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201. Fidelity Assessment in Community Programs: An Approach to Validating Simplified Methodology

Author

Suhrheinrich, Jessica, Dickson, Kelsey S., Chan, Neilson, Chan, Janice C., Wang, Tiffany, and Stahmer, Aubyn C.

Abstract

Fidelity to intervention protocol is linked to best outcomes for individuals with autism spectrum disorder (ASD; see Boyd & Corley [Autism 5(4):430–441, 2001]; Pellecchia et al. [J Autism Dev Disord 45(9):2917–2927, 2015]); however, fidelity measurement tools that are both accurate and feasible for community use are often not available. In this paper we explore methods for validated simplification of fidelity assessment procedures toward the goal of increased use in clinical practice. Video recordings (n= 36) of therapists working with children with ASD were coded using three variations of fidelity assessment methodology (trial-by-trial, 5-point Likert Scale, and 3-point Likert Scale), and the results were compared for exact agreement, mastery criterion agreement, and overall reliability. The results indicated overall a very high percentage of exact agreement (mean 99.44%, range 94.4–100%) and excellent reliability (mean Krippendorff’s alpha [Kα] 1.0) between the trial-by-trial and 5-point Likert Scale across all components; however, the 3-point method may be viewed as being the more feasible strategy within community programs.

Published
2020
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202. Exploring Associations Between Inner-Context Factors and Implementation Outcomes

Author

Suhrheinrich, Jessica, Rieth, Sarah R., Dickson, Kelsey S., and Stahmer, Aubyn C.

Abstract

Classroom pivotal response teaching (CPRT) is an evidence-based practice (EBP) adapted for classroom use. A recent effectiveness trial of CPRT involved training 98 special education classrooms in Southern California. The Exploration, Planning, Implementation, and Sustainment (EPIS) conceptual framework illustrates the impact of inner- and outer-context factors on implementation outcomes. This article evaluates how teacher factors (including attitudes toward EBP) and organizational factors (implementation climate and district support) influence training outcomes (fidelity of intervention, report of use, sustainment, and satisfaction). Teachers’ ratings of training quality were related to higher fidelity during their follow-up year, β = .34, t(78) = 2.97, p< .004, and rating of intervention ease of use was related to higher daily CPRT use. Teacher ratings on the appeal scale of the attitudes measure were associated with individual sustainment, β = .35, t(55) = 2.76, p< .01. Leader involvement at recruitment meetings, β = .35, t(48) = 2.58, p= .01, and provision of CPRT training space, β = .44, t(48) = 2.73, p< .01, were significantly related to school sustainment. Teachers’ overall attitudes toward the intervention were significantly related to satisfaction with CPRT training, β = .41, t(80) = 3.96, p< .01. This study makes important preliminary contributions to understanding the impact of inner-context implementation determinants of a classroom-based EBP for students with autism spectrum disorder.

Published
2020
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204. How meaningful is more? Considerations regarding intensity in early intensive behavioral intervention.

Author

Pellecchia, Melanie, Iadarola, Suzannah, and Stahmer, Aubyn C

Subjects
TREATMENT of autism, ADAPTABILITY (Personality), BEHAVIOR therapy, CHILD behavior, COGNITION, COMMUNICATION, EMOTIONS, HEALTH services accessibility, INTELLECT, MEDICAL protocols, OCCUPATIONAL therapy, SERIAL publications, SPEECH evaluation, FAMILY relations, COMMUNITY-based social services, TREATMENT effectiveness, HEALTH & social status
Abstract

The authors convey their concerns on Early Intensive Behavioral Intervention (EIBI) dose for children with autism spectrum disorder. Topics mentioned include the positive impact of EIBI on intelligence quotient, communication, and behavior use, how EIBI is implemented in community programs, and the general consensus that intervention should be individualized based on child characteristics and family factors.

Published
2019
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205. Strategies to Engage Underrepresented Parents in Child Intervention Services: A Review of Effectiveness and Co-occurring Use.

