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主动与被动:在实施基于学校的自闭症学生服务中的策略。

Proactive versus Reactive: Strategies in the Implementation of School-based Services for Students with ASD.

机构信息

Department of Special Education, Child and Adolescent Services Research Center, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-1170, USA.

出版信息

Adm Policy Ment Health. 2022 Jul;49(4):575-586. doi: 10.1007/s10488-021-01184-w. Epub 2022 Jan 7.

Abstract

Autism spectrum disorder (ASD) is increasingly prevalent, intervention costs are high, and long-term outcomes are poor. Proactive implementation of evidence-based practices (EBPs; Steinbrenner et al., Evidence-Based Practices for Children, Youth, and Young Adults with Autism, 2020) through an assessment or planning process can lead to more effective services (Rubin et al., Admin Policy Mental Health Mental Health Serv Res 43(6), 1023-1028, 2016). The objective of this study is (a) to identify factors associated with the use of proactive versus reactive strategies for school-based services for students with ASD and (b) to examine school personnel perceptions of the use of proactive versus reactive strategies. Data were from a larger project in which 6 semi-structured focus groups were conducted to understand school personnel perceptions of how school districts implement new programs for ASD. Transcripts were coded using an iterative coding and review process. In the present study, primary themes were identified and classified as proactive or reactive. Participants reported both proactive and reactive allocation of district resources for intervention implementation. Reactive implementation was associated with litigation or due process, escalated student behavior, and non-public school placement, whereas proactive implementation was associated with ASD-specific programming, grants, personnel experience with EBPs, and prospective needs assessment. Participants perceived the reactive strategies as disadvantageous, and yet these strategies were sometimes still employed. Understanding the role of proactive and reactive strategies and the factors that influence their use could enable more effective planning for EBP use to improve both cost savings and student outcomes. This study is an important first step to explore resource allocation for school-based services for students with ASD.

摘要

自闭症谱系障碍 (ASD) 的发病率越来越高,干预成本高昂,长期预后不佳。通过评估或规划过程积极实施循证实践 (EBPs;Steinbrenner 等人,《自闭症儿童、青少年和年轻人的循证实践》,2020 年) 可以提供更有效的服务 (Rubin 等人,《行政政策心理健康与心理健康服务研究》,43(6),1023-1028,2016 年)。本研究的目的是:(a) 确定与自闭症学生学校服务中主动与被动策略使用相关的因素;(b) 检查学校人员对主动与被动策略使用的看法。数据来自一个更大的项目,该项目进行了 6 次半结构化焦点小组,以了解学校人员对学区如何实施新的自闭症计划的看法。使用迭代编码和审查过程对转录本进行编码。在本研究中,确定了主要主题,并将其分类为主动或被动。参与者报告了干预实施中地区资源的主动和被动分配。被动实施与诉讼或正当程序、学生行为升级以及非公立学校安置有关,而主动实施与自闭症特定编程、赠款、人员对 EBPs 的经验以及前瞻性需求评估有关。参与者认为被动策略不利,但有时仍会采用这些策略。了解主动和被动策略的作用以及影响其使用的因素,可以更有效地规划 EBPs 的使用,从而节省成本并改善学生的预后。本研究是探索自闭症学生学校服务资源分配的重要第一步。

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