Dissemination of Evidence-Based Practice: Can We Train Therapists from a Distance?

Background: Although knowledge about the efficacy of behavioral interventions for children with autism is increasing, there is little research on the effectiveness and transportability of empirically supported models in diverse community settings.

Objectives: The current study conducted an effectiveness trial to compare distance learning versus live instruction for training community-based therapists to implement the Early Start Denver Model (ESDM), a developmental, relationship and behavioral-based method for use with infants and toddlers with Autism Spectrum Disorder.

Methods: The following three training conditions were provided sequentially to teach direct intervention and parent coaching of the ESDM: (a) self-instruction with the training materials using print and video materials provided on a DVD; (b) didactic workshops with direct instruction and group training exercises; and (c) team supervision for specific discussion of training cases.

Results: Findings revealed: (a) distance learning and live instruction were equally effective for teaching therapists to both implement the model and to train parents; (b) didactic workshops and team supervision were required to improve therapists’ skill use; (c) significant child gains occurred over time and across teaching modalities; and (d) parents implemented the model more skillfully after coaching.

Conclusions: Family characteristics, therapist variables, and contextual factors will be examined to determine whether modifications from the original efficacious intervention model are needed for the generalization of positive treatment effects to large community populations. Findings are also discussed in terms of the circumstances under which the ESDM is effective and for whom.