The role of treatment fidelity on outcomes during a randomized field trial of an autism intervention.

New CAR Research Sheds Light on

 

Universal Screening for Autism in Toddlers

TitleThe role of treatment fidelity on outcomes during a randomized field trial of an autism intervention.
Publication TypeJournal Article
Year of Publication2013
AuthorsMandell, DS, Stahmer, AC, Shin, S, Xie, M, Reisinger, E, Marcus, SC
JournalAutism
Volume17
Issue3
Pagination281-95
Date Published2013 May
ISSN1461-7005
KeywordsAutistic Disorder, Child, Child, Preschool, Faculty, Female, Humans, Male, Schools, Teaching
Abstract

This randomized field trial comparing Strategies for Teaching based on Autism Research and Structured Teaching enrolled educators in 33 kindergarten-through-second-grade autism support classrooms and 119 students, aged 5-8 years in the School District of Philadelphia. Students were assessed at the beginning and end of the academic year using the Differential Ability Scales. Program fidelity was measured through video coding and use of a checklist. Outcomes were assessed using linear regression with random effects for classroom and student. Average fidelity was 57% in Strategies for Teaching based on Autism Research classrooms and 48% in Structured Teaching classrooms. There was a 9.2-point (standard deviation = 9.6) increase in Differential Ability Scales score over the 8-month study period, but no main effect of program. There was a significant interaction between fidelity and group. In classrooms with either low or high program fidelity, students in Strategies for Teaching based on Autism Research experienced a greater gain in Differential Ability Scales score than students in Structured Teaching (11.2 vs. 5.5 points and 11.3 vs. 8.9 points, respectively). In classrooms with moderate fidelity, students in Structured Teaching experienced a greater gain than students in Strategies for Teaching based on Autism Research (10.1 vs. 4.4 points). The results suggest significant variability in implementation of evidence-based practices, even with supports, and also suggest the need to address challenging issues related to implementation measurement in community settings.

DOI10.1177/1362361312473666
Alternate JournalAutism
PubMed ID23592849
PubMed Central IDPMC3738205
Grant ListR01 MH083717 / MH / NIMH NIH HHS / United States
R01MH083717 / MH / NIMH NIH HHS / United States
R324A080195 / / PHS HHS / United States
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