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Introduction
Skills and Expertise
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Publications
Publications (133)
Burnout is the leading cause of the special education teacher shortage. A burnout intervention adapted for teachers was tested in two studies. Study 1 used a randomized design; Study 2 was a pre-post design. In Study 1, 44 teachers were randomized into the intervention or an active control. To enhance impact, for Study 2, personal goal-setting was...
Autism trainers often prioritize professional development restricted to discussion of evidence-based practices (EBP) with limited applicability across the range of individuals with autism. Best practices are not diagnosis-focused (the standard for EBPs) but individual-focused and are oversimplified by an approach that presumes a simple matching fro...
Schools need to find innovative methods for keeping the promise of transition as a coordinated set of activities that successfully facilitate the seamless movement from school to post-school activities. The need for novel approaches comes from research that documents the disparities in transition outcomes in autism and highlights the need to improv...
The high attrition and turnover rates of qualified special education teachers (SETs) is a significant concern exacerbated by COVID‐19. Unfortunately, there are limited studies available on research‐based interventions to decrease burnout. The purpose of this study was to describe our processes and results for adaptations and modifications of BREATH...
Research and clinical interest in self-compassion has grown due to its associations with physical and mental health benefits. Widely used measures of self-compassion have conceptual and psychometric limitations that warrant attention. The purpose of this project was to develop a new self-compassion measure, the Brief Self-Compassion Inventory (BSCI...
Little is known about differences in dosage or feedback that make teacher coaching effective in relation to teacher and student outcomes. This study builds upon previous research on the Collaborative Model for Promoting Competence and Success (COMPASS) to understand the impact of different types (face-to-face coaching vs. emailed feedback) and dosa...
Background
Students with ASD have some of the worst postsecondary outcomes when compared to other students with disabilities indicating transition planning may not be working effectively. One source of support for postsecondary planning is development of the transition Individualized Education Program (IEP). However, little research is available to...
Background
Evidence-based educational instruction includes teaching elements common across different approaches as well as specific elements of the chosen evidence-based practice. We were interested in evaluating the use and impact of common elements of teaching. Specifically, we adopted a model of elements of high quality teaching sequences and de...
Although there is substantial research investigating metacognitive capacity in clinical manifestations of psychosis, few studies have explored whether similar deficits exist in schizotypy—a personality structure with positive, negative, and disorganized traits akin to those seen in chronic psychosis but at a less severe level. This study sought to...
Little is known about factors impacting poor post-school outcomes for transition-age students with autism spectrum disorder. Guided by the Exploration, Preparation, Implementation, and Sustainment implementation science framework, we sought to better understand the interdependent impacts of policy, organizational, provider, and individual factors t...
The current meta-analysis comprehensively reviewed group-design studies of interventions designed to improve ASD caregiver psychosocial outcomes and explored potential moderators of effectiveness. Forty-one unique studies targeting 1771 caregivers met inclusion criteria. Overall, the interventions had a small positive effect in improving psychosoci...
The school, student and family factors underlying poor postsecondary outcomes of students with autism spectrum disorder (ASD) are not well understood. The potential impact of school [e.g., transition planning quality (TPQ)], family (e.g., parent activation), and student factors (e.g., adaptive functioning) and their interaction (e.g., parent-teache...
Although teachers reporting high teaching self-efficacy demonstrate positive teaching behaviors, minimal stress, and superior classroom management techniques, surprisingly few studies have demonstrated a relationship between teacher self-efficacy and student outcomes. This study explored self-efficacy specific to teaching students with autism spect...
Purpose:
Utilization of behavioral health treatment services among adolescents who have been detained or incarcerated within the juvenile justice system is poorly understood, with estimated utilization rates varying widely across studies. This meta-analysis was conducted to review and synthesize the literature on the prevalence of service utilizat...
Implementation science provides guidance on adapting existing evidence based practices (EBPs) by incorporating implementation concerns from the start. Focus-group methodology was used to understand barriers and facilitators of transition planning and implementation for students with autism spectrum disorder (ASD) who often experience disparate post...
