Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study

Abstract

Schools play a major role in delivering behavioral health services to autistic youth. School culture and climate are strong predictors of the extent to which these services incorporate evidence-based practices; however, little is known about how school leaders shape culture and climate. Drawing on the concept of culture and climate embedding mechanisms, we conducted a qualitative study to understand the ways in which school principals embed cultures and climates that support effective implementation of evidence-based practices for youth with autism. Semi-structured interviews with 32 teachers in schools that implemented three closely related evidence-based practices for youth with autism (discrete trial training, pivotal response training, and visual schedules) explored teachers’ experiences regarding (a) implementation of the three evidence-based practices, (b) perceptions of school culture and climate, and (c) principals’ behaviors, practices, and decisions that supported or detracted from the aspects of culture and climate that supported successful implementation. Thematic analysis detailed seven mechanisms that principals used to embed cultures and climates that shaped evidence-based practice implementation. These mechanisms represent actionable targets for school leaders and inform strategies to improve the implementation of evidence-based practices for youth with autism in schools.

Lay abstract

Schools play a major role in providing services to youth with autism; however, not all schools use evidence-based practices, defined as interventions that are proven to improve youth well-being through rigorous research. School culture and climate are strong predictors of whether or not a school uses evidence-based practices; however, little is known about how principals can create school cultures and climates that support the use of these practices. This study interviewed 32 teachers in elementary schools that implemented three closely related evidence-based practices for youth with autism to better understand how principals create school cultures and climates that support effective services. Analysis of the teachers’ responses identified seven strategies principals can use to create school cultures and climates that support the implementation of effective practices for youth with autism. The strategies include the following: (a) support teachers to obtain professional development focused on autism, (b) align performance expectations and evaluations with the needs of students with autism and evidence-based practice delivery, (c) allocate resources to ensure adequate staff, materials, and training are available to implement evidence-based practices, (d) be open and flexible to allow teachers to use the building and resources as needed to meet students’ needs, (e) provide direct assistance, feedback, and coaching to troubleshoot challenges or involve outside experts to do so, (f) openly value the work of special education teachers and provide recognition to those who develop expertise in evidence-based practices, and (g) look for opportunities to integrate special and general education teachers and students to foster a truly inclusive climate.

Keywords

education services evidence-based practice implementation interventions psychosocial/behavioral leadership organizational climate organizational culture

Introduction

“If you have a good leader in the school, it trickles down to your teachers. It trickles down to your students, and supports your school overall.”

—Autism Support Teacher

Schools play a major role in delivering behavioral health care for autistic youth in the United States (Farmer et al., 2003; Kang-Yi et al., 2016; Lyon, Ludwig, Stoep, et al., 2013). Recently, documented gaps in the quality and outcomes of these services have led to increased pressure on school leaders to increase the use of evidence-based practices (EBPs; Stahmer et al., 2015). EBPs are interventions shown through rigorous research to improve youth well-being (Weisz et al., 2006; Weisz & Kazdin, 2010). In many schools, youth with autism do not receive EBPs, and in schools where EBPs are delivered, fidelity to the practice models often is poor (Locke et al., 2015; Mandell et al., 2013; Pellecchia et al., 2015; Suhrheinrich et al., 2013). Identifying strategies that school leaders can use to facilitate high-fidelity implementation of EBPs for autistic youth in schools can improve their quality of care.

Conceptualizing organizational culture and climate in schools

One factor that predicts effective EBP implementation in schools is the school’s organizational culture and climate (Fair et al., 2018; Williams et al., 2019), where culture is defined as the shared norms and behavioral expectations that guide how work is completed within the organization (Glisson, Landsverk, et al., 2008) and climate is defined as employees’ shared perceptions of the impact of the work environment on their personal well-being (James et al., 2008). Several studies have drawn on a theoretical model that defines organizational culture along three dimensions of proficiency, rigidity, and resistance, and organizational climate along three dimensions of engagement, functionality, and stress (Glisson, Landsverk, et al., 2008). They have shown that service organizations with a specific profile of culture and climate, referred to as a comprehensive profile, have better service outcomes for youth (Glisson et al., 2013), higher staff fidelity to EBPs (Olin et al., 2014; Williams et al., 2019), longer sustainment of innovative practices, and reduced staff turnover (Glisson, Schoenwald, et al., 2008).

Comprehensive profiles are characterized by (a) high levels of proficient culture, in which employees perceive that they are expected to place the well-being of their students first and to maintain competence in up-to-date, effective practices; (b) relatively low levels of rigid and resistant culture, which capture the extent to which employees are expected to closely follow prescribed rules and maintain the status quo; and (c) high levels of functional and engaged climate relative to the level of stressful climate. Functionality indicates the extent to which employees perceive that they receive cooperation and support they need from colleagues to do their work well, have opportunities for growth, and experience role clarity. Engagement indicates the extent to which employees perceive a sense of professional accomplishment from their work. Stress pertains to employees’ shared perceptions of role overload (too many tasks) and role conflict (too many different tasks).

Recently, Williams et al. (2019) showed that teachers and staff in schools with comprehensive culture and climate profiles exhibited superior fidelity, with large effect sizes (ds = 0.95–1.64), to two out of three EBPs for youth with autism, even after controlling for external policy and resource factors. Using latent profile analysis, the researchers analyzed the cultures and climates of 65 schools and found that 9% of the schools exhibited a comprehensive culture and climate profile in which proficient culture was high, rigid and resistant culture were moderate to low, functional and engaged climate were high, and stressful climate was low—fidelity to EBPs for youth with autism was significantly higher in these schools (Williams et al., 2019). These findings extend a substantial body of school-based research showing that school cultures and climates predict student achievement, social-emotional well-being and behavior, and staff retention and burnout (Anderson, 1982; Fair et al., 2018; Hargreaves, 2013; Hoy, 1990; Huang et al., 2017; Kohl et al., 2013; Macneil et al., 2009; Reaves et al., 2018; Thapa et al., 2013). These findings also beg the question: what can school leaders do to create comprehensive cultures and climates that support EBP implementation for youth with autism? In this study, we address this question using qualitative data from 32 teachers who implemented three EBPs for autistic youth—discrete trial training, pivotal response training, and visual schedules (Arick et al., 2004; Dettmer et al., 2000; Schreibman, 2000; Smith, 2001).