Author

Pellecchia, Melanie, Nuske, Heather J., Straiton, Diondra, McGhee Hassrick, Elizabeth, Gulsrud, Amanda, Iadarola, Suzannah, Vejnoska, Sarah Fulton, Bullen, Beth, Haine-Schlagel, Rachel, Kasari, Connie, Mandell, David S., Smith, Tristram, and Stahmer, Aubyn C.

Subjects
PARENT participation in education, INTERVENTION (Social services), FAMILY services, CHILD mental health services, AFFECTIVE disorders in children, BEHAVIOR disorders in children, PSYCHOLOGY information storage & retrieval systems, MENTAL health services, PARENTS, SOCIAL networks, HUMAN research subjects
Abstract

The purpose of this review was to estimate the impact of parent engagement strategies tested with underrepresented families of young children with social, emotional, or behavioral disorders, and describe the combinations in which these strategies are commonly used together. We conducted a systematic review using the PracticeWise Engagement Coding System to identify which strategies had the strongest empirical support for engaging underrepresented (i.e., minority race or ethnicity, or low income) families receiving psychosocial services for their children. Social network analyses were used to identify the frequency of strategy use and how strategies were combined to engage underrepresented families. Linear regression was used to estimate the impact of each strategy on parent engagement, using attrition as a proxy for non-engagement. Thirty-five studies met inclusion criteria. Parent attrition was predicted by larger sample sizes, lower maternal education, interventions that were more community or home-based, less therapist monitoring, positive reinforcement from therapists, and more pairing families with peers. Social network analyses suggested that more effective strategies were more frequently implemented alone and less effective strategies were commonly combined with each other. Our findings suggest that researchers and practitioners require guidance in selecting engagement strategies to reduce attrition of underrepresented families in treatment. Although we identified promising strategies for improving parent engagement in treatment for underrepresented children with social, emotional, or behavioral disorders, the frequent combining of engagement strategies in research means that there is little data on the independent effects of interventions to increase parent engagement for this population. [ABSTRACT FROM AUTHOR]

Published
2018
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210. Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

