Examining US Public Early Intervention for Toddlers With Autism: Characterizing Services and Readiness for Evidence-Based Practice Implementation
Por:
Aranbarri A, Stahmer AC, Talbott MR, Miller ME, Drahota A, Pellecchia M, Barber AB, Griffith EM, Morgan EH and Rogers SJ
Publicada:
16 dic 2021
Ahead of Print:
16 dic 2021
Resumen:
As the rates of Autism Spectrum Disorder (ASD) increase and early screening efforts intensify, more toddlers with high likelihood of ASD are entering the United States' (US') publicly funded early intervention system. Early intervention service delivery for toddlers with ASD varies greatly based on state resources and regulations. Research recommends beginning ASD-specific evidence-based practices (EBP), especially caregiver-implemented intervention, as early as possible to facilitate the development of social-communication skills and general learning. Translating EBP into practice has been challenging, especially in low-resourced areas. The main goal of this study was to obtain a more comprehensive understanding of public early intervention system structure, service delivery practices, and factors influencing EBP use for children with ASD in the US. Participants (N = 133) included 8 early intervention state coordinators in 7 states, 29 agency administrators in those states, 57 early intervention providers from those agencies, and 39 caregivers of children with ASD receiving services from those providers. Online surveys gathered stakeholder and caregiver perspectives on early intervention services as well as organizational factors related to EBP implementation climate and culture. Stakeholders identified key intervention needs for young children with ASD. In general, both agency administrators and direct providers reported feeling somewhat effective or very effective in addressing most needs of children with ASD. They reported the most difficulty addressing eating, sleeping, family stress, and stereotyped behaviors. Data indicate that children from families with higher income received significantly higher service intensity. While administrators and providers reported high rates of high-quality caregiver coaching (>60%), caregivers reported low rates (23%). Direct providers with more favorable attitudes toward EBP had greater EBP use. In turn, provider attitudes toward EBP were significantly associated with implementation leadership and culture at their agency. Results suggest that publicly funded early intervention programs in the US require additional resources and training for providers and leaders to support improved implementation climate and attitudes toward ASD EBPs. Results also suggest that more state system support is needed to increase use of ASD-specific EBP use, including high-quality caregiver coaching, to better serve toddlers with ASD. Recommendations for implementation strategies are addressed.
Filiaciones:
Aranbarri A:
Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
Child and Adolescent Mental Health Area, Psychiatry and Psychology, Hospital Sant Joan de Déu Barcelona, Esplugues de Llobregat, Spain
Child and Adolescent Mental Health Research Group, Psychiatry and Psychology, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Stahmer AC:
Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
Talbott MR:
Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
Miller ME:
Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
Drahota A:
Department of Psychology, Michigan State University, East Lansing, MI, United States
Pellecchia M:
Center for Mental Health, Psychiatry Department, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States
Barber AB:
Department of Communicative Disorders, University of Alabama, Tuscaloosa, AL, United States
Griffith EM:
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
Morgan EH:
Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
College of Education, California State University, Sacramento, CA, United States
Rogers SJ:
Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
gold, Green Published
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