The postsecondary outcomes of individuals with autism spectrum disorder (ASD) are significantly worse than peers with other disabilities. One problem is the lack of empirically-supported transition planning interventions to guide services and help produce better outcomes. We applied an implementation science approach to adapt and modify an evidence...
Background: The study examined the burden of caring for individuals with autism spectrum disorder (ASD) transitioning from high school and factors associated with burden derived from the Double ABCX model of family adaptation (i.e., autism symptom severity, problem behaviors, pile-up life demands, personality traits, social support, cognitive appra...
Although data-based decision making is an evidence-based practice, many special educators have difficulty applying the practice within daily routines. We applied the theory of planned behavior (TPB) to understand the influences that promote or hinder early childhood special educators’ intentions to collect data. We assessed three influences on beha...
Children with autism spectrum disorder (ASD) and developmental disabilities are high users of services, yet very little is known about how parents of these children interact with the health care system. Further, compared to parents of children with other developmental disabilities, parents of children with ASD experience more stress and dissatisfac...
Objective: This study aims to identify consumer-level predictors of level of treatment response to illness management and recovery (IMR) to target the appropriate consumers and aid psychiatric rehabilitation settings in developing intervention adaptations. Method: Secondary analyses from a multisite study of IMR were conducted. Self-report data fro...
Consultation is essential to the daily practice of school psychologists (National Association of School Psychologist, 2010). Successful consultation requires fidelity at both the consultant (implementation) and consultee (intervention) levels. We applied a multidimensional, multilevel conception of fidelity (Dunst, Trivette, & Raab, 2013) to a cons...
Teacher stress and burnout have a detrimental effect on the stability of the teaching workforce. However, the possible consequences of teacher burnout on teaching quality and on student learning outcomes are less clear, especially in special education settings. We applied Maslach and Leiter’s (1999) model to understand the direct effects of burnout...
Successful implementation of evidence-based practices requires valid, yet practical fidelity monitoring. This study compared the costs and acceptability of three fidelity assessment methods: on-site, phone, and expert-scored self-report. Thirty-two randomly selected VA mental health intensive case management teams completed all fidelity assessments...
Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and...
Background:
While explicit negative stereotypes of mental illness are well established as barriers to recovery, implicit attitudes also may negatively impact outcomes. The current study is unique in its focus on both explicit and implicit stigma as predictors of recovery attitudes of mental health practitioners.
Method:
Assertive Community Treat...
This study examined the experiences of parents receiving an autism spectrum disorder (ASD) diagnosis for their child. Mixed methods were used to give a detailed account of the sequence of events, parents’ experiences and actions associated with the ASD diagnosis. Parents waited nearly two and a half years (mean = 28.72 months) before receiving the...
Burnout is prevalent among mental health providers and is associated with significant employee, consumer, and organizational costs. Over the past 35 years, numerous intervention studies have been conducted but have yet to be reviewed and synthesized using a quantitative approach. To fill this gap, we performed a meta-analysis on the effectiveness o...
The article discusses current empirical evidence, also identifying gaps and areas for future research, for the three critical elements of evidence-based practice in psychology (EBPP) (evidence-based practice; client characteristics, preferences, and culture; and clinical expertise) as applied to autism spectrum disorder (ASD). We contrast EBPP to a...
Stigma resistance is consistently linked with key recovery outcomes, yet theoretical work is limited. This study explored stigma resistance from the perspective of individuals with serious mental illness (SMI). Twenty-four individuals with SMI who were either peer-service providers (those with lived experience providing services; N = 14) or consume...
Objective:
To examine provider competence in providing Illness Management and Recovery (IMR), an evidence-based self-management program for people with severe mental illness, and the association between implementation supports and IMR competence.
Method:
IMR session recordings, provided by 43 providers/provider pairs, were analyzed for IMR compe...
We applied the ABCX model of stress and coping to assess the association between child and family demands, school-based resources (i.e., parent-teacher alliance and COMPASS, a consultation intervention), and two measures of parent stress: perceptions of the demands of raising a child (Child domain) and reactions to those demands (Parent domain). Da...
