Implementation of school-based services for students with autism: Barriers and facilitators across urban and rural districts and phases of implementation
Authors: Suhrheinrich Jessica , Melgarejo Melina , Root Brittney , Aarons Gregory A , Brookman-Frazee Lauren 
Published: June 2021

Research regarding variables influencing evidence-based practice implementation within school services for students with autism spectrum disorder is limited. Using qualitative methods, the current study applies the Exploration, Preparation, Implementation, and Sustainment framework to characterize factors impacting the implementation of practices for students with autism spectrum disorder across urban and rural school districts. The guiding questions of the study include: (1) Are contextual factors perceived as barriers or facilitators, and do these perceptions vary by district location? and (2) What are the key factors impacting implementation across the Exploration, Preparation, Implementation, and Sustainment phases? Focus group participants ( n = 33) were service providers to children with autism spectrum disorder from urban- and rural-located school districts. Several personnel-related themes (attitudes and buy-in, knowledge and skills, staffing, and burnout) were shared by participants representing both urban and rural districts. However, some themes related to system and organizational factors (leadership approval, support and expectations, district structure, competing priorities, time for effective professional development, litigation and due process, and materials and resources) differed between the district locations. This project serves as an initial step in understanding the current process of evidence-based practice implementation within the school context and may help identify intervention targets to include in implementation planning. Lay abstract The law requires that schools use evidence-based practices to educate students with autism spectrum disorder. However, these practices are often not used, or are not used correctly in school programs. Understanding barriers and facilitators of use of evidence-based practices in schools will help improve the implementation process. This study uses focus groups to characterize how school-based providers representing urban or rural school districts perceive barriers and facilitators for implementing new practices for students with autism spectrum disorder. Guiding questions include the following: (1) Are contextual factors perceived as barriers or facilitators and how do these vary by district location? and (2) What are the key factors impacting implementation across the Exploration, Preparation, Implementation, and Sustainment phases? Focus group participants ( n = 33) were service providers to children with autism spectrum disorder from urban- and rural-located school districts. Several personnel-related themes (attitudes and buy-in, knowledge and skills, staffing, and burnout) were shared by participants representing both urban and rural districts. However, some personnel-related themes and organizational factors were unique to rural or urban districts. For example, themes related to system and organizational factors (leadership approval, support and expectations, district structure, competing priorities, time for effective professional development, litigation and due process, and materials and resources) differed between the district locations. This project serves as an initial step in identifying implementation strategies that may improve the use of evidence-based practices in schools.