Moving Triadic Gaze Intervention Into Practice: Measuring Clinician Attitude and Implementation Fidelity Purpose This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into ... Research Article
Research Article  |   May 24, 2017
Moving Triadic Gaze Intervention Into Practice: Measuring Clinician Attitude and Implementation Fidelity
 
Author Affiliations & Notes
  • Julie Feuerstein
    Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD
    Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
  • Lesley B. Olswang
    Department of Speech and Hearing Sciences, University of Washington, Seattle
  • Kathryn Greenslade
    Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD
    Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
  • Gay Lloyd Pinder
    Children's Therapy Center of Kent, WA
  • Patricia Dowden
    Department of Speech and Hearing Sciences, University of Washington, Seattle
  • Jodi Madden
    Kent School District, WA
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Julie Feuerstein: Feuerstein@kennedykrieger.org
  • Editor: Sean Redmond
    Editor: Sean Redmond×
  • Associate Editor: Joanne Volden
    Associate Editor: Joanne Volden×
Article Information
Special Populations / Early Identification & Intervention / Research Issues, Methods & Evidence-Based Practice / Language / Research Articles
Research Article   |   May 24, 2017
Moving Triadic Gaze Intervention Into Practice: Measuring Clinician Attitude and Implementation Fidelity
Journal of Speech, Language, and Hearing Research, May 2017, Vol. 60, 1285-1298. doi:10.1044/2016_JSLHR-L-16-0189
History: Received May 9, 2016 , Revised September 21, 2016 , Accepted November 3, 2016
 
Journal of Speech, Language, and Hearing Research, May 2017, Vol. 60, 1285-1298. doi:10.1044/2016_JSLHR-L-16-0189
History: Received May 9, 2016; Revised September 21, 2016; Accepted November 3, 2016

Purpose This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into practice and implementation fidelity in DA protocol delivery were examined following training.

Method Seven early intervention clinicians from multiple disciplines were trained to deliver the four essential elements of the DA protocol: (a) provide communication opportunity, (b) recognize child's potentially communicative signal, (c) shape child's signal toward triadic gaze, and (d) reinforce with play. Clinician attitude regarding adopting evidence into practice was measured at baseline and follow-up, with the Evidence-Based Practice Attitude Scale (Aarons, 2004). Implementation fidelity in delivering the protocol was measured for adherence (accuracy) and competence (quality) during trial implementation.

Results Clinicians' attitudes about trying new evidence that at first was perceived as incongruent with their practice improved over the course of the research. Clinicians demonstrated strong adherence to the DA protocol; however, competence varied across clinicians and appeared related to child performance.

Conclusions The results provided insight into moving Triadic Gaze Intervention into practice and yielded valuable information regarding the implementation process, with implications for future research.

Acknowledgments
This publication was supported by the University of Washington, Department of Speech and Hearing Sciences, and the National Center for Advancing Translational Sciences of the National Institutes of Health, under Award Numbers UL1TR000423 and TL1TR000422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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