Skip to main content

Advertisement

Log in

Bridging the Research-to-Practice Gap in Autism Intervention: An Application of Diffusion of Innovation Theory

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

There is growing evidence that efficacious interventions for autism are rarely adopted or successfully implemented in public mental health and education systems. We propose applying diffusion of innovation theory to further our understanding of why this is the case. We pose a practical set of questions that administrators face as they decide about the use of interventions. Using literature from autism intervention and dissemination science, we describe reasons why efficacious interventions for autism are rarely adopted, implemented, and maintained in community settings, all revolving around the perceived fit between the intervention and the needs and capacities of the setting. Finally, we suggest strategies for intervention development that may increase the probability that these interventions will be used in real-world settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Akshoomoff, N. A., & Stahmer, A. (2006). Early intervention programs and policies for children with autism spectrum disorders. In H. E. Fitzgerald, B. M. Lester, & B. Zuckerman (Eds.), The crisis in youth mental health: Critical issues and effective Programs. Vol. 1. Childhood disorders (pp. 109–131). Westport, CT: Praeger.

    Google Scholar 

  • Arick, J., Young, H., Falco, R., Loos, L., Krug, D., Gense, M., et al. (2003). Designing an outcome study to monitor the progress of students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18, 75–87.

    Article  Google Scholar 

  • Boardman, A. G., Argüelles, M. E., Vaughn, S., Hughes, M. T., & Klingner, J. (2005). Special education teachers’ views of research-based practices. The Journal of Special Education, 39, 168–180.

    Article  Google Scholar 

  • Browder, D. M., & Cooper-Duffy, K. (2003). Evidence-based practices for students with severe disabilities and the requirement for accountability in “No Child Left Behind”. The Journal of Special Education, 37, 157–163.

    Article  Google Scholar 

  • Callahan, K., Henson, R. K., & Cowan, A. K. (2008). Social validation of evidence-based practices in autism by parents, teachers, and administrators. Journal of Autism and Developmental Disorders, 38, 678–692.

    Article  PubMed  Google Scholar 

  • Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66(1), 7–18.

    Article  PubMed  Google Scholar 

  • Chasson, G. S., Harris, G. E., & Neely, W. J. (2007). Cost comparison of early intensive behavioral intervention and special education for children with autism. Journal of Child and Family Studies, 16, 401–413.

    Article  Google Scholar 

  • Cochran-Smith, M., & Lytle, S. (1999). Relationships of knowledge and practice: Teacher learning in communities. In A. Iran-Nejar & P. D. Pearson (Eds.), Review of research in education. Washington, D.C.: American Educational Research Associates.

    Google Scholar 

  • Dunlap, G. (1999). Consensus, engagement, and family involvement for young children with autism. Journal of the Association for Persons with Severe Handicaps, 24, 222–225.

    Article  Google Scholar 

  • Feinberg, E., & Vacca, J. (2000). The drama and trauma of creating policies on autism: Critical issues to consider in the new millennium. Focus on Autism and Other Developmental Disabilities, 15, 130–137.

    Article  Google Scholar 

  • Freedman, J. (2002). The diffusion of innovations into psychiatric practice. Psychiatric Services, 53(12), 1539–1540.

    Article  PubMed  Google Scholar 

  • Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261–1267.

    Article  PubMed  Google Scholar 

  • Glasgow, R. E., McKay, H. G., Piette, J. D., & Reynolds, K. D. (2001). The RE-AIM framework for evaluating interventions: What can it tell us about approaches to chronic illness management? Patient Education and Counseling, 44, 119–127.

    Article  PubMed  Google Scholar 

  • Glisson, C. (2007). Assessing and changing organizational culture and climate for effective services. Research on Social Work Practice, 17(6), 736–747.

    Article  Google Scholar 

  • Glisson, C., & Schoenwald, S. K. (2005). The ARC organizational and community intervention strategy for implementing evidence-based children’s mental health treatments. Mental Health Services Research, 7(4), 243–259.

    Article  PubMed  Google Scholar 

  • Gotham, H. J. (2004). Diffusion of mental health and substance abuse treatments: Development, dissemination, and implementation. Clinical Psychology: Science and Practice, 11(2), 160–176.

    Article  Google Scholar 

  • Greenhalgh, T., Robert, G., MacFarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629.

    Article  PubMed  Google Scholar 

  • Gresham, F. M., Cook, C. R., Crews, S. D., & Kern, L. (2004). Social skills training for children and youth with emotional and behavioral disorders: Validity considerations and future directions. Behavioral Disorders, 30, 32–46.

    Google Scholar 

  • Heidgerken, A., Geffken, G., Modi, A., & Frakey, L. (2005). A survey of autism knowledge in a health care setting. Journal of Autism and Developmental Disorders, 3, 323–330.

