Improving the Fit of Interventions for Autism in Schools: Lessons Learned Following Paraeducator Coaching on the RUBIES Program.

Implementing evidence-based behavioral interventions in school settings presents various challenges, particularly for paraeducators who often have limited formal training in working with autistic students, let alone specific behavior management strategies for this population. This study examined paraeducator feedback on the RUBI in Educational Settings (RUBIES) intervention, an adapted evidence-based behavioral intervention for schools. Sixteen paraeducators who participated in a randomized controlled trial of RUBIES completed semi-structured interviews, providing insights into the program's strengths and areas for improvement. Using the Framework for Reporting Adaptations and Modifications - Expanded (FRAME), feedback was categorized into (a) positive feedback and (b) adaptation suggestions in the areas of (a) content and (b) implementation and scale-up activities. Paraeducators found RUBIES content effective in reducing challenging behaviors and improving student engagement. However, implementation barriers such as scheduling constraints, difficulty accessing materials, and limited coordination with broader educational teams were identified. Recommendations included expanding staff training and integrating digital tools for real-time strategy use and data collection. Findings highlight the need for ongoing monitoring and iterative adaptation of RUBIES implementation strategies in collaboration with community partners to ensure its feasibility and sustainability in school settings. Future research should focus on refining RUBIES and assessing long-term outcomes to enhance the program's impact on paraeducators and autistic students.