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Early Intervention Provider-Reported NDBI Use and Relationships with Provider- to System-Level Implementation Determinants

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Abstract

An expanding evidence base has advocated for delivery of naturalistic developmental behavioral interventions (NDBIs) within community systems, thus extending the reach of these practices to young autistic children. The current study examined provider-reported use of NBDIs within a Part C Early Intervention (EI) system and the extent to which provider background, attitudes, and perceived organizational support predicted NDBI use. Results from 100 EI providers representing multiple disciplines indicated reported use of NDBI strategies within their practice despite inconsistent reported competency with manualized NDBI programs. Although NDBI strategy use was not predicted by provider experiences or perceived organizational support, provider openness to new interventions predicted the reported use of NDBI strategies. Future directions include mixed methods data collection across and within EI systems to better understand NDBI use and ultimately facilitate NDBI implementation.

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References

  • Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The evidence-based practice attitude scale (EBPAS). Mental Health Services Research, 6, 61–74.

    Article  PubMed Central  PubMed  Google Scholar 

  • Aarons, G. A. (2005). Measuring provider attitudes toward evidence-based practice: Consideration of organizational context and individual differences. Child and Adolescent Psychiatric Clinics, 14(2), 255–271.

    Article  Google Scholar 

  • Aarons, G. A. (2006). Transformational and transactional leadership: Association with attitudes toward evidence-based practice. Psychiatric Services, 57(8), 1162–1169.

    Article  PubMed  Google Scholar 

  • Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38, 4–23.

    Article  PubMed  Google Scholar 

  • Adams, R. C., & Tapia, C. D. (2013). Early intervention, IDEA part C services, and the medical home: Collaboration for best practice and best outcomes. Pediatrics, 132, e1073–e1088.

    Article  PubMed  Google Scholar 

  • Aranbarri, A., Stahmer, A. C., Talbott, M. R., Miller, M. E., Drahota, A., Pellecchia, M., Griffith, E. M., Morgan, E. H., & Rogers, S. J. (2021). Examining U.S. public early intervention for toddlers with autism: Characterizing services and readiness for evidence-based practice implementation. Frontiers in Psychiatry, 12.

  • Brian, J., Drmic, I., Roncadin, C., Dowds, E., Shaver, C., Smith, I. M., Zwaigenbaum, L., Sacrey, L. R., & Bryson, S. E. (2022). Effectiveness of a parent-mediated intervention for toddlers with autism spectrum disorder: Evidence from a large community implementation. Autism, 26(7), 1882–1897.

    Article  PubMed  Google Scholar 

  • Brookman-Frazee, L., Stadnick, N. A., Lind, T., Roesch, S., Terrones, L., Barnett, M. L., Regan, J., Kennedy, C. A., Garland, A. F., & Lau, A. S. (2021). Therapist-observer concordance in ratings of EBP strategy delivery: Challenges and targeted directions in pursuing pragmatic measurement in children’s mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 48, 155–170.

    Article  PubMed  Google Scholar 

  • Cidav, Z., Mandell, D., Ingersoll, B., & Pellecchia, M. (2023). Programmatic costs of Project ImPACT for children with autism: A time-driven activity based costing study. Administration and Policy in Mental Health and Mental Health Services Research, 1–15.

  • Crank, J. E., Sandbank, M., Dunham, K., Crowley, S., Bottema-Beutel, K., Feldman, J., & Woynaroski, T. G. (2021). Understanding the effects of naturalistic developmental behavioral interventions: A Project AIM meta‐analysis. Autism Research, 14(4), 817–834.

    Article  PubMed Central  PubMed  Google Scholar 

  • D’Agostino, S. R., Dueñas, A. D., Bravo, A., Tyson, K., Straiton, D., Salvatore, G. L., Pacia, C., & Pellecchia, M. (2023). Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions. Autism, 27(1), 253–258.

    Article  PubMed  Google Scholar 

  • Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 1–15.

    Article  Google Scholar 

  • Dorsey, S., Kerns, S. E., Lucid, L., Pullmann, M. D., Harrison, J. P., Berliner, L., Thompson, K., & Deblinger, E. (2018). Objective coding of content and techniques in workplace-based supervision of an EBT in public mental health. Implementation Science, 13(1), 1–12.

