focused on school-based social interventions for students with autism spectrum disorder who were educated in inclusive school settings. Typically developing peers also participated in the interventions to varying degrees. Secondary aims explored naturalistic observation instruments and subsequent social outcomes used to record the social behaviors of students with autism spectrum disorder at school. Social intervention components varied across studies, but all studies reported improvement in the targeted social behaviors of students with autism spectrum disorder. There were many similarities in the ways in which researchers measured and defined social outcomes. Observation protocols were able to measure change in the social behaviors of students with autism spectrum disorder across a wide age range. The recognition of evidence-based practices used in school-based social skills interventions, as well as the identification of observation protocols and salient social outcomes, provides a starting point for school practitioners to consider as they move to implement social skills interventions for students with autism spectrum disorder into inclusive school settings.

Forms and functions of bridging factors: specifying the dynamic links between outer and inner contexts during implementation and sustainment

BACKGROUND

Bridging factors are relational ties, formal arrangements, and processes that connect outer system and inner organizational contexts. They may be critical drivers of evidence-based practice (EBP) implementation and sustainment. Yet, the complex interplay between outer and inner contexts is often not considered. Bridging factors were recently defined in the updated Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Further identification and specification of this construct will advance implementation models, measures, and methods. Our goal is to advance bridging factor research by identifying relevant dimensions and exemplifying these dimensions through illustrative case studies.

METHODS

We used a multiple case study design. Each case (n = 10) represented different contexts, EBPs, and bridging factor types. Inclusion criteria were the presence of clearly distinguishable outer and inner contexts, identifiable bridging factor, sufficient information to describe how the bridging factor affected implementation, and variation from other cases. We used an iterative qualitative inquiry process to develop and refine a list of dimensions. Case data were entered into a matrix. Dimensions comprised the rows and case details comprised the columns. After a review of all cases, we collectively considered and independently coded each dimension as function or form.

RESULTS

We drew upon the concepts of functions and forms, a distinction originally proposed in the complex health intervention literature. Function dimensions help define the bridging factor and illustrate its purpose as it relates to EBP implementation. Form dimensions describe the specific structures and activities that illustrate why and how the bridging factor has been customized to a local implementation experience. Function dimensions can help researchers and practitioners identify the presence and purpose of bridging factors, whereas form dimensions can help us understand how the bridging factor may be designed or modified to support EBP implementation in a specific context. We propose five function and three form bridging factor dimensions.

CONCLUSIONS

Bridging factors are described in many implementation models and studies, but without explicit reference or investigation. Bridging factors are an understudied and critical construct that requires further attention to facilitate implementation research and practice. We present specific recommendations for a bridging factors research agenda.