Conceptualizing leaders’ influence on culture and climate

Little research has examined the antecedents or mechanisms that school leaders use to influence culture and climate. Research from other youth-serving institutions, such as mental health clinics, indicates that culture and climate are malleable (Williams & Glisson, 2020), can be improved (Glisson et al., 2013), and that improvement is associated with both providers’ increased implementation of EBP (Glisson et al., 2016b; Williams & Beidas, 2019; Williams et al., 2017) and improved youth outcomes (Glisson et al., 2013). Research also confirms that leader behaviors are correlated with organizational culture and climate (Ostroff et al., 2013). However, these studies do not identify the specific behaviors or mechanisms that leaders use to improve culture and climate nor do they address the unique issues that arise in schools.

In this study, we draw on Schein’s (2010) concept of organizational culture and climate embedding mechanisms. Schein (2010) argued that organizational leaders shape culture and climate through specific behaviors, decisions, and practices, referred to as embedding mechanisms, that communicate to organizational members, the operating assumptions, values, behavioral norms, and expectations they are expected to enact in order for the organization to achieve its goals and for the member to succeed within the organization. Examples of embedding mechanisms include the following: what leaders pay attention to, measure, and control on a regular basis; how leaders allocate rewards and status; how leaders allocate resources; and how leaders design workflow and space. Understanding the embedding mechanisms that principals use to shape comprehensive cultures and climates in schools can inform principals’ leadership behaviors and strategies designed to help principals support the implementation of EBPs for youth with autism in their schools.

Study aims

The aim of this qualitative study was to understand, from the perspective of special education teachers, the embedding mechanisms school principals use to create comprehensive cultures and climates that are empirically linked to high observed fidelity to EBPs for youth with autism in schools. We focused on identifying mechanisms that contributed to cultures characterized by high or low levels of proficiency, rigidity, and resistance and to climates characterized by high or low levels of functionality, engagement, and stress.

Method

Participants and setting

Details of the larger context and study within which this work was completed are provided elsewhere (Locke et al., 2016, 2019; Williams et al., 2019). In brief, 65 schools, incorporating 86 kindergarten through third-grade autism support classrooms, were included in a study that assessed teachers’ fidelity to three EBPs for youth with autism, and organizational and individual factors that predicted variation in EBP fidelity. Participating schools were located in the northeastern and northwestern United States. School leaders had chosen to implement three autism-focused EBPs based on the principles of applied behavior analysis—discrete trial training, pivotal response training, and visual schedules—all of which have strong empirical support and have been used in schools (Arick et al., 2004; Dettmer et al., 2000; Schreibman, 2000; Smith, 2001; Stahmer, 1999). Training was provided to all teachers working in autism support classrooms at the beginning of the school year, and teachers were instructed to use the three practices as part of their standard operating procedures. The research protocol involved (a) collection of quantitative survey data (including assessments of organizational culture and climate) from teachers and classroom staff following the EBP training (November and December 2015), (b) observation of teacher and staff fidelity to the EBPs by trained coders from January to April during the academic year, and (c) completion of qualitative interviews with a purposive sample of teachers in April and May of the same year. This article reports on the qualitative interviews.

In an effort to conduct interviews that captured a full range of teacher experiences related to culture, climate, leadership, and EBP implementation, teachers were purposefully sampled based on their average levels of fidelity (i.e. high vs low) across the three EBPs. The goal of the sampling approach was to ensure that thematic elements could be identified from teachers with many different types of implementation experiences. Teachers in the top tertile based on their average fidelity rating across all three practices and those in the bottom tertile were invited to complete interviews. Teachers were rank-ordered and invited to participate—we invited the next participant with the highest or lowest implementation fidelity scores when participants declined following procedures outlined in Beidas et al. (2013) and Lyon, Ludgwig, Romano, et al. (2013). We conducted enough interviews from both the high- and low-fidelity conditions to achieve data saturation (Guest et al., 2006).

Table 1 presents the characteristics of the N = 32 teachers who completed qualitative interviews for this study, including the average fidelity ratings of teachers in the high- and low-fidelity groups. Trained coders viewed teachers’ use of the practices in class and rated their implementation from 0 (Does not implement) to 4 (Highly accurate implementation). Table 1 also presents the characteristics of the K = 30 schools where these teachers worked. Twenty-eight schools had one teacher included in the sample; 2 schools had two teachers included in the sample. The schools came from all four profiles identified in the original Williams et al.’s (2019) study and exhibited considerable variability on all six dimensions of culture and climate (see Table 1).

Table 1.

Characteristics of study participants.

	M (SD) or n
Teachers (N = 32)
Age in years	35.69 (9.71)
Years of experience	6.84 (4.84)
Sex
Male	2
Female	30
Race
Black/African American	2
White	30
Educational attainment
Bachelor’s degree	4
Graduate/professional	28
Level of fidelity (0–4 scale)
High-fidelity group (n = 17)	2.80 (0.58)
Low-fidelity group (n = 15)	1.36 (0.15)
Schools (K = 30)
Proficient culture (z-score)	0.19 (1.07)
Rigid culture (z-score)	0.15 (0.87)
Resistant culture (z-score)	0.08 (0.91)
Engaged climate (z-score)	−0.05 (0.98)
Functional climate (z-score)	0.12 (0.92)
Stressful climate (z-score)	0.14 (1.02)
Culture and climate profile
Comprehensive	3
Supportive	9
Indifferent	12
Constrained	6

The study sample included n = 1 teacher per school for k = 28 schools; k = 2 schools had n = 2 teachers. Culture and climate z-scores reported in this table were originally calculated based on the full sample of K = 65 schools in Williams et al. (2019); thus, the average proficient culture score in this sample of K = 30 schools was 0.19 standard deviation units above the mean of the full sample of K = 65 schools in Williams et al. (2019). There were no statistically significant differences in culture/climate scores between schools represented in the qualitative study sample versus those not represented (all ps > 0.150).

Procedure

Participating teachers completed individual, semi-structured interviews lasting 45–60 min. The senior author (J.L.) conducted the interviews following a guide designed to elicit participants’ experiences regarding the EBP implementation process within their school, perceptions of their work environment (including organizational culture and climate), and specific leadership behaviors, decisions, and practices that had facilitated or hindered the implementation of the EBPs (see Supplemental File 1 for the interview guide). All interviewees provided written informed consent and were paid US$50. Ethics approval for the study was provided by the University of Pennsylvania and the University of Washington Institutional Review Boards and the school districts.

