A Tangled Web: The Challenges of Implementing an Evidence-Based Social Engagement Intervention for Children With Autism in Urban Public School Settings

Abstract

There is growing evidence that efficacious autism-related interventions rarely are adopted or successfully implemented in public schools, in part because of the lack of fit between the intervention and the needs and capacities of the school setting. There is little systematic information available regarding the barriers to implementation of complex interventions such as those addressing social engagement for children with autism. The present study used fieldnotes from an implementation trial to explore barriers that emerged during the training of school personnel and subsequent implementation of a social engagement intervention. A number of barriers at the individual (training) and school levels (policies surrounding recess, staffing, prioritization of competing demands, level of respect and support, and availability of resources) interfered with the continued use and sustainment of the intervention. We offer potential strategies to overcome these barriers and provide directions for future research in this critical area.

Examining playground engagement between elementary school children with and without autism spectrum disorder

“…Rather, Bottema-Beutel et al (2014) suggest that the number of observations required to produce reliable estimates may vary depending on the outcome measure and time point in the school semester. While behavioral observations serve as a gold standard for assessing children’s social engagement on the playground, they often are time intensive and costly to conduct (Locke et al, 2014). Future research should carefully consider increasing the number of observations to ensure reliability of the data.…”

“…Often teachers and parents have limited knowledge of what happens during recess. Teaching assistants rather than teachers often supervise recess, and parents are not present at school (Locke et al, 2015). …”

Clearing hurdles: the challenges of implementation of mental health evidence-based practices in under-resourced schools

“…This has the unintended consequence of reducing availability of mental health services in schools that desperately need them. Team members employed by community mental health agencies may have different training backgrounds, theoretical orientation, supervision requirements and sense of mission than those employed by the school district, which may lead to a fragmented system of care (Locke et al, 2015). …”

A systematic review of peer-mediated interventions for children with autism spectrum disorder

“…Although only one study reported achieving above 80% implementation fidelity when school personnel implemented the intervention, the expectation of achieving 80% implementation fidelity, the level to which we train experts in clinic or university-based studies, in school or other community settings may not be realistic given the barriers and constraints (e.g., inexperienced and untrained school personnel, time, resources, etc.) to implementation observed in the school context (Locke et al, 2015). Perhaps engaging in the core components of the intervention or using certain evidence-based strategies as opposed to none is a sufficient catalyst for improvement in various social outcomes in schools and other community contexts.…”