The chapter provides an overview, brief critique, and description of how COMPASS fits within the Evidence Based Practices in Psychology (EBPP) framework. We also describe the models that guided the development and testing of COMPASS. Specifically, we describe the Ladder of Evidence, Dunst and Trivette’s (2012) implementation science framework and i...
COMPASS originated from the need for a training framework for community-based service providers to understand the unique learning challenges, preferences, and strengths of each individual. COMPASS explicitly calls for the individualization of teaching and therapeutic strategies—a task that is particularly challenging in ASD given the extreme hetero...
COMPASS is comprised of two distinct, but related implementation practice activities—the initial consultation and the follow-up teacher coaching activities. Both are designed to empower parents and teachers as the active decision-makers on behalf of a student and assist them in their efforts to intervene with the student using performance-based out...
In our prior chapters, we described what we have learned about our implementation practice and intervention practice in terms of quality and internal and external factors and investigated the potential impact of these variables in explaining variability in COMPASS outcomes. In this chapter we cover what we learned about child factors. Most autism r...
In this chapter we report results from our two randomized controlled trials (RCTs) of COMPASS. The goal of our first RCT was to conduct a proof of concept study. We wanted to demonstrate the efficacy of COMPASS using goal attainment scaling as our outcome measure. The goal of our second RCT was both to replicate our initial results and test a secon...
Our last chapter reviewed critical teacher behaviors that are observable. In contrast, this chapter explores less understood but equally important teacher behaviors that are internal and not observable. Internal factors evaluated included self-efficacy, stress, and burnout as well as teachers’ attitudes toward data collection. Our analysis of self-...
In this chapter we continue to explore the elements of the Integrated Model, focusing specifically on the quality of the intervention practice, i.e., teaching quality and thus, teacher behavior. One key question concerning teaching quality, e.g., fidelity, is to examine whether the intended outcomes were indeed a result of the intervention. If the...
Consultation research is a complex task because we need to study both the implementation practice and the intervention practice. COMPASS has served as the evidence-based implementation strategy proven to result in better educational outcomes for children with ASD. In our concluding chapter we reflect on our Integrated Model and what we have learned...
One critical challenge to educators and to researchers is how to assess progress for group comparison designs when children have different goals, different stating baseline levels, and different intervention plans and, therefore, different milestones for what constitutes success. Evaluation of Individual Education Program (IEP) outcomes at the stud...
Assertive community treatment is known for improving consumer outcomes, but is difficult to implement. On-site fidelity measurement can help ensure model adherence, but is costly in large systems. This study compared reliability and validity of three methods of fidelity assessment (on-site, phone-administered, and expert-scored self-report) using a...
This study examined three methodological approaches to defining the critical elements of Illness Management and Recovery (IMR), a curriculum-based approach to recovery. Sixty-seven IMR experts rated the criticality of 16 IMR elements on three dimensions: defining, essential, and impactful. Three elements (Recovery Orientation, Goal Setting and Foll...
Caregiver burden and marital adjustment of mothers of children diagnosed with Autism Spectrum Disorder (ASD) were assessed at baseline, i.e., within six months of diagnosis (n = 79), and again 12 months later (n = 65), using predictors from the double ABCX family adaptation model, e.g., life demands, social support, appraisal, coping. Although ther...
More than a decade has passed since the National Research Council described the common elements of effective educational programs for young children with autism. Since that time, few studies have attempted to understand the mechanisms of change and factors affecting the effectiveness of research supported interventions implemented in community sett...
Background: Self-efficacy is described as confidence in one’s ability to complete task demands (Bandura, 1997). Self-efficacy is associated with higher degree of effort, willingness to endure hardships, and ability to manage difficult situations. Self-efficacy is of particular interest to implementation science researchers because of the importance...
Background:
Individuals with ASD are high users of medical services costing about $35 billion annually. Surprisingly, very little is known about the interactions between caregivers of children with ASD and their healthcare providers. Because high quality care is associated with informed decision-making, ways to assess and improve the knowledge of...