Analysis

Semi-structured interviews were transcribed and uploaded to NVivo QSR 12 for data management. The coding scheme was developed using a systematic, transparent, and iterative thematic analysis (Braun & Clarke, 2006) that incorporated two stages. Stage 1 involved a deductive approach to identify and extract segments of text that characterized school culture and climate based on the six dimensions described by the Glisson, Landsverk, et al. (2008) model (proficiency, rigidity, resistance, engagement, functionality, and stress). Prior to coding, the research team met as a group to develop a preliminary codebook that operationally defined each dimension of culture and climate based on the literature and expert consensus (Glisson, Landsverk, et al., 2008). Examples of high and low levels of each dimension were documented (e.g. high vs low levels of proficient culture), as were rules about when to use each code. This deductive coding scheme was then applied to all 32 interviews to produce a descriptive analysis of each dimension of culture and climate (Bradley et al., 2007). Two coders (L.F. and A.C.) coded all data, and inter-rater reliability was calculated for 20% of the transcripts (MacPhail et al., 2015). The coders met weekly to discuss, clarify, verify, and compare codes; disagreements were discussed with the entire research team to attain consensus. Percent agreement was calculated based on the number of words the two coders agreed on for each code. Specifically, NVivo calculates the percentage of the source’s content (amount of text) where the two users agree on whether the content should be coded. Average agreement was 97.5% across all codes.

Stage 2 of the thematic analysis involved an iterative, inductive approach in which the segments of text related to culture and climate and extracted during Stage 1 were re-analyzed and re-coded to identify embedding mechanisms (i.e. behaviors, decisions, and practices) that principals used to influence these dimensions (Braun & Clarke, 2006). To develop the coding scheme, members of the research team (N.W. and J.L.) independently reviewed the segments of text from each culture/climate dimension to identify recurring themes related to embedding mechanisms. They then met as a group to (a) develop a preliminary codebook that integrated the themes identified by each reviewer, (b) operationally define each theme, and (c) determine which themes to incorporate into the final codebook. Finally, the coding scheme was applied to all of the Stage 1 culture/climate texts to produce a descriptive analysis of each embedding mechanism. Themes were refined throughout the analytic process (Bradley et al., 2007), and data saturation was reached at the point at which no new insights were obtained and no new themes were identified when the codebook was applied across the text segments (Guest et al., 2006; Saunders et al., 2018).

Results

Characterizing organizational culture and climate in schools

Table 2 presents the frequency of high and low codes for each dimension of culture and climate along with the total coverage (percent of total words). The most frequently discussed dimension of culture was proficiency. The most frequently discussed dimensions of climate were functionality and stress. Supplemental File 2 presents example quotes that illustrate high and low levels of each dimension of culture and climate.

Table 2.

Frequency of qualitative codes describing school culture and climate.

Code	No. of codes	Percentage of total codes	Percentage of total words
Culture
Proficient
High	40	6	3
Low	30	5	4
Rigid
High	5	1	1
Low	20	3	1
Resistant
High	14	2	2
Low	39	6	3
Climate
Engaged
High	64	10	4
Low	3	<1	4
Functional
High	194	30	9
Low	136	21	8
Stressful
High	108	16	6
Low	3	<1	1
Total	656	100	47

Codes were derived from interviews completed with N = 32 teachers of autism support classrooms. The study sample included n = 1 teacher per school for k = 28 schools and n = 2 teachers for k = 2 schools. Raters deductively coded interviews and identified sections of text that described dimensions of organizational culture and climate based on Glisson, Landsverk, et al.’s (2008) model. Number of codes is equal to the total number of times text was coded as a reference to the dimension of high or low culture/climate. Percentage of total codes is calculated as the number of codes referring to that dimension of high/low culture/climate divided by the total number of codes. Percentage of total words is calculated as the number of words coded for that high/low dimension of culture/climate divided by the total number of words in all N = 32 transcripts.

Culture and climate embedding mechanisms

The Stage 2 inductive coding process identified seven embedding mechanisms that principals used to influence school culture (i.e. proficiency, rigidity, and resistance) and climate (i.e. engagement, functionality, and stress), as perceived by teachers. Table 3 presents the frequency with which each embedding mechanism was coded by dimension of culture/climate. Some dimensions of culture/climate were related to many or all of the embedding mechanisms (e.g. proficient culture, resistant culture, functional climate, and stressful climate), whereas others were associated with teachers’ perceptions of their principals’ behaviors less frequently (e.g. rigid culture, and engaged climate). Below we describe each embedding mechanism and highlight how it related to specific dimensions of culture and climate as described by teachers.

Table 3.

Frequency of embedding mechanism codes by dimension of culture/climate.

Embedding mechanism	Culture			Climate			Total
	Proficient	Rigid	Resistant	Engaged	Functional	Stressful	N	%
Professional development	27	2	5	0	13	5	52	22
Performance expectations and evaluations	13	4	4	4	18	4	47	20
Resource allocation	2	0	2	2	16	14	36	16
Accommodation for student needs	2	0	8	1	14	2	27	12
Allocation of status and recognition	1	9	8	1	7	1	27	12
Direct assistance, coaching or role-modeling	2	0	2	0	15	2	21	9
Integrating general and special education	1	0	6	3	10	2	22	9

Cells indicate the frequency (count) of codes unless otherwise stated. Codes were derived from interviews completed with N = 32 teachers of autism support classrooms.

Professional development

One of the most prominent embedding mechanisms described by teachers involved principals’ approach to professional development, specifically (a) the applicability and usefulness of professional development to teachers who work with students with autism, (b) the level of teacher discretion in selecting professional development, and (c) the nature and quality of autism-focused professional development opportunities.

Teachers who described their school cultures as highly proficient, shared that their principals encouraged them to attend professional development opportunities that focused on autism. Said one teacher, “She’s provided the time for us to go for professional development all year long.” Principals disseminated information about upcoming trainings focused on autism, encouraged teachers and classroom staff to attend, allowed teachers to miss school days to attend, and sometimes provided time and space for teachers to share what they learned. One teacher summarized her principals’ approach: “She really wants me to be the best that I can, and so if I agree to it, she usually agrees to it.”

These principal behaviors contributed to proficient culture by communicating clear expectations for teacher competence in effective practices that are responsive to student needs. They also contributed to high perceptions of functional climate because teachers experienced role clarity regarding their job duties and perceived that their principals gave them the tools and support needed to be effective. In some cases, these principal behaviors also contributed to perceptions of low rigidity culture because teachers believed their principals trusted them to know which professional development opportunities were most useful and allowed teachers the autonomy to choose.

