2 - (SYM 47) Incorporating Autistic Voice to Iterative Redesign of an Implementation Toolkit Targeting Autism Evidence-based Intervention Selection

Background: The documented misalignment between researchers’ priorities for research and those of the autistic community^1,2 underscores the importance for inclusion of autistic voice as part of evidence-based intervention (EBI) design and implementation efforts to ensure EBI relevance, fit, feasibility, and resulting use in community settings. We describe the systematic process and impact of incorporating autistic voice in the iterative redesign of an autism EBI implementation toolkit for middle and high schools.

Methods: A packaged, multifaceted implementation toolkit, the Autism Community Toolkit: Systems to Measure and Adopt Research-based Treatments (ACT SMART), was redesigned for middle and high schools using a multi-step community-engaged process. We conducted two focus groups with autistic teens (n=7) and their caregivers (n=2) to identify perspectives on needs for school programming; evaluate ACT SMART feasibility, acceptability, and usability; and identify areas for redesign. We then engaged an advisory board consisting of autistic young adults (n=3) to inform the iterative redesign of ACT SMART. Finally, we conducted a pilot test of the redesigned toolkit during which we integrated autistic student (n=6) feedback to inform school application of ACT SMART.

Results: Autistic teens and caregivers indicated the need to incorporate and include autistic student input regarding educational needs and preferences. Our autistic advisory panel informed the redesign of ACT SMART, including co-design of the recommended student-specific assessment evaluating autistic student needs, including providing perspectives on necessary assessment construct inclusion, definition, and representation. Finally, results from our ongoing pilot test of the redesigned toolkit confirmed the importance and utility of the included student-specific assessment, with initial results indicating specific student needs and EBI targets that expand and complement data gathered as part of the ACT SMARTS process. This includes supports in areas of emotional well-being, socialization, and organization and goal setting supports.

Conclusion: The current project highlights the value and impact of incorporating autistic voice in the redesign of a multifaceted implementation tool for middle and high schools. Involving end recipients, particularly autistic voice, is key to ensuring relevance and maximizing the impact of implementation tools to the intended population. Implications, recommendations, and future directions will be discussed.