Background: Little is known about the lives of adults with autism and their parents. A 20-year follow-up longitudinal study is presented. Several outcomes were evaluated including adaptive behavior, medical issues, employment information, residential status, community inclusion, and self-direction. Parent outcomes such as caregiver burden and conce...
Background:
Parent caregivers of children with autism report greater levels of stress compared to parents of children with other developmental disabilities and parents of typically developing children (e.g., Baker-Ericzn et al., 2005; Yamada et al., 2007; Hayes & Watson, 2013). The transactional model of stress posits that stress is subjective an...
Objective:
Assertive Community Treatment (ACT) is an evidence-based practice for individuals living with serious mental illnesses. Although studies estimate that at least half of people with serious mental illnesses are parents, little is known about ACT policies and services for parent consumers.
Method:
Seventy-three ACT providers from 67 team...
The extent to which explicit and implicit stigma are endorsed by mental health practitioners using evidence-based practices is unknown. The purposes of the current study were to a) examine implicit and explicit biases among Assertive Community Treatment (ACT) staff and b) explore the extent to which biases predicted the use of treatment control mec...
The purpose of the current study was to evaluate a new measure, the Autism Self-Efficacy Scale for Teachers (ASSET) for its dimensionality, internal consistency, and construct validity derived in a sample of special education teachers (N = 44) of students with autism. Results indicate that all items reflect one dominant factor, teachers' responses...
It is encouraging that children with autism show a strong response to early intervention, yet more research is needed for understanding the variability in responsiveness to specialized programs. Treatment predictor variables from 47 teachers and children who were randomized to receive the COMPASS intervention (Ruble et al. in The collaborative mode...
Background:
Approaches to measuring recovery orientation are needed, particularly for programs that may struggle with implementing recovery-oriented treatment.
Objective:
A mixed-methods comparative study was conducted to explore effective approaches to measuring recovery orientation of assertive community treatment (ACT) teams.
Design:
Two AC...
Objective:
Misperceptions about individuals with mental illness and their ability to recover and live productive lives are common. Consumer presentation programs, such as NAMI's (National Alliance on Mental Illness) In Our Own Voice (IOOV), employ psychoeducation and direct contact to help correct misperceptions and offer encouraging messages abou...
Objective:
Monitoring fidelity of assertive community treatment (ACT) teams is costly. This study investigated the reliability and validity of a less burdensome approach: self-reported assessment.
Methods:
Phone-administered and self-reported assessments were compared for 16 ACT teams. Team leaders completed a self-report protocol providing info...
Objective:
Assertive Community Treatment (ACT) is an evidence-based practice for individuals with severe mental illness. Although at least half of all people with severe mental illness are parents, little is known about their experiences as parents and as recipients of mental health interventions like ACT. The purpose of the current study was to e...
Objective:
Most children with autism rely on schools as their primary source of intervention, yet research has suggested that teachers rarely use evidence-based practices. To address the need for improved educational outcomes, a previously tested consultation intervention called the Collaborative Model for Promoting Competence and Success (COMPASS...
Assertive Community Treatment (ACT) is an evidence-based practice for individuals with severe mental illness. Although studies estimate at least half of all people with severe mental illness are parents, little is known about ACT policies and services for consumers who are parents. ACT providers from 67 teams completed a survey assessing policies f...
Background:
The utility of an endophenotype depends on its ability to reduce complex disorders into stable, genetically linked phenotypes. P50 and P300 event-related potential (ERP) measures are endophenotype candidates for schizophrenia; however, their abnormalities are broadly observed across neuropsychiatric disorders. This study examined the d...
Background:
Numerous authors have identified the need for teachers to be trained in evidence based practices for children with autism (Hess, Morrier, Heflin, & Ivey, 2008; Morrier, Hess, & Heflin, 2011; Simpson, Mundschenk, & Heflin, 2011; Stahmer, et al., 2005). One method ideally suited for supporting teachers is consultation. We have developed...
