Jessica Suhrheinrich

Implementation challenges in translating pivotal response training into community settings.

Implementing evidence-based practices (EBPs) for children with autism is challenging for teachers because these practices are often complex, requiring significant training and resources that are not available in most school settings. This brief investigation was designed to identify areas of strength and difficulty for teachers implementing one such EBP, pivotal response training (PRT). Observational data were gathered from 41 teachers participating in two separate investigations involving PRT. Despite differences in training procedures, teachers demonstrated similarities in areas of strength (clear opportunities/instruction and child choice) and difficulty (turn taking and multiple cues). These findings suggest next steps toward systematic adaptation of PRT for classroom use. The research may serve as a model for the process of adapting EBPs for practice settings.

Pivotal Response Teaching in the Classroom Setting

ABSTRACT Pivotal response teaching (PRT) is an empirically supported naturalistic behavioral intervention proven to be efficacious in the education of children with autism. This intervention involves loosely structured learning environments, teaching during ongoing interactions between student and teacher, child initiation of teaching episodes, child choice of teaching activities or materials, prompting, providing reinforcers directly related to the childs behavior, and providing reinforcement for child goal-directed attempts to respond. PRT has been widely studied and has been effective in increasing verbal communication, joint attention, play skills, peer social interactions, and homework skills. Although the use of PRT in classroom settings has not yet been empirically studied, work is underway to develop PRT-based procedures for such settings. The authors discuss barriers to PRT translation to classroom settings and strategies for improving such implementation.

Examination of the prevalence of stimulus overselectivity in children with ASD.

Many individuals with autism spectrum disorders (ASD) display stimulus overselectivity, wherein a subset of relevant components in a compound stimulus controls responding, which impairs discrimination learning. The original experimental research on stimulus overselectivity in ASD was conducted several decades ago; however, interventions for children with ASD now typically include programming to target conditional discriminations in ways that might minimize the prevalence of stimulus overselectivity. The present study assessed 42 children who had been diagnosed or educationally identified with ASD using a discrimination learning assessment. Of these 42 children, 19% displayed overselective responding, which is a lower percentage than that seen in early research. Possible explanations for this decreased percentage, implications for intervention, and future directions for research are discussed.

A sustainable model for training teachers to use pivotal response training

The increase in the rate of autism diagnoses has created a growing demand for teachers who are trained to use effective interventions. The train-the-trainer model, which involves training supervisors to train others, may be ideal for providing cost-effective training and ongoing support to teachers. Although research supports interventions, such as pivotal response training, as evidence-based, dissemination to school environments has been problematic. This study assessed the benefits of using the train-the-trainer model to disseminate pivotal response training to school settings. A multiple-baseline design was conducted across three training groups, each consisting of one school staff member (trainer), three special education teachers, and six students. Trainers conducted the teacher-training workshop with high adherence to training protocol and met mastery criteria in their ability to implement pivotal response training, assess implementation of pivotal response training, and provide feedback to teachers. Six of the nine teachers mastered all components of pivotal response training. The remaining three teachers implemented 89% of the pivotal response training components correctly. The majority of trainers and teachers maintained their abilities at follow-up. These results support the use of the train-the-trainer model as an effective method of disseminating evidence-based practices in school settings.

Identifying critical elements of treatment: Examining the use of turn taking in autism intervention

Evidence-based treatments for autism spectrum disorders (ASD) are comprised of components that identify therapist behavior necessary to implement the treatment with integrity. Some components are shared across approaches from diverse theoretical backgrounds. One component included in several interventions that has not been researched in isolation is turn taking, or the manner in which the therapist facilitates back-and-forth interaction with the child. The current study used an alternating treatments design to examine the efficacy of four types of turn taking. Six children, ages 30 to 39 months, received behavioral treatment while therapists systematically varied the nature of the turn taking component. Children’s responses were behaviorally scored to examine differences based on turn condition. Consistent patterns of behavior were found across children. Results suggest that the optimal type of turn is dependent on developmental level and target skill. Implications for treatment of ASD and future research directions are discussed.

Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder

Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent–teacher concordance of ratings of adaptive functioning and ASD-specific symptomatology across time. The impact of child clinical characteristics on concordance was also examined. Participants included 246 children, their caregivers and teachers. Parent–teacher concordance was variable but generally consistent across time. Concordance was significantly impacted by autism severity and child cognitive abilities. Findings inform the broader concordance literature and support the need to consider child clinical factors when assessing child functioning in samples of children with ASD.

Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol

BackgroundThis study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for the positive effects of EBPs for ASD, these practices are not consistently or effectively used in schools. Although special education programs are mandated to use EBPs, there are very few evidence-based methods for selecting, implementing, and sustaining EBPs. Research focuses primarily on teacher training, without attention to contextual factors (e.g., implementation climate, attitudes toward EBPs, resource allocation, and social networks) that may impact outcomes. Using an implementation science framework, this project will prospectively examine relations between system-wide factors and teachers’ use of EBPs and student education outcomes.Methods/designSurvey data will be collected from approximately 85 regional special education directors, 170 regional program specialists, 265 district special education directors, 265 behavior specialists, 925 school principals, 3538 special education teachers, and 2700 paraprofessionals. Administrative data for the students with ASD served by participating teachers will be examined. A total of 79 regional-, district-, and school-level personnel will also participate in social network interviews. Mixed methods, including surveys, administrative data, and observational checklists, will be used to gather in-depth information about system-wide malleable factors that relate to positive teacher implementation of EBPs and student outcomes. Multi-level modeling will be used to assess system-wide malleable factors related to EBP implementation which will be linked to the trainer, teacher, and student outcomes and examined based on moderators (e.g., district size, Special Education Local Plan Area structure, teachers’ ASD experience). Finally, a dynamic social network approach will be used to map EBP-related connectivity across all levels of the system for selected regions. Dynamic network analysis will be used to gauge the degree to which and ways that EBP trainings, resources, and interventions are shared (or not shared) among school staff.DiscussionResults are expected to inform the development of system-wide interventions to improve the school-based implementation of EBPs for students with ASD.

Correction: Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): A study protocol [Implement Sci, 13, (2018) (3)] DOI: 10.1186/s13012-017-0698-1

After publication of the original article [1] it was brought to our attention that author Elizabeth McGhee Hassrick was erroneously included as Elizabeth McGee Hassrick. The correct spelling of the author’s name is included in the author list of this erratum.