Redesigning an Autism Evidence-Based Practice Adoption and Decision-Making Implementation Toolkit for Middle and High Schools.

Research indicates inadequate evidence-based practice (EBP) implementation for autistic adolescents in schools, despite schools being the most accessed service system by autistic youth. It is critical for school personnel to have a systematic approach to select and adopt autism EBPs. The Autism Community Toolkit: Systems to Measure and Adopt Research-based Treatments (ACT SMART) is a packaged implementation process tool designed to facilitate autism EBP adoption and uptake in community agencies, with promising feasibility, utility, and effectiveness. The current study describes the first iterative study of a community-partnered, iterative redesign of ACT SMART for use in educational settings. Using mixed-methods (focus groups, surveys), we gathered district and school administrators', teachers', paraeducators', autistic students' and their caregivers' perspectives of the feasibility, usability, and appropriateness of ACT SMART. We also gathered recommendations for redesign to ensure its contextual appropriateness and usability in middle and high schools. Results indicated the perceived acceptability (satisfaction with ACT SMART), feasibility (practicability of ACT SMART), and appropriateness (perceived fit or relevance of ACT SMART) but more limited usability (extent to which ACT SMART can be used by educators to achieve intended goals) of ACT SMART for schools. Key modifications include integrating the toolkit with school structures (i.e., conducting training on professional development days, aligning budget planning with the district timeline, tying the toolkit to students' IEPs, aligning with school calendars) and content modifications (i.e., altering language, shortening assessments, incorporating toolkit engagement strategies) to improve usability in schools. The current study highlights the relevance and potential of tools targeting EBP selection and adoption support for public schools. Next steps include further application of community-partnered and human-centered design methods to further refine and finalize the redesigned ACT SMART Toolkit and subsequent feasibility pilot testing.