    Article  Google Scholar 

  • Herie, M., & Martin, G. W. (2002). Knowledge diffusion in social work: A new approach to bridging the gap. Social Work, 47, 85–95.

    PubMed  Google Scholar 

  • Hoagwood, K., & Johnson, J. (2003). School psychology: A public health framework. I. From evidence-based practices to evidence-based policies. Journal of School Psychology, 41, 3–21.

    Article  Google Scholar 

  • Honig, M. I., & Coburn, C. (2008). Evidence-based decision making in school district central offices: Toward a policy and research agenda. Educational Policy, 22, 578–608.

    Article  Google Scholar 

  • Howlin, P., Gordon, R., Pasco, G., Wade, A., & Charman, T. (2007). The effectiveness of picture exchange communication system (PECS) training for teachers of children with autism: A pragmatic, group randomised controlled trial. Journal of Child Psychology and Psychiatry, 48(5), 473–481.

    Article  PubMed  Google Scholar 

  • Israel, B. A., Krieger, J., Vlahov, D., Ciske, S., Foley, M., Fortin, P., et al. (2006). Challenges and facilitating factors in sustaining community-based participatory research partnerships: Lessons learned from the Detroit, New York City and Seattle Urban Research Centers. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 83, 1022–1040.

    Google Scholar 

  • Israel, B. A., Parker, E. A., Rowe, Z., Salvatore, A., Minkler, M., López, J., et al. (2005). Community-based participatory research: Lessons learned from the Centers for Children’s Environmental Health and Disease and Prevention Research. Environmental Health Perspectives, 113(10), 1463–1471.

    Article  PubMed  Google Scholar 

  • Jacobson, J. W., Mulick, J. A., & Green, G. (1998). Cost-benefit estimates for early intensive behavioral intervention for young children with autism: General model and single state case. Behavioral Interventions, 13, 201–226.

    Article  Google Scholar 

  • Jennett, H. K., Harris, S. L., & Mesibov, G. B. (2003). Commitment to philosophy, teacher efficacy, and burnout among teachers of children with autism. Journal of Autism and Developmental Disorders, 33, 583–593.

    Article  PubMed  Google Scholar 

  • Jocelyn, L., Casiro, O., Beattie, D., Bow, J., & Kneisz, J. (1998). Treatment of children with autism: A randomized controlled trial to evaluate a caregiver-based intervention program in community day-care centers. Journal of Developmental Behavioral Pediatrics, 19, 326–334.

    Google Scholar 

  • Johnson, K., Hays, C., Center, H., & Daley, C. (2004). Building capacity and sustainable prevention innovations: A sustainability planning model. Evaluation and Program Planning, 27, 135–149.

    Article  Google Scholar 

  • Kazdin, A. E. (2004). Evidence-based treatments: Challenges and priorities for practice and research. Child and Adolescent Psychiatric Clinics of North America, 13, 923–940.

    Article  PubMed  Google Scholar 

  • Koegel, L. K., Carter, C. M., & Koegel, R. L. (2003). Teaching children with autism self-initiations as a pivotal response. Topics in Language Disorders, 23, 134–145.

    Article  Google Scholar 

  • Koegel, R. L., O’Dell, M. C., & Koegel, L. K. (1987). A natural language teaching paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders, 17, 187–200.

    Article  PubMed  Google Scholar 

  • Krauss, M. W., Gulley, S., Sciegaj, M., & Wells, N. (2003). Access to speciality medical care for children with mental retardation, autism, and other special health care needs. Mental Retardation, 41, 329–339.

    Article  PubMed  Google Scholar 

  • Lerman, D. C., Vorndran, C. M., Addison, L., & Kuhn, S. C. (2004). Preparing teachers in evidence-based practices for young children with autism. School Psychology Review, 33(4), 510–526.

    Google Scholar 

  • Lipsky, M. (1980). Street-level bureaucracy: Dilemmas of the individual in public services. New York: Russell Sage Foundation.

    Google Scholar 

  • Lord, C. (2000). Commentary: Achievements and future directions for intervention research in communication and autism spectrum disorders. Journal of Autism and Developmental Disorders, 30(5), 393–398.

    Article  PubMed  Google Scholar 

  • Lord, C., Wagner, A., Rogers, S., Szatmari, P., Aman, M., Charman, T., et al. (2005). Challenges in evaluating psychosocial interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 35(6), 695–708.

    Article  PubMed  Google Scholar 

  • Lovaas, O. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.

    Article  PubMed  Google Scholar 

  • Machalicek, W., O’Reilly, M. F., Beretvas, N., Sigafoos, J., & Lancioni, G. (2007). A review of interventions to reduce challenging behavior in school settings for students with autism spectrum disorders. Research in Autism Spectrum Disorders, 1, 229–246.