Author

Lewis, Cara, primary, Darnell, Doyanne, additional, Kerns, Suzanne, additional, Monroe-DeVita, Maria, additional, Landes, Sara J., additional, Lyon, Aaron R., additional, Stanick, Cameo, additional, Dorsey, Shannon, additional, Locke, Jill, additional, Marriott, Brigid, additional, Puspitasari, Ajeng, additional, Dorsey, Caitlin, additional, Hendricks, Karin, additional, Pierson, Andria, additional, Fizur, Phil, additional, Comtois, Katherine A., additional, Palinkas, Lawrence A., additional, Chamberlain, Patricia, additional, Aarons, Gregory A., additional, Green, Amy E., additional, Ehrhart, Mark. G., additional, Trott, Elise M., additional, Willging, Cathleen E., additional, Fernandez, Maria E., additional, Woolf, Nicholas H., additional, Liang, Shuting Lily, additional, Heredia, Natalia I., additional, Kegler, Michelle, additional, Risendal, Betsy, additional, Dwyer, Andrea, additional, Young, Vicki, additional, Campbell, Dayna, additional, Carvalho, Michelle, additional, Kellar-Guenther, Yvonne, additional, Damschroder, Laura J., additional, Lowery, Julie C., additional, Ono, Sarah S., additional, Carlson, Kathleen F., additional, Cottrell, Erika K., additional, O’Neil, Maya E., additional, Lovejoy, Travis L., additional, Arch, Joanna J., additional, Mitchell, Jill L., additional, Lewis, Cara C., additional, Marriott, Brigid R., additional, Scott, Kelli, additional, Coldiron, Jennifer Schurer, additional, Bruns, Eric J., additional, Hook, Alyssa N., additional, Graham, Benjamin C., additional, Jordan, Katelin, additional, Hanson, Rochelle F., additional, Moreland, Angela, additional, Saunders, Benjamin E., additional, Resnick, Heidi S., additional, Stirman, Shannon Wiltsey, additional, Gutner, Cassidy A., additional, Gamarra, Jennifer, additional, Vogt, Dawne, additional, Suvak, Michael, additional, Wachen, Jennifer Schuster, additional, Dondanville, Katherine, additional, Yarvis, Jeffrey S., additional, Mintz, Jim, additional, Peterson, Alan L., additional, Borah, Elisa V., additional, Litz, Brett T., additional, Molino, Alma, additional, McCaughan, Stacey Young, additional, Resick, Patricia A., additional, Pandhi, Nancy, additional, Jacobson, Nora, additional, Serrano, Neftali, additional, Hernandez, Armando, additional, Schreiter, Elizabeth Zeidler-, additional, Wietfeldt, Natalie, additional, Karp, Zaher, additional, Pullmann, Michael D., additional, Lucenko, Barbara, additional, Pavelle, Bridget, additional, Uomoto, Jacqueline A., additional, Negrete, Andrea, additional, Cevasco, Molly, additional, Kerns, Suzanne E. U., additional, Franks, Robert P., additional, Bory, Christopher, additional, Miech, Edward J., additional, Damush, Teresa M., additional, Satterfield, Jason, additional, Satre, Derek, additional, Wamsley, Maria, additional, Yuan, Patrick, additional, O’Sullivan, Patricia, additional, Best, Helen, additional, Velasquez, Susan, additional, Barnett, Miya, additional, Brookman-Frazee, Lauren, additional, Regan, Jennifer, additional, Stadnick, Nicole, additional, Hamilton, Alison, additional, Lau, Anna, additional, Roesch, Scott, additional, Powell, Byron J., additional, Waltz, Thomas J., additional, Chinman, Matthew J., additional, Damschroder, Laura, additional, Smith, Jeffrey L., additional, Matthieu, Monica M., additional, Proctor, Enola K., additional, Kirchner, JoAnn E., additional, Matthieu, Monica J., additional, Rosen, Craig S., additional, Walker, Sarah C., additional, Bishop, Asia S., additional, Lockhart, Mariko, additional, Rodriguez, Allison L., additional, Manfredi, Luisa, additional, Nevedal, Andrea, additional, Rosenthal, Joel, additional, Blonigen, Daniel M., additional, Mauricio, Anne M., additional, Dishion, Thomas D., additional, Rudo-Stern, Jenna, additional, Smith, Justin D., additional, Wolk, Courtney Benjamin, additional, Harker, Colleen, additional, Olsen, Anne, additional, Shingledecker, Travis, additional, Barg, Frances, additional, Mandell, David, additional, Beidas, Rinad S., additional, Hansen, Marissa C., additional, Aranda, Maria P., additional, Torres-Vigil, Isabel, additional, Hartzler, Bryan, additional, Steinfeld, Bradley, additional, Gildred, Tory, additional, Harlin, Zandrea, additional, Shephard, Fredric, additional, Ditty, Matthew S., additional, Doyle, Andrea, additional, Bickel, John A., additional, Cristaudo, Katharine, additional, Fox, Dan, additional, Combs, Sonia, additional, Lischner, David H., additional, Van Dorn, Richard A., additional, Tueller, Stephen J., additional, Hinde, Jesse M., additional, Karuntzos, Georgia T., additional, Peterson, Roselyn, additional, Berliner, Lucy, additional, Murray, Laura K., additional, Botanov, Yevgeny, additional, Kikuta, Beverly, additional, Chen, Tianying, additional, Navarro-Haro, Marivi, additional, DuBose, Anthony, additional, Korslund, Kathryn E., additional, Linehan, Marsha M., additional, Harker, Colleen M., additional, Karp, Elizabeth A., additional, Edmunds, Sarah R., additional, Ibañez, Lisa V., additional, Stone, Wendy L., additional, Andrews, Jack