Early Intervention Staff Views on Supporting Evidence Based Practice

Background:  While a range of evidence-based interventions are available to children on the autism spectrum and their families, applying these within an evidence-based practice (EBP) framework in community-based early intervention (EI) settings remains challenging. Common barriers to EBP identified through previous research include a lack of staff training, time, and workplace resources, as well as incongruences between interventions developed in research environments and clinical realities in community settings. Unfortunately, few studies have examined strategies for supporting EBP, and rarely have EI staff been consulted regarding their views on how to support their own practice, thus jeopardising the ecological and social validity of strategies developed.

Objectives:  Our aim in this study was to examine EI staff views on supporting their engagement in EBP in order to identify ecologically and socially valid strategies for doing so.

Methods:  We conducted a qualitative study involving five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff who worked in a community-based EI service to explore their views. The service provides a comprehensive program delivered by a multidisciplinary team to approximately 200 children per annum across multiple sites. Audio recordings were transcribed verbatim and analysed using thematic analysis.

Results:  Two central themes, comprising six categories, emerged to account for the participants’ views. Initiative and Effort (theme 1) accounted for the range of creative strategies staff had developed and adopted to support their use of EBP. These included methods aimed at rapidly transferring core skills to new untrained staff and ensuring clear communication between team members working inconsistent shifts to ensure continuity of care. Staff also expressed the need for A better way (theme 2) involving organisation-wide strategies with direct applicability for supporting staff in their use of evidence-based intervention strategies with fidelity when working in the classroom with children.

Conclusions:  The findings demonstrate that EI staff are ideally positioned to play a key role in developing ecologically and socially valid strategies to support their engagement in EBP. In particular, the findings highlight the importance of organisational-wide models for supporting EBP, with a focus on peer-to-peer mentoring. Clinical and research implications, particularly those pertaining to the translation of research to practice in community settings, will be presented with reference to the themes and illustrated with participants’ comments.