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1/ Recently, we started thinking about the question of treatment adaptation and how to best align our intervention studies with the needs of real-world settings (e.g., schools) to better serve children with language and literacy needs. #impsci #SLP #DevLangDis #Dyslexia #ELAchat
2/ Interventions are often developed under "ideal" conditions. But real-world settings are not "ideal". So what do we do? People talk about finding the right balance between adaptation and fidelity, to ensure that adaptation DOES NOT compromise the effectiveness of EBPs.
3/ I guess you may ask, "Should we even try to adapt?". The answer is yes. Otherwise, there is a high probability that the intervention will not do what it's supposed to do. Also, that's what clinicians do. EVERY SINGLE DAY.
4/ So the question is not if we need to adapt, but how do we adapt AND preserve the effectiveness of EBPs? How do we change things that can be changed and preserve things that cannot. We need systematic approaches for that.
5/ This is why @MauraKCurran @tiffanyphogan and I decided to write this paper. https://psyarxiv.com/pu6sa/
6/ When schools closed due to #COVID19 we had to make a tough choice: stop providing essential intervention to children at risk of #DevLangDis and #Dyslexia OR make rapid changes to transition to tele-intervention under highly-restricted conditions. We of course chose the latter.
7/ We looked at the existing lit to find a systematic approach that could help us adapt and continue supporting our amazing students, families, and teachers. The Minimal Intervention Needed for Change or MINC by Glasgow and colleagues seemed promising. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958586/
8/ Using the MINC approach, we made decisions around the goal of our intervention, its intensity, its complexity, strategies and techniques, and of course cost. We had to go from a multi-component and highly-interactive paper version to a SIMPLE online version.
9/ Many decisions were made around the MINC components. The most important one was that we needed to continue helping our students achieve MEANINGFUL progress during these difficult times.
10/ So using this approach, we removed many things from the program that could not fit in tele-intervention but still preserved its core: develop foundational skills to reading comprehension.
11/ We think this paper can be useful for both clinicians and researchers. For clinicians, it presents an example of adaptation using a systematic approach (check out the checklist at the end!).
12/ For researchers, it reinforces the idea that we must start being comfortable with less if we want our interventions to fit in real-world settings that often lack the infrastructure to accommodate complex programs. So, LESS CAN BE MORE!
13/ A big THANK YOU to our amazing partners @hkentschool @RSMUSLLP and @MGHInstitute for supporting this work and allowing us to do what needs to be done!!!
