Although evidence-based practices (EBPs) have been shown to improve a variety of outcomes for autistic children, they are often inconsistently implemented or not implemented in community settings where many autistic children primarily receive care. One multi-faceted implementation strategy that researchers have developed and tested in a pilot study to support the implementation of EBPs for ASD in community settings is The Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments (ACT SMART Toolkit). Here, we used a case study approach to assess fidelity to the toolkit during its pilot study (implementation strategy fidelity) using measures of adherence, dose, and participant responsiveness and examined the relationship between implementation strategy fidelity and EBP use in an exploratory analysis. Overall, we found that adherence, dose, and participant responsiveness to the ACT SMART Toolkit were high with some variability by toolkit phase and activity. However, our exploratory analysis was ultimately unequipped to evaluate the relationship between increased fidelity and increased EBP use given the limited sample size of the pilot study. Our case study evaluation provides one of the first models of considering fidelity in the context of multi-faceted implementation strategies as well as important insights into potential core and peripheral components of the ACT SMART Toolkit.
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