Overview: This chapter describes COMPASS as the first research-supported consultation model for young students with autism spectrum disorders (ASD). It describes why COMPASS is specialized for ASD, is proactive, and is based on collaboration.
Overview: This chapter provides more details that assist with the activities that are described in Chaps. 7 and 8. The consultant facilitates the consultation by guiding the participants in using all the available information about the student to select objectives in communication, social, and work skills. Objectives must be well written using sugg...
Overview: This chapter covers Step A of the COMPASS Consultation Action Plan, which is conducted prior to the consultation. This information will inform the framework for the student’s personalized COMPASS profile.
Overview: This chapter explains the theoretical framework of COMPASS. Also provided is an overview of the World Health Organization’s (WHO) definitions of impairment, disability, and handicap and how this conceptual framework influences COMPASS.
Overview: Chapter 7 covers Step B of the COMPASS consultation process and provides forms and handouts used to conduct the consultation.
Overview: Effective consultation requires attention to many factors outside the immediate consultant–teacher interaction. Chapter 4 reviews influences on the consultation and coaching processes and identifies outcomes to consider. Consultant factor and teacher factors are described, as well as parent and student factors.
Overview: This chapter discusses content knowledge and process skills needed by the COMPASS consultant. Various types of training and the competencies achieved from the training are discussed. A self-evaluation form is provided for further self-study.
Overview: Chap. 9 provides case study examples of the COMPASS consultation and coaching procedural steps for three children with autism spectrum disorder who vary by age, cognitive functioning level, verbal skill, and primary classroom placement.
Overview: This chapter covers the essential components of teacher coaching. The importance of follow-up sessions from the initial COMPASS consultation is described and coaching is defined. Also provided are practical forms and a coaching protocol. The primary outcome measure of a COMPASS consultation is described, and instructions are provided for...
Goal attainment scaling (GAS) holds promise as an idiographic approach for measuring outcomes of psychosocial interventions in community settings. GAS has been criticized for untested assumptions of scaling level (i.e., interval or ordinal), inter-individual equivalence and comparability, and reliability of coding across different behavioral observ...
Rising numbers of young children diagnosed with autism spectrum disorders means more students with ASD entering pre-school and the elementary grades. For these young learners, individualized instruction toward measurable goals is crucial to effective education. The COMPASS program—Collaborative Model for Promoting Competence and Success for Student...
Processes underlying success and failure in assertive community treatment (ACT), a widely investigated treatment model for persons with severe mental illness, are poorly understood.
The purpose of the current study was to examine processes in ACT by (1) understanding how consumers and staff describe the processes underlying treatment success and fa...
The significant increase in the numbers of students with autism combined with the need for better trained teachers (National Research Council, 2001) call for research on the effectiveness of alternative methods, such as consultation, that have the potential to improve service delivery. Data from 2 randomized controlled single-blind trials indicate...
This study investigated the reliability and validity of a phone-administered fidelity assessment instrument based on the Dartmouth Assertive Community Treatment Scale (DACTS).
An experienced rater paired with a research assistant without fidelity assessment experience or a consultant familiar with the treatment site conducted phone-based assessment...
Teacher self-efficacy refers to the beliefs teachers hold regarding their capability to bring about desired instructional outcomes and may be helpful for understanding and addressing critical issues such as teacher attrition and teacher use of research-supported practices. Educating students with autism likely presents teachers with some of the mos...
Background:
The critical shortage in the numbers of special education teachers with appropriate training and available to respond to the epidemic increase in the prevalence of children with autism spectrum disorders (ASD) is a major challenge for schools. Shortfalls in the current training system have given impetus to the investigation of innovat...
Objective:
Although assertive community treatment (ACT) has been consistently recognized as effective, there has been little research as to what constitutes success in ACT. The purpose of this study was to understand how ACT consumers and staff define treatment success and failure and to examine whether definitions varied between staff and consume...
Although assertive community treatment (ACT) has been consistently recognized as effective, there has been little research as to what constitutes success in ACT. The purpose of this study was to understand how ACT consumers and staff define treatment success and failure and to examine whether definitions varied between staff and consumers.
