It’s time to close the research to practice gap in autism: The need for implementation science

Boyd, Brian A.; Stahmer, Aubyn C.; Odom, Samuel L.; Wallisch, Anna; Matheis, Maya

doi:10.1177/13623613211064422

Cited by 33 publications

(28 citation statements)

References 35 publications

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“…NDBIs, like other evidence-based practices, face barriers to uptake at multiple levels including funders, leaders, practitioners, and consumers (Boyd et al, 2021). We encourage wide-scale NDBI implementation for the following three reasons: (1) their strong and growing evidence base, (2) their capacity to affect clinically and socially meaningful outcomes at a lower treatment intensity, and (3) their emphasis on community and stakeholder development (Sandbank et al, 2020; Tiede & Walton, 2019).…”

Section: Support For Wide-scale Ndbi Implementationmentioning

confidence: 99%

Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions

D’Agostino

Dueñas

Bravo

et al. 2022

Autism

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Naturalistic Developmental Behavioral Interventions (NDBIs) have a strong and growing evidence base. Yet, NDBIs are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons for the slow adoption of NDBIs likely stem from the differing theoretical orientations of behavioral and developmental sciences from which NDBI are derived, and a lack of training, knowledge, and support for implementing NDBIs within the behavior analytic community. In support of efforts to promote wide-scale implementation of NDBIs, we clarify their common features, discuss possible misconceptions, offer reasons why NDBIs should be widely implemented, and provide recommendations to the autism service community, intervention developers, and researchers to improve their dissemination and implementation. Lay Abstract Naturalistic Developmental Behavioral Interventions (NDBIs) are a group of early interventions that use a variety of strategies from applied behavioral and developmental sciences. Although Naturalistic Developmental Behavioral Interventions have been demonstrated effective, Naturalistic Developmental Behavioral Interventions are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons likely stem from differing theoretical orientations of developmental and behavioral sciences and practitioners’ lack training, knowledge, and support for implementing Naturalistic Developmental Behavioral Interventions. In support of efforts to promote wide-scale implementation of Naturalistic Developmental Behavioral Interventions, we (1) clarify their common features, (2) discuss possible misconceptions, and (3) offer reasons why Naturalistic Developmental Behavioral Interventions should be widely implemented. We also provide recommendations to the autism service community, intervention developers, and researchers.

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Section: Support For Wide-scale Ndbi Implementationmentioning

confidence: 99%

Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions

D’Agostino

Dueñas

Bravo

et al. 2022

Autism

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“…Although the BACB requires individuals to obtain CEUs and engage in professional development, an additional point of importance is the extent to which engaging with high-quality sources of CEUs and professional development helps bridge the research-to-practice gap (see Valentino, 2022 , for a comprehensive discussion). Research-to-practice gaps within applied behavior analysis (or any applied field) are particularly troublesome, because not using interventions based on the best available evidence can also be ethically untenable (Boyd et al, 2022 ). There has been an increased focus on closing the research-to-practice gap in behavior analysis in general and applied behavior analysis in particular (Normand et al, 2021 ; Slocum et al, 2014 ).…”

Section: Professional Development For Bcbasmentioning

confidence: 99%

Evaluating Sources of Continuing Education and Professional Development Used by Behavior Analysts

Kranak

Andzik

Falligant

2022

Behav Analysis Practice

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Board certified behavior analysts (BCBAs) are required to accrue continuing education units (CEUs) every 2 years, and to regularly engage in professional development. Identifying sources of CEUs and professional development activities, what factors BCBAs consider when choosing them, and their preferences and opinions could help inform the provision of CEU and professional development activities. However, little is known about those collective sources nor the preferences of behavior analysts in obtaining them. We surveyed individuals certified as BCBAs or board certified assistant behavior analysts through the Behavior Analyst Certification Board mass e-mail service to identify trends in CEU accruement and professional development and factors driving individuals to certain sources over others. Respondents indicated they value and believe peer-reviewed articles, in-person conferences, and well-known speakers over less verifiable sources such as social media platforms (e.g., Facebook groups or podcasts). Implications for improving the accessibility of high-quality sources of CEUs and professional development are discussed.