    Article  Google Scholar 

  • Eisenhower, A., Martinez Pedraza, F., Sheldrick, R. C., Frenette, E., Hoch, N., Brunt, S., & Carter, A. S. (2021). Multi-stage screening in early intervention: A critical strategy for improving ASD identification and addressing disparities. Journal of Autism and Developmental Disorders, 51(3), 868–883.

    Article  PubMed Central  PubMed  Google Scholar 

  • Feldstein, A. C., & Glasgow, R. E. (2008). A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. The Joint Commission Journal on Quality and Patient Safety, 34(4), 228–243.

    Article  PubMed  Google Scholar 

  • Fleming, J. L., Sawyer, L. B., & Campbell, P. H. (2011). Early intervention providers’ perspectives about implementing participation-based practices. Topics in Early Childhood Special Education, 30(4), 233–244.

    Article  Google Scholar 

  • Frost, K. M., & Ingersoll, B. (2019). May 1–4). Utilization of developmental and behavioral intervention techniques in usual care: Initial validation of a self-report rating scale in a sample of applied behavior analysis providers. International Society for Autism Research 2019 Meeting, Montreal, Canada.

  • Frost, K. M., Brian, J., Gengoux, G. W., Hardan, A., Rieth, S. R., Stahmer, A., & Ingersoll, B. (2020). Identifying and measuring the common elements of naturalistic developmental behavioral interventions for autism spectrum disorder: Development of the NDBI-Fi. Autism, 24(8), 2285–2297.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gengoux, G. W., McNerney, E., & Minjarez, M. B. (2020). Selecting meaningful skills for teaching in the natural environment. In Y. Bruinsma, M. B. Minjarez, L. Schreibman, & A. C. Stahmer (Eds.), Naturalistic developmental behavioral interventions for autism spectrum disorder. Brookes Publishing.

  • Hampton, L. H., & Sandbank, M. P. (2022). Keeping up with the evidence base: Survey of behavior professionals about naturalistic developmental behavioral interventions. Autism, 26(4), 875–888.

    Article  PubMed  Google Scholar 

  • Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.

    Article  PubMed  Google Scholar 

  • Hurlburt, M. S., Garland, A. F., Nguyen, K., & Brookman-Frazee, L. (2010). Child and family therapy process: Concordance of therapist and observational perspectives. Administration and Policy in Mental Health and Mental Health Services Research, 37, 230–244.

    Article  PubMed  Google Scholar 

  • Ibañez, L. V., Scott, S., & Stone, W. L. (2021). The implementation of reciprocal imitation training in a part C early intervention setting: A stepped-wedge pragmatic trial. Autism Research, 14(8), 1777–1788.

    Article  PubMed  Google Scholar 

  • Individuals With Disabilities Education Act [IDEA] (2004). 20 U S C § 1400.

  • Institute of Behavioral Research. (2009). TCU Organizational Readiness for Change (ORC-D4). Texas Christian University, Institute of Behavioral Research.

  • Koegel, L. K., Koegel, R. L., & Carter, C. M. (1998). Pivotal responses and the natural language teaching paradigm. Seminars in Speech and Language, 19(4), 355–372.

    Article  PubMed  Google Scholar 

  • Landa, R. J. (2018). Efficacy of early interventions for infants and young children with and at risk for autism spectrum disorders. International Review of Psychiatry, 30(1), 25–39.

    Article  PubMed  Google Scholar 

  • Lawson, G. M., Mandell, D. S., Tomczuk, L., Fishman, J., Marcus, S. C., & Pellecchia, M. (2022). Clinician intentions to use the components of parent coaching within community early intervention systems. Administration and Policy in Mental Health and Mental Health Services Research, 1–9.

  • Lee, J., Sone, B., Rooney, T., & Roberts, M. Y. (2023). The role of naturalistic developmental behavioral interventions in early intervention for autistic toddlers: An observational study. American Journal of Speech-Language Pathology, 32(2), 439–451.

    Article  PubMed Central  PubMed  Google Scholar 

  • McManus, B. M., Murphy, N. J., Richardson, Z., Khetani, M. A., Schenkman, M., & Morrato, E. H. (2020). Family-centred care in early intervention: Examining caregiver perceptions of family‐centred care and early intervention service use intensity. Child: Care Health and Development, 46(1), 1–8.

    Article  PubMed  Google Scholar 

  • Melgarejo, M., Lind, T., Stadnick, N. A., Helm, J. L., & Locke, J. (2020). Strengthening capacity for implementation of evidence-based practices for autism in schools: The roles of implementation climate, school leadership, and fidelity. American Psychologist, 75(8), 1105–1115.

