Toward a strengths-based model for designing virtual reality learning experiences for autistic users

LAY ABSTRACT

Virtual reality has been studied for its potential in supporting individuals with autism, but existing research often focuses on deficits and lacks consideration of individual preferences and strengths. This article introduces a framework that emphasizes the strengths and abilities of autistic individuals when designing virtual reality interventions. It builds upon an existing taxonomy of educational technology affordances and extends it to align with the unique needs of autistic individuals. The framework provides guidance for incorporating virtual reality technology that supports and amplifies autistic strengths, such as visual perception and response to positive feedback. The framework has implications for practice, research, and policy. For practitioners, it offers a tool for designing virtual reality experiences that cater to the strengths of autistic individuals, enhancing engagement and educational outcomes. Researchers can utilize the framework to guide the development of user-centered virtual reality interventions and expand our understanding of the potential benefits of virtual reality for autistic populations. Policymakers and educators can consider this framework when incorporating virtual reality into educational settings, ensuring that virtual reality technology is used in a way that aligns with the strengths and needs of autistic learners. Overall, the framework promotes a strengths-based approach in utilizing virtual reality technology for individuals with autism, fostering inclusivity and maximizing the benefits of immersive experiences.

The Power Card Strategy: Strength-Based Intervention Against Bullying for Children with Autism Spectrum Disorder

The pattern of behaviors and abilities that reflect the core characteristics of students with autism spectrum disorder (ASD) and an environment that lacks the ability to understand individuals with ASD can make these students targets of bullying. Bullying is a serious problem for students with ASD, and practices against it are important in terms of improving students' coping strategies and overall well-being. In this study, we used a multiple probe model with an interprobe phase across participants to evaluate the effectiveness of the power card strategy to teach three students with ASD to respond to bullying. At baseline, the students gave few appropriate responses based on coping strategies for bullying after listening to stories about bullying. During the application of the power cards, the students read scenarios and power cards created for their favorite heroes or special interests, which included coping strategies for three different bullying situations (exclusion, being pushed, and being tickled). Then, they watched animations prepared for these bullying situations and were asked to answer questions about strategies to deal with bullying. The findings showed that all three students learned targeted strategies for coping with bullying in the context of the sessions using power cards. The students were able to generalize to different bullying situations (teasing, damaging one's belongings, being ignored) while retaining their strategies for coping with bullying in the context of the sessions held after the teaching was completed. The social validity findings of the power card strategy showed that one out of three students exhibited coping strategies for bullying in the school environment. The findings of the present study are discussed in the context of bullying and ASD, limitations, and recommendations.

Competency drivers to support implementation of early intensive behavioral intervention in large-scale community-based services: Perspectives of caseworkers and organization representatives

Implementing evidence-based practices in "real-world" settings poses significant challenges. Organizations involved must address this issue by providing supportive infrastructures. Among the elements to consider are competency drivers, which refer to the selection, training, and supervision of caseworkers. The purpose of this study was to describe the perspectives of caseworkers and representatives on competency drivers that organizations put in place to support the implementation of early intensive behavioral intervention (EIBI) in large-scale community-based services. The sample consisted of 109 caseworkers and 23 organization representatives who completed questionnaires. Results demonstrated that respondents consider clinical support and training as key elements in EIBI implementation. However, despite recognizing these factors, respondents reported considerable variability in practices. It appears necessary to better define and plan the implementation of these competency drivers with a view to improving EIBI implementation.

Inclusion of autistic students: promising modalities for supporting a school team

PURPOSE

School staff who work with autistic students are at a high risk of exhaustion. More training and guidance are needed to enable them to respond to these students' needs. The purpose of this study was to design and evaluate a professional development program offered by an occupational therapist to help a team of school staff facilitate the participation of autistic students and their peers.

METHODS

A design-based research approach guided the development and evaluation of the modalities of the program. A case study was conducted in a school with nine school staff members using individual interviews, questionnaires, and a logbook.

RESULTS

The program comprised five modalities: regular presence of the occupational therapist, a needs analysis, content focused on the features of an inclusive school, individual coaching, and team coaching. The following elements emerged as particularly helpful for the participants: frequent interactions with the occupational therapist, opportunities to collaborate, personalized support, experimentation of new practices with the occupational therapist, and concrete training content that can benefit all students.

