在自闭症领域,人们对将循证干预措施(EBIs)转化为为自闭症儿童及其家庭服务的系统越来越感兴趣。公共早期干预系统一直是基于研究的实施工作的重点,因为根据《残疾人教育法》C部分,这些系统被联邦政府授权为三岁以下发育迟缓的儿童提供服务。尽管现在越来越多的研究正在培训早期干预提供者提供自闭症EBI,这项工作的规模相对较小,刚刚开始考虑这些模式与早期干预系统的一致性,以及是否有足够的基础设施来扩大这些培训工作并维持其对公共卫生的影响。本评论旨在通过回顾已发现的因素来解决这一差距,这些因素会统一影响不同公共系统中EBIs的扩大规模(Fagan20,1147-1168,2019),并将此框架扩展到公共早期干预系统中EBIs的实施。这些因素包括开发者和资助者的能力,公众对EBI的认识和支持,系统对EBI使用的领导支持,社区参与实施工作的能力,能够提供EBIs的熟练劳动力的可用性,以及数据监控和质量改进的能力。本评论讨论了这些因素如何具体影响EI系统中自闭症EBI的扩大,以支持幼儿和年轻人,自闭症儿童,以及对自闭症研究人员的影响。
In the autism field, there is increasing interest in translating evidence-based interventions (EBIs) into
systems that serve young autistic children and their families. Public Early Intervention
systems have been a focal point of research-based implementation efforts given that these
systems are federally mandated to provide services to children birth to three years of age with developmental delays under Part C of the Individuals with Disabilities Education Act. Although a growing number of research studies are now training Early Intervention providers to deliver autism EBIs, this work has been conducted on a relatively small scale and has only just begun to consider the alignment of these models with Early Intervention
systems and whether sufficient infrastructure exists to scale up these training efforts and to sustain their public health impact. This commentary aims to address this gap by reviewing factors that have been found to uniformly impact the scale-up of EBIs across diverse public systems (Fagan 20, 1147-1168, 2019), and to extend this framework to the implementation of EBIs within public Early Intervention
systems. These factors include developer and funder capacity, the public\'s awareness of and support for EBIs, the system\'s leadership support for EBI use, the capacity for community engagement in implementation efforts, the availability of a skilled workforce capable of delivering EBIs, and the capacity for data monitoring and quality improvement. This commentary discusses how these factors may specifically impact the scale-up of autism EBIs within EI systems to support toddlers and young, autistic children, and implications for autism researchers.