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Proactive versus Reactive: Strategies in the Implementation of School-based Services for Students with ASD

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Abstract

Autism spectrum disorder (ASD) is increasingly prevalent, intervention costs are high, and long-term outcomes are poor. Proactive implementation of evidence-based practices (EBPs; Steinbrenner et al., Evidence-Based Practices for Children, Youth, and Young Adults with Autism, 2020) through an assessment or planning process can lead to more effective services (Rubin et al., Admin Policy Mental Health Mental Health Serv Res 43(6), 1023–1028, 2016). The objective of this study is (a) to identify factors associated with the use of proactive versus reactive strategies for school-based services for students with ASD and (b) to examine school personnel perceptions of the use of proactive versus reactive strategies. Data were from a larger project in which 6 semi-structured focus groups were conducted to understand school personnel perceptions of how school districts implement new programs for ASD. Transcripts were coded using an iterative coding and review process. In the present study, primary themes were identified and classified as proactive or reactive. Participants reported both proactive and reactive allocation of district resources for intervention implementation. Reactive implementation was associated with litigation or due process, escalated student behavior, and non-public school placement, whereas proactive implementation was associated with ASD-specific programming, grants, personnel experience with EBPs, and prospective needs assessment. Participants perceived the reactive strategies as disadvantageous, and yet these strategies were sometimes still employed. Understanding the role of proactive and reactive strategies and the factors that influence their use could enable more effective planning for EBP use to improve both cost savings and student outcomes. This study is an important first step to explore resource allocation for school-based services for students with ASD.

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References

  • 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(1), 4–23.

    Article  PubMed  Google Scholar 

  • Anderson, K. A., Shattuck, P. T., Cooper, B. P., Roux, A. M., & Wanger, M. (2014). Prevalence and correlates of postsecondary residential status among young adults with an autism spectrum disorder. Autism, 18, 562–570. https://doi.org/10.1177/1362361313481860

    Article  PubMed  Google Scholar 

  • Barnett, W. S., & Escobar, C. M. (2002). Research on the cost effectiveness of early educational intervention: Implications for research and policy. In T. A. Revenson (Ed.), Ecological Research to Promote Social Change (pp. 63–92). Springer.

    Chapter  Google Scholar 

  • Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., …, Maternal and Child Nutrition Study Group. (2013). Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The lancet, 382(9890), 452–477.

    Article  Google Scholar 

  • Buescher, A. V., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics, 168(8), 721–728.

    Article  PubMed  Google Scholar 

  • Bitterman, A., Daley, T. C., Misra, S., Carlson, E., & Markowitz, J. (2008). A national sample of preschoolers with autism spectrum disorders: Special education services and parent satisfaction. Journal of Autism and Developmental Disorders, 38(8), 1509–1517.

    Article  PubMed  Google Scholar 

  • Brock, M. E., Dynia, J. M., Dueker, S. A., & Barczak, M. A. (2020). Teacher-reported priorities and practices for students with autism: Characterizing the research-to-practice gap. Focus on Autism and Other Developmental Disabilities, 35(2), 67–78.

    Article  Google Scholar 

  • Brookman-Frazee, L., Baker-Ericzén, M., Stahmer, A., Mandell, D., Haine, R. A., & Hough, R. L. (2009). Involvement of youths with autism spectrum disorders or intellectual disabilities in multiple public service systems. Journal of Mental Health Research in Intellectual Disabilities, 2(3), 201–219.

    Article  PubMed  PubMed Central  Google Scholar 

  • Burke, M. M., & Goldman, S. E. (2015). Identifying the associated factors of mediation and due process in families of students with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(5), 1345–1353.

    Article  PubMed  Google Scholar 

  • California Department of Education. (2020a). Special Education- CalEd Facts. Retrieved from https://www.cde.ca.gov/sp/se/sr/cefspeced.asp

  • California Department of Education. (2020b). California Special Education Local Plan Areas. Retrieved from https://www.cde.ca.gov/sp/se/as/caselpas.asp

  • Chasson, G. S., Harris, G. E., & Neely, W. J. (2007). Cost comparison of early intensive behavioral intervention and special education for children with autism. Journal of Child and Family Studies, 16(3), 401–413.

