Practices of professionals providing services to children with autism spectrum disorders: Testing the theory of planned behavior in predicting use of evidence-based interventions and family-centered care

PRACTICES OF PROFESSIONALS PROVIDING SERVICES TO CHILDREN WITH AUTISM SPECTRUM DISORDERS: TESTING THE THEORY OF PLANNED BEHAVIOR IN PREDICTING USE OF EVIDENCE-BASED INTERVENTIONS AND FAMILYCENTERED CARE By Lillian M. Christon, M.A. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Director: Barbara J. Myers, Ph.D. Associate Professor Department of Psychology Autism spectrum disorders (ASDs) are chronic and pervasive developmental disorders; children with ASDs require more multidisciplinary services than children with other developmental, behavioral, and emotional disorders (Kogan et al., 2008). Little research has been done on the practices and perspectives of the professionals providing services to children with ASDs. Evidence-based practice (combining use of evidence-based interventions [EBIs], family-centered care [FCC] respecting patient/family values, and clinical expertise) leads to the best outcomes for children with ASDs (APA Presidential Task Force on Evidence-Based Practice, 2006). The aim of this study was to assess the extent to which psychological constructs (attitudes, subjective norms, perceived behavioral control) within the Theory of Planned Behavior (Ajzen, 1991) are helpful for understanding the behavior of professionals in regards to two areas of evidence-based practice: recommending and/or providing EBIs and using a FCC approach to care with children with ASDs. Professionals (N=709) providing direct services to children with ASDs were recruited from different disciplines (Education, Medicine/Nursing, Occupational and Physical Therapy, Psychology, Social Work, Speech Language Pathology/Audiology) and were asked to fill out an Internet or paper survey including measures on TPB constructs and EBI and FCC behavior. Participants were recruited from a convenience Internet sample and a stratified random sample of online provider listings (from professional and autism-specific organizations). Professionals’ attitudes and familiarity with EBIs significantly predicted their self-reported recommendation and provision of EBIs in the positive direction. Professionals’ attitudes, perceived-behavioral control, and years in practice significantly predicted self-reported use of an FCC approach with children with ASDs in the positive direction. There was a trend for explicit training on EBI or FCC to predict professionals’ behavior, but these findings did not reach conventional levels of significance. Subjective norms did not significantly predict EBI or FCC behavior. Discipline membership did not moderate the relationship between TPB and EBI and FCC self-reported behavior measures. The TPB is a useful framework for better understanding professionals’ evidence-based practice behavior. This study sheds light on practices and perspectives of professionals working with children with ASDs and highlights areas for future research and training with this population.