Predictors of Evidence-Based Communication Strategy Use in Preschool Settings: The Role of Knowledge, Self-Efficacy, and Organizational Support in Autism Education
-
Kareem Jebur Dhaian
,
Enas Ahmed Abdel Karim
,
Qasim Kadhim Ashour
,
Rasha Hussein Oleiwi
,
Asmahan Qasim Mohammed
Abstract
Objective: This study investigated the predictive relationships between kindergarten teachers' knowledge of communication skills for children with autism spectrum disorder (ASD), the teachers’ self-efficacy beliefs, their attitudes towards inclusive education, their perceived organizational support, and their self-reported utilization of evidence-based communication strategies.
Method: A cross-sectional predictive correlational design was employed across government-operated kindergartens in Kerbala Governorate, Iraq. Stratified random sampling recruited 243 kindergarten teachers. Data were collected using a comprehensive self-administered questionnaire comprising validated instruments measuring demographic characteristics, autism-specific communication knowledge, teacher self-efficacy for inclusive practices using the Teacher Efficacy for Inclusive Practices Scale, attitudes towards inclusion using the Multidimensional Attitudes Scale Toward Persons with Disabilities, perceived organizational support using the Survey of Perceived Organizational Support, and frequency of evidence-based strategy use. Hierarchical multiple regression analysis was conducted to identify significant independent predictors of strategy implementation.
Results: The final regression model was highly significant (F (7, 235) = 25.32, P < 0.001) and accounted for 42% of the variance in teachers' use of evidence-based communication strategies (R2 = 0.42). Teacher self-efficacy emerged as the strongest independent predictor (β = 0.35, P < 0.001), followed by perceived organizational support (β = 0.28, P < 0.01) and professional experience (β = 0.22, P < 0.05). General knowledge about autism spectrum disorder (β = 0.06, P = 0.12) and attitudes towards inclusion (β = 0.05, P = 0.23) did not retain statistical significance as independent predictors when self-efficacy and organizational support were controlled.
Conclusion: Effective communication support for children with autism in inclusive preschool environments is determined by a complex interplay of individual psychological factors and organizational contextual variables. Professional development initiatives should prioritize cultivating teacher self-efficacy through experiential learning and coaching while fostering supportive school cultures and providing adequate resources and administrative encouragement.
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3. Mohammadi MR, Ahmadi N, Khaleghi A, Zarafshan H, Mostafavi SA, Kamali K, et al. Prevalence of Autism and its Comorbidities and the Relationship with Maternal Psychopathology: A National Population-Based Study. Arch Iran Med. 2019;22(10):546-53.
4. Akomolafe AF, Abdallah BM, Mahmood FR, Elshoeibi AM, Al-Khulaifi AA, Mahmoud E, et al. Estimates of the prevalence of autism spectrum disorder in the Middle East and North Africa region: A systematic review and Meta-Analysis. BMC Public Health. 2025;25(1):2519.
5. Zarafshan H, Mohammadi MR, Abolhassani F, Motevalian SA, Sharifi V. Developing a Comprehensive Evidence-Based Service Package for Toddlers with Autism in a Low Resource Setting: Early Detection, Early Intervention, and Care Coordination. Iran J Psychiatry. 2019;14(2):120-9.
6. Rasouli A, Khaleghi A, Bashi SK, Zarafshan H. A Narrative Review of Challenges and Management Strategies for Pediatric Clients with Neurodevelopmental Disorders in Non-Psychiatric Settings. Iran J Psychiatry. 2026:1-8.
7. Sadeghian A, Javidypour N, Mohammadi-Far MA, Mahmoudi Siahmazgi M. Can Replacing Screen Time with Social-Media and Mobile Apps Enhance Social Skills in Autistic Children? Iran J Psychiatry. 2025;20(4):431-40.
8. Banker SM, Gu X, Schiller D, Foss-Feig JH. Hippocampal contributions to social and cognitive deficits in autism spectrum disorder. Trends Neurosci. 2021;44(10):793-807.
9. Wang Y, Lv R, Jiang Z, Liu Y, Zhang J, Zhao Z, et al. Autism spectrum disorder across the lifespan: Dynamic symptom trajectories and multidimensional support framework. Mol Psychiatry. 2026;31(7):4124-43.
10. Khaleghi A, Zarafshan H, Vand SR, Mohammadi MR. Effects of Non-invasive Neurostimulation on Autism Spectrum Disorder: A Systematic Review. Clin Psychopharmacol Neurosci. 2020;18(4):527-52.
