Abstract
Plain Language Summary
Teachers and paraeducators face challenges when deciding what evidence-based practices (EBPs) to use for Autistic children. This decision-making process is crucial and may contribute to the ongoing gap in using these practices effectively. To better understand what educators consider or think about when deciding to use or not use a practice, we interviewed 81 educators (general education teachers, special education teachers, and paraeducators) on why and how they choose practices for Autistic students who they serve in inclusive settings. The study aims to identify the how educators learned about practices (i.e., information source), how they considered factors related to the student, the intervention, the educator, and the classroom environment, and how they worked together to make these decisions. General and special education teachers often mentioned teacher preparation programs, school-based training, and advice from colleagues as their main sources of information. In contrast, paraeducators relied more on existing classroom practices and guidance from other educators. When making decisions about EBPs, educators focused mainly on the characteristics of the student and the intervention, paying less attention to factors related to the educator, the environment, and available resources. They described different ways of collaborating, from team-based decision-making to following directions from others. This study provides insights into the decision-making processes of key team members in using EBPs. These insights can help develop better supports to improve collaboration among educators and enhance the selection of EBPs for use in inclusive settings.
Introduction
Autistic students are increasingly served in inclusive general education settings, yet a persistent gap remains between evidence-based practice (EBP) recommendations and their implementation in schools (IDEA, 2004; Hugh et al., 2024b; NCES, 2023). For these Autistic students, educators of different roles and professional backgrounds—including paraeducators, general education teachers, and special education teachers—are expected to implement EBPs (Domitrovich, 2008; IDEA, 2004; McLeod et al., 2020). Although there is growing familiarity with EBPs, training alone does not ensure their use (Hugh et al., 2023). At the outset of the implementation process, educators struggle deciding which EBPs to use (Brock et al., 2020). Despite the identification of multilevel factors influencing educators’ EBP use (Aarons et al., 2011; Barry et al., 2020; Domitrovich et al., 2008; Locke et al., 2019; Suhrheinrich et al., 2021), influences on teachers’ and paraeducators’ EBP decision-making prior to implementation remain underexamined (Moullin et al., 2019). Understanding these perspectives is essential to developing supports—such as decision guides—that can improve EBP selection and use (Boyd et al., 2022; Van de Velde et al., 2018).
Educators’ Decision-Making for EBP Use
Before implementing individualized interventions in schools, educators must evaluate the instructional fit of EBPs for each student's individualized education plan, which often includes 10–20 goals across developmental areas (Domitrovich et al., 2008; IDEA, 2004; Kurth & Mastergeorge, 2010). Various EBP combinations may address these goals, each differing in complexity, feasibility, and social validity (Hume et al., 2022; McNeill, 2019; Ruble et al., 2023; Williams et al., 2022). Educators must then implement these EBPs in highly individualized ways across diverse settings (e.g., classrooms, cafeteria) and throughout the school day, often with varied training and responsibilities (IDEA, 2004; Mason et al., 2021). An educator's appropriate selection and planning for EBP use remains critical to initiating implementation (Boyd et al., 2022) and students’ achievement (Brock et al., 2020; Ruble et al., 2013, 2023).
Emerging research reveals a complex and incomplete understanding of the factors that may impact educators’ selections of EBPs across implementation levels (e.g., innovation, implementer, context; Damschroder et al., 2022). While student needs often guide decisions (Knight et al., 2018), other influences include educators’ attitudes, beliefs, and information sources (Hugh et al., 2022)—revealing that individual perceptions and contextual factors may determine selection in the absence of structured guidance (Borko & Cadwell, 1982; Hugh et al., 2022). Recent interview studies with educators serving Autistic students in general education settings identified additional factors—such as classroom context, EBP simplicity and feasibility, and student preferences—as determining decision-making (Fleming et al., 2024; Hugh et al., 2023; Sulek et al., 2019). Although teachers expressed a desire to collaborate with team members (e.g., students, caregivers, paraeducators, general education teachers) to ensure EBP fit (Hugh et al., 2023), no studies have examined decision-making across all implementer roles, who may face distinct challenges (Mason et al., 2021) and select different practices (Morin et al., 2020). Collectively, this research highlights the potential for multilevel influences to decision-making (Damschroder et al., 2022; Domitrovich et al., 2008) and a gap in awareness of the impact of factors for educators of various roles.