    Article  Google Scholar 

  • Mandell, D., Cao, J., Ittenbach, R., & Pinto-Martin, J. (2006). Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999. Journal of Autism and Developmental Disorders, 36(4), 475–485.

    Article  PubMed  Google Scholar 

  • Maurice, C., Mannion, K., Setso, S., & Perry, L. (2001). Parent voices: Difficulty in accessing behavioral intervention for autism; working toward solutions. Behavioral Interventions, 16, 147–165.

    Article  Google Scholar 

  • Motiwala, S. S., Gupta, S., & Lilly, M. B. (2006). The cost-effectiveness of expanding intensive behavioural intervention to all autistic children in Ontario. Healthcare Policy, 1, 135–151.

    PubMed  Google Scholar 

  • National Institute of Mental Health. (2001). Blueprint for change: research on child and adolescent mental health. Report of the National Advisory Mental Health Council’s workgroup on child and adolescent mental health intervention development. Bethesda, MD.

  • National Research Council (Ed.). (2001). Educating children with autism. Washington, DC: National Academy Press.

    Google Scholar 

  • Odom, S. L., Brown, W. H., Frey, T., Karasu, N., Smith-Canter, L. L., & Strain, P. S. (2003). Evidence-based practices for young children with autism: Contributions for single-subject design research. Focus on Autism and Other Developmental Disabilities, 18(3), 166–175.

    Article  Google Scholar 

  • Ospina, M. B., Seida, J. K., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., et al. (2008). Behavioural and developmental interventions for autism spectrum disorder: A clinical systematic review. PLoS ONE, 3, e3755.

    Article  PubMed  Google Scholar 

  • Proctor, E. K., Landsverk, J., Aarons, G. A., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy In Mental Health, 36, 24–34.

    Article  PubMed  Google Scholar 

  • Rakos, R. F. (2006). Applied behavior analysis: niche therapy par excellance. Behavior and Social Issues, 15, 187–191.

    Google Scholar 

  • Rogers, E. M. (1962). Diffusion of innovation. New York: Free Press.

    Google Scholar 

  • Rogers, E. M. (1995). Diffusion of innovations (4th ed.). New York: Free Press.

    Google Scholar 

  • Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press.

    Google Scholar 

  • Rogers, S. J., & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37, 8–38.

    Article  Google Scholar 

  • Rohrbach, L. A., Graham, J. W., & Hansen, W. B. (1993). Diffusion of a school-based substance abuse prevention program: predictors of program implementation. Preventive Medicine, 22, 237–260.

    Article  PubMed  Google Scholar 

  • Rohrbach, L. A., Grana, R., Sussman, S., & Valente, T. W. (2006). Type II translation: transporting prevention interventions from research to real-world settings. Evaluation & the Health Professions, 29(3), 302–333.

    Article  Google Scholar 

  • Rohrbach, L. A., Ringwalt, C. L., Ennett, S. T., & Vincus, A. A. (2005). Factors associated with adoption of evidence-based substance use prevention curricula in US school districts. Health Education Research: Theory & Practice, 20, 514–526.

    Google Scholar 

  • Scheuermann, B., Webber, J., Boutot, E. A., & Goodwin, M. (2003). Problems with personnel preparation in autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18, 197–206.

    Article  Google Scholar 

  • Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52(9), 1190–1197.

    Article  PubMed  Google Scholar 

  • Schreibman, L. (2000). Intensive behavioral/psychoeducational treatments for autism: Research needs and future directions. Journal of Autism and Developmental Disorders, 30(5), 373–378.

    Article  PubMed  Google Scholar 

  • Shattuck, P., & Grosse, S. (2007). Issues related to the diagnosis and treatment of autism spectrum disorders. Mental Retardation and Developmental Disabilities Research Reviews, 13, 129–135.

    Article  PubMed  Google Scholar 

  • Shediac-Rizkallah, M. C., & Bone, L. R. (1998). Planning for the sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Education Research, 13, 87–108.

    Article  PubMed  Google Scholar 

  • Simpson, R. L. (2001). ABA and students with autism spectrum disorders: Issues and considerations for effective practice. Focus on Autism and Other Developmental Disabilities, 16(2), 68–71.

    Article  Google Scholar 

  • Simpson, R. L. (2003). Policy-related research and perspectives. Focus on Autism and Other Developmental Disabilities, 18, 192–196.

    Article  Google Scholar 

  • Smith, T., Scahill, L., Dawson, G., Guthrie, D., Lord, C., et al. (2007). Designing research studies on psychosocial interventions in autism. Journal of Autism and Developmental Disorders, 37, 354–366.