11. Iacono T, Trembath D, Erickson S. The role of augmentative and alternative communication for children with autism: current status and future trends. Neuropsychiatr Dis Treat. 2016;12:2349-61.
12. Zarafshan H, Mohammadi MR, Motevalian SA, Abolhassani F, Khaleghi A, Sharifi V. Autism research in Iran: a scientometric study. 2017.
13. Song J, Reilly M, Reichow B. Overview of Meta-Analyses on Naturalistic Developmental Behavioral Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord. 2025;55(1):1-13.
14. Alahmari FS, Alhabbad AA, Alshamrani HA, Almuqbil MA. Effectiveness of social skills training interventions for children with autism spectrum disorder: A systematic review and meta-analysis. Saudi Med J. 2025;46(3):226-37.
15. Bateman KJ, Wilson SE, Gauvreau A, Matthews K, Gucwa M, Therrien W, et al. Visual Supports to Increase Conversation Engagement for Preschoolers With Autism Spectrum Disorder During Mealtimes: An Initial Investigation. J Early Interv. 2023;45(2):163-84.
16. Hsiao Y-J, Sorensen Petersen S. Evidence-based practices provided in teacher education and in-service training programs for special education teachers of students with autism spectrum disorders. Teach Educ Spec Educ. 2019;42(3):193-208.
17. Hugh ML, Johnson LD, Cook C. Preschool teachers' selection of social communication interventions for children with autism: An application of the theory of planned behavior. Autism. 2022;26(1):188-200.
18. Koutroubas V, Galanakis M. Bandura’s social learning theory and its importance in the organizational psychology context. Psychology. 2022;12(6):315-22.
19. Chezan LC, McCammon MN, Wolfe K, Drasgow E, Tabacu LM. Teachers' Familiarity, Confidence, Training, and Use of Problem Behavior Interventions for Learners with Autism Spectrum Disorder in School Settings. J Dev Phys Disabil. 2022:1-25.
20. Alexander JL, Ayres KM, Smith KA. Training teachers in evidence-based practice for individuals with autism spectrum disorder: A review of the literature. Teach Educ Spec Educ. 2015;38(1):13-27.
21. Gómez-Marí I, Sanz-Cervera P, Tárraga-Mínguez R. Teachers’ attitudes toward autism spectrum disorder: A systematic review. Education Sciences. 2022;12(2):138.
22. Russell A, Scriney A, Smyth S. Educator attitudes towards the inclusion of students with autism spectrum disorders in mainstream education: A systematic review. Rev J Autism Dev Disord. 2023;10(3):477-91.
23. Tsegaye M, Menbere F, Godie Y, Birhanu D. Preschool and primary school teachers' attitude towards inclusive education for students with autism spectrum disorders in Ethiopian public schools: multicenter cross-sectional study. BMC Neurol. 2025;25(1):123.
24. Dinc MS, Super JF, Kuzey C, Youssef D. Perceived organizational support in reducing emotional exhaustion and increasing citizenship behaviors of faculties: the multiple mediating effects of affective commitment. International Journal of Leadership in Education. 2025;28(5):1088-119.
25. Kim SY, Crowley S. Understanding perceptions and experiences of autistic undergraduate students toward disability support offices of their higher education institutions. Res Dev Disabil. 2021;113:103956.
26. Bejnö H, Bölte S, Linder N, Långh U, Odom SL, Roll-Pettersson L. From Someone Who May Cause Trouble to Someone You Can Play With: Stakeholders' Perspectives on Preschool Program Quality for Autistic Children. J Autism Dev Disord. 2022;52(9):3890-908.
27. Smith TE, LaBrot Z, Kim AM, Lawson A, Maxime E. Using School-Based Consultation and Coaching to Improve Student Generalization and Target Outcomes Through Teacher Evidence-Based Practices: A Meta-Analysis. J Educ Psychol Consult. 2026:1-26.
28. Boyd BA, Watson LR, Reszka SS, Sideris J, Alessandri M, Baranek GT, et al. Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial. J Autism Dev Disord. 2018;48(9):3144-62.
29. Demirel IN, Islamoglu H. Improving pre-service teachers’ self-efficacy to employ activity-based art practices in inclusive education. International Journal of Inclusive Education. 2026;30(8):1926-44.
30. Hao EOY, Nordin MN. School-Based Emotion Regulation Support for Learners with Autism Spectrum Disorder: A Systematic Literature Review of Interventions, Mechanisms, and Implementation. International Journal of Special Education. 2026;41(9s):392-427.
31. Alnahdi GH. Rasch validation of the Arabic version of the Teacher Efficacy for Inclusive Practices (TEIP) scale. Studies in Educational Evaluation. 2019;62:104-10.