In contrast, many teachers who characterized their school cultures as low on proficiency and school climates as low on functionality reported that their principal did not provide access to autism-relevant professional development and instead required them to attend professional development activities that were of higher priority to the school but did not apply to their students. The experience of many teachers was summarized by this comment, “More often than not, I am sitting in professional development that has nothing to do with me.” Some teachers noted that when autism-focused professional development was provided, it focused on compliance issues, such as documentation rather than on EBP. These behaviors contributed to the perceptions of low proficiency culture by demonstrating that teacher competence in responsive practices was not expected or prioritized within the school. They contributed to low functionality by reducing opportunities for teachers’ growth and advancement and diminishing perceptions of cooperation from supervisors and colleagues.

Performance expectations and evaluations

Performance evaluations are important for teacher promotion and compensation. How principals defined expectations for teachers who worked with autistic youth and evaluated their performance, both formally and informally, shaped teachers’ perceptions of culture and climate. Three key issues were (a) the applicability of performance evaluation criteria and the validity of principals’ performance ratings, (b) the utility of principals’ performance feedback, and (c) how principal reactions shaped the responses of other faculty and community members.

Teachers who described their school cultures as highly proficient, low resistance, and their climates as highly functional reported that their principals applied performance standards that accounted for the unique needs of autistic students. Principals knew about EBPs used with this population and could give meaningful feedback about teachers’ performance and their use of EBPs during classroom observations. Representative comments included:

[The principal] is supportive when we have evaluations. He was a special education teacher . . . So he understands how what we’re doing can fit into the general framework of the evaluations and kind of does his best to try to place us within this framework that is really meant for general education teaching and teachers.

… as a functional core team in the district, we actually went through and completely took apart the teacher evaluation system and made it our own. In the sense of we still adhere to all of the standards, but if it’s student to student talk, what does that look like in our classroom? . . . And then teaching [the principal] or showing him a little bit about the discrete trial training—why I’m working with the student one-on-one, and you’re giving it more explanations and stuff like that.

Even when principals did not know a lot about autistic youth, they were open to feedback. Said one teacher, “When I sit and I chat with her and I explain why that suggestion doesn’t necessarily work in a Special Ed curriculum, she’s very open to that. She’s open to figuring out how my programs do work.” Teachers perceived that their principal paid attention to what the teacher did and incorporated that understanding into performance evaluations. These behaviors contributed to perceptions of highly proficient culture by communicating expectations that school staff should be competent in effective practices that are responsive to students’ needs. They contributed to perceptions of low resistance culture by making it normative to embrace new ways of working. Tailored evaluations contributed to more functional climate because they enhanced teachers’ perceptions of role clarity and that they experienced the cooperation and support needed from their supervisors to work effectively.

In contrast, unrealistic, inappropriate, and even harmful principal performance expectations and evaluations, expressed either informally or formally during observations or on teacher performance evaluations, were a common experience for teachers who indicated their schools had low proficiency cultures and low functionality, high stress climates. Many of these teachers described receiving low marks on performance evaluations because their students could not meet academic or behavioral standards that were inappropriate for them. Other teachers described being rated poorly for using interventions that were appropriate for their students; for example, principals criticized how the classroom was set up and run even though it was consistent with evidence-based approaches. One teacher described the issue well:

If I’ve got classroom management to the point where my kids go, all right, here’s your check-in point, you know where you’re supposed to go next. That’s a huge step in autism. I’ve gotten dinged on that from my principal because he doesn’t understand autism . . . and it hurts us as a teacher professionally because we’re doing what we know we’re supposed to do for this population. But yet, professionally, we’re getting dinged.

Another teacher noted, “There are sometimes when she gives us feedback that she may not necessarily understand how a program works in my room, and that suggestion she may have may work better in a [General] Ed classroom.” Sometimes, this dynamic led teachers to ignore feedback from the principal and “take the hit” in the form of a negative performance evaluation to do what was perceived as best for the students: “. . . if there’s something that’s told to you that will not work with your kids, it’s sometimes best to smile and close the door and do what’s best for your kids anyway.”

Teacher also described how negative evaluations from principals contributed to negative appraisals from other faculty and community members. In one case, negative performance ratings were posted formally online. Several other teachers described being informally criticized by peers. As one teacher described it,

I get a lot of flak from my coworkers . . . because I don’t use that negative punishment model. I use positive behavior support model . . . I don’t get chastised by administration or asked to change my methods, I just don’t get a lot of support. I get a lot of eye-rolling. I get a lot of “you’re too soft” from people. “Oh, our kids don’t need all that and the prizes, they need an ass-whooping,” or whatever.

Some teachers indicated the problem was not criticism, but rather a lack of feedback about what to do or how to improve. For example,

Well I guess positive feedback’s always nice. But I would love to have some good, constructive criticism where I feel like, okay, that gives me guidance and a plan, how to make it more what their vision is, what they need me to do.

Resource allocation

Teachers who described their school cultures as highly proficient and low resistance indicated that their principals ensured that they had the resources necessary to meet student needs. Several teachers described how principals provided funds for adequate classroom staff, curriculum materials, and collaboration time with general education teachers:

First of all, I have an amazingly supportive principal so that makes a world of difference. She’s insured that we have two adults in the room; one, one-on-one, and then one who’s our regular classroom assistant . . . having an administrator who understands the need for extensive folks to make this practice work is huge.

She’s more than willing to try to find funds to provide us with needed materials because, quite frankly, doing this job without materials is almost impossible.

She’s been very open to trying new programs with our students—obviously it has to be a research-based program. So if we’re able to support it and show her research that shows that it’s effective, she’s all for trying it.

These behaviors contributed to perceptions of high proficiency culture by communicating clear expectations to prioritize responsiveness to student well-being and by contributing to a normative environment in which responsiveness to student needs is the expected way of working within the school. They supported low resistance culture by demonstrating expectations to embrace new ways of working that are in alignment with the school’s mission.

In contrast, teachers who described their school cultures as low on proficiency reported that their principals did not allocate adequate resources to meet student needs and instead indicated that resources would be better directed elsewhere. Said one teacher,

I feel like our numbers, we’re always over where we should be, and I just feel like it’s not fair to the students because they don’t get the support they need always because we’re trying to work with more kids than should be on our caseload or in the classroom.

Another teacher summarized the experience this way:

One of the things I would like my principal to understand is when we have one-on-one’s assigned in the classroom. Those one-on-one’s are in the classroom because the student they may be assigned to may have severe needs. Telling me I have so many adults in my classroom, one can be sent [somewhere else] –you’re taking away from the student needs.

Resource allocation also affected climate. Lack of resources contributed to perceptions of low functionality, high stress climate—teachers felt they did not receive the cooperation and support they needed to do their jobs effectively and often were overburdened (role overload) and pulled in conflicting directions (role conflict). One teacher described the situation well:

I find that a lot of times these classrooms are the least of their worries—they’re not worried about trying to help us in here. . . . they treat my room like the daycare or the detention room because it’s the quiet room—they think, “Well, she only has eight kids in there. Let’s throw a couple in there so she can babysit them for the day because they can’t function wherever else they are.

