Early Intervention Service Providers Knowledge and Use of Intervention Practices

Background: Recent research has made significant progress in the identification and description of evidence-based practices (EBP) for working with children with Autism Spectrum Disorders (ASD) (e.g., Wong et al., 2013). However, a “research to practice gap” is widely acknowledged (e.g., Cook, Cook, & Landrum, 2013). For example, unsupported treatments (e.g., sensory integration therapy, vitamin supplements, and elimination diets) continue to be reported to be used frequently in surveys of both parents (for a review see Carlon, Stephenson, & Carter, 2014) and professionals (e.g., Kadar et al., 2012). Little is known however, about what intervention practices are used in community-based early intervention services for children with ASD, or what factors may facilitate or hinder the uptake of EBPs in such services. This information is vital for improving outcomes for all children with ASD.     

Objectives: The present study aimed to explore the level of knowledge and use of EBP and links to organisational culture, individual attitude, and demographic variables in a state-wide community-based ASD early intervention service in Australia using a questionnaire design. 

Methods: Participants included 99 staff at an ASD early intervention service including professional (teachers and therapists) and paraprofessional (learning facilitators) staff across both rural/regional and metropolitan areas. Questionnaires measures included the Organisational Culture Questionnaire (Russell et al., 2010); the Evidence-based Attitudes Scales (Aarons, 2004), ratings of knowledge and use of a range of intervention practices (EBP, promising, and unsupported) drawn from the literature (e.g., Odom et al., 2010), and demographics.

Results: Participants reported a moderate level of organisational culture supporting the use of EBP in terms of available resources, culture, and supervisor support. Greater perception of a supportive organisational culture was linked to greater knowledge and greater use of EBP. Participants likewise reported a moderate level of attitudinal support towards the use of EBP in terms of willingness to use EBP if they were a requirement, appealed, and their openness to using EBP. Only openness was linked to knowledge and use. Knowledge and use of EBP were also linked to each other with greater knowledge linked to higher self-reported use. Demographic differences were found in use of EBP including that professionals reported using EBP more than paraprofessionals. Additionally, participants in the metropolitan area reported greater use than rural/regional participants.

Conclusions: This study adds to our knowledge and understanding about factors related to knowledge and use of EBPs in community settings. Results suggest a need for organisations to address staff knowledge and use of EBPs, particularly for paraprofessionals and for staff working in regional/remote areas. These results also suggest that organisational culture and individual attitudes may also affect uptake. Further research using direct observation could extend this research by investigating whether practices are implemented with fidelity and how they align with self-report. Such research would provide valuable insight into the needs of community-based paraprofessionals and professionals to better translate EBP into practice to support the use of high quality interventions with all children with ASD.