H., additional, Johnides, Benjamin D., additional, Hausman, Estee M., additional, Hawley, Kristin M., additional, Prusaczyk, Beth, additional, Ramsey, Alex, additional, Baumann, Ana, additional, Colditz, Graham, additional, Choy-Brown, Mimi, additional, Meza, Rosemary D., additional, Wiltsey-Stirman, Shannon, additional, Sedlar, Georganna, additional, Lucid, Leah, additional, Zounlome, Nelson, additional, Lewis, Cara, additional, Monson, Candice M., additional, Shields, Norman, additional, Mastlej, Marta, additional, Landy, Meredith SH, additional, Lane, Jeanine, additional, Finn, Natalie K., additional, Torres, Elisa M., additional, Malte, Carol A., additional, Lott, Aline, additional, Saxon, Andrew J., additional, Boyd, Meredith, additional, Pierce, Jennifer D., additional, Lorthios-Guilledroit, Agathe, additional, Richard, Lucie, additional, Filiatrault, Johanne, additional, Hallgren, Kevin, additional, Crotwell, Shirley, additional, Muñoz, Rosa, additional, Gius, Becky, additional, Ladd, Benjamin, additional, McCrady, Barbara, additional, Epstein, Elizabeth, additional, Clapp, John D., additional, Ruderman, Danielle E., additional, Barwick, Melanie, additional, Barac, Raluca, additional, Zlotkin, Stanley, additional, Salim, Laila, additional, Davidson, Marnie, additional, Bunger, Alicia C., additional, Robertson, Hillary A., additional, Botsko, Christopher, additional, Smith, Brandy N., additional, Trent, Lindsay R., additional, Harned, Melanie S., additional, Ivanoff, André, additional, Garcia, Antonio R., additional, Kim, Minseop, additional, Snowden, Lonnie, additional, Landsverk, John, additional, Sweetland, Annika C., additional, Fernandes, Maria Jose, additional, Santos, Edilson, additional, Duarte, Cristiane, additional, Kritski, Afrânio, additional, Krawczyk, Noa, additional, Nelligan, Caitlin, additional, Wainberg, Milton L., additional, Sommerfeld, David H., additional, Chi, Benjamin, additional, Ezeanolue, Echezona, additional, Sturke, Rachel, additional, Kline, Lydia, additional, Guay, Laura, additional, Siberry, George, additional, Bennett, Ian M., additional, Beidas, Rinad, additional, Gold, Rachel, additional, Mao, Johnny, additional, Powers, Diane, additional, Vredevoogd, Mindy, additional, Unutzer, Jurgen, additional, Schroeder, Jennifer, additional, Volpe, Lane, additional, Steffen, Julie, additional, Pullmann, Michael D, additional, Jungbluth, Nathaniel, additional, Thompson, Kelly, additional, Segell, Eliza, additional, McGee-Vincent, Pearl, additional, Liu, Nancy, additional, Walser, Robyn, additional, Runnals, Jennifer, additional, Shaw, R. Keith, additional, Rosen, Craig, additional, Schmidt, Janet, additional, Calhoun, Patrick, additional, Varkovitzky, Ruth L., additional, Drahota, Amy, additional, Martinez, Jonathan I., additional, Brikho, Brigitte, additional, Meza, Rosemary, additional, Stahmer, Aubyn C., additional, Williamson, Anna, additional, Rubin, Ronnie M., additional, Hurford, Matthew O., additional, Weaver, Shawna L., additional, Mandell, David S., additional, Evans, Arthur C., additional, Stewart, Rebecca E., additional, Matlin, Samantha L., additional, Weaver, Shawna, additional, Hadley, Trevor R., additional, Gerke, Donald R., additional, Lewis, Ericka M., additional, McWilliam, Jenna, additional, Brown, Jacquie, additional, Tucker, Michelle, additional, Conte, Kathleen P, additional, Melvin, Abigail, additional, Liu, Freda, additional, Kotte, Amelia, additional, Hill, Kaitlin A., additional, Mah, Albert C., additional, Korathu-Larson, Priya A., additional, Au, Janelle R., additional, Izmirian, Sonia, additional, Keir, Scott, additional, Nakamura, Brad J., additional, Higa-McMillan, Charmaine K., additional, Cooper, Brittany Rhoades, additional, Funaiole, Angie, additional, Dizon, Eleanor, additional, Hawkins, Eric J., additional, Hagedorn, Hildi J., additional, Berger, Douglas, additional, Frank, Anissa, additional, Achtmeyer, Carol E., additional, Mariano, Anthony J., additional, Wolitzky-Taylor, Kate, additional, Rawson, Richard, additional, Ries, Richard, additional, Roy-Byrne, Peter, additional, Craske, Michelle, additional, Simmons, Dena, additional, Torrente, Catalina, additional, Nathanson, Lori, additional, Carroll, Grace, additional, Brown, Kimbree, additional, Ramos, Karina, additional, Thornton, Nicole, additional, Dishion, Thomas J., additional, Stormshak, Elizabeth A., additional, Shaw, Daniel S., additional, Wilson, Melvin N., additional, Tiderington, Emmy, additional, Smith, Bikki Tran, additional, Padgett, Deborah K., additional, Ray, Marilyn L., additional, Wandersman, Abraham, additional, Lamont, Andrea, additional, Hannah, Gordon, additional, Alia, Kassandra A., additional, Saldana, Lisa, additional, Schaper, Holle, additional, Campbell, Mark, additional, Shapiro, Valerie B., additional, Kim, B.K. Elizabeth, additional, Fleming, Jennifer L., additional, LeBuffe, Paul A., additional, Comtois, Katherine Anne, additional, Weiner, Bryan J., additional, and Halko, Heather, additional