Sometimes the lack of support resulted in unsafe conditions for teachers and students. Said one teacher,

There have been instances where I’ve felt that a student was in crisis, and I have called for support, and I haven’t been supported. . . . I had to make a phone call last week, and literally they said “noted.” I was like, no, I need you to send somebody—he’s biting me. . . . nobody ever showed up.

Accommodation for student needs

Principals’ openness and flexibility with regard to adapting school procedures and practices to accommodate the needs of youth with autism also shaped culture and climate. Teachers who described their school cultures as high proficiency, low resistance and their climates as highly functional and engaged, indicated that their principals modified procedures and practices to meet student needs. Examples included adjusting schedules to minimize disruptive changes for students with autism, allowing teachers to use prep time to transition students, allowing the teacher to leave classroom lights off or on a low setting, allowing students to take a walk in the hallway when needed, and having a therapy dog in the classroom. One teacher summarized it well:

… she doesn’t question, within reason, the things that are in the positive behavior support plans, like evacuating the room. . . . she allows me to use the building and the resources within it as much as I can to follow through with the plans.

Another important dimension of flexibility involved principals supporting teachers’ efforts to integrate students with autism into the larger student body. Said one teacher,

In this classroom, there are some students who display more appropriate behaviors than most and I need to have these students with more experiences outside of the autism support classroom. So I brought this matter to the principal–she was on board from the start. I gave her my rationale, my reasoning, and I had a plan ready. I found a second-grade teacher who was on board and was willing to work with me to give this a try. And [the principal] should get much credit for having blind faith in my judgment and my teaching ability to make this work. And she took a risk and she took a chance.

These efforts contributed to proficient culture by demonstrating that teachers and staff were expected to prioritize student needs and be responsive in meeting those needs. They contributed to low resistance culture by making it normative within the school to embrace new ways of working. High levels of functional and engaged climate were developed because teachers perceived the cooperation and support needed from their peers to be effective and because teachers perceived they were able to make a positive difference in their students’ lives—a highly meaningful personal outcome for many teachers.

When teachers characterized their school cultures as non-proficient, high resistance, and their climates as low on functionality and engagement, the picture was opposite. Principals resisted making accommodations for students with autism and resented changes that had to be made. Said one teacher, “She wanted us to rearrange our schedule to accommodate what she wanted instead of what we thought would be best for [our] kids.” Another teacher felt their job security was threatened when they requested accommodations for students:

I kinda more and more got the impression that she was trying to sweep things under the rug and there were a couple situations where I was advocating for my students and I realized that she was gonna put me on the chopping block.

This had a chilling effect on the teacher’s ability to meet students’ needs.

Allocation of status and recognition

Two ways that teachers described principals allocating status and recognition to create cultures and climates that affected EBP use were (a) the extent to which principals conveyed respect and appreciation for the expertise of special education teachers within the school and (b) by providing recognition and rewards for the use of EBPs and EBP expertise. In schools that teachers described as having highly proficient, low rigidity cultures, teachers indicated that they were praised and recognized for using EBPs even if the principal did not understand every detail of the procedures. Said one teacher, “She doesn’t use the words PRT [pivotal response training] or DT [discrete trial training] usually, but she recognizes the differentiation in the groups. And she gives me a lot of praise for my communication with parents.” Principals of these teachers also asked for their advice on how to manage student issues, involved teachers in decision-making about policies outside the special education classroom, and allowed teachers to do in-service training for general education teachers and staff. One teacher summarized the experience well:

They treat me like a professional, that I know what I’m supposed to be doing. They don’t micromanage and come in and critique everything. They leave me as the professional in autism and Special Ed and ask if I need any help.

These principal behaviors contributed to perceptions of proficient cultures by conveying clear expectations for teacher competence in effective practices. Low rigidity cultures were generated by supporting teacher autonomy to meet student needs rather than tightly prescribing and controlling every aspect of teachers’ work.

Teachers, who perceived their school culture as low on proficiency and their climate as low on functionality, made comments like “She does not,” when asked how their principal recognized, appreciated, or rewarded their use of EBPs. These teachers also expressed a sense of isolation and being left out of key decisions regarding their students. These were taken as evidence of a lack of respect for their expertise and importance. One teacher remarked,

I didn’t even find out that [the student] was going to transfer until it was already done and in place. Not completed like out of the building, but the discussion was done. And it was all done with my special educational liaison, the principal and the parent and that just felt shitty.

Direct assistance, coaching, and/ or role-modeling

Teachers who perceived their school cultures as highly proficient and their school climates as functional reported that their principals provided direct assistance or coaching to support the implementation of EBPs or, if the principal lacked that expertise, she or he created opportunities for others to provide this support to teachers who worked with students with autism. Examples of these principal behaviors included reviewing lesson plans and providing suggestions, attending individualized education plan meetings, coming into the classroom and getting to know the children by name, and working to problem-solve specific behavioral issues or challenges. One teacher gave an example:

He has great ideas. I mean, he is definitely an incredible person to talk to. If I go to him, and I’m like, hey, I’m working on this. Then he’ll go, oh, well I wonder if you have a bin set up, they can take the object to the bin. And he’ll bounce ideas off me all day. And it’s awesome to have somebody that’s supportive and encouraging and not judgmental . . . Even if it’s just again me thinking through my own thought process, you’re there to help me through that.

Another teacher shared,

If I go to her with a concern about behavior and tantrumming and stuff like that, she’ll try to help problem-solve and say, okay, let’s get the behavior specialist involved, let’s see if we can call an interagency meeting and see if we can get support from that end.

One teacher connected this willingness to join with teachers in the work as an example of good leadership; another indicated that it helped alleviate the pressures of an inherently stressful job: “He just encourages me that I’m doing a good job and that I’m doing what I need to be doing. He reaffirms me that I’ve come a long way with these kids.” This support was not available to teachers who described their schools as less proficient and less functional. As a result, these teachers also experienced increased perceptions of stressful climate due to role overload, emotional exhaustion, and lessened ability to achieve meaningful outcomes in their work with students.