CONCLUSION

The modalities of the program appear promising to help a school team facilitate the participation of all students, including those who are autistic.Implications for rehabilitationOccupational therapists can help school teams to facilitate the participation of autistic students and their peers.A combination of individual and team coaching sessions appears promising in helping school staff adopt practice changes to make their school more inclusive.Using a multi-tiered approach can help therapists collaborate with school staff members to first find solutions that will be applicable with all of their students.

Participatory autism research: Early career and established researchers' views and experiences

LAY ABSTRACT

'Participatory autism research' refers to ways of involving autistic people and their allies (e.g. family members) in making decisions about research. These decisions can include what research gets done, how it gets done and how research findings are used. While there is more and more interest in participatory autism research, we know little about how researchers at different stages of their careers use this approach. To find out more, we discussed these issues with 25 researchers. Fourteen of these were at an early stage of their careers, and 11 were more senior researchers. We spoke to people in individual interviews or in groups. We then used a technique called thematic analysis to analyse our data, which involved us looking for common topics or 'themes' discussed by our participants. What did we find? Our participants told us that participatory autism research was a flexible approach, meaning that autistic people can be involved in research in many different ways. While people viewed this flexibility in a positive way, it also caused some confusion about what does or does not 'count' as participatory research. Our participants also spoke about how important it was to build relationships with those involved in their research, but they also said it could be difficult to communicate well with diverse groups of people who may not have much experience of research. Finally, our participants said it was hard to do participatory research when there was not much time, funding or support available to researchers. In this article, we discuss these findings, focusing on what needs to change to ensure that autistic people and their allies are meaningfully involved in autism research.

A sequential mixed-methods approach to exploring the experiences of practitioners who have worked in multi-sensory environments with autistic children

BACKGROUND & AIMS

Multi-Sensory Environments (MSEs) are common in special-needs schools and are widely used with autistic pupils. In this exploratory sequential mixed-methods study, we explored the beliefs and experiences of practitioners who regularly use MSEs with autistic pupils.

METHODS

Qualitative interviews with ten practitioners (9 female, aged 24-62 years) identified six themes reflecting beliefs about MSE use with autistic children. To explore wider relevance of these themes, codes from the themes were converted into a 28-item online survey.

RESULTS

Qualitative themes included: (1) MSEs are perceived to benefit behaviour, attention and mood, (2) MSEs have distinct properties that facilitate benefits, (3) MSE use should be centred on the child's needs, (4) MSEs are most effective when the practitioner plays an active role, (5) MSEs can be used for teaching and learning, and (6) MSE use can present challenges. Responses to the survey (n = 102, 93 female, aged 21-68 years) generally showed good agreement with the original interviews, and there was modest evidence that MSE training affected beliefs about the benefits of MSE use.

CONCLUSIONS & IMPLICATIONS

These results provide insight into possible benefits of MSE use for autistic children and are relevant when considering the development of practitioner guidelines.

A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts

Children with autism spectrum disorder (ASD) experience social communication difficulties which can be compounded by increased social demands and expectations of the school environment. Play offers a unique context for social communication development in educational settings. This systematic review aimed to synthesize play-based interventions for the social communication skills of children with ASD in educational contexts and identified nine studies. Overall, studies in this review provided a promising evidence base for supporting social communication skills through play in education for children with ASD. The review also highlighted gaps in research on play-based interventions for the social communication skills of children with ASD within naturalistic educational settings.

