A Tangled Web: The Challenges of Implementing an Evidence-Based Social Engagement Intervention for Children With Autism in Urban Public School Settings☆
Section snippets
Participants
Nine children with autism, 9 school staff members (5 one-to-one assistants, 3 noon-time aides, and 1 bus attendant), and 100 typically developing peers from six classrooms in two schools participated. Both schools were located in a large (149,535 students), urban, ethnically and racially diverse district, where nearly 14% of students have a disability and 82% are considered economically disadvantaged. Children with autism were included in this study if they:
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had a documented diagnosis of autism
Implementation fidelity
Fidelity of implementation was mixed in session notes used to identify barriers to implementation. The average number of completed steps of the intervention as rated by an independent observer (during one recess period when the interventionist was not present) is presented in Figure 1. While school personnel used more components of the intervention as time progressed (adherence), their overall observer-rated quality of program delivery was approximately 50%. The average observer-rated
Discussion
This study used quantitative and qualitative data to (a) describe the implementation fidelity and quality of a social engagement intervention for children with autism; and (b) identify important barriers to implementation in an urban public school district. The results indicated that average implementation adherence fidelity ranged from 0–4 steps out of 7 total; however, over the course of intervention, quality of implementation fidelity improved. The training of the school personnel over the 6
Conflict of Interest Statement
The authors declare that there are no conflicts of interest.
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This study was funded by an Autism Science Foundation postdoctoral fellowship (Grant # 11-1010), Autism Science Foundation (Grant # 13-ECA-01L) and FARFund Early Career Award granted to the first author as well as grant UA3 MC 11055 AIR-B from the Maternal and Child Health Research Program, Maternal and Child Health Bureau (Combating Autism Act Initiative), Health Resources and Services Administration, Department of Health and Human Services awarded to the sixth author. We thank the children, parents, school personnel and schools who participated and the two research associates who contributed countless hours of assessments and data collection: Laura Macmullen Freeman and Emily Cross.