Provider Use of Evidence-Based Practices for Students with Autism in School-Age Transition Periods

Background: Several treatment methods found to be effective for teaching children with autism have been identified as evidence-based practices (EBP) (Odom et al., 2010; Wong et al., 2014), and training teachers on EBPs is best way for schools to provide effective education students with ASD. Teachers may struggle with implementation of EBPs as interventions are time intensive, costly, and require significant training to implement with high fidelity (Lopata et al. 2012). Teachers face additional barriers including decreased financial resources, lack of curriculum materials, high staff turnover, poor training, and resource challenges for children whose families live at or below the poverty line (Mandell et al., 2013; Pellechia et al., 2015). Educators often use practices with limited evidence-base for individuals with ASD (Stahmer, Collings & Palinkas, 2005). Teachers may particularly disengage in EBP use during stressful times, such as times of transition. Research highlights the importance of successful transitions as well as the difficulties for children considered at risk (Pears et al., 2015). Given the associated difficulties of transition, teachers report a lack of training opportunities, knowledge and attention to students’ individual needs as well as school coordination gaps during transition (Nuske et al. 2018).

Objectives: To identify reported use of evidence-based strategies and interventions for under-resourced individuals with ASD in public school classrooms during times of transition.

Methods: Under-resourced students with ASD attending public schools enrolled in the study prior to transition to primary or secondary school. School personnel providing interventions were interviewed before and after transition and asked to report strategies used in pre and post transition classrooms to meet student goals. Authors first coded reported intervention data using codes that identified general types of interventions (n=10 intervention types), derived from a list of common practice intervention types, then authors coded the reported intervention data using EBP codes, derived from Wong et al. (2014) (n=15 EBP). For both coding rounds, coders reached IRR at 0.8 and 20% of data were double coded. For double coded data, discrepant codes were coded using consensus. SPSS was used to report descriptive statistics for the coded data.

Results: Pre and post-transition school personnel (n=30) reported implementing 198 total strategies for students (n=7). Overall, 35% of strategies were identified as not EBP. The most frequently used EBPs reported were prompting (13%) and visual supports (13%). The least frequently reported EBPs were technology aided instruction and intervention (1%), discrete trial training (1%) and PECS (1%) (Table 1). Of the strategies identified as not EBP (n=70), instructional interventions (14), self-regulation (11) and consequence-based interventions (10) were most frequent. The percent frequency of reported EBP interventions was similar pre-transition (64%) and post-transition (65%).

Conclusions: Educators reported implementing various strategies for students with ASD during transitions. Although many strategies were reported, there is variability in the evidence-base of the strategies being used. Understanding these patterns highlights current gaps in EBP and may inform needed adjustments to implementation and dissemination efforts in real-world settings.