Published
2016
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213. Rethinking the idea of late autism spectrum disorder onset.

Author

Bacon, Elizabeth C., Courchesne, Eric, Barnes, Cynthia Carter, Cha, Debra, Pence, Sunny, Schreibman, Laura, Stahmer, Aubyn C., and Pierce, Karen

Subjects
AUTISM spectrum disorders in children, EARLY diagnosis, TODDLERS, COMMUNICATION, SYMPTOMS, PROGNOSIS, DISEASES
Abstract

A common theory of autism spectrum disorder (ASD) symptom onset includes toddlers who do not display symptoms until well after age 2, which are termed late-onset ASD cases. Objectives were to analyze differences in clinical phenotype between toddlers identified as ASD at initial evaluations (early diagnosed) versus those initially considered nonspectrum, then later identified as ASD (late diagnosed). Two hundred seventy-three toddlers recruited from the general population based on a failed developmental screening form or parent or physician concerns were followed longitudinally from 12 months and identified as early- and late-diagnosed cases of ASD, language delayed, or typically developing. Toddlers completed common standardized assessments and experimental eye-tracking and observational measures every 9–12 months until age 3. Longitudinal performance on standardized assessments and experimental tests from initial evaluations were compared. Delay in social communication skills was seen in both ASD groups at early-age initial assessment, including increased preference for nonsocial stimuli, increased stereotypic play, reduced exploration, and use of gestures. On standardized psychometric assessments, early-diagnosed toddlers showed more impairment initially while late-diagnosed toddlers showed a slowing in language acquisition. Similar social communication impairments were present at very early ages in both early-detected ASD and so-called late-onset ASD. Data indicate ASD is present whether detected or not by current methods, and development of more sensitive tools is needed. [ABSTRACT FROM AUTHOR]

Published
2018
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214. Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder.

Author

Dickson, Kelsey S., Suhrheinrich, Jessica, Rieth, Sarah R., and Stahmer, Aubyn C.