Integrating general education and special education

Principals play a key role in either facilitating or failing to facilitate a shared sense of inclusion for all students and staff—the sense that everyone is part of the school community. Several teachers noted that how their principal addressed or failed to address this issue played a key role in shaping culture and climate. Teachers who perceived their school culture as proficient and their climate as functional indicated that it was clear that both general and special education students and staff were an essential part of the school and their principal made efforts to develop shared relationships and integration. One teacher complimented her school’s administration by contrasting it with others she had heard about, “A lot of teachers report that their classroom feels like a burden to the principal. I don’t feel that way here. We’re a part of the school.” These principal behaviors contributed to proficient culture by sending a clear message regarding the importance of responsiveness to student needs. They contributed to functional climate by fostering active cooperation and support between staff in all areas of the school.

Teachers who described their school culture as low proficiency and high resistance, noted that their students were excluded (“Even the very first weeks of school, administration was leery of us even going out to recess with them.”) and that they themselves were excluded from collaborating with their colleagues (“We don’t get the time at all to collaborate with the teachers . . . They have their own grade group, we’re not included.”). For several teachers, these experiences resulted in a sense of isolation which contributed to highly stressful, low functionality climates and low engagement. Said one, “What is it like? Alone. . . . Half of the time the school doesn’t even know I’m a teacher . . . they thought I was a sub.” Another commented, “We’re on the [highest] floor. We’re the only classroom up there. So I kind of feel like we’re isolated. That was her decision to put us there, so I guess out of sight out of mind, maybe.”

Discussion

Teachers in this study provided a rich and compelling description of the embedding mechanisms that principals used to generate cultures and climates that facilitated or detracted from their implementation of EBPs for autistic youth. Results have direct implications for how to support autistic youth in schools through specific administrative practices and school-focused implementation strategies. Findings also offer fresh insights into how the school environment affects service delivery.

The most practical implication of these results is the well-defined list of behaviors and practices (i.e. embedding mechanisms) that principals can use to create comprehensive cultures and climates that support EBP use with fidelity for autistic youth. Table 4 presents a list of suggestions for how principals can support comprehensive cultures and climates in schools based on the responses of teachers in this sample. As one example, many teachers shared that principals’ performance expectations and evaluations should be aligned with the needs of students with autism and EBP delivery. For example, some teachers indicated that they were evaluated poorly for not using higher-order questioning with students for whom such interventions may not be developmentally appropriate. Principals may need to exercise flexibility when completing standard ratings and consider that implementation of best practices for students with autism may not be consistent with certain evaluation areas.

Table 4.

List of embedding mechanisms and concrete suggestions for schools.

Embedding mechanism	Suggestions
Professional development	• Allow staff to attend professional development of their choice• Provide professional development opportunities throughout the school year• Partner with experts (e.g. intervention developers, researchers, and consultants) to provide professional development
Performance expectations and evaluations	• Be clear what is expected of staff (e.g. use of EBPs)• Be flexible when completing performance evaluations if the question is not relevant or appropriate to students with autism (e.g. staff should not be poorly rated if a skill is not applicable for use with students with autism).• Consider staff performance in relation to the developmental level and needs of students with autism (e.g. are staff engaging strategies that meet the student where they are?)
Resource allocation	• Dedicate resources to staff who work with students with autism• Dedicate necessary personnel to support students with autism
Accommodation for student needs	• Dedicate physical space for students with autism to use that are sensory-friendly, if needed (e.g. break room and quiet area)
Allocation of status and recognition	• Provide recognition and praise to staff• Provide meaningful but cost-neutral titles to staff
Direct assistance, coaching, or role-modeling	• Provide direct feedback to staff• Provide direct assistance to staff• Coach staff• Troubleshoot and problem-solve with staff
Integrating general and special education	• Maintain a master schedule to support inclusion• Protect time for general and special education staff to meet, co-plan, and co-teach• Include staff and students with autism in grade-group (e.g. field trips) and whole-school activities (e.g. assemblies, eating in the cafeteria)

The embedding mechanisms identified in this study are not only consistent with those proposed by Schein (2010) but also reflect the unique contours of organizing work within schools and providing services to autistic youth within that setting. Some of the mechanisms identified by teachers aligned directly with primary embedding mechanisms identified by Schein (i.e. how leaders allocate resources, how leaders allocate status and recognition, and leaders’ direct assistance and coaching). Others mapped onto mechanisms proposed by Schein but reflected the unique exigencies of this work. For example, teacher performance expectations and evaluations map onto Schein’s primary embedding mechanism of what leaders pay attention to, measure, and control on a regular basis; accommodation of student needs maps onto the secondary embedding mechanism of organizational systems and procedures; and integrating general and special education maps onto the secondary embedding mechanism of organizational design. Perhaps the most salient embedding mechanism identified by teachers—professional development—maps onto multiple primary embedding mechanisms identified by Schein (2010), including what leaders pay attention to, resource allocation, and criteria for promotion. The convergence of Schein’s (2010) proposed mechanisms with the results of this study supports the validity of the study results and the utility of Schein’s framework.

This study also has broader implications for understanding the role leaders play in creating cultures and climates that facilitate positive outcomes for youth. Many of the embedding mechanisms were linked to multiple dimensions of culture and climate. This finding is consistent with prior research that showed that school cultures and climates are best represented as holistic profiles (rather than individual dimensions) that either support or detract from EBP implementation (Williams et al., 2019) and with some studies of the Glisson, Landsverk, et al. (2008) model which show that an organization’s holistic culture and climate profile may matter more than a single dimension (Glisson, Schoenwald, et al., 2008; Olin et al., 2014).

These results also extend research addressing how culture and climate relate to each other. Glisson, Landsverk, et al.’s (2008) model proposes that culture serves as an antecedent to climate in human service organizations, and empirical research has provided some evidence to support that claim (Williams & Glisson, 2014). Results from this study illustrate how perceived cultural norms and expectations may contribute to climate perceptions regarding the impact of the work environment on employees’ well-being. For example, teachers noted that when principals refused to allow them to participate in professional development activities that were relevant to their work and instead required them to attend trainings that were irrelevant to students with autism, this enactment of low proficiency culture norms and expectations (i.e. norms and expectations that do not prioritize responsiveness to student needs or competence in effective practices) subsequently contributed to a low functionality climate (i.e. perceived lack of opportunities for growth and advancement, not receiving support from supervisors to do one’s job). While further research is needed to clarify the relationships between culture and climate, findings from this study support theories which contend that employees’ climate perceptions are shaped in part by their organization’s norms and expectations (e.g. Glisson, Landsverk, et al., 2008; Ostroff et al., 2013).