Study Purpose
Educators’ reports of influential factors at different implementation levels present a need collaborative, context-specific support to navigate these decisions effectively (Boyd et al., 2022; Hugh et al., 2023; Sulek et al., 2019). However, existing research offers only limited scope of potential factors or determinants of selection—focusing solely on teachers and overlooking the broader school context and the perspectives of educators in different roles. To address this gap, this study used qualitative methods to examine how general education teachers, special education teachers, and paraeducators make decisions about EBPs for Autistic students.
What information sources do key implementers (general education teachers [GENED], special education teachers [SPED], and paraeducators [PARA]) describe in how they select a practice? What factors do these implementers describe that determined their selection of an EBP for an Autistic student?
Method
This study was part of an exploratory multiphase study on educators’ use of EBPs to support the inclusion of Autistic elementary students (Locke et al., 2022 protocol and interview guide) grounded in the Exploration, Preparation, Implementation, and Sustainment framework (Aarons et al., 2011). Phase 1 of the larger project, from which this study was derived, focused on identifying barriers and facilitators to educators’ EBP use specific to EBPs they reported on in a survey study. The authors declare no conflict of interest.
Participants
Participants included 81 educators from one Northwestern state (26 general education teachers, 31 special education teachers, and 24 paraeducators who served at least one Autistic elementary student in an inclusive setting in the prior school year; see Table 1). Most participants were white (n = 69) and female (n = 76), which is representative of educators in the state. On average, general education teachers had 7.96 years (±5.3), special education teachers had 4.8 years (±4.52), and paraeducators had 6.68 years (± 4.2) working in their current position. All the general education teachers (100%), most special education teachers (71%), and many paraeducators (28.6%) held general education teaching licenses. Some general educators (22.2%), all special educators (100%), and several paraeducators (21.4%) had special education licenses.
Participant Demographics.
Note. Gen = general; Spec = special; Ed. = education.
Multiracial breakdown: (1) White, Black or African American, and American Indian/Alaskan Native (2) White, Asian, and Pacific Islander (3) White and Asian (4) White and American Indian/Alaskan Native (5)White and Black or African American.
** Certification, grades taught, classroom model adds to more than 100%.
The research team contacted districts for lists of elementary schools by emailing 358 principals recruitment materials. We asked 56 schools across 28 districts to distribute study invitations to general and special education teachers and paraeducators. Of 126 interested individuals, 104 met eligibility criteria (serving at least one Autistic student included in general education for part of the day). Eighty-six provided informed consent and completed demographic and EBP training/use surveys based on a validated list of 28 practices (Hugh et al., 2022; Hume et al., 2022). Ultimately, 81 participants from 49 schools in 23 districts completed interviews; five did not respond to follow-up.
The senior author trained three team members to conduct interviews. Four female nonAutistic staff (one PhD-level faculty, one postdoc, two research staff), all trained in EBPs for Autistic students, conducted the interviews. Interviewers had no prior relationship with participants. Interviews were held virtually at a time and private location chosen by participants, recorded via Zoom, and transcribed by Rev.com. Mean interview length was 32:28 (range: 14:04–1:03:51): GENED 32:19 (16:06–55:59), PARA 32:36 (14:04–56:44), SPED 32:30 (18:59–1:03:51). Interviewers recorded field notes to support coding and reduce bias. Transcripts were not returned to participants.