Choosing strategies that work from the start: A mixed methods study to understand effective development of community-academic partnerships

Community-academic partnerships are believed to increase the effectiveness and feasibility of action research. While factors facilitating and hindering community-academic partnerships have been identified, their influence on the collaborative process is unknown, especially during community-academic partnership initiation and development. This explanatory sequential mixed methods study (quantitative→QUALITATIVE) evaluated perspectives of members in an autism community-academic partnership to determine frequently endorsed and influential factors facilitating and hindering the collaborative process during the community-academic partnership's development. Participants (n = 11; community stakeholders, implementation scientist, and researchers) endorsed and ranked the importance of factors present in the formation of the community-academic partnership then completed a semi-structured qualitative interview to elaborate on survey responses. Interviews were coded using a coding, comparison, and consensus method and analyzed using the Rapid Assessment Process for frequency and salience of themes across interviews. Integrating mixed methods yielded ranked factors that were perceived to facilitate and hinder the development of the community-academic partnership, and highlighted the relative influence of interpersonal factors on the facilitation of community-academic partnership processes and organizational factors on the hindrance of community-academic partnership processes during development. Some discrepancies emerged between community and academic partners. Results may assist to improve the development of community-academic partnerships, which is becoming increasingly important in healthcare services research, dissemination, and implementation.

Field testing an Australian model of practice for teaching young school-age students on the autism spectrum

BACKGROUND

Internationally, many mainstream teachers have identified that they lack the specialised knowledge and skills to adequately include and educate the increasing number of students on the autism spectrum in their classrooms.

AIMS

We investigated the experiences and perceptions of Australian mainstream teachers who field-tested a validated Model of Practice designed to support their daily work with young school-aged students on the spectrum. This new online resource comprised 29 foundational research-informed practices, each accompanied by a 2-page practice brief.

METHODS AND PROCEDURES

A convergent parallel mixed-methods design used semi-structured interviews and surveys to gather data from a sample of teachers (n = 38) prior to and following an 8-week field-testing period. Differentiated levels of professional support to facilitate engagement with the model were provided, with teachers receiving either in-person support, online support, or no additional support.

OUTCOMES AND RESULTS

A majority of teachers endorsed the practice model. Those who engaged with the model reported statistically significant increases in knowledge, confidence, and efficacy. Professional support facilitated teacher use of the model. No significant changes in practice use were found.

CONCLUSIONS AND IMPLICATIONS

This field-testing provides preliminary evidence of the applicability of the practice model in Australian early years classrooms. These findings have wider implications for the ways in which professional development can be targeted to promote research-informed teaching practice. What this paper adds This novel practice-based resource shows promise for building the capacity of mainstream teachers in educating young school-age students on the autism spectrum in the Australian context. Outcomes from this field testing confirm the usefulness of focusing on foundational teaching practices rather than single, stand-alone interventions. In addition, this research has highlighted the benefit of professional support in bridging the research-to-practice gap in autism education.

Does the learning environment 'make the grade'? A systematic review of accommodations for children on the autism spectrum in mainstream school

BACKGROUND

The 2030 Agenda for Sustainable Development adapted by the United Nations envisions inclusive and equitable quality education. While there is a growing body of research on interventions designed to help children on the autism spectrum adapt to the school environment, accommodations to children needs have been given less attention.

OBJECTIVE

To synthesize the literature on accommodations in the learning environment for children on the autism spectrum (ages 5-19 years) in mainstream school, with a specific focus on the effects on functioning, educational outcomes and well-being.

METHODS

A systematic search was conducted. The study selection and data extraction were performed by two independent reviewers. Eligible studies were assessed according to the What Works Clearinghouse (WWC) standards.

RESULTS

The search yielded 6102 citations. Only 37 eligible studies were identified, of which 14 met the WWC standards. This inconclusive and heterogeneous body of research tentatively suggest that accommodations in the pedagogical and psychosocial leaning environment can improve performance and function in school.

CONCLUSION AND SIGNIFICANCE

Accommodations in the learning environment is a promising but understudied approach. Creative research and innovation will be needed to support policy makers and school personnel in their quest to ensure inclusive and equitable education.

Disseminating Information on Evidence-Based Practices for Children and Youth with Autism Spectrum Disorder: AFIRM

Comprehensive reviews of the research literature have identified that focused intervention practices for children and youth with autism spectrum disorder have evidence of producing positive developmental and learning outcomes. The Autism Focused Intervention Resources and Modules (AFIRM) project has translated evidence-based practices identified by Wong et al. (Journal of Autism and Developmental Disorders 45(7):1951-1966, 2015) into online learning modules. The purpose of this paper is to describe (1) the process for translating the research literature into practical information that practitioners can use, (2) its dissemination through a freely accessible website, (3) the use of the modules by over 64,500 users located in the United States and abroad, (4) knowledge gained as a result of completing the modules, and (5) consumers' evaluations of modules usefulness and relevance.

