Practitioner Self-Reports of Adherence to Evidence-Based Practices for Autistic Youth: Psychometric Properties and Association with Youth Outcomes in a Multiple Baseline Study

Background: Practitioner ratings of their adherence to evidence-based psychotherapy or counseling practices in working with autistic youth could be an efficient method for tracking the success of efforts to implement effective practices in community behavioral health service settings. Tools of this sort that generalize across multiple evidence-based practices (EBPs) have not been developed to date. In this study, a practitioner self-report measure of adherence to EBPs for autistic youth was developed and evaluated. Method: A multiple baseline study of seven behavioral health practitioners was conducted to determine if internet-based self-directed training on Modular EBPs for Youth on the Autism Spectrum (MEYA; meya.ucla.edu), a free internet-based practitioner training app, would facilitate an increase in clinician adherence to EBP techniques such as cognitive behavioral therapy and behavioral intervention practices. Practitioners made self-ratings on the MEYA Integrity Scale-Practitioner Version (MEYA-IS-PV). Expert coders unaware of phase or study hypotheses also rated the therapists’ adherence to EBPs for each session. Caregivers rated youth outcomes at each session on the Youth Top Problems scale. Results: Linear mixed models showed that MEYA-IS-PV scores corresponded to expert ratings of adherence, increased following the onset of training in EBPs, and predicted improvements in youth behavioral health. Visual analysis of the multiple baseline data confirmed that 5 of 7 practitioners increased their self-reported adherence in EBPs once training began. Conclusion: Self-ratings of adherence are promising for examining adherence to EBPs in psychotherapy or counseling for autistic youth.