In an Imperfect World: Barriers and Facilitators to Educators' Evidence-Based Practice Use for Elementary-Aged Autistic Students in Inclusive Settings.
Teachers will use anxiety-CBT with autistic students only if training shows kid-to-kid variety and gives them a coach who sticks around.
01Research in Context
What this study did
The team talked to 24 elementary teachers and school staff who work with autistic students every day.
They asked what helps and what blocks the use of proven anxiety tools like CBT in regular classrooms.
The chats were recorded, typed out, and sorted into themes by two coders.
What they found
Staff said they want training that shows how anxiety looks different in each autistic child.
They also want a coach who stays around after the first workshop to answer real-life questions.
Without both parts, they fall back to old habits like simple comfort or sending the child out.
How this fits with other research
Alhuzimi (2026) asked 101 Saudi teachers about AAC tools and heard the same story: if the tool looks hard, it sits on the shelf.
Tassé et al. (2013) surveyed rural therapists who claimed they did CBT for anxiety, yet most skipped the key step—exposure. The new study shows teachers make the same skip without ongoing coaching.
Perez et al. (2015) proved remote coaching keeps staff faithful to the plan. Their online feedback matched the in-person mentor teachers beg for in Aguirre Mtanous et al. (2026).
Why it matters
You can boost classroom CBT tomorrow by adding a five-minute daily check-in with teachers. Ask what anxiety signal showed up, praise the exposure they tried, and plan the next tiny step. This cheap habit turns one-off training into the steady coaching staff say they need.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Schedule a 10-minute Zoom each day this week with one teacher; review yesterday’s anxiety cue and set today’s tiny exposure goal.
02At a glance
03Original abstract
BACKGROUND: Autistic youth experience high rates of anxiety, which has been treated with modified cognitive-behavioral therapy (CBT), often integrating exposure therapy. Such anxiety treatments are effective for this population; however, there remains a gap between these evidence-based mental health interventions and their implementation in community mental health (CMH) services where autistic youth receive care. METHOD: This qualitative study conducted semi-structured interviews with four types of community members in the United States: 15 autistic youth with anxiety, 15 caregivers of autistic youth with anxiety, 11 CMH clinicians, and 8 CMH clinic leaders. Participants identified the training needs of CMH clinicians to support the delivery of CBT for autistic youth with anxiety. RESULTS: Through inductive thematic analysis, three themes were found: presentation of autism and anxiety, intervention delivery, and training format. Participants highlighted the need for clinician education to understand the varying presentations of autism and co-occurring anxiety and how to effectively deliver a personalized mental health intervention for autistic youth. Clinicians also desired a clinician training program that includes engaging components and offers individualized, ongoing support while the intervention is delivered. CONCLUSIONS: Findings from this study will inform the development of a clinician training program to deliver CBT modified for autistic youth with anxiety in CMH contexts.
Journal of autism and developmental disorders, 2026 · doi:10.1016/j.beth.2014.07.003