Subjects
TREATMENT of autism, ADAPTABILITY (Personality), CAREGIVERS, CHILD behavior, COGNITION, INTERPERSONAL relations, TIME, SOCIAL support, TREATMENT effectiveness, PARENT attitudes, SEVERITY of illness index, COLLEGE teacher attitudes, ADOLESCENCE
Abstract

Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent-teacher concordance of ratings of adaptive functioning and ASD-specific symptomatology across time. The impact of child clinical characteristics on concordance was also examined. Participants included 246 children, their caregivers and teachers. Parent-teacher concordance was variable but generally consistent across time. Concordance was significantly impacted by autism severity and child cognitive abilities. Findings inform the broader concordance literature and support the need to consider child clinical factors when assessing child functioning in samples of children with ASD. [ABSTRACT FROM AUTHOR]

Published
2018
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215. Integrating a Parent-Implemented Blend of Developmental and Behavioral Intervention Strategies into Speech-Language Treatment for Toddlers at Risk for Autism Spectrum Disorder.

Author

Rieth, Sarah R., Haine-Schlagel, Rachel, Burgeson, Marilee, Searcy, Karyn, Dickson, Kelsey S., and Stahmer, Aubyn C.

Subjects
TREATMENT of autism, BEHAVIOR therapy, PATIENT-professional relations, PARENT-child relationships, RESEARCH funding, SPEECH therapy, EARLY intervention (Education), TREATMENT effectiveness
Abstract

Naturalistic developmental behavioral interventions include an explicit focus on coaching parents to use therapy techniques in daily routines and are considered best practice for young children with autism. Unfortunately, these approaches are not widely used in community settings, possibly due to the clinical expertise and training required. This article presents the work of the Bond, Regulate, Interact, Develop, Guide, Engage (BRIDGE Collaborative), a multidisciplinary group of service providers (including speech-language pathologists), parents, funding agency representatives, and researchers dedicated to improving the lives of young children with autism spectrum disorder and their families. The group selected and adapted a parent coaching naturalistic developmental behavioral intervention specifically for use with toddlers and their families for community implementation. Lessons learned from the implementation process include the importance of therapist background knowledge, the complexity of working with parents of young children, and needed supports for those working closely with parents, including specific engagement strategies and the incorporation of reflective practice. [ABSTRACT FROM AUTHOR]

Published
2018
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216. Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol.

Author

Stahmer, Aubyn C., Suhrheinrich, Jessica, Schetter, Patricia L., McGee Hassrick, Elizabeth, and McGhee Hassrick, Elizabeth

Subjects
*EDUCATIONAL programs, *ACADEMIC achievement, *EDUCATIONAL technology, *AUDIOVISUAL education, *SPECIAL education, *LONGITUDINAL method, *RESEARCH protocols, *SCHOOLS, *STUDENTS, *EVIDENCE-based medicine, *PROFESSIONAL practice
Abstract

Background: This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for the positive effects of EBPs for ASD, these practices are not consistently or effectively used in schools. Although special education programs are mandated to use EBPs, there are very few evidence-based methods for selecting, implementing, and sustaining EBPs. Research focuses primarily on teacher training, without attention to contextual factors (e.g., implementation climate, attitudes toward EBPs, resource allocation, and social networks) that may impact outcomes. Using an implementation science framework, this project will prospectively examine relations between system-wide factors and teachers' use of EBPs and student education outcomes.Methods/design: Survey data will be collected from approximately 85 regional special education directors, 170 regional program specialists, 265 district special education directors, 265 behavior specialists, 925 school principals, 3538 special education teachers, and 2700 paraprofessionals. Administrative data for the students with ASD served by participating teachers will be examined. A total of 79 regional-, district-, and school-level personnel will also participate in social network interviews. Mixed methods, including surveys, administrative data, and observational checklists, will be used to gather in-depth information about system-wide malleable factors that relate to positive teacher implementation of EBPs and student outcomes. Multi-level modeling will be used to assess system-wide malleable factors related to EBP implementation which will be linked to the trainer, teacher, and student outcomes and examined based on moderators (e.g., district size, Special Education Local Plan Area structure, teachers' ASD experience). Finally, a dynamic social network approach will be used to map EBP-related connectivity across all levels of the system for selected regions. Dynamic network analysis will be used to gauge the degree to which and ways that EBP trainings, resources, and interventions are shared (or not shared) among school staff.Discussion: Results are expected to inform the development of system-wide interventions to improve the school-based implementation of EBPs for students with ASD. [ABSTRACT FROM AUTHOR]

