Factors associated with implementation of a school-based comprehensive program for students with autism.

Pettingell et al. (2022) looked at 39 elementary schools that were rolling out a full ABA program for students with autism.

They asked: what makes the program stick? They measured how closely each school followed the plan and then checked three things: principal leadership style, how much coaching teachers got, and the income level of the neighborhood.

Schools hit high fidelity when three stars lined up. First, the principal acted as a transformational leader—sharing vision, cheering staff, and removing barriers. Second, coaches spent enough time in classrooms giving feedback. Third, the school served more low-income families.

The story starts with Mulvaney et al. (1974) and Preston (1994). These early studies showed that simple principal praise could lift attendance and math scores. L et al. extend that work—leadership still matters, but now it must be bigger and paired with expert coaching.

HMelegari et al. (2025) ran a three-year trial with rural schools using PBIS. They also found that coaching hours predicted fidelity. The match supports L et al.: dosage of coaching is a core driver across very different school-wide programs.

Nuta et al. (2021) and Penney et al. (2019) moved coaching into homes. Parents reached high fidelity only after BST plus ongoing coaching. The same rule applies in classrooms—initial training is not enough; people need continued support.

If you help schools adopt comprehensive autism programs, target the principal first. Offer a short leadership package that covers goal setting, feedback, and praise. Then lock in weekly coach visits. Finally, ask about neighborhood resources; lower-SES schools may need extra coach hours to reach the same fidelity bar.