32. Hammad H, Elbarazi I, Bendak M, Obaideen K, Amanatullah A, Khan BSB, et al. Influence of Religiosity on Youths' Attitudes Towards People with Disabilities in the United Arab Emirates. J Relig Health. 2024;63(3):2423-42.
33. Saadeh IM, Suifan TS. Job stress and organizational commitment in hospitals: The mediating role of perceived organizational support. International Journal of Organizational Analysis. 2020;28(1):226-42.
34. Petersson-Bloom L, Hansson E. A Systematic Research Review on Teachers' Self-Efficacy in Educating Autistic Students. Autism Dev Lang Impair. 2025;10:23969415251392318.
35. Han C, Cumming TM. Teachers’ beliefs about the provision of education for students with autism spectrum disorder: A systematic review. Rev J Autism Dev Disord. 2024;11(3):545-63.
36. Kisbu-Sakarya Y, Doenyas C. Can school teachers' willingness to teach ASD-inclusion classes be increased via special education training? Uncovering mediating mechanisms. Res Dev Disabil. 2021;113:103941.
37. Pang F, Yang L, Tse CY, Sin KF. Assessing the Relationship Between Teacher Inclusive Beliefs, Behaviors, and Competences of Students with Autism Spectrum Disorders. J Autism Dev Disord. 2025;55(10):3631-46.
38. Flippin M, Reszka S, Watson LR. Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: a meta-analysis. Am J Speech Lang Pathol. 2010;19(2):178-95.
39. Kokina A, Kern L. Social Story interventions for students with autism spectrum disorders: a meta-analysis. J Autism Dev Disord. 2010;40(7):812-26.
40. Hill LB, Hill RL, Frey RF, Buchanan D. Developing as inclusive instructors through high-engagement professional development. Innovative Higher Education. 2025;50(4):1357-80.
41. Zhou X, Shu L, Xu Z, Padrón Y. The effect of professional development on in-service STEM teachers’ self-efficacy: A meta-analysis of experimental studies. Int J STEM Educ. 2023;10(1):37.
42. Snyder PA, Hemmeter ML, Fox L. Supporting implementation of evidence-based practices through practice-based coaching. Topics Early Child Spec Educ.2015;35(3):133-43.
43. Greysen SR, Schiliro D, Curry L, Bradley EH, Horwitz LI. "Learning by doing"--resident perspectives on developing competency in high-quality discharge care. J Gen Intern Med. 2012;27(9):1188-94.
44. Flannery KA, Wisner-Carlson R. Autism and Education. Child Adolesc Psychiatr Clin N Am. 2020;29(2):319-43.
45. Guldberg K, Parsons S, Porayska‐Pomsta K, Keay‐Bright W. Challenging the knowledge‐transfer orthodoxy: Knowledge co‐construction in technology‐enhanced learning for children with autism. Br Educ Res J. 2017;43(2):394-413.
46. An J, Meaney KS. Inclusion practices in elementary physical education: A social-cognitive perspective. International Journal of Disability, Development and Education. 2015;62(2):143-57.
2. The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021. Lancet Psychiatry. 2025;12(2):111-21.
3. Mohammadi MR, Ahmadi N, Khaleghi A, Zarafshan H, Mostafavi SA, Kamali K, et al. Prevalence of Autism and its Comorbidities and the Relationship with Maternal Psychopathology: A National Population-Based Study. Arch Iran Med. 2019;22(10):546-53.
4. Akomolafe AF, Abdallah BM, Mahmood FR, Elshoeibi AM, Al-Khulaifi AA, Mahmoud E, et al. Estimates of the prevalence of autism spectrum disorder in the Middle East and North Africa region: A systematic review and Meta-Analysis. BMC Public Health. 2025;25(1):2519.
5. Zarafshan H, Mohammadi MR, Abolhassani F, Motevalian SA, Sharifi V. Developing a Comprehensive Evidence-Based Service Package for Toddlers with Autism in a Low Resource Setting: Early Detection, Early Intervention, and Care Coordination. Iran J Psychiatry. 2019;14(2):120-9.
6. Rasouli A, Khaleghi A, Bashi SK, Zarafshan H. A Narrative Review of Challenges and Management Strategies for Pediatric Clients with Neurodevelopmental Disorders in Non-Psychiatric Settings. Iran J Psychiatry. 2026:1-8.