Published
2018
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217. Classroom Pivotal Response Teaching for Children with Autism

Author

Stahmer, Aubyn C. and Stahmer, Aubyn C.

Subjects
Autistic children--Behavior modification, Autistic children--Education
Abstract

This practical manual and accompanying DVD-ROM present a research-supported behavioral intervention for children with autism that teachers can easily integrate into their existing classroom curriculum. Classroom Pivotal Response Teaching (CPRT) enhances children's motivation and participation in learning; increases the number of learning opportunities they experience each day; and promotes mastery of targeted communication, play, social, and academic skills. In a convenient large-size format with lay-flat binding, the book features more than two dozen reproducible worksheets and forms to aid in planning and implementing the procedures. The DVD-ROM includes narrated PowerPoint presentations with invaluable video examples of CPRT in action, along with copies of the reproducibles.

Published
2011

218. Diagnosis of autism spectrum disorders in two year-olds: A study of community practice

Author

Corsello, Christina M., Akshoomoff, Natacha, and Stahmer, Aubyn C.

Subjects
Male, Psychiatric Status Rating Scales, Child Development Disorders, Pervasive, Child, Preschool, Surveys and Questionnaires, Age Factors, Humans, Reproducibility of Results, Sensitivity and Specificity, Article
Abstract

Longitudinal research studies have demonstrated that experienced clinicians using standardized assessment measures can make a reliable diagnosis of autism spectrum disorders (ASDs) in children under age 3. Limited data are available regarding the sensitivity and specificity of these measures in community settings. The aims of this study were to determine how well a standardized diagnostic observational measure (Autism Diagnostic Observation Schedule - ADOS) functions alone, and with a brief parent measure within a community setting when administered by community clinicians.Clinical records for 138 children between the ages of 24 and 36 months of age who were evaluated for possible ASD or social/language concerns at a hospital-based developmental evaluation clinic were examined. Evaluations were conducted by community-based clinical psychologists. Classification results obtained from standardized diagnostic measures were compared with case reviewer diagnosis, by reviewers blind to scores on diagnostic measures, using The Records-based Methodology for ASD Case Definition that was developed by the Metropolitan Atlanta Developmental Disabilities Surveillance Program.When compared with case review diagnosis, the ADOS demonstrated strong sensitivity and specificity for both Autism versus Not Autism and ASD versus Nonspectrum (NS) diagnoses in this young sample. The Social Communication Questionnaire (SCQ), using the lower cutoff of ≥12, had adequate sensitivity when differentiating Autism from Not Autism, but weak sensitivity when differentiating ASD from NS, missing about 80% of the children with pervasive developmental disorder - not otherwise specified. Using either the Modified Checklist for Autism in Toddlers or the SCQ in combination with the ADOS did not result in improved specificity over the ADOS alone and led to a drop in sensitivity when differentiating ASD from NS disorders.These results demonstrate that following best practice guidelines, the ADOS can be successfully incorporated into clinical practice with relatively good sensitivity and specificity, and worked well with a referred sample of 2-year-olds. A parent questionnaire did not lead to any improvement in diagnostic classification above the ADOS used in isolation.

