Education and mental health are two key public service sectors providing care to autistic children. However, while autism evidence-based interventions (EBIs) are available (Wong et al., 2015), they are not routinely delivered in these settings (Brookman-Frazee et al., 2010; Stahmer et al., 2005). This symposium presents findings from the multi-site, multi-sector TEAMS Study, two linked randomized Hybrid Type 3 implementation trials testing two implementation strategies on implementation mechanisms and outcomes when paired with training with two autism EBIs (AIM HI, CPRT) and adaptation data from a subsequent extension trial. The two implementation strategies were: (1) TLI (Teams Leadership Institute), an adaptation of the Leadership and Organizational Change for Implementation (LOCI) leadership training, and (2) TIPS (TEAMS Individual Provider Strategies), a provider training protocol enhanced with motivational interviewing. These implementation strategies targeted key implementation mechanisms identified in the AIM HI and CPRT effectiveness trials (implementation leadership and climate, provider motivation; Brookman-Frazee & Stahmer, 2018). It is critical to understand the effectiveness of these implementation strategies within the inner/outer implementation contexts (e.g. service system, COVID disruption, community socioeconomic resources, provider factors) to maximize the public health impact of autism EBIs.
This symposium will illustrate key findings related to the joint impact of implementation strategies and context on implementation mechanisms and outcomes (i.e. provider EBI fidelity). First, we will present the primary outcomes and mechanisms of the TEAMS Trial (Paper 1), highlighting the effectiveness of multilevel implementation strategies on implementation outcomes. Paper 2 will provide further examination of the effect of the implementation strategies on the proposed mechanisms (e.g., implementation climate). Paper 3 will describe adaptations to TLI to enhance the effectiveness of implementation support teams in an extension trial of TLI. The panel will end with a facilitated discussion including leaders who participated in the team-based TLI. Our discussion, Patricia Schetter, has experience implementing TLI and is a Placer Counter Office of Education administrator. She will facilitate a discussion of the implementation strategies with administrators from a community children’s mental heal clinic and a school district. We will discuss key takeaways for enhancing the public health impact of both EBIs and implementation strategies by considering key role of leaders and implementation support teams in EBI implementation.
References:
Brookman-Frazee, L., & Stahmer, A. C. (2018). Effectiveness of a multi-level implementation strategy for ASD interventions: Study protocol for two linked cluster randomized trials. Implementation Science, 13(1), 66. https://doi.org/10.1186/s13012-018-0757-2
Brookman-Frazee, L., Taylor, R., & Garland, A. F. (2010). Characterizing Community-Based Mental Health Services for Children with Autism Spectrum Disorders and Disruptive Behavior Problems. Journal of Autism and Developmental Disorders, 40(10), 1188–1201. https://doi.org/10.1007/s10803-010-0976-0
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. https://doi.org/10.1177/10883576050200020301
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P., & Schultz, T. R. (2015). Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z
Chair: Aubyn Stahmer, University of California, Davis,
Second Chair:,,
Discussant: Patricia Schetter, Placer County Office of Education
First Presentation: Primary Outcomes of Statewide Trial Testing Multi-Level Implementation Strategies for two Evidence-Based Autism Interventions in Children’s Mental Health Services and Schools
Lauren Brookman-Frazee, University of California, Davis,
Second Presentation: Identifying Mechanisms of Multi-Level Implementation Strategies for two Evidence-Based Autism Interventions in a Statewide Trial in Children’s Mental Health Services and Schools
Aubyn Stahmer, University of California, Davis,
Third Presentation: Implementation Leadership Across Systems and Interventions for Autistic Children
Amanda Johnson, University of California, San Diego,