title: Inconsistent staffing and its impact on service delivery in ASD early-intervention.
abstract: BACKGROUND
  Inconsistent staffing (high turnover, casual workforce) is problematic in organisations, with the potential to impact both staff and services provided. Research has primarily focused on the impacts of inconsistent staffing in child welfare and community services with little evidence surrounding their ability to impact the outcomes for children with Autism Spectrum Disorders attending early-intervention services.
  
  
  OBJECTIVE
  The aim of this study was to explore staff views regarding the impact of staff turnover on the delivery of group based early intervention for children with ASD.
  
  
  METHODS
  We conducted five focus groups involving 29 professional (e.g. teachers, behaviour therapists), para-professional (e.g. child care workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim for use in thematic analysis.
  
  
  RESULTS
  Two central themes, comprising five categories emerged to encompass participants' views. "Impacts on Staff" accounted for the challenges existing staff felt when working with new and untrained staff in the centre. Participants also expressed concerns for the "Impacts on Service Delivery" that resulted from dynamic staffing, affecting fidelity of interventions and the program itself.
  
  
  CONCLUSIONS
  The findings suggest that lacking a consistent staffing structure is problematic when attempting to provide high quality early intervention services to children with ASD and suggest that future research should investigate the extent of inconsistent staffing, impacts of inconsistent staffing on providing intervention, and develop a range of tools to help measure these effects.
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Australia. Electronic address: R.Sulek@Griffith.edu.au.
authors.forename: Rhylee
authors.initials: R
authors.lastname: Sulek
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Trembath
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Paynter
authors.affiliation: Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Australia.
authors.forename: Deb
authors.initials: D
authors.lastname: Keen
authors.affiliation: Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Simpson
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D000067877:Autism Spectrum Disorder / Q000534:rehabilitation*; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D018479:Early Intervention, Educational; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D000072087:Occupational Therapists; D010561:Personnel Staffing and Scheduling; D010563:Personnel Turnover; D011787:Quality of Health Care; D011793:Queensland; D000070777:School Teachers; D013070:Speech Therapy; D055815:Young Adult
keywords: Autism; Early intervention; Inconsistent staffing; Staff turnover