7. Sadeghian A, Javidypour N, Mohammadi-Far MA, Mahmoudi Siahmazgi M. Can Replacing Screen Time with Social-Media and Mobile Apps Enhance Social Skills in Autistic Children? Iran J Psychiatry. 2025;20(4):431-40.
8. Banker SM, Gu X, Schiller D, Foss-Feig JH. Hippocampal contributions to social and cognitive deficits in autism spectrum disorder. Trends Neurosci. 2021;44(10):793-807.
9. Wang Y, Lv R, Jiang Z, Liu Y, Zhang J, Zhao Z, et al. Autism spectrum disorder across the lifespan: Dynamic symptom trajectories and multidimensional support framework. Mol Psychiatry. 2026;31(7):4124-43.
10. Khaleghi A, Zarafshan H, Vand SR, Mohammadi MR. Effects of Non-invasive Neurostimulation on Autism Spectrum Disorder: A Systematic Review. Clin Psychopharmacol Neurosci. 2020;18(4):527-52.
11. Iacono T, Trembath D, Erickson S. The role of augmentative and alternative communication for children with autism: current status and future trends. Neuropsychiatr Dis Treat. 2016;12:2349-61.
12. Zarafshan H, Mohammadi MR, Motevalian SA, Abolhassani F, Khaleghi A, Sharifi V. Autism research in Iran: a scientometric study. 2017.
13. Song J, Reilly M, Reichow B. Overview of Meta-Analyses on Naturalistic Developmental Behavioral Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord. 2025;55(1):1-13.
14. Alahmari FS, Alhabbad AA, Alshamrani HA, Almuqbil MA. Effectiveness of social skills training interventions for children with autism spectrum disorder: A systematic review and meta-analysis. Saudi Med J. 2025;46(3):226-37.
15. Bateman KJ, Wilson SE, Gauvreau A, Matthews K, Gucwa M, Therrien W, et al. Visual Supports to Increase Conversation Engagement for Preschoolers With Autism Spectrum Disorder During Mealtimes: An Initial Investigation. J Early Interv. 2023;45(2):163-84.
16. Hsiao Y-J, Sorensen Petersen S. Evidence-based practices provided in teacher education and in-service training programs for special education teachers of students with autism spectrum disorders. Teach Educ Spec Educ. 2019;42(3):193-208.
17. Hugh ML, Johnson LD, Cook C. Preschool teachers' selection of social communication interventions for children with autism: An application of the theory of planned behavior. Autism. 2022;26(1):188-200.
18. Koutroubas V, Galanakis M. Bandura’s social learning theory and its importance in the organizational psychology context. Psychology. 2022;12(6):315-22.
19. Chezan LC, McCammon MN, Wolfe K, Drasgow E, Tabacu LM. Teachers' Familiarity, Confidence, Training, and Use of Problem Behavior Interventions for Learners with Autism Spectrum Disorder in School Settings. J Dev Phys Disabil. 2022:1-25.
20. Alexander JL, Ayres KM, Smith KA. Training teachers in evidence-based practice for individuals with autism spectrum disorder: A review of the literature. Teach Educ Spec Educ. 2015;38(1):13-27.
21. Gómez-Marí I, Sanz-Cervera P, Tárraga-Mínguez R. Teachers’ attitudes toward autism spectrum disorder: A systematic review. Education Sciences. 2022;12(2):138.
22. Russell A, Scriney A, Smyth S. Educator attitudes towards the inclusion of students with autism spectrum disorders in mainstream education: A systematic review. Rev J Autism Dev Disord. 2023;10(3):477-91.
23. Tsegaye M, Menbere F, Godie Y, Birhanu D. Preschool and primary school teachers' attitude towards inclusive education for students with autism spectrum disorders in Ethiopian public schools: multicenter cross-sectional study. BMC Neurol. 2025;25(1):123.
24. Dinc MS, Super JF, Kuzey C, Youssef D. Perceived organizational support in reducing emotional exhaustion and increasing citizenship behaviors of faculties: the multiple mediating effects of affective commitment. International Journal of Leadership in Education. 2025;28(5):1088-119.
25. Kim SY, Crowley S. Understanding perceptions and experiences of autistic undergraduate students toward disability support offices of their higher education institutions. Res Dev Disabil. 2021;113:103956.
26. Bejnö H, Bölte S, Linder N, Långh U, Odom SL, Roll-Pettersson L. From Someone Who May Cause Trouble to Someone You Can Play With: Stakeholders' Perspectives on Preschool Program Quality for Autistic Children. J Autism Dev Disord. 2022;52(9):3890-908.