Music Therapist Experiences of a Randomized Controlled Trial as Clinician Researchers

Music therapy clinicians bring an important perspective to the design and conduct of clinically meaningful studies. Unfortunately, there continue to be roadblocks that hinder clinician involvement in research and the development of successful partnerships between academic researchers and practicing clinicians. To help grow clinician involvement, it is important that research teams share their experiences. As such, the purpose of this qualitative study was to share music therapists' perspectives about their experience of working as a research clinician on a large multisite randomized controlled trial. 10 board-certified music therapists provided written responses to 6 data-generating questions about: (a) reasons for participating, (b) perceived challenges and benefits, (c) experiences of quality assurance monitoring, (d) professional growth, (e) value of research, and (f) advice for clinicians considering research involvement. Using thematic content analysis, we identified primary themes and subthemes for each question (20 themes; 30 subthemes). Qualitative analysis revealed not only common challenges, such as reconciling clinical and research responsibilities, but also benefits, including continued professional growth, greater understanding of research processes, and research participation as a way to advocate and advance the profession. Finally, for clinicians interested in becoming involved in research, therapists noted the importance of having workplace support from a mentor, supervisor, and/or administrator; seeking out available resources; and knowing roles and responsibilities before initiating research involvement. Findings offer important insight and recommendations to support the involvement of clinicians in research and support further exploration of clinician involvement in dissemination efforts to improve translation and uptake of research into practice.

Developmental and sequenced one-to-one educational intervention (DS1-EI) for autism spectrum disorder and intellectual disability: a two-year interim report of a randomized single-blind multicenter controlled trial

Background

Children with autism spectrum disorder (ASD) and moderate to severe intellectual disability (ID) face many challenges. There is little evidence-based research into educational settings for children with ID and ASD and in France. Little is known about how this unserved population could benefit from intervention and education. This study assessed the feasibility and efficacy of a new intervention model using an individualized educational approach.

Methods

We conducted a randomized, single-blind controlled trial to assess a novel intervention: the “Developmental and Sequenced One-to-One Intervention (DS1-EI)”. In DS1-EI, trained teachers worked one-to-one with each child in a small classroom setting, offering 10 h per week of the intervention. The focus was on encouraging spontaneous communication, promoting skills through play with peers, supporting positive interactions, and developmental and sequenced learning. We enrolled 5- to 9-year-old children with ASD and ID across 11 French child care institutions for children with co-occurring ASD and ID. Participants were matched in dyads by developmental quotient and randomized to the treatment-as-usual (TAU) group or the DS1-EI group. Independent raters blindly assessed the primary variables: The Childhood Autism Rating scale (CARS) and the Psychoeducational Profile, third edition (PEP-3). The secondary variables included the Vineland Adaptive Behavior Scale II (VABS-II) and the Clinical Global Assessment Scale (CGAS). Here we perform interim analyses at 24 months.

Results

At baseline, 72 participants were randomized. Nine patients (5 in the DS1-EI group and 4 in the TAU group) dropped out of the study. Using linear mixed models, both intent-to-treat (ITT) and per-protocol (PP) analyses at the 12-, 18- and 24-month outcomes showed no significant group nor group-by-time interaction effects. However, we found significant improvements in most primary and secondary variables over time in both groups.

Conclusions

The study did not show that DS1-EI was superior to TAU in treating children with ASD and ID over 24 months. However, the low dropout rate shows that DS1-EI is feasible, and well accepted. As the study is still ongoing, we need to wait for data at 36 months to ensure whether DS1-EI could be recommended.

