title: A tangled web: the challenges of implementing an evidence-based social engagement intervention for children with autism in urban public school settings.
abstract: There is growing evidence that efficacious autism-related interventions rarely are adopted or successfully implemented in public schools, in part because of the lack of fit between the intervention and the needs and capacities of the school setting. There is little systematic information available regarding the barriers to implementation of complex interventions such as those addressing social engagement for children with autism.The present study used fieldnotes from an implementation trial to explore barriers that emerged during the training of school personnel and subsequent implementation of a social engagement intervention. A number of barriers at the individual (training) and school levels (policies surrounding recess, staffing, prioritization of competing demands, level of respect and support, and availability of resources) interfered with the continued use and sustainment of the intervention. We offer potential strategies to overcome these barriers and provide directions for future research in this critical area.
authors.affiliation: University of Pennsylvania. Electronic address: jlocke@upenn.edu.
authors.forename: Jill
authors.initials: J
authors.lastname: Locke
authors.affiliation: University of Pennsylvania.
authors.forename: Anne
authors.initials: A
authors.lastname: Olsen
authors.affiliation: University of Pennsylvania.
authors.forename: Rukiya
authors.initials: R
authors.lastname: Wideman
authors.affiliation: University of Pennsylvania.
authors.forename: Margaret Mary
authors.initials: MM
authors.lastname: Downey
authors.affiliation: University of California, Los Angeles.
authors.forename: Mark
authors.initials: M
authors.lastname: Kretzmann
authors.affiliation: University of California, Los Angeles.
authors.forename: Connie
authors.initials: C
authors.lastname: Kasari
authors.affiliation: University of Pennsylvania.
authors.forename: David S
authors.initials: DS
authors.lastname: Mandell
mesh_terms: D001321:Autistic Disorder / Q000628:therapy*; D002648:Child; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010290:Parents; D057766:Policy; D011569:Psychiatric Status Rating Scales; D012574:Schools / Q000458:organization & administration*; D012931:Social Environment; D014505:Urban Population; D000078329:Workforce
keywords: autism; implementation; intervention; schools; social engagement