Content Analysis
Data were deidentified and assigned unique IDs. The study team conducted qualitative content analysis for Phase 1 of the larger study to examine how educators’ training, barriers, and facilitators to their EBP use (Locke et al., 2022). Initial codes were developed inductively by memoing and coding seven randomly selected transcripts, followed by group discussions to identify recurring codes (see Locke et al., 2022). Because these codes reflected a range of contextual domains (Damschroder et al., 2009), we revisited all transcripts and selected exemplar quotes. The first and senior author trained coders to ≥90% agreement and led a three-member team using Dedoose software (2023), maintaining 95.1% agreement on 20% of randomly selected transcripts.
Subcoding Decision-Making Excerpts
From the Phase 1 dataset, the first and second authors analyzed excerpts coded as “decision-making about EBP use” (Hugh et al., 2022). Using Creswell and Poth's (2018) spiral method, we organized data based on interviewer memos and multilevel implementation frameworks (Damschroder et al., 2022; Domitrovich et al., 2008): (a) student characteristics and needs, (b) implementer factors, (c) information source, (d) intervention factors, and (e) external resources. We inductively coded excerpts from two educators per role (n = 6), identifying one emergent code: collaboration. Final subcodes and examples are presented in Table 2. After developing a stable codebook, the first and second authors coded ten excerpts and two full interviews to achieve >90% interrater reliability. Coders then independently coded remaining excerpts with 20% overlap per role (81.2%–99.4%, avg. 91.7%), meeting regularly to avoid drift. The team refined codes, recoded all excerpts, and resolved disagreements by consensus.
Emergent Subcodes, Definitions, and Examples.
Results
EBP Source
Most participants reflected on how they first learned about a practice (GEN, n = 16; SPED, n = 24; PARA, n = 12). Participants across roles reflected on learning an EBP within teacher preparation programs, through training, and from colleagues. Both general and special educators shared that some EBPs were “always a part of their instruction” or something they came up with when “grasping at straws” to help a student. These educators shared a few public resources they found helpful, whereas paraeducators did not. General education and special education teachers described selecting some practices intuitively, saying that practices were part of their “teaching all along” and that some EBPs are “classroom norms.” Similarly, paraeducators described that the EBPs were already in place when they joined the classroom.
Decision-Making Factors
Most often, educators considered more than one factor when describing their decision-making (n = 88%); however, there were only a few decision-making excerpts in which a participant described factors at all four levels (n = 4, 1.2%). Across decision-making excerpts, student and intervention characteristics were often most discussed (n = 162, 41% of decision-making excerpts, n = 139, 35.6% of decision-making excerpts, respectively). Special education teachers mentioned student and intervention factors most often (n = 147 decision-making excerpts) and paraeducators least frequently (n = 108). Regarding how frequently an individual mentioned these factors, most special educators mentioned factors (n = 70 decision-making excerpts from special education teachers included at least one factor), followed by general education teachers (n = 66), and finally, paraeducators (n = 50). Illustrative quotes are presented in Table 3 by participant role and factor.
Abbreviated Illustrative Quotes Representing Themes of Factors Educators Consider Across Levels.
Note. * indicates it was presented as a reason for selecting to use a practice, rather than not to use a practice. The number of excerpts subcoded as that theme is presented in parenthesis within the total number of excerpts meeting that subcode. These quotes are presented to expand upon unique themes identified in the analysis. Thus, some codes have more representation from educators of a specific role, indicating a unique theme or perspective.
Sums of factor counts considered by the participant showed special educators considered the most factors (max = 4, PARA, max = 3, GEN max = 3), and, on average, described considering more factors than educators in other roles (SPED m = 2.66, GEN m = 2.5; PARA m = 2.2). The most frequently discussed factors were at the student level (e.g., skill, interest, autism characteristics, n = 18 GEN, SPED n = 21 PARA, n =19). The fewest paraeducators considered educator factors (GEN, n = 8; SPED, n = 16; PARA n = 19).