    Article  PubMed  Google Scholar 

  • Sperry, L. A., Whaley, K. T., Shaw, E., & Brame, K. (1999). Services for young children with autism spectrum disorders: Voices of parents and providers. Infants and Young Children, 11(4), 17–33.

    Article  Google Scholar 

  • Stahmer, A. C. (2007). The basic structure of community early intervention programs for children with autism: Provider descriptions. Journal of Autism and Developmental Disorders, 37(7), 1344–1354.

    Article  PubMed  Google Scholar 

  • Stahmer, A. C., Collings, N. M., & Palinkas, L. A. (2005). Early intervention practices for children with autism: Descriptions from community providers. Focus on Autism and Other Developmental Disabilities, 20(2), 66–79.

    Article  PubMed  Google Scholar 

  • Stanovich, P. J., & Stanovich, K. E. (1997). Research into practice in special education. Journal of Learning Disabilities, 30, 477–481.

    Article  PubMed  Google Scholar 

  • Storch, E. A., & Crisp, H. L. (2004). Taking it to the schools—transporting empirically supported treatments for childhood psychopathology to the school setting. Clinical Child and Family Psychology Review, 7(4), 195–209.

    Article  Google Scholar 

  • Svenkerud, P. J., & Singhal, A. (1998). Enhancing the effectiveness of HIV/AIDS prevention programs targeted to unique population groups in Thailand: lessons learned from applying concepts of diffusion of innovation and social marketing. Journal of Health Communication, 3, 193–216.

    Article  PubMed  Google Scholar 

  • Swanson, G. M., & Ward, A. J. (1995). Recruiting minorities into clinical trials: Toward a participant-friendly system. Journal of the National Cancer Institute, 87, 1747–1759.

    Article  PubMed  Google Scholar 

  • Swiezy, N., Stuart, M., & Korzekwa, P. (2008). Bridging for success in autism: Training and collaboration across medical, educational, and community systems. Child and Adolescent Psychiatric Clinics of North America, 17, 907–922.

    Article  PubMed  Google Scholar 

  • Tornatzky, L., & Klein, K. J. (1982). Innovation characteristics and innovation adoption-implementation: A meta-analysis of findings. Transactions on Engineering Management, EM-29(1), 28–43.

    Google Scholar 

  • US Department of Education. (2004). Report of children with disabilities receiving special education under part B of the Individuals with Disabilities Education Act o. Document Number).

  • Walker, H. M. (2004). Commentary: Use of evidence-based interventions in schools: where we’ve been, where we are, and where we need to go. School Psychology Review, 33(3), 398–407.

    Google Scholar 

  • Weisz, J. R., Chu, B. C., & Polo, A. J. (2004). Treatment dissemination and evidence-based practice: Strengthening intervention through clinician-researcher collaboration. Clinical Psychology: Science and Practice, 11, 300–307.

    Article  Google Scholar 

  • Weisz, J. R., Doss, A. J., & Hawley, K. M. (2005). Youth psychotherapy outcome research: A review and critique of the evidence base. Annual Review of Psychology, 56, 337–363.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., & Hawley, K. M. (1998). Finding, evaluating, refining, and applying empirically supported treatments for children and adolescents. Journal of Clinical Child Psychology, 27(2), 206–216.

    Article  PubMed  Google Scholar 

  • Wheeler, J. J., Baggett, B. A., Fox, J., & Blevins, L. (2006). Treatment integrity: A review of intervention studies conducted with children with autism. Focus on Autism and Other Developmental Disabilities, 21(1), 45–54.

    Article  Google Scholar 

  • Yancey, A. K., Ortega, A. N., & Kumanyika, S. K. (2006). Effective recruitment and retention of minority research participants. Annual Review of Public Health, 27, 1–28.

    Article  PubMed  Google Scholar 

  • Yell, M. L., & Drasgow, E. (2000). Litigating a free appropriate public education: The Lovaas hearings and cases. The Journal of Special Education, 33(4), 205–214.

    Article  Google Scholar 

  • Yell, M. L., Drasgow, E., & Lowrey, K. A. (2005). No child left behind and students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20, 130–139.

    Article  Google Scholar 

  • Young, A., Ruble, L. A., & McGrew, J. H. (2009). Public vs. private insurance: Cost, use, accessibility, and outcomes of services for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3, 1023–1033.

    Article  Google Scholar 

Download references

Acknowledgments

This work was supported by a grant from the National Institute of Mental Health (F31MH088172-02).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hilary E. Dingfelder.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dingfelder, H.E., Mandell, D.S. Bridging the Research-to-Practice Gap in Autism Intervention: An Application of Diffusion of Innovation Theory. J Autism Dev Disord 41, 597–609 (2011). https://doi.org/10.1007/s10803-010-1081-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-010-1081-0

Keywords

Navigation