Alongside other research showing that school culture and climate are linked to the quality of EBP implementation in schools (Williams et al., 2019), findings from this study raise the question of how malleable school culture and climate are, how long they might take to change, and what strategies might be most effective for changing them. For example, some authors have argued that organizational culture is impossible, difficult, or slow to change (e.g. Ehrhart et al., 2013; Fitzgerald, 1988). While the criteria for assessing the timeliness of change are subjective, randomized controlled trials have shown that organizational culture can be changed in behavioral health agencies in 18–24 months (Glisson et al., 2013; Williams et al., 2017) and that its improvement explains subsequent improvement in providers’ use of EBPs (Williams et al., 2017; Williams & Glisson, 2020). These trials also have shown that interventions designed to improve organizational culture and climate resulted in improved clinical outcomes for youth (Glisson et al., 2010, 2013, 2016a). Research is needed to better understand the extent to which culture and climate are malleable in schools, timelines for change, and the extent to which culture- and climate-focused interventions may be effective for improving EBP implementation and youth outcomes in schools.

We note several study limitations. First, because interviews were conducted in person and recorded, participants may have been motivated to respond in a socially desirable manner. Second, despite the diversity in the districts in which this study was conducted, the majority of the sample was white and limits our generalizability to other school settings with more racially/ethnically diverse educators. Third, these results are unidirectional, reflecting only the experiences and perspectives of autism support teachers, and not those of principals or district leaders who also play a key role in EBP implementation decision-making. Fourth, findings presented here represent the perceptions of teachers and not observations of principals’ behaviors. Future studies should examine the perspectives of other key stakeholders involved in the implementation of EBPs for youth with autism in schools.

Some teachers linked their principal’s culture and climate-enhancing behaviors to the principal’s past experience with special education and/or experience with autism. However, there were also several examples of principals who did not have a background in autism but who still contributed to comprehensive cultures and climates. The key factor seemed to be principals’ openness and understanding of the fact that students with autism have unique needs and viewing accommodations to meet those needs as a positive adaptation versus an inconvenience or negative occurrence. We encourage principals to adopt a similar approach to foster a truly inclusive setting.

Supplemental Material

sj-pdf-1-aut-10.1177_1362361320974509 – Supplemental material for Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study

Supplemental material, sj-pdf-1-aut-10.1177_1362361320974509 for Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study by Nathaniel J Williams, Lindsay Frederick, Alix Ching, David Mandell, Christina Kang-Yi and Jill Locke in Autism

Supplemental Material

sj-pdf-2-aut-10.1177_1362361320974509 – Supplemental material for Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study

Supplemental material, sj-pdf-2-aut-10.1177_1362361320974509 for Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study by Nathaniel J Williams, Lindsay Frederick, Alix Ching, David Mandell, Christina Kang-Yi and Jill Locke in Autism

Supplemental Material

sj-pdf-3-aut-10.1177_1362361320974509 – Supplemental material for Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study

Supplemental material, sj-pdf-3-aut-10.1177_1362361320974509 for Embedding school cultures and climates that promote evidence-based practice implementation for youth with autism: A qualitative study by Nathaniel J Williams, Lindsay Frederick, Alix Ching, David Mandell, Christina Kang-Yi and Jill Locke in Autism

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the following grants from the US National Institute of Mental Health: K01 MH100199 (PI: Locke), P50 MH113840 (MPIs: Beidas, Mandell, Buttenheim), and R01MH106175 (PI: Mandell).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

ORCID iDs

Nathaniel J Williams

Jill Locke

Supplemental material

Supplemental material for this article is available online.

References

Anderson

(1982). The search for school climate: A review of the research. Review of Educational Research, 52(3), 368–420.

Arick

J. R.

Falco

Loos

Krug

D. A.

(2004). The STAR program: Strategies for teaching based on autism research. Pro-Ed.

Beidas

R. S.

Aarons

G. A.

Barg

Evans

Hadley

Hoagwood

Mandell

D. S.

(2013). Policy to implementation: Evidence-based practice in community mental health: Study protocol. Implementation Science, 8(1), 38.

Bradley

Curry

Devers

(2007). Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Services Research, 42(4), 1758–1772.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

Dettmer

Simpson

Myles

Ganz

(2000). The use of visual supports to facilitate transitions of students with autism. Focus on Autism and Other Developmental Disabilities, 15(3), 163–169.

Ehrhart

M. G.

Schneider

Macey

W. H.

(2013). Organizational climate and culture: An introduction to theory, research, and practice. Routledge.

Fair

Solari Williams

Warren

McKyer

Ory

(2018). The influence of organizational culture on school-based obesity prevention interventions: A systematic review of the literature. Journal of School Health, 88(6), 462–473.

Farmer

Burns

Phillips

Angold

Costello

(2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54(1), 60–66.

10.

Fitzgerald

T. H.

(1988). Can change in organizational culture really be managed? Organizational Dynamics, 17(2), 5–15.

11.

Glisson

Hemmelgarn

Green

Williams

(2013). Randomized trial of the Availability, Responsiveness and Continuity (ARC) organizational intervention for improving youth outcomes in community mental health programs. Journal of the American Academy of Child & Adolescent Psychiatry, 52(5), 493–500.

12.

Glisson

Landsverk

Schoenwald

Kelleher

Hoagwood

Mayberg

Green

(2008). Assessing the Organizational Social Context (OSC) of mental health services: Implications for research and practice. Administration and Policy in Mental Health and Mental Health Services Research, 35(1), 98–113.

13.

Glisson

Schoenwald

S. K.

Hemmelgarn

Green

Dukes

Armstrong

K. S.

Chapman

J. E.

(2010). Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy. Journal of Consulting and Clinical Psychology, 78(4), 537–550.

14.

Glisson

Schoenwald

S. K.

Kelleher

Landsverk

Hoagwood

Mayberg

Green

(2008). Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Administration and Policy in Mental Health and Mental Health Services Research, 35(1–2), 124–133.

15.

Glisson

Williams

N. J.

Hemmelgarn

Proctor

Green

(2016a). Aligning organizational priorities with ARC to improve youth mental health service outcomes. Journal of Consulting and Clinical Psychology, 84(8), 713–725.

16.

Glisson

Williams

N. J

Hemmelgarn

Proctor

Green

(2016b). Increasing clinicians’ EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC. Behaviour Research and Therapy, 76, 40–46.

17.

Guest

Bunce

Johnson

(2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82.

18.

Hargreaves

D. H.

(2013). School culture, school effectiveness and school improvement. In H. Tomlinson (Ed.), Educational management: Major themes in education (Vol. 4, pp. 341–354). Taylor & Francis.

19.

Hoy

(1990). Organizational climate and culture: A conceptual analysis of the school workplace. Journal of Educational and Psychological Consultation, 1(2), 149–168.

20.