    Article  PubMed  Google Scholar 

  • Mirenda, P., Smith, V., Colozzo, P., Vismara, L. A., Ungar, W. J., & Kalynchuk, K. (2021). Training coaches in community agencies to support parents of children with suspected autism: Outcomes, facilitators, and barriers. Journal of Autism and Developmental Disorders, 1–18.

  • Nilsen, P. (2015). Making sense of implementation theories, models, and frameworks. Implementation Science, 10(53), 1–13.

    Google Scholar 

  • Noyes-Grosser, D. M., Elbaum, B., Wu, Y., Siegenthaler, K. M., Cavalari, R. S., Gillis, J. M., & Romanczyk, R. G. (2018). Early intervention outcomes for toddlers with autism spectrum disorder and their families. Infants and Young Children, 31(3), 177–199.

    Article  Google Scholar 

  • Pellecchia, M., Mandell, D. S., Beidas, R. S., Dunst, C. J., Tomczuk, L., Newman, J., Ziegler, L., & Stahmer, A. C. (2022). Parent coaching in early intervention for autism spectrum disorder: A brief report. Journal of Early Intervention, 45(2), 185–197.

  • Pickard, K., Mellman, H., Frost, K., Reaven, J., & Ingersoll, B. (2021). Balancing fidelity and flexibility: Usual care for young children with an increased likelihood of having autism spectrum disorder within an early intervention system. Journal of Autism and Developmental Disorders, 1–13.

  • Pickard, K., Hendrix, N., & Greenfield, E. (2023a). Examining the infrastructure for the adoption of autism evidence-based practices in an Early Intervention system. International Society for Autism Research 2023 Meeting, Stockholm, Sweden.

  • Pickard, K., Hendrix, N., Guerra, K., Brane, N., & Islam, N. (2023b). Examining provider decisions around the delivery and adaptation of a parent-mediated intervention within an Early Intervention system. Autism, 27(8), 2384–2396.

  • R Foundation for Statistical Computing. (2022). R: A language and environment for statistical computing (version 4.2.0). Author.

  • Rieth, S. R., Dickson, K. S., Ko, J., Haine-Schlagel, R., Gaines, K., Brookman-Frazee, L., & Stahmer, A. C. (2022). Provider perspectives and reach of an evidence-based intervention in community services for toddlers. Autism, 26(3), 628–639.

    Article  PubMed  Google Scholar 

  • Rogers, S. J., Stahmer, A., Talbott, M., Young, G., Fuller, E., Pellecchia, M., Barber, A., & Griffith, E. (2022). Feasibility of delivering parent-implemented NDBI interventions in low-resource regions: A pilot randomized controlled study. Journal of Neurodevelopmental Disorders, 14(1), 1–14.

    Article  Google Scholar 

  • Saldana, L., Chapman, J. E., Henggeler, S. W., & Rowland, M. D. (2007). The organizational readiness for change scale in adolescent programs: Criterion validity. Journal of Substance Abuse Treatment, 33(2), 159–169.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., Crank, J., Albarran, S. A., Raj, S., Mahbub, P., & Woynaroski, T. G. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychological Bulletin, 146(1), 1–29.

    Article  PubMed  Google Scholar 

  • Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., Kaiser, A. P., Bruinsma, Y., McNerney, E., Wetherby, A., & Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411–2428.

    Article  PubMed Central  PubMed  Google Scholar 

  • Stadnick, N. A., Meza, R. D., Suhrheinrich, J., Aarons, G. A., Brookman-Frazee, L., Lyon, A. R., Mandell, D. S., & Locke, J. (2019). Leadership profiles associated with the implementation of behavioral health evidence-based practices for autism spectrum disorder in schools. Autism, 23(8), 1957–1968.

    Article  PubMed  Google Scholar 

  • Stahmer, A. C., & Aarons, G. A. (2009). Attitudes toward adoption of evidence-based practices: A comparison of autism early intervention providers and children’s mental health providers. Psychological Services, 6(3), 223–234.

    Article  PubMed Central  PubMed  Google Scholar 

  • Stahmer, A. C., & Mandell, D. S. (2007). State infant/toddler program policies for eligibility and services provision for young children with autism. Administration and Policy in Mental Health and Mental Health Services Research, 34(1), 29–37.