Investig...
The effects of a teacher consultation intervention were examined-namely, the collaborative model for promoting competence and success (COMPASS), which was designed to improve objectives of individualized education programs for children with autism. The intervention consists of an initial parent-teacher consultation, followed by four teacher consult...
Objective: Although coping with positive symptoms of schizophrenia has been studied widely, few studies have examined coping with negative symptoms. This study compares the appraisal of stressfulness and coping patterns in response to positive and negative symptoms experienced by clients with schizophrenia attending a community mental health center...
Separate hierarchical regression analyses were conducted for each predictor: the first block included only one pretreatment variable (all were centered to adjust for effects of multicollinearity) plus the covariate (Time 1 goal attainment score), the second block added group assignment (COMPASS vs no COMPASS), and the third block added the interact...
Background:
Research that provides scientific decision making in the selection and use of professional development models has the potential for major impact in both urban and rural areas of the U.S (Pianta, 2006). Access to specialists in ASD is problematic for rural communities, and this difficulty is exacerbated in rural communities that are ge...
The purpose of this study was to develop an Individual Education Program (IEP) evaluation tool based on Individuals with Disabilities Education Act (IDEA) requirements and National Research Council recommendations for children with autism; determine the tool's reliability; test the tool on a pilot sample of IEPs of young children; and examine assoc...
Research on the effectiveness of vocational rehabilitation for individuals with severe mental illness describes many barriers to employment, but it has not addressed 2 important questions: whether perceptions of personal barriers to employment are modified during rehabilitation, and whether reductions in perceived barriers predict better outcome. S...
This study reports on an evaluation of Our Town, an innovative case management program based on the Village Integrated Service Agency (ISA) program of Long Beach, Calif., and focusing on providing early, intensive psychiatric and psychosocial intervention for transition-age youth aged 18–25 with serious mental illness. A longitudinal, 2-year pre-po...
The current paper reports on the feasibility of using the HAPI-A, an instrument designed to assess a person's level of functioning in the community: (1) to help determine eligibility to receive behavioral health services, (2) to assign reimbursement case rates; and (3) to provide data for a service provider report card. A 3-year field study of the...
Background:
Therapeutic care for a child with autism is often extremely complex, entailing a high rate of service utilization and a multifaceted approach to treatment. In turn, parents of children with autism often report problems with accessibility, coordination, and family-centeredness of care, as well as problems with adequacy of insurance cov...
Background:
The increasing numbers of students with autism combined with the limited number of teachers with training in autism presents a serious issue in providing effective services and producing positive educational outcomes. Child-specific teacher consultation is often employed as an indirect method of influencing teacher behavior with the h...
The study examined factors impacting caregiver burden following diagnosis of an autism spectrum disorder (ASD). Primary caregivers of children diagnosed with an ASD within the past 6 months (n = 78) were assessed on variables thought to influence outcomes associated with family stress as proposed within the double ABCX model of family adaptation, i...
Background: The National Research Council (2001) has called for more trained school personnel with child-specific consultation skills related to autism. However, there is little research that actually has investigated consultation as an intervention. To begin to address this problem, outcomes from a collaborative intervention planning framework dev...
The psychometric properties of the HAPI-A were examined at intake and 90-day follow-up in consumers with mental illness (MI) or chronic addiction (CA) being served at one of 11 treatment facilities (n = 1168). A 4-factor subscale structure was confirmed and factor invariance tests indicated a single model for the CA and MI samples. Internal consist...
In an era in which evidence based practices are becoming the standard of care, there is little evidence that the current array of services commonly delivered for those with autism is helpful. This study describes community-based service utilization and caregiver-rated outcomes of services on symptoms of 113 children with autism spectrum disorders a...
Sustainable implementation of evidence-based practices (EBPs) requires establishing standards, financial support, and technical assistance for the EBP. In response to a competitive, broad agency announcement to create a technical assistance center for Assertive Community Treatment (ACT) in the state of Indiana, we have created the ACT Center of Ind...