Published
2012

219. BUILDING A RESEARCH-COMMUNITY COLLABORATIVE TO IMPROVE COMMUNITY CARE FOR INFANTS AND TODDLERS AT-RISK FOR AUTISM SPECTRUM DISORDERS

Author

Brookman-Frazee, Lauren, Stahmer, Aubyn C., Lewis, Karyn, Feder, Joshua D., and Reed, Sarah

Subjects
Pediatric, Mental Health, Clinical Research, Intellectual and Developmental Disabilities (IDD), Autism, Prevention, Behavioral and Social Science, Psychology, Developmental & Child Psychology, Article, Brain Disorders
Abstract

This article describes the formation and initial outcomes of a research-community collaborative group that was developed based on community-based participatory research principles. The group includes a transdisciplinary team of practitioners, funding agency representatives, researchers, and families of children with autism spectrum disorders, who partnered to improve community-based care for infants and toddlers at risk for autism through the implementation of evidence-based practices. Data from this group provide support for the feasibility of developing and sustaining a highly synergistic and productive research-community collaborative group who shares common goals to improve community care.

Published
2012

220. Are we overmedicating our children?

Author

Harrington, John W., Mandell, David S., Morales, Knashawn H., Marcus, Steven C., Stahmer, Aubyn C., Doshi, Jalpa, and Polsky, Daniel E.

Subjects
Psychotropic drugs -- Reports, Psychotropic drugs -- Dosage and administration, Autism -- Drug therapy
Published
2008

223. All Together Now

Author

Kratz, Hilary E., primary, Locke, Jill, additional, Piotrowski, Zinnia, additional, Ouellette, Rachel R., additional, Xie, Ming, additional, Stahmer, Aubyn C., additional, and Mandell, David S., additional

Published
2014
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224. Exploring the Relationship between Classroom Type and Teacher Intervention Fidelity.

Author

SUHRHEINRICH, Jessica, DICKSON, Kelsey S., RIETH, Sarah R., LAU, Austin F., and STAHMER, Aubyn C.

Subjects
AUTISM spectrum disorders, AUTISTIC children, TEACHER training, TEACHING methods, LOYALTY
Abstract

As special education enrollment for children with autism spectrum disorders (ASD) has increased, school-based programs and providers have been challenged to expand the scope and quality of services. Researchers and school-based providers are aligned in the goal of providing high-quality services to students with ASD, however current literature does not address how training and implementation needs may differ by the age of children served. The current study evaluates variability in teacher fidelity of Classroom Pivotal Response Teaching (CPRT), an evidence-based naturalistic behavioral intervention based on the principals of applied behavior analysis. Data included 479 individual video units collected from 101 teacher and 221 student participants. Videos were coded using behavioral coding definitions and student demographic information was collected from parents of participating children. Analyses explored differences in fidelity of CPRT by age of students. Results indicate a significant relationship between classroom type (preschool/elementary) and teachers' fidelity of CPRT, suggesting the possibility of targeted training based on student age. [ABSTRACT FROM AUTHOR]

Published
2016

250. Identifying Critical Elements of Treatment: Examining the Use of Turn Taking in Autism Intervention.

Author

Rieth, Sarah R., Stahmer, Aubyn C., Suhrheinrich, Jessica, Schreibman, Laura, Kennedy, Joanna, and Ross, Benjamin

Abstract

Evidence-based treatments for autism spectrum disorders (ASD) are comprised of components that identify therapist behavior necessary to implement the treatment with integrity. Some components are shared across approaches from diverse theoretical backgrounds. One component included in several interventions that has not been researched in isolation is turn taking, or the manner in which the therapist facilitates back-and-forth interaction with the child. The current study used an alternating treatments design to examine the efficacy of four types of turn taking. Six children, ages 30 to 39 months, received behavioral treatment while therapists systematically varied the nature of the turn taking component. Children’s responses were behaviorally scored to examine differences based on turn condition. Consistent patterns of behavior were found across children. Results suggest that the optimal type of turn is dependent on developmental level and target skill. Implications for treatment of ASD and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Published
2008
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