Trial registration

ANSM130282B-31 (April 16, 2013) and ACTRN12616000592448. Registered 6 May 2016, retrospectively registered, http://www.anzctr.org.au/

The Development and Feasibility Study of a Multimodal 'Talking Wall' to Facilitate the Voice of Young People with Autism and Complex Needs: A Case Study in a Specialist Residential School

Limited research has examined methods to investigate the views, preferences and experiences of young people with autism and complex needs. The aim of this study, based at a specialist residential school in England, was to develop and pilot an innovative method for this purpose—a ‘Talking Wall’—that was trialled over a 6-month period. Thematic analysis of data from focus groups and semi structured interviews with staff, combined with structured observations of pupils, resulted in three key themes: supporting the expression and evaluation of emotions that underlie preferences; recognising the impact of transitions; and the important role of familiar adults in interpreting communication bids. These positive, initial findings suggest the Talking Wall approach merits further development and evaluation.

The role of technology-mediated music-making in enhancing engagement and social communication in children with autism and intellectual disabilities

Very little research has explored the impact of interventions combining music and technology on children with a dual diagnosis of autism and intellectual disabilities (ID) incorporating the active involvement of school staff. Video recordings and group interviews were used to collect data in this study. Video recordings of five children with autism and ID were conducted as they engaged with a technology-mediated music-making intervention over a period of 5 weeks. Additionally, five group interviews with classroom staff were carried out. This study is the first to explore the impact of a technology-mediated music-making intervention on the engagement levels and social communication skills of children with autism and ID at school. Some positive outcomes, especially regarding social communication skills, are reported, which are of significant value to educational researchers and school staff.

Social Validity and Teachers' Use of Evidence-Based Practices for Autism

The autism intervention literature focuses heavily on the concept of evidence-based practice, with less consideration of the acceptability, feasibility, and contextual alignment of interventions in practice. A survey of 130 special educators was conducted to quantify this "social validity" of evidence-based practices and analyze its relationship with knowledge level and frequency of use. Results indicate that knowledge, use, and social validity are tightly-connected and rank the highest for modeling, reinforcement, prompting, and visual supports. Regression analysis suggests that greater knowledge, higher perceived social validity, and a caseload including more students with autism predicts more frequent use of a practice. The results support the vital role that social validity plays in teachers' implementation, with implications for both research and practice.

Inclusive school practices supporting the primary to secondary transition for autistic children: pupil, teacher, and parental perspectives

Purpose

The primary to secondary school transition can have a significant and long-lasting impact on young people. Autistic children are particularly vulnerable to negative transition experiences; however, there is a lack of research examining effective practices and provision for these pupils. This case study involves a mainstream secondary school in the South of England, which has a dedicated Learning Support base. The purpose of this paper is to collect qualitative data on experiences of the primary to secondary school transition from multiple stakeholders.

Design/methodology/approach

A photovoice activity followed by a semi-structured interview was conducted with five autistic pupils aged 12–16 years; semi-structured interviews were also carried out with six parents and four teachers.

Findings

Five key themes emerged from the data in relation to effective practices: inclusion, child-centred approach, familiarisation, visual supports and communication and consistency.

Research limitations/implications

As a small-scale case study, there are limitations regarding generalisation. However, this research illuminates transition practices that are experienced as effective by autistic children, their families and teachers.

Practical implications

Practical implications related to each of these themes are highlighted. These implications are important in the context of the mandatory responsibilities of schools in England to include the voices of children and young people with special educational needs in decisions about their education.

Originality/value

The findings challenge a rights-based approach to inclusion and illustrate the importance of a needs-based approach which appropriately recognises and understands what autism means for children, their families and the teachers who support them.

Making the future together: Shaping autism research through meaningful participation

Participatory research methods connect researchers with relevant communities to achieve shared goals. These methods can deliver results that are relevant to people’s lives and thus likely to have a positive impact. In the context of a large and growing body of autism research, with continued poor implementation, and some evidence of community dissatisfaction, there is a powerful case for participatory autism research. In order to develop a framework for such collaborative working, a UK seminar series was organised and co-produced by autistic and non-autistic people with academic, practitioner and lived expertise. This article reports on the outcomes from the series, identifying five topics relevant to building a community of practice in participatory research: Respect, Authenticity, Assumptions, Infrastructure and Empathy. Each topic is connected to a specific example from within and beyond research, to inspire new practices in the field. We call for the development of participatory research skills among the autism research community and the facilitation of greater autistic leadership of, and partnership in, research. Such work, if delivered to a high standard, is likely to lead to better translation into practice and improved outcomes for autistic people and those who support them.