All educators noted that EBPs helped Autistic students meet specific needs and strengths such as sensory needs (GEN), anxiety (GEN and SPED), visual processing strengths (paraeducators), and a need for predictability and concrete thinking (all roles). General educators mentioned that Autistic students “like the structure and things being clear” and that teaching social skills with EBPs helped because “it is not ambiguous. It is direct enough that they understand where we're going with it and why we're talking about it.” Special educators often described tailoring to the “level of support that's needed” for a specific child and choosing practices that fit with a child's verbal, self-regulation, and processing skills. One special educator shared that they use a practice to support a child's focus because a child's anxiety may get them off track.
General educators and paraeducators often described access as a rationale for using the EBP. One general educator shared, “I am sure there are a million reasons since I am here talking. It just gives access, right? It gives students an access point to what we're doing, a way to communicate about what we're doing.” A paraeducator described: I think the visual and the hands-on modeling for that is super helpful because I don't myself know much about autism a whole, but I do know as far as it doesn't mean that they don't have the intellectual ability. It's just the accessible points that you're helping them access their knowledge.
Special educators demonstrated confidence in their autism knowledge, explaining why interventions may be effective and chosen, which differed from general education teachers and paraeducators in several ways. Special educators reflected on their reasoning for specific students, often linked to students’ developmental level (language, IQ, “functioning”), their processing (“concrete,” “slow processer”), and autism-specific traits (preference for structure). Special educators described matching the Autistic students’ support needs with the EBPs. Other educators shared that they used a specific EBP because it supports a child's “speaking.”
Many special educators described selecting practices that leverage autism traits and strengths, such as using naturalistic intervention because “it's usually pretty easy to find out what their interests are because they're hyper-aware of their interest.” Another shared that resistance to change benefited students in learning from direct instruction, saying, “I think particularly with [Autistic students], that ‘I'm going to teach you it. We're going to do it together; then you're going to do it.’ Is really helpful.” The educator went on to describe that “Most of the [Autistic] kids are really bright that I work with, and they want to learn, and they're very focused and that structure just is really comforting and predictable for them.” Last, these educators described that the Autistic students “did need this” referring to direct instruction and communication supports to “be able to express what they need to say.”
In contrast, many general educators and paraeducators described educator factors that served as barriers for selection, noting a lack of or insufficient training in them, with one saying, “a lot of times paraeducators just have to wing it and try any strategies that they have learned along the way, to use with their students, and unfortunately, there's that lack of structure.” General educators shared similar reflections, of “trial and error” and “I have lived the fight of giving too much instruction and it just blowing up in my face.” Special educators demonstrated a more nuanced application of practices by “observing and trying to make that my own.” Some special educators reflected on their prior experience as a paraeducator as pivotal, as well as some general educators who held special education degrees as their learning and reasoning for picking practices.
Participants of all roles often described the EBP they selected as part of their “routine practice” (GEN), stating that the use represented “how we teach our children” (PARA) and that they “do this with all my kids” (SPED). When reflecting on positive reinforcement, general educators described that they “do all of these things with all of my students all of the time” and that it is the “foundation of [my] classroom instruction.” One general educator shared that these approaches were part of “when I learned how to be a teacher, a really important factor in behavior management is support and positive reinforcement.” Many special educators reported that the practices felt “intuitive” because they could make decisions “in the moment” and found them to be “automatic, almost.” General educators shared varied considerations of their professional role as part of their decision-making. While one general educator shared that it was “their job” to use EBPs such as reinforcement, another stated that it was “not [their] job” to use task analysis.
Paraeducators mentioned selecting EBPs that were not disruptive or “distracting” to the classroom environment and selecting practices that helped Autistic students focus due to the distractions in general education classrooms. One shared that the practice was “effective because it really doesn't interrupt anything else.” They also considered that these EBPs could be used in other community settings, such that it “doesn't look any different than any of the other kids.” Paraeducators also described a need to use specific practices because the general education environment may be “noisy” or “escalate [our] students.” One paraeducator highlighted their use of visual supports as a tool that aided students in “remember[ing] to stay on task and not get distracted, not to distract the other students.”
