# Redesigning an Autism Evidence-Based Practice Implementation Toolkit for Middle and High Schools

> **NIH NIH R21** · SAN DIEGO STATE UNIVERSITY · 2023 · $232,346

## Abstract

PROJECT SUMMARY
In response to PAR-21-235, we propose to systematically and iteratively redesign an autism implementation
toolkit, entitled Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments (ACT
SMART), for middle and high schools to meet the community-identified need for tools enabling the appropriate
identification and selection of autism evidence-based practices (EBPs). Unmet service needs and care
disparities are common for autistic adolescents, contributing to poor outcomes and deleterious public health
effects. Public schools are the most frequently accessed service system for autistic youth and schools are
mandated to provide research-supported practices for autistic students. Yet, routine use of EBPs is limited and
the quality of school programming is low. Educators receive limited support in identifying and selecting autism
EBPs, likely contributing to poor implementation and sustainment, with downstream effects on adolescent
outcomes. To date, most school implementation efforts have focused on the later implementation phases
(active implementation) versus the earlier phases (adoption-decision) critical to implementation success. There
is a critical need for systematic supports targeting autism EBP selection and decision making in public schools.
This proposal addresses these gaps through iteratively redesigning an autism implementation toolkit targeting
EBP decision-making. Funded by NIMH (K01MH093477), the ACT SMART implementation toolkit was
developed and shown effective in targeting autism EBP adoption and decision-making in community settings.
ACT SMART has immense potential to improve autism EBP decision-making, adoption, and implementation in
schools; however, systematic and iterative redesign is necessary to optimize its fit to the unique context of
public schools. The Exploration, Preparation, Implementation and Sustainment (EPIS) and Discover, Design,
Build, and Test Framework (DDBT) frameworks will be applied to redesign ACT SMART. EPIS was selected
given its specific development for public child service settings and application to the original development of
ACT SMART, while DDBT provides the necessary guidance regarding implementation strategy development to
enhance the usability and contextual fit. The proposed study is highly responsive to NIMH (e.g., Strategy 4.2C
developing decision-support tools that increase intervention effectiveness in public service settings) and the
IACC (e.g., the need to expand research with autistic adolescents and the translation of efficacious
interventions to the community) research priorities. The specific aims are: Aim 1. Engage stakeholders to
identify targets for ACT SMART redesign to optimize its fit for middle and high school providers that work with
autistic adolescents. Aim 2. Conduct prototyping and usability field testing of the refined ACT SMART and
iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in scho...

## Key facts

- **NIH application ID:** 10694098
- **Project number:** 5R21MH130793-02
- **Recipient organization:** SAN DIEGO STATE UNIVERSITY
- **Principal Investigator:** Kelsey S Dickson
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $232,346
- **Award type:** 5
- **Project period:** 2022-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10694098

## Citation

> US National Institutes of Health, RePORTER application 10694098, Redesigning an Autism Evidence-Based Practice Implementation Toolkit for Middle and High Schools (5R21MH130793-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10694098. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*