Autism Treatment: Families’ Use Varies Across U.S. Regions

Many treatment types are available for children with autism spectrum disorder (ASD), and various factors affect treatment selection. This study investigated potential variations in treatment types selected by parents in all four U.S. Census Bureau Regions + Montreal, Quebec. Data from 2,647 families from the Simons Simplex Collection were analyzed, and statistically significant differences in using various treatment types were found, depending on where families lived. For example, compared with other Regions, families from the Northeast were more likely to have used most treatment types queried, whereas families from the South and Midwest were more likely to have used psychotropic medications. Statistically significant differences were also found within geographical regions. Understanding variations in the use of treatment types by families affected by ASD is important in identifying needs and opportunities for services in different locations. These findings have implications for addressing families’ treatment access and use when they are considered in terms of both research and practice policies.

Profiles of children with Down syndrome who meet screening criteria for autism spectrum disorder (ASD): a comparison with children diagnosed with ASD attending specialist schools

BACKGROUND

Recent research suggests that around 16% to 18% of children with Down syndrome (DS) also meet diagnostic criteria for autism spectrum disorder (ASD). However, there are indications that profiles of autism symptoms in this group may vary from those typically described in children with ASD.

METHOD

Rates of autism symptoms and emotional and behavioural problems among children with DS who screened positive for ASD on the Social Communication Questionnaire (SCQ) (n = 183) were compared with a group of children with clinical diagnoses of ASD (n = 189) attending specialist schools in the UK. Groups were matched for age and approximate language level (use of phrase speech).

RESULTS

Profiles of autistic symptoms in the two groups were generally similar, but children with DS meeting ASD cut-off on the SCQ tended to show fewer problems in reciprocal social interaction than those in the ASD group. They also showed slightly lower rates of emotional and peer-related problems. The results mostly confirm findings from a previous study in which the original validation sample for the SCQ was used as a comparison group.

CONCLUSION

Findings suggest that children with DS who meet screening criteria for ASD show similar profiles of communication and repetitive behaviours to those typically described in autism. However, they tend to have relatively milder social difficulties. It is important that clinicians are aware of this difference if children with DS and ASD are to be correctly diagnosed and eligible for specialist intervention and education services.

Knowledge acquisition and research evidence in autism: Researcher and practitioner perspectives and engagement

BACKGROUND

Government policy and national practice guidelines have created an increasing need for autism services to adopt an evidence-based practice approach. However, a gap continues to exist between research evidence and its application. This study investigated the difference between autism researchers and practitioners in their methods of acquiring knowledge.

METHODS

In a questionnaire study, 261 practitioners and 422 researchers reported on the methods they use and perceive to be beneficial for increasing research access and knowledge. They also reported on their level of engagement with members of the other professional community.

RESULTS

Researchers and practitioners reported different methods used to access information. Each group, however, had similar overall priorities regarding access to research information. While researchers endorsed the use of academic journals significantly more often than practitioners, both groups included academic journals in their top three choices. The groups differed in the levels of engagement they reported; researchers indicated they were more engaged with practitioners than vice versa.

CONCLUSIONS

Comparison of researcher and practitioner preferences led to several recommendations to improve knowledge sharing and translation, including enhancing access to original research publications, facilitating informal networking opportunities and the development of proposals for the inclusion of practitioners throughout the research process.

Educational interventions for children with ASD: A systematic literature review 2008–2013

Systematic literature reviews can play a key role in underpinning evidence-based practice. To date, large-scale reviews of interventions for individuals with Autism Spectrum Disorder (ASD) have focused primarily on research quality. To assist practitioners, the current review adopted a broader framework which allowed for greater consideration of educational utility. Between July and August 2013, 20 databases were searched, alongside web searches and hand searches, to identify ASD intervention studies published between 2008 and 2013. This search yielded 6,232 articles and the subsequent screening and evaluation process identified 85 best evidence studies. Studies were grouped into categories and individual interventions were assessed and classified as providing most; moderate; some; or a small amount of evidence. Interventions with most evidence tended to focus on younger children and core difficulties associated with ASD. Emerging trends, such as increasing evidence for technology-based interventions and peer-mediated interventions, were identified. An encouraging finding for practitioners is that in 59% of the studies, interventions were undertaken with or by school staff. Implications for school psychology practice as well as factors to consider when selecting educational interventions are discussed.

