This study identified patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder within publicly funded mental health services and compared patterns for therapists delivering usual care to those trained in AIM HI (“An Individualized Mental Health Intervention for ASD”). Data were drawn from a randomized community effectiveness trial and included a subsample of 159 therapists (86% female) providing outpatient or school-based psychotherapy. Therapist strategies were measured via observational coding of psychotherapy session recordings. Exploratory factor analysis used to examine patterns of strategy delivery showed that among therapists in the usual care condition, strategies loaded onto the single factor, General Strategies, whereas for therapists in the AIM HI training condition, strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies. Among usual care therapists, General Strategies were associated with an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were associated with reductions in child behavior problems over 18 months. Results support the effectiveness of training therapists in evidence-based interventions to increase the specificity of strategies delivered to children with autism spectrum disorder served in publicly funded mental health settings. Findings also support the use of active teaching strategies in reducing challenging behaviors.

Lay abstract

This study was conducted to identify patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder receiving publicly funded mental health services and compare strategy use for therapists delivering usual care to those trained to deliver AIM HI (“An Individualized Mental Health Intervention for ASD”), an intervention designed to reduce challenging behaviors in children with autism spectrum disorder. For therapists trained in AIM HI, intervention strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies, while strategies used by usual care therapists grouped onto a broader single factor, General Strategies. Among usual care therapists, General Strategies were related to an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were related with reductions in child behavior problems over 18 months. Findings support the use of active teaching strategies in reducing challenging behaviors in children with autism spectrum disorder and provide support for the effectiveness of training therapists in evidence-based interventions to promote the delivery of targeted, specific intervention strategies to children with autism spectrum disorder in mental health services.

中文翻译：

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表征治疗师在公共资助的自闭症谱系障碍儿童心理健康服务中提供循证干预策略：区分常规护理和 AIM HI 交付中的实践模式

这项研究确定了治疗师在公共资助的心理健康服务中为患有自闭症谱系障碍的儿童提供循证干预策略的模式，并比较了治疗师向接受 AIM HI 培训的人提供常规护理的模式（“针对 ASD 的个性化心理健康干预”） . 数据来自随机社区有效性试验，包括 159 名提供门诊或学校心理治疗的治疗师（86% 为女性）的子样本。治疗师的策略是通过心理治疗会议记录的观察编码来衡量的。用于检查策略交付模式的探索性因素分析表明，在常规护理条件下的治疗师中，策略加载到单一因素上，一般策略，而对于 AIM HI 培训条件下的治疗师，策略分为两个因素，自闭症参与策略和主动教学策略。在常规护理治疗师中，一般策略与儿童行为问题的增加有关，而对于 AIM HI 治疗师，主动教学策略与 18 个月以上儿童行为问题的减少有关。结果支持培训治疗师在循证干预方面的有效性，以提高在公共资助的心理健康环境中为自闭症谱系障碍儿童提供的策略的特异性。调查结果还支持使用积极的教学策略来减少挑战性行为。

文摘

进行这项研究是为了确定治疗师对接受公共资助的心理健康服务的自闭症谱系障碍儿童提供循证干预策略的模式，并将提供常规护理的治疗师的策略使用情况与接受过 AIM HI 培训的人进行比较（“个性化心理健康Intervention for ASD”），一种旨在减少自闭症谱系障碍儿童挑战性行为的干预措施。对于接受过 AIM HI 培训的治疗师，干预策略分为两个因素，即自闭症参与策略和主动教学策略，而常规护理治疗师使用的策略则分为一个更广泛的单一因素，即一般策略。在常规护理治疗师中，一般策略与儿童行为问题的增加有关，而对于 AIM HI 治疗师来说，主动教学策略与 18 个月内儿童行为问题的减少有关。研究结果支持使用积极的教学策略来减少自闭症谱系障碍儿童的挑战性行为，并支持训练治疗师在循证干预方面的有效性，以促进对患有自闭症谱系障碍的儿童进行有针对性的、具体的干预策略。健康服务。