Category: Autism Spectrum and Developmental Disorders
Jeffrey Wood, Ph.D.
Professor
UCLA
Los Angeles, California
Aaron Hogue, Ph.D.
Vice President
Partnership to End Addiction
New York, New York
Bryce McLeod, Ph.D.
Professor
Virginia Commonwealth University
Richmond, Virginia
Karen Wood, Ph.D.
University of California Los Angeles
Los Angeles, California
Amanda Johnson, None
University of California, Los Angeles
Culver City, California
Although a number of cognitive and behavioral interventions for children with autism have been designated as evidence-based practices (EBPs) in comprehensive reviews of the literature, is it uncommon for families to access these EBPs in community practice settings (Christon et al., 2010, 2015). In response to this science-practice gap, we developed a free-of-charge internet-based clinician training platform entitled Modular EBPs for Youth with Autism (MEYA; meya.ucla.edu). This symposium provides an overview to the development of MEYA and initial findings pertaining to implementation outcomes.
An emerging consensus in the field of implementation science is that the most economical and scalable platform for training therapists entails at least partial reliance on technology (i.e., internet/video). The Covid pandemic underscored the need for remote training options. MEYA is an internet-based clinician training and guidance system developed from existing efficacious EBPs for autism (e.g., Wood et al., 2020, 2021) distilled into modules that address autism symptoms along with common comorbid symptoms (e.g., anxiety; externalizing) in school-aged children. In the development of MEYA, a just-in-time paradigm was used in which training on a specific module (e.g., self-management) addressing a top-priority clinical need for a given child (e.g. repetitive behaviors) is “pushed” to a clinician via the internet in the days before an upcoming therapy session. Training entailed watching brief video models of the CBT technique, reading simplified instructions, session support materials like handouts and sample CBT cartoons, and self-reflection exercises to facilitate session preparation. Children’s top-priority clinical needs were ascertained from session to session using parent-rated personalized symptom descriptions using the Youth Top Problems (YTP) approach, which was integrated into the MEYA website to guide module selection via an algorithm (i.e., the highest-rated YTP for the week determines which therapy module to implement for the week).
In the initial evaluation of MEYA, an observational treatment fidelity tool (MEYA-FS) was developed and tested for psychometric reliability and validity in a sample of 77 youth from two trials of CBT for autism spectrum disorders. The MEYA-FS Adherence and Competence scales were both reliable and sensitive to treatment outcome in this sample, suggesting their utility for evaluating clinician fidelity during MEYA training. These results are presented in the first paper in this symposium. The observational MEYA-FS scale was then used in a multiple baseline study of 7 therapist research participants learning CBT techniques on the MEYA website, and results suggested that use of the MEYA website significantly improved their adherence and competence in autism-specific CBT practices. These same clinicians participated in post-training interviews and reflected on the acceptability, adoption, and feasibility of MEYA; these findings are described in the second and third papers in this symposium. Overall, MEYA appears to be a promising training tool that is freely available to clinicians worldwide that may be able to facilitate improved practice in serving youth with autism.
Presenter: Bryce D. McLeod, Ph.D. – Virginia Commonwealth University
Presenter: Karen S. Wood, Ph.D. – University of California Los Angeles
Co-author: Jeffrey J. Wood, Ph.D. – UCLA
Co-author: Kashia Rosenau, Ph.D. – UCLA
Co-author: An-Chuen Cho, Ph.D. – UC Davis
Presenter: Amanda R. Johnson, None – University of California, Los Angeles
Co-author: An-Chuen Cho, Ph.D. – UC Davis
Co-author: Kashia Rosenau, Ph.D. – UCLA