    Article  Google Scholar 

  • Cidav, Z., Munson, J., Estes, A., Dawson, G., Rogers, S., & Mandell, D. (2017). Cost offset associated with Early Start Denver Model for children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 56(9), 777–783.

    Article  Google Scholar 

  • Cook, B. G., & Odom, S. L. (2013). Evidence-based practices and implementation science in special education. Exceptional Children, 79(2), 135–144.

    Article  Google Scholar 

  • Counsell, S. R., Callahan, C. M., Tu, W., Stump, T. E., & Arling, G. W. (2009). Cost analysis of the geriatric resources for assessment and care of elders care management intervention. Journal of the American Geriatrics Society, 57(8), 1420–1426.

    Article  PubMed  PubMed Central  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 

  • Deckers, A., Muris, P., & Roelofs, J. (2017). Being on your own or feeling lonely? Loneliness and other social variables in youths with autism spectrum disorders. Child Psychiatry & Human Development, 48(5), 828–839.

    Article  Google Scholar 

  • Dhaliwal, I., Duflo, E., Glennerster, R., & Tulloch, C. (2013). Comparative cost-effectiveness analysis to inform policy in developing countries: a general framework with applications for education. Education Policy in Developing Countries. https://doi.org/10.7208/chicago/9780226078854.003.0008

    Article  Google Scholar 

  • Fixsen, D. L., & Fixsen, A. A. (2016). An Integration and Synthesis of Current Implementation Frameworks. National Implementation Research Network.

    Google Scholar 

  • Fixsen, D., Ward, C., & Sims, B. (2014). Exploration Stage Scaling-Up Brief (Report No. 4). State Implementation and Scaling-up of Evidence-based Practices Center.

  • Gibbs, A. (1997). Focus groups. Social Research Update, 19(8), 1–8.

    Google Scholar 

  • Goldman, H. H., Ganju, V., Drake, R. E., Gorman, P., Hogan, M., Hyde, P. S., & Morgan, O. (2001). Policy implications for implementing evidence-based practices. Psychiatric Services, 52(12), 1591–1597.

    Article  CAS  PubMed  Google Scholar 

  • Gray, S. A., Zraick, R. I., & Atcherson, S. R. (2019). Readability of individuals with disabilities education act part B procedural safeguards: An update. Language, Speech, and Hearing Services in Schools, 50(3), 373–384.

    Article  PubMed  Google Scholar 

  • Hall, L. J. (2015). Sustaining evidence-based practices by graduated special educators of students with ASD: Creating a community of practice. Teacher Education and Special Education, 38(1), 28–43.

    Article  Google Scholar 

  • Hamilton, A. B., & Finley, E. P. (2019). Qualitative methods in implementation research: an introduction. Psychiatry Research, 280, 112516.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hollands, F.M., Levin, H. M., (2017). The critical importance of costs for education decisions Washington, DC: U.S. Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance, Analytic Technical Assistance and Development. Retrieved from https://ies.ed.gov/ncee/pubs/REL_2017274/pdf/REL_2017274.pdf

  • Individuals with Disabilities Education Act (IDEA), 20 U.S.C. § 1400 (2004).

  • Karoly, L. A., Kilburn, M. R., & Cannon, J. (2005). Proven benefits of early childhood interventions (Report No. MG-341-PNC). Rand Corporation.

  • Klonoff, D. C., & Schwartz, D. M. (2000). An economic analysis of interventions for diabetes. Diabetes Care, 23(3), 390–404.

    Article  CAS  PubMed  Google Scholar 

  • Kratz, H. E., Stahmer, A., Xie, M., Marcus, S. C., Pellecchia, M., Locke, J., …, Mandell, D. S. (2019). The effect of implementation climate on program fidelity and student outcomes in autism support classrooms. Journal of Consulting and Clinical Psychology, 87(3), 270.

    Article  PubMed  Google Scholar 

  • Iadarola, S., Hetherington, S., Clinton, C., Dean, M., Reisinger, E., Huynh, L., …, Kasari, C. (2015). Services for children with autism spectrum disorder in three, large urban school districts: Perspectives of parents and educators. Autism, 19(6), 694–703.

