Therapists' Adaptations to an Intervention to Reduce Challenging Behaviors in Children with Autism Spectrum Disorder in Publicly Funded Mental Health Services.
Margaret W Dyson, Colby Chlebowski, Lauren Brookman-Frazee
PMID 30368628WHAT IT FOUND
95% of therapists made adaptations while delivering AIM HI to children with autism.
They commonly changed language, slowed the pace, added other approaches, and involved teachers. The study did not show whether these adaptations improved challenging behavior.
Key findings
0195% of therapists reported making adaptations to the AIM HI intervention.
02Common adaptations included modifying language (76%), slowing the pace (74%), integrating components from MAP, Triple P, CBT, and solution-focused therapy (73%), and involving others beyond primary caregivers (58%).
03Reported reasons included the child's presentation (82%), caregiver participation (80%), caregiver presentation (72%), and fit with the therapist's approach (70%); no therapist background characteristics were associated with the four common adaptations.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
All data were therapist self-report; no independent observation of sessions was used, so adaptations may have been missed or under-reported. Therapists came only from Southern California agencies, so findings may not apply to other regions or services. The study did not measure child behavior, communication, or caregiver outcomes, so it cannot show whether adaptations helped or harmed clients. Three therapists stopped after the workshop and did not provide adaptation data, though they did not differ from participating therapists on reported demographics. This is a descriptive analysis of therapists' reports, not a test of AIM HI effectiveness.
Declared interests
All authors declared no conflict of interest.
The easy way to misread this
Do not read the 95% adaptation rate as evidence that AIM HI alone reduces challenging behaviors. Therapists also integrated components from MAP, Triple P, CBT, and solution-focused therapy, and the study did not test child outcomes.