Category: Dissemination / Implementation

Symposium

Therapists' Adaptations to a Mental Health Intervention for Children With Autism Spectrum Disorder

Sunday, November 19
8:30 AM - 10:00 AM
Location: Sapphire Ballroom B, Level 4, Sapphire Level

Keywords: Autism Spectrum Disorders | Dissemination | Community-Based Assessment / Intervention
Presentation Type: Symposium

Growing evidence indicates that community therapists adapt EBPs. Characterizing the type of adaptations and understanding what drives these adaptations has the potential to improve intervention development and implementation. This mixed-methods study characterized the types of adaptations and reasons therapists adapted AIM HI (“An Individualized Mental Health Intervention for ASD”), a package of evidence-based strategies designed to reduce challenging behaviors in children with autism spectrum disorder.


Participants included 62 therapists who delivered AIM HI in a community effectiveness trial. Stirman et al., (2015)’s framework was applied to characterize adaptations reported by therapists via online survey and semi-structured interviews.


On the survey, 95% of therapists reported making adaptations to AIM HI, and the most common types of adaptations included: (1) lengthening the pacing of the AIM HI protocol (45%); (2) integrating components of other treatments into AIM HI (36%); (3) involving other individuals (e.g., teachers) into treatment (36%); and (4) modifying the terminology when describing AIM HI concepts/components (29%). The most common reasons for adaptations included: (1) accommodating the child (48%) and caregivers’ (48%) clinical functioning, and (2) fit with the therapists’ previous clinical practice/style (28%). Themes from the qualitative interviews confirmed and expanded upon the most common adaptations and reasons for these adaptations. For example, therapists indicated that they modified AIM HI terminology to make concepts easier to understand for a range of caregiver characteristics (e.g., Spanish-speaking; lower literacy levels).

Although results suggest the majority of therapists made adaptations, these adaptations were consistent with the AIM HI protocol. Adaptations were made with the primary intent of augmenting the intervention to fit with therapeutic style and address clients’ functioning. Findings suggest that therapists are able to implement fidelity-consistent adaptations to the AIM HI protocol and provide insight into areas in which therapists would benefit from training on how to systematically adapt the AIM HI protocol. 

Margaret Dyson

Senior Project Researcher
University of California, San Diego

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Therapists' Adaptations to a Mental Health Intervention for Children With Autism Spectrum Disorder



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