Department of Speech and Hearing Sciences, University of Washington, 1417 NE 42nd St, Seattle, WA, 98105, USA.
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA.
Implement Sci. 2019 Mar 13;14(1):29. doi: 10.1186/s13012-019-0877-3.
Children with autism receive most of their intervention services in public schools, but implementation of evidence-based practices (EBPs) for autism varies. Studies suggest that individual (attitudes) and organizational characteristics (implementation leadership and climate) may influence providers' use of EBPs, but research is relatively limited in this area. This study examined individual and organizational factors associated with implementation of three EBPs-discrete trial training, pivotal response training, and visual schedules-for children with autism in special education classrooms in public elementary schools.
Participants included 67 autism support teachers and 85 other classroom staff from 52 public elementary schools in the northeastern United States. Participants reported their attitudes toward EBPs (e.g., intuitive appeal, willingness if required, openness, and divergence), implementation leadership and climate of their school, and the frequency with which they deliver each of three EBPs. Linear regression was used to estimate the association of attitudes about EBPs with organizational characteristics and intensity of EBP use. Demographic covariates with a bivariate association with EBP use significant at p < .20 were entered into the adjusted models.
There were significant findings for only one EBP, discrete trial training. Teachers who reported higher perceived divergence (perceived difference of usual practice with academically developed or research-based practices) between EBPs and current practices used less discrete trial training (f = .18), and teachers who reported higher appeal (willingness to adopt EBPs given their intuitive appeal) of EBPs used more discrete trial training (f = .22). No organizational factors were significantly associated with implementation with any of the three EBPs.
Attitudes toward EBPs may affect teachers' decisions to use EBPs; however, implementation leadership and climate did not predict EBP use. Future implementation efforts ought to consider the type of EBP and its fit within the context in terms of the EBP's similarities to and differences from existing practices and programs in the setting. Implementation strategies that target individual attitudes about EBPs may be warranted in public schools.
自闭症儿童在公立学校接受大部分干预服务，但自闭症的循证实践（EBP）的实施情况各不相同。研究表明，个人（态度）和组织特征（实施领导力和氛围）可能会影响提供者对 EBP 的使用，但该领域的研究相对有限。本研究考察了与在公立小学特殊教育教室中自闭症儿童实施三种 EBP（离散试训、关键反应训练和视觉时间表）相关的个人和组织因素。
参与者包括来自美国东北部 52 所公立小学的 67 名自闭症支持教师和 85 名其他课堂工作人员。参与者报告了他们对 EBP 的态度（例如，直觉吸引力、需要时的意愿、开放性和分歧）、学校的实施领导力和氛围，以及他们实施三种 EBP 的频率。线性回归用于估计 EBP 态度与组织特征和 EBP 使用强度的关系。与 EBP 使用有显著双变量关联的人口统计学协变量（p<.20）被纳入调整后的模型。
只有一种 EBP（离散试训）有显著发现。报告 EBP 与当前实践之间感知分歧（感知 EBP 与学术开发或基于研究的实践之间的差异）较高的教师使用离散试训较少（f=.18），而报告 EBP 吸引力较高（考虑到其直觉吸引力而愿意采用 EBP）的教师使用离散试训较多（f=.22）。没有组织因素与三种 EBP 中的任何一种实施显著相关。
对 EBP 的态度可能会影响教师使用 EBP 的决策；然而，实施领导力和氛围并不能预测 EBP 的使用。未来的实施工作应该考虑 EBP 的类型及其在设置中与现有实践和计划的相似性和差异性方面的适用性。在公立学校中，针对教师对 EBP 的个人态度的实施策略可能是合理的。