    Article  PubMed  Google Scholar 

  • Institute of Education Sciences. (2020). Cost Analysis: A Stater Kit (Report No. 2020–001rev). U.S. Department of Education. Retrieved from https://ies.ed.gov/seer/pdf/IES_Cost_Analysis_Starter_Kit_V

  • Legislative Analyst’s Office (LAO). (2019). Overview of special education in California. Retrieved from https://lao.ca.gov/reports/2019/4110/overview-spec-ed-110619.pdf

  • Lavelle, T. A., Weinstein, M. C., Newhouse, J. P., Munir, K., Kuhlthau, K. A., & Prosser, L. A. (2014). Economic burden of childhood autism spectrum disorders. Pediatrics, 133(3), e520–e529.

    Article  PubMed  Google Scholar 

  • Leigh, J. P., & Du, J. (2015). Brief report: Forecasting the economic burden of autism in 2015 and 2025 in the United States. Journal of Autism and Developmental Disorders, 45(12), 4135–4139.

    Article  PubMed  Google Scholar 

  • Locke, J., Kang-Yi, C., Frederick, L., & Mandell, D. S. (2020). Individual and organizational characteristics predicting intervention use for children with autism in schools. Autism, 24(5), 1152–1163.

    Article  PubMed  Google Scholar 

  • Locke, J., Wolk, C. B., Harker, C., Olsen, A., Shingledecker, T., Barg, F., …, Beidas, R. (2017). Pebbles, rocks, and boulders: The implementation of a school-based social engagement intervention for children with autism. Autism, 21(8), 985–994.

    Article  PubMed  Google Scholar 

  • Maenner, M. J., Shaw, K. A., & Baio, J. (2020). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveillance Summaries, 69(4), 1.

    Article  PubMed Central  Google Scholar 

  • Merton, R. K. (1987). The focussed interview and focus groups: Continuities and discontinuities. The Public Opinion Quarterly, 51(4), 550–566.

    Article  Google Scholar 

  • Merton, R. K., & Kendall, P. L. (1946). The focused interview. American Journal of Sociology, 51(6), 541–557.

    Article  Google Scholar 

  • Montes, G., Halterman, J. S., & Magyar, C. I. (2009). Access to and satisfaction with school and community health services for US children with ASD. Pediatrics, 124(Supplement 4), S407–S413.

    Article  PubMed  Google Scholar 

  • Mueller, T. G., & Carranza, F. (2011). An examination of special education due process hearings. Journal of Disability Policy Studies, 22(3), 131–139.

    Article  Google Scholar 

  • National Council on Disability. (2018). Broken Promises: The Underfunding of IDEA. National Council on Disability. Retrieved from https://ncd.gov/sites/default/files/NCD_BrokenPromises_508.pdf

  • No Child Left Behind Act of 2001, P.L. 107–110, 20 U.S.C. § 6319 (2002).

  • Orsmond, G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A. (2013). Social participation among young adults with an autism spectrum disorder. Journal of Autism and Development Disorders, 43, 2710–2719. https://doi.org/10.1007/s10803-013-1833-8

    Article  Google Scholar 

  • Roux, A. M., Rast, J. E., Anderson, K. A., & Shattuck, P. T. (2017). National Autism Indicators Report: Developmental Disability Services and Outcomes in Adulthood. Life Course Outcomes Program, AJ Drexel Autism Institute, Drexel University.

    Google Scholar 

  • Rubin, R. M., Hurford, M. O., Hadley, T., Matlin, S., Weaver, S., & Evans, A. C. (2016). Synchronizing watches: The challenge of aligning implementation science and public systems. Administration and Policy in Mental Health and Mental Health Services Research, 43(6), 1023–1028.

    Article  PubMed  Google Scholar 

  • Sam, A. M., Odom, S. L., Tomaszewski, B., Perkins, Y., & Cox, A. W. (2021). Employing evidence-based practices for children with autism in elementary schools. Journal of Autism and Developmental Disorders, 51(7), 2308–2323.

    Article  PubMed  Google Scholar 

  • Schensul, S. L., Schensul, J. J., & LeCompte, M. D. (1999). Essential Ethnographic Methods: Observations, Interviews, and Questionnaires (Vol. 2). Rowman Altamira.