    Article  PubMed  Google Scholar 

  • Stahmer, A. C., Collings, N. M., & Palinkas, L. A. (2005). Early intervention practices for children with autism: Descriptions from community providers. Focus on Autism and Other Developmental Disabilities, 20(2), 66–79.

    Article  PubMed  Google Scholar 

  • Stahmer, A. C., Rieth, S. R., Dickson, K. S., Feder, J., Burgeson, M., Searcy, K., & Brookman-Frazee, L. (2020). Project ImPACT for toddlers: Pilot outcomes of a community adaptation of an intervention for autism risk. Autism, 24(3), 617–632.

    Article  PubMed  Google Scholar 

  • Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy-Özkan, S., & Savage, M. N. (2020). Evidence-based practices for children, youth, and young adults with autism. Frank Porter Graham Child Development Institute.

  • Straiton, D., Groom, B., & Ingersoll, B. (2021). Parent training for youth with autism served in community settings: A mixed-methods investigation within a community mental health system. Journal of Autism and Developmental Disorders, 51, 1983–1994.

    Article  PubMed  Google Scholar 

  • Straiton, D., Frost, K., & Ingersoll, B. (2023). Factors that influence clinical decisions about offering parent coaching for autistic youth served within the Medicaid system. Implementation Research and Practice, 4, 1–13.

    Article  Google Scholar 

  • Tiede, G., & Walton, K. M. (2019). Meta-analysis of naturalistic developmental behavioral interventions for young children with autism spectrum disorder. Autism, 23(8), 2080–2095.

    Article  PubMed  Google Scholar 

  • Tomczuk, L., Stewart, R. E., Beidas, R. S., Mandell, D. S., & Pellecchia, M. (2022). Who gets coached? A qualitative inquiry into community clinicians’ decisions to use caregiver coaching. Autism, 26(3), 575–585.

    Article  PubMed  Google Scholar 

  • U.S. Department of Education (2021). 43rd Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2021. Retrieved from: https://sites.ed.gov/idea/files/43rd-arc-for-idea.pdf.

  • U.S. Department of Education (2022). Number of infants and toddlers ages birth through 2 and 3 and older, and percentage of population, receiving early intervention services under IDEA, Part C, by age and state (2020–2021 data table) Retrieved from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c-child-count-and-settings-table-1/resources?resource=f28a5f96-d3b5-4fb7-af87-413e9be64e47.

  • Vivanti, G., Kasari, C., Green, J., Mandell, D., Maye, M., & Hudry, K. (2018). Implementing and evaluating early intervention for children with autism: Where are the gaps and what should we do? Autism Research, 11(1), 16–23.

    Article  PubMed  Google Scholar 

  • Williams, M. E., Harley, E. K., Quebles, I., & Poulsen, M. K. (2021). Policy and practice barriers to early identification of autism spectrum disorder in the California early intervention system. Journal of Autism and Developmental Disorders, 51(10), 3423–3431.

    Article  PubMed  Google Scholar 

  • Yoder, P. J., Stone, W. L., & Edmunds, S. R. (2021). Parent utilization of ImPACT intervention strategies is a mediator of proximal then distal social communication outcomes in younger siblings of children with ASD. Autism, 25(1), 44–57.

    Article  Google Scholar 

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Acknowledgements

We would like to acknowledge the contributions of providers within Georgia’s Part C Early Intervention system, Babies Can’t Wait. We also recognize the effort and support of Synita Griswell, the autism services coordinator within Babies Can’t Wait, and other administrators within the system for supporting data collection.

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Authors and Affiliations

  1. Department of Pediatrics, Emory University School of Medicine, Atlanta, USA

    Nicole Hendrix, Yijin Xiang, Shannon Harper, Jennifer Stapel-Wax & Katherine Pickard

  2. Marcus Autism Center, Emory University and Children’s Healthcare of Atlanta, 1920 Briarcliff Road NE, Atlanta, GA, 30329, USA

    Nicole Hendrix, Emma Chatson, Hannah Davies, Brooke Demetri, Millena Yohannes, Ainsley Buck, Shannon Harper, Jennifer Stapel-Wax & Katherine Pickard

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  1. Nicole Hendrix
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Hendrix, N., Chatson, E., Davies, H. et al. Early Intervention Provider-Reported NDBI Use and Relationships with Provider- to System-Level Implementation Determinants. J Autism Dev Disord (2023). https://doi.org/10.1007/s10803-023-06203-3

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