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“…Within the field of autism research, there has been a movement to examine the efficacy of evidence-based practices through implementation science. 22 , 23 , 24 , 25 With regard to racial and ethnic differences in the implementation of autism treatment, studies have highlighted disparities that exist for minoritized racial and ethnic groups in the early identification of autism as well as the differential use patterns of ASD resources through school systems, academic hospitals, and insurance billing codes. 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 However, the research community has yet to characterize the extent to which geographic proximity to autism resources varies between racial and ethnic groups on a national scale.…”

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Disparities in Geographic Access to Autism Resources Across the US

et al. 2023

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ImportanceWhile research has identified racial and ethnic disparities in access to autism services, the size, extent, and specific locations of these access gaps have not yet been characterized on a national scale. Mapping comprehensive national listings of autism health care services together with the prevalence of autistic children of various races and ethnicities and evaluating geographic regions defined by localized commuting patterns may help to identify areas within the US where families who belong to minoritized racial and ethnic groups have disproportionally lower access to services.ObjectiveTo evaluate differences in access to autism health care services among autistic children of various races and ethnicities within precisely defined geographic regions encompassing all serviceable areas within the US.Design, Setting, and ParticipantsThis population-based cross-sectional study was conducted from October 5, 2021, to June 3, 2022, and involved 530 965 autistic children in kindergarten through grade 12. Core-based statistical areas (CBSAs; defined as areas containing a city and its surrounding commuter region), the Civil Rights Data Collection (CRDC) data set, and 51 071 autism resources (collected from October 1, 2015, to December 18, 2022) geographically distributed into 912 CBSAs were combined and analyzed to understand variation in access to autism health care services among autistic children of different races and ethnicities. Six racial and ethnic categories (American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, and White) assigned by the US Department of Education were included in the analysis.Main Outcomes and MeasuresA regularized least-squares regression analysis was used to measure differences in nationwide resource allocation between racial and ethnic groups. The number of autism resources allocated per autistic child was estimated based on the child’s racial and ethnic group. To evaluate how the CBSA population size may have altered the results, the least-squares regression analysis was run on CBSAs divided into metropolitan (&gt;50 000 inhabitants) and micropolitan (10 000-50 000 inhabitants) groups. A Mann-Whitney U test was used to compare the model estimated ratio of autism resources to autistic children among specific racial and ethnic groups comprising the proportions of autistic children in each CBSA.ResultsAmong 530 965 autistic children aged 5 to 18 years, 83.9% were male and 16.1% were female; 0.7% of children were American Indian or Alaska Native, 5.9% were Asian, 14.3% were Black or African American, 22.9% were Hispanic or Latino, 0.2% were Native Hawaiian or other Pacific Islander, 51.7% were White, and 4.2% were of 2 or more races and/or ethnicities. At a national scale, American Indian or Alaska Native autistic children (β = 0; 95% CI, 0-0; P = .01) and Hispanic autistic children (β = 0.02; 95% CI, 0-0.06; P = .02) had significant disparities in access to autism resources in comparison with White autistic children. When evaluating the proportion of autistic children in each racial and ethnic group, areas in which Black autistic children (&gt;50% of the population: β = 0.05; &lt;50% of the population: β = 0.07; P = .002) or Hispanic autistic children (&gt;50% of the population: β = 0.04; &lt;50% of the population: β = 0.07; P &lt; .001) comprised greater than 50% of the total population of autistic children had significantly fewer resources than areas in which Black or Hispanic autistic children comprised less than 50% of the total population. Comparing metropolitan vs micropolitan CBSAs revealed that in micropolitan CBSAs, Black autistic children (β = 0; 95% CI, 0-0; P &lt; .001) and Hispanic autistic children (β = 0; 95% CI, 0-0.02; P &lt; .001) had the greatest disparities in access to autism resources compared with White autistic children. In metropolitan CBSAs, American Indian or Alaska Native autistic children (β = 0; 95% CI, 0-0; P = .005) and Hispanic autistic children (β = 0.01; 95% CI, 0-0.06; P = .02) had the greatest disparities compared with White autistic children.Conclusions and RelevanceIn this study, autistic children from several minoritized racial and ethnic groups, including Black and Hispanic autistic children, had access to significantly fewer autism resources than White autistic children in the US. This study pinpointed the specific geographic regions with the greatest disparities, where increases in the number and types of treatment options are warranted. These findings suggest that a prioritized response strategy to address these racial and ethnic disparities is needed.

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It’s time to close the research to practice gap in autism: The need for implementation science

Cited by 33 publications

References 35 publications

Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions

Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions

Evaluating Sources of Continuing Education and Professional Development Used by Behavior Analysts

Racial and Ethnic Disparities in Geographic Access to Autism Resources Across the US

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