27. Smith TE, LaBrot Z, Kim AM, Lawson A, Maxime E. Using School-Based Consultation and Coaching to Improve Student Generalization and Target Outcomes Through Teacher Evidence-Based Practices: A Meta-Analysis. J Educ Psychol Consult. 2026:1-26.
28. Boyd BA, Watson LR, Reszka SS, Sideris J, Alessandri M, Baranek GT, et al. Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial. J Autism Dev Disord. 2018;48(9):3144-62.
29. Demirel IN, Islamoglu H. Improving pre-service teachers’ self-efficacy to employ activity-based art practices in inclusive education. International Journal of Inclusive Education. 2026;30(8):1926-44.
30. Hao EOY, Nordin MN. School-Based Emotion Regulation Support for Learners with Autism Spectrum Disorder: A Systematic Literature Review of Interventions, Mechanisms, and Implementation. International Journal of Special Education. 2026;41(9s):392-427.
31. Alnahdi GH. Rasch validation of the Arabic version of the Teacher Efficacy for Inclusive Practices (TEIP) scale. Studies in Educational Evaluation. 2019;62:104-10.
32. Hammad H, Elbarazi I, Bendak M, Obaideen K, Amanatullah A, Khan BSB, et al. Influence of Religiosity on Youths' Attitudes Towards People with Disabilities in the United Arab Emirates. J Relig Health. 2024;63(3):2423-42.
33. Saadeh IM, Suifan TS. Job stress and organizational commitment in hospitals: The mediating role of perceived organizational support. International Journal of Organizational Analysis. 2020;28(1):226-42.
34. Petersson-Bloom L, Hansson E. A Systematic Research Review on Teachers' Self-Efficacy in Educating Autistic Students. Autism Dev Lang Impair. 2025;10:23969415251392318.
35. Han C, Cumming TM. Teachers’ beliefs about the provision of education for students with autism spectrum disorder: A systematic review. Rev J Autism Dev Disord. 2024;11(3):545-63.
36. Kisbu-Sakarya Y, Doenyas C. Can school teachers' willingness to teach ASD-inclusion classes be increased via special education training? Uncovering mediating mechanisms. Res Dev Disabil. 2021;113:103941.
37. Pang F, Yang L, Tse CY, Sin KF. Assessing the Relationship Between Teacher Inclusive Beliefs, Behaviors, and Competences of Students with Autism Spectrum Disorders. J Autism Dev Disord. 2025;55(10):3631-46.
38. Flippin M, Reszka S, Watson LR. Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: a meta-analysis. Am J Speech Lang Pathol. 2010;19(2):178-95.
39. Kokina A, Kern L. Social Story interventions for students with autism spectrum disorders: a meta-analysis. J Autism Dev Disord. 2010;40(7):812-26.
40. Hill LB, Hill RL, Frey RF, Buchanan D. Developing as inclusive instructors through high-engagement professional development. Innovative Higher Education. 2025;50(4):1357-80.
41. Zhou X, Shu L, Xu Z, Padrón Y. The effect of professional development on in-service STEM teachers’ self-efficacy: A meta-analysis of experimental studies. Int J STEM Educ. 2023;10(1):37.
42. Snyder PA, Hemmeter ML, Fox L. Supporting implementation of evidence-based practices through practice-based coaching. Topics Early Child Spec Educ.2015;35(3):133-43.
43. Greysen SR, Schiliro D, Curry L, Bradley EH, Horwitz LI. "Learning by doing"--resident perspectives on developing competency in high-quality discharge care. J Gen Intern Med. 2012;27(9):1188-94.
44. Flannery KA, Wisner-Carlson R. Autism and Education. Child Adolesc Psychiatr Clin N Am. 2020;29(2):319-43.
45. Guldberg K, Parsons S, Porayska‐Pomsta K, Keay‐Bright W. Challenging the knowledge‐transfer orthodoxy: Knowledge co‐construction in technology‐enhanced learning for children with autism. Br Educ Res J. 2017;43(2):394-413.
46. An J, Meaney KS. Inclusion practices in elementary physical education: A social-cognitive perspective. International Journal of Disability, Development and Education. 2015;62(2):143-57.
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| Autism Spectrum Disorder (ASD) Early Childhood Education and Care Evidence-Based Practice Self-Efficacy School Teachers | ||
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How to Cite
1.
Jebur Dhaian K, Abdel Karim EA, Kadhim Ashour Q, Oleiwi RH, Qasim Mohammed A. Predictors of Evidence-Based Communication Strategy Use in Preschool Settings: The Role of Knowledge, Self-Efficacy, and Organizational Support in Autism Education. Iran J Psychiatry. 2026;:1-11.