Knowledge and use of intervention practices by community-based early intervention service providers

This study investigated staff attitudes, knowledge and use of evidence-based practices (EBP) and links to organisational culture in a community-based autism early intervention service. An EBP questionnaire was completed by 99 metropolitan and regionally-based professional and paraprofessional staff. Participants reported greater knowledge and use of EBPs compared to emerging and unsupported practices. Knowledge and use of EBPs were linked to each other independent of significant correlations with organisational culture and attitudes. Knowledge and use of EBPs was greater in metropolitan than regional locations and paraprofessionals reported greater use of unsupported practices and lower levels of knowledge and use of EBPs than professionals. The implications of these findings for the facilitation of knowledge transfer are discussed.

Services for children with autism spectrum disorder in three, large urban school districts: Perspectives of parents and educators

This study used qualitative methods to evaluate the perceptions of parents, educators, and school administrators in three large, urban school districts (Los Angeles, Philadelphia, and Rochester) regarding services for children with autism spectrum disorder within the context of limited district resources. Facilitators followed a standard discussion guide that contained open-ended questions regarding participants' views on strengths and limitations of existing services and contextual factors that would facilitate or inhibit the process of introducing new interventions. Three primary themes were identified: (1) tension between participant groups (teachers and paraprofessionals, staff and administration, teachers and parents, special education and general education teachers), (2) necessity of autism spectrum disorder-specific and behavioral training for school personnel, and (3) desire for a school culture of accepting difference. These themes highlight the importance of developing trainings that are feasible to deliver on a large scale, that focus on practical interventions, and that enhance communication and relationships of school personnel with one another and with families.

What should autism research focus upon? Community views and priorities from the United Kingdom

The rise in the measured prevalence of autism has been accompanied by much new research and research investment internationally. This study sought to establish whether the pattern of current UK autism research funding maps on to the concerns of the autism community. Interviews and focus groups were conducted with autistic adults, family members, practitioners and researchers to identify their priorities for research. We also captured the views of a large number of stakeholders via an online survey. There was a clear disparity between the United Kingdom's pattern of funding for autism research and the priorities articulated by the majority of participants. There was general consensus that future priorities for autism research should lie in those areas that make a difference to people's day-to-day lives. There needs to be greater involvement of the autism community both in priority setting and in research more broadly to ensure that resources reach where they are most needed and can make the most impact.

Exploratory study describing 6 month outcomes for young children with autism who receive treatment as usual in Italy

BACKGROUND

In the last few years, the results of different studies have confirmed, in different ways, the importance of early intervention for autism. This study aims to evaluate the role of early "as usual" interventions in the outcome of toddlers diagnosed with autism spectrum disorder (ASD).

METHOD

Seventy children with ASD aged between 24 and 48 months were recruited at different centers in Italy. They were evaluated by blind researchers at baseline and after 6 months of using Autism Diagnostic Observation Schedule-Generic (ADOS-G), Griffiths Mental Developmental Scales, and Vineland Adaptive Behavior scales. Parents filled out the MacArthur Inventory, Social Communication Questionnaire, and Child Behavior Check List. All children were referred to community providers for available interventions.

RESULTS

At the endpoint, most of the children were still classified as having an ADOS-G classification of ASD. However, 21 (34.2%) passed from autism to autism spectrum, and 3 (4.2%) passed from autism spectrum to no spectrum. Treatment effects were obtained for cognitive functioning, language, adaptive behavior, and child behavior without differences between development-oriented and behavior-oriented interventions. Parent involvement was a mediator for the best clinical outcome. Baseline low impairments of communication, language comprehension, and gesture were predictors of positive outcome.

CONCLUSION

Treatment as usual, composed of individual therapy plus school-supported inclusion, may be an effective intervention in ASD. Better initial levels of communication in child and parent involvement during treatment have an important role for a positive outcome.