Huang

Eklund

Cornell

(2017). Authoritative school climate, number of parents at home, and academic achievement. School Psychology Quarterly, 32(4), 480–496.

21.

James

Choi

Mcneil

Minton

Wright

Kim

(2008). Organizational and psychological climate: A review of theory and research. European Journal of Work and Organizational Psychology: Psychological and Organizational Climate Research: Contrasting Perspectives and Research Traditions, 17(1), 5–32.

22.

Kang-Yi

Locke

Marcus

Hadley

Mandell

(2016). School-based behavioral health service use and expenditures for children with autism and children with other disorders. Psychiatric Services, 67(1), 101–106.

23.

Kohl

Recchia

Steffgen

(2013). Measuring school climate: An overview of measurement scales. Educational Research, 55(4), 411–426.

24.

Locke

Beidas

R. S.

Marcus

Stahmer

Aarons

G. A.

Lyon

A. R.

… .Mandell

D. S.

(2016). A mixed methods study of individual and organizational factors that affect implementation of interventions for children with autism in public schools. Implementation Science, 11(1), 135.

25.

Locke

Lawson

G. M.

Beidas

R. S.

Aarons

G. A.

Xie

Lyon

A. R.

… Mandell

D. S.

(2019). Individual and organizational factors that affect implementation of evidence-based practices for children with autism in public schools: A cross-sectional observational study. Implementation Science, 14(1), 29.

26.

Locke

Olsen

Wideman

Downey

Kretzmann

Kasari

Mandell

(2015). A tangled web: The challenges of implementing an evidence-based social engagement intervention for children with autism in urban public school settings. Behavior Therapy, 46(1), 54–67.

27.

Lyon

Ludwig

K. A.

Romano

Leonard

Stoep

Mccauley

(2013). “If it’s worth my time, I will make the time”: School-based providers’ decision-making about participating in an evidence-based psychotherapy consultation program. Administration and Policy in Mental Health and Mental Health Services Research, 40(6), 467–481.

28.

Lyon

Ludwig

K. A.

Stoep

Gudmundsen

McCauley

(2013). Patterns and predictors of mental healthcare utilization in schools and other service sectors among adolescents at risk for depression. School Mental Health, 5(3), 155–165.

29.

Macneil

Prater

Busch

(2009). The effects of school culture and climate on student achievement. International Journal of Leadership in Education, 12(1), 73–84.

30.

MacPhail

Khoza

Abler

Ranganathan

(2015). Process guidelines for establishing intercoder reliability in qualitative studies. Qualitative Research, 16, 198–212.

31.

Mandell

Stahmer

Shin

Xie

Reisinger

Marcus

(2013). The role of treatment fidelity on outcomes during a randomized field trial of an autism intervention. Autism, 17(3), 281–295.

32.

Olin

Williams

Pollock

Armusewicz

Kutash

Glisson

Hoagwood

(2014). Quality indicators for family support services and their relationship to organizational social context. Administration and Policy in Mental Health and Mental Health Services Research, 41(1), 43–54.

33.

Ostroff

Kinicki

A. J.

Muhammad

R. S.

(2013). Organizational culture and climate. In Schmitt

N. W.

Highhouse

Weiner

I. B.

(Eds.), Handbook of psychology: Industrial and organizational psychology (pp. 643–676). John Wiley.

34.

Pellecchia

Connell

Beidas

Xie

Marcus

Mandell

(2015). Dismantling the active ingredients of an intervention for children with autism. Journal of Autism and Developmental Disorders, 45(9), 2917–2927.

35.

Reaves

Mcmahon

Duffy

Ruiz

(2018). The test of time: A meta-analytic review of the relation between school climate and problem behavior. Aggression and Violent Behavior, 39, 100–108.

36.

Saunders

Sim

Kingstone

Baker

Waterfield

Bartlam

… Jinks

(2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity, 52(4), 1893–1907.

37.

Schein

(2010). Jossey-Bass business & management series. Organizational culture and leadership (4th ed.). Jossey-Bass.

38.

Schreibman

(2000). Intensive behavioral/psychoeducational treatments for autism: Research needs and future directions. Journal of Autism and Developmental Disorders, 30(5), 373–378.

39.

Smith

(2001). Discrete trial training in the treatment of autism. Focus on Autism and Other Developmental Disabilities, 16(2), 86–92.

40.

Stahmer

(1999). Using pivotal response training to facilitate appropriate play in children with autistic spectrum disorders. Child Language Teaching and Therapy, 15(1), 29–40.

41.

Stahmer

Rieth

Lee

Reisinger

Mandell

Connell

(2015). Training teachers to use evidence-based practices for autism: Examining procedural implementation fidelity. Psychology in the Schools, 52(2), 181–195.

42.

Suhrheinrich

Stahmer

Reed

Schreibman

Reisinger

Mandell

(2013). Implementation challenges in translating pivotal response training into community settings. Journal of Autism and Developmental Disorders, 43(12), 2970–2976.

43.

Thapa

Cohen

Guffey

Higgins-D’Alessandro

(2013). A review of school climate research. Review of Educational Research, 83(3), 357–385.

44.

Weisz

Jensen-Doss

Hawley

(2006). Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychologist, 61(7), 671–689.

45.

Weisz

Kazdin

A. E.

(2010). Evidence-based psychotherapies for children and adolescents (2nd ed.). Guilford Press.

46.

Williams

N. J.

Beidas

R. S.

(2019). Annual research review: The state of implementation science in child psychology and psychiatry: A review and suggestions to advance the field. Journal of Child Psychology and Psychiatry, 60(4), 430–450.

47.

Williams

N. J.

Frank

Frederick

Beidas

Mandell

Aarons

… Locke

(2019). Organizational culture and climate profiles: Relationships with fidelity to three evidence-based practices for autism in elementary schools. Implementation Science, 14(1), 15.

48.

Williams

N. J.

Glisson

(2014). Testing a theory of organizational culture, climate and youth outcomes in child welfare systems: A United States national study. Child Abuse & Neglect, 38, 757–767.

49.

Williams

N. J.

Glisson

(2020). Changing organizational social context to support evidence-based practice implementation: A conceptual and empirical review. In Albers

Shlonsky

Mildon

(Eds.), Implementation science 3.0 (pp. 145–172). Springer.

50.

Williams

N. J.

Glisson

Hemmelgarn

Green

(2017). Mechanisms of change in the ARC organizational strategy: Increasing mental health clinicians’ EBP adoption through improved organizational culture and capacity. Administration and Policy in Mental Health and Mental Health Services Research, 44(2), 269–283.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.36 MB

0.16 MB

0.06 MB