    Google Scholar 

  • Shattuck, P. T., Narendorf, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). Postsecondary education and employment among youth with an autism spectrum disorder. The American Academy of Pediatrics, 129, 1042–1049. https://doi.org/10.1542/peds.2011-2864

    Article  Google Scholar 

  • Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., ... & Savage, M. N. (2020). Evidence-Based Practices for Children, Youth, and Young Adults with Autism. FPG Child Development Institute.

  • Spoth, R. L., Guyll, M., & Day, S. X. (2002). Universal family-focused interventions in alcohol-use disorder prevention: Cost-effectiveness and cost-benefit analyses of two interventions. Journal of Studies on Alcohol, 63(2), 219–228.

    Article  PubMed  Google Scholar 

  • Stadnick, N. A., Meza, R. D., Suhrheinrich, J., Aarons, G. A., Brookman-Frazee, L., Lyon, A. R., …, 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  PubMed Central  Google Scholar 

  • Stahmer, A. C., Suhrheinrich, J., Schetter, P. L., & Hassrick, E. M. (2018). Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): A study protocol. Implementation Science, 13(1), 1–11.

    Google Scholar 

  • Stewart, R. E., Adams, D. R., Mandell, D. S., Hadley, T. R., Evans, A. C., Rubin, R., … Beidas, R. S. (2016). The perfect storm: Collision of the business of mental health and the implementation of evidence-based practices. Psychiatric Services, 67(2), 159–161.

    Article  PubMed  Google Scholar 

  • Suhrheinrich, J., Melgarejo, M., Root, B., Aarons, G. A., & Brookman-Frazee, L. (2021a). Implementation of school-based services for students with autism: Barriers and facilitators across urban and rural districts and phases of implementation. Autism, 25(8), 2291–2304. https://doi.org/10.1177/13623613211016729

    Article  PubMed  Google Scholar 

  • Suhrheinrich, J., Root, B. V., Melgarejo, M., Dickson, K., Vejnoska, S., & Reith, S. R. (2021b). Exploring differences and disparities in school-based services received by students with autism: A systematic review. Research in Autism Spectrum Disorders, 85, 101791.

    Article  Google Scholar 

  • U.S. Census Bureau. (2019). Income in the past 12 months (in 2018 Inflation-Adjusted Dollars), 2014–2018 American Community Survey 5-year estimates. Retrieved from https://data.census.gov/cedsci/table?q=median%20income

  • Wei, X., Yu, J. W., Wagner, M., Hudson, L., Roux, A. M., Shattuck, P., & Blackorby, J. (2018). Job searching, job duration, and job loss among young adults with autism spectrum disorder. Journal of Vocational Rehabilitation, 48(1), 1–10.

    Article  Google Scholar 

  • Willis, J., Doutre, S.M., Krausen, K., Barret, T., Ripma, T., & Caparas, R., (2020). California special education funding system study: A descriptive analysis of special education funding in California. WestEd. Retrieved from https://www.wested.org/wp-content/uploads/2020/10/WestEd_SpecialEdFundingReport_Final_508.pdf

  • Willging, C. E., Green, A. E., Gunderson, L., Chaffin, M., & Aarons, G. A. (2015). From a “perfect storm” to “smooth sailing”: Policymaker perspectives on implementation and sustainment of an evidence-based practice in two states. Child Maltreatment, 20(1), 24–36. https://doi.org/10.1177/1077559514547384

    Article  PubMed  Google Scholar 

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Acknowledgements

This study follows guidelines for qualitative methods listed on the Administration and Policy in Mental Health and Mental Health Services Research guidelines.

Funding

This work was generously funded by NIMH K01MH109574 and IES R324A170063.

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  1. Department of Special Education, Child and Adolescent Services Research Center, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-1170, USA

    Brittney V. Root, Melina Melgarejo & Jessica Suhrheinrich

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  1. Brittney V. Root
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Root, B.V., Melgarejo, M. & Suhrheinrich, J. Proactive versus Reactive: Strategies in the Implementation of School-based Services for Students with ASD. Adm Policy Ment Health 49, 575–586 (2022). https://doi.org/10.1007/s10488-021-01184-w

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