When special educators mentioned environmental considerations, they most often described reasons for not selecting a practice for the general education setting, such as first using direct instruction for specialized instruction in the hallway or separate classroom for initial exposure or acquisition of the skill, to prepare the child for the “general education classroom.” Likewise, they described that they would not use resource-intensive approaches in general education, such as requiring “one-on-one” interactions or expertise that the team may not possess; “I don't know if a general education teacher would even be able to or know to do that.”
General educators and paraeducators reflected on their work with special educators, noting that they had gained expertise from these educators that helped them select an EBP. One former paraeducator who is now a general educator described the special educator she worked with, saying, “I kind of embraced a lot of her learning, and then she kind of passed on those strategies to myself or to the rest of us.” Another general educator shared their perspective that paraeducators may not get enough support or respect from teachers based on their prior experience as a paraeducator saying: I personally don't think that teachers special ed or otherwise respect the fact that these staff members are with the students at the most integral times … and so, paras that are not utilized; I think [it] is a real shame.
Many educators described a lack of opportunity to collaborate on EBP selection. Paraeducators (n = 13 excerpts) and general educators (n = 5) mentioned they were instructed or required to do certain practices, whereas special educators never mentioned this theme. Some participants mentioned unidirectional advisement to use certain practices from a special educator, “well, either I do it on my own, or I would be advised by the case manager of the child that [practice] works the best” (GEN). Another educator described the special education teacher guiding their use of practices, and that they didn't select any. Another general educator explained the challenges to other specialists, who would then “generate” the EBP support. Some paraeducators described their role as following directions on practices, “Well, I am a paraeducator, so a lot of times the teacher or my supervisor will direct me in a way that they want me to work with the students,” but also with the flexibility to provide expertise and input “other times I've been allowed to say, ‘I've used this in the past, in another setting, this works.’” One shared, “That [EBP] was pretty much established … I'm asked to do it, so I don't even make the decision. I'm enacting it.”
Discussion
To address educators’ need for support in selecting EBPs for Autistic students (Brock et al., 2020; Hugh et al., 2023; Sulek et al., 2019), we examined educator-identified factors that can be used to develop implementation supports. Overall, educators shared both challenges and successes in EBP selection, ranging from the need to “grasp at straws” and use “trial and error” to selecting some EBPs “intuitively” or to support all students’ learning. When describing resources, these educators relied heavily on their own prior experience or other educators’ school-based autism expertise. Notably, educators described a student-centered implementation process (Damschroder et al., 2022), thinking critically about intervention factors as they aligned with student characteristics, classroom context, and the needs of all students in the classroom. Importantly, these insights varied by role and minimally incorporated student or parent perspectives, highlighting the need for inclusive, team-based decision-making that leverages each educator's expertise and supports their desire for collaboration, which can improve implementation (Boyd et al., 2022).
Our findings that initial exposure influenced EBP selection underscores the importance of repeated exposure during teacher preparation, early teaching years, and as new circumstances and student needs arise (Hugh et al., 2024a; Locke et al., 2022). Both general and special educators who received preservice training reflected on core aspects of EBP alignment with that training—suggesting the potential for preservice preparation in common elements of EBPs, curriculum, and programs, such as Universal Design for Learning (Carrington et al., 2020), may benefit selection, implementation, and student outcomes (Ruble et al., 2023). In addition, educators largely learned about specific EBPs from colleagues with autism expertise. Given personnel and resource constraints in schools (American Speech Language and Hearing Association, n.d.), strategies such as identifying EBP champions and forming professional learning communities may be both feasible and necessary to leverage the expertise educators found essential (Lyon et al., 2019).
