The impact of implementation support on the use of a social engagement intervention for children with autism in public schools.

Only 31 children with autism were included, and the age range was wide, so the study cannot show effects for many children with autism. The study took place in public elementary schools in the Northeastern United States, so results may not transfer to schools with different staffing, resources, or student populations. The sample was predominantly male, so findings may not apply equally to girls with autism. Autism diagnosis and IQ were taken from school records and not independently confirmed; children had IQ 65 or higher, were performing at grade level, and could engage without assistive technology or communication devices, so findings may not apply to children with lower cognitive or language abilities. There was no true control group because all schools received Remaking Recess training; the study compared training only with training plus implementation support. Follow-up was only six weeks, and self-rated fidelity was missing for seven children (22.7% of all children) at follow-up, so longer-term maintenance and staff self-report are uncertain. Fidelity was low even after training, and the study did not quantitatively measure fidelity of school-level implementation support.

The authors declare no potential conflicts of interest. The article is listed as supported by NIH extramural and non-U.S. government research support.

Do not read the social network inclusion result as proof that implementation support improves child engagement overall. The primary staff-use outcome did not differ between conditions, playground engagement did not differ between conditions, and all schools received Remaking Recess training.