Educators’ diverse perspectives, despite some common ground, illustrate that decision-making involves complex, individualized considerations beyond student fit. General education teachers focused on pedagogical fit and classroom-level considerations; special educators emphasized disability-specific expertise and ease of implementation; and paraeducators prioritized student characteristics. Many educators described their selection of EBPs as ways to help Autistic students feel “safer,” access learning alongside nondisabled peers, and capitalize on student strengths, reflecting deep understanding of individual students. In contrast, some educators expressed a desire for students to avoid stigma or “fit in.” These varied perspectives have two key implications: First, they highlight the need for partnership with Autistic students to ensure neurodiversity-affirming practices—those aligned with divergent developmental pathways, traits, and preferences, and aimed at addressing ableist systems and supports (Murphy, 2023). Researchers should follow guidance from Autistic researchers to develop interventions and implementation supports focused on socially valid goals, learning contexts, and EBPs (Lee et al., 2025). Second, the variability in perspectives suggests that educators, like students, may benefit from tailored supports and training (Hugh et al., 2023).
This study highlights the value of and need for collaboration and teaming in EBP decision-making (Boyd et al., 2022). Educators described teaming as often informal, occasionally supported by structured training (Desimone, 2009; Hugh et al., 2022), and central to EBP use. However, many paraeducators—despite their deep knowledge of students and classroom contexts—reported limited influence in decision-making. Similarly, special educators rarely mentioned input from general educators or paraeducators, revealing divides between general and special education that may stem from role-based perceptions of responsibility for students with disabilities (Ahlers et al., 2023; Mason et al., 2021). Shared planning could harness each educator's unique insights into students, EBPs, and contexts to build collective expertise and shared responsibility. Future research should develop and test feasible models of embedded collaboration that enable bidirectional learning among educators and related service providers.
Overall, these findings reveal both successful collaboration and fragmented decision-making within the complex, multilevel structure of schools (Domitrovich et al., 2008). While educators frequently considered student, intervention, and educator-level factors, few reflected on organizational influences. Nevertheless, implementation science research demonstrates that all levels and contexts are interconnected (Aarons et al., 2011; Damschroder et al., 2022; Domitrovich et al., 2008). Leadership, organizational, and structural factors shape opportunities for teaming, relationships, and adaptations described by educators (Boyd et al., 2022; Damschroder et al., 2022; Drahota et al., 2012; Stahmer et al., 2019). Future research should partner with educators and Autistic adults and students to codesign implementation supports across all levels, ensuring systems and structures foster supportive implementation climates and contexts (Boyd et al., 2022).
Limitations
This study has several limitations to consider when interpreting the findings. First, due to the COVID-19 pandemic, we had to revise our plans and remove observational data. Second, key perspectives are missing, including those of Autistic students, Autistic researchers, and individuals from racially and ethnically marginalized groups. The sample reflects only one U.S. state, which is relatively racially and educationally homogenous (93% of educators identified as White; Institute of Education Sciences, 2016), and we did not collect data on participants’ disability identities. Insights from individuals with underrepresented training, disabilities, and racial backgrounds are essential for guiding research that supports racially/ethnically minoritized educators—critical for advancing racial equity for both students and teachers (Scott et al., 2023). Third, we did not assess the quality of inclusive education beyond placement in general education settings. Finally, we did not probe factors across all levels or contexts; educators may hold additional insights specific to levels worth exploring in future research.
Conclusion
In this study, educators shared insight into how they determine which EBPs may be effective for a given student, based on student, EBP, educator, and classroom factors. Their student-centered EBP selection process underscores that, within individualized school services, educators often determine EBP implementation through their ongoing decision-making with minimal structural support (Domitrovich et al., 2008). These educators’ insights can inform the development of interventions and implementation supports that move from ensuring implementers have EBP knowledge and skills to helping educators specify how, when, why, where, and for whom specific EBPs may be effective—meeting educators’ demonstrated needs (Brock et al., 2020; Hugh et al., 2024b). Additionally, our findings highlight the need to incorporate the lived and collective expertise of educators in various roles into a facilitated, collaborative decision-making guide, which may help individuals and teams make more effective and efficient EBP selections.
Footnotes
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was financially supported by the Institute for Education Sciences (Grant Nos. R305B170021 and R324A200033).
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.