Research at Bethesda - Advancing knowledge through Collaboration and Innovation

Bethesda is committed to advancing the field of developmental services through evidence-based research, community partnerships, and innovation. Our research initiatives bring together academic institutions, clinicians, and community partners to evaluate, improve, and expand the supports available to individuals with intellectual and/or developmental disabilities and their families.

These projects reflect our dedication to quality improvement, best practices, and meaningful outcomes for the people we serve.

The PECS®perts Collaborative - Innovating Caregiver Training in Communication for Children with Autism

The PECS®perts Collaborative, established in 2019 by Melissa Elliott, Clinical Supervisor at Bethesda, and Dr. Julie Koudys of Brock University, is a community-integrated research initiative advancing the field of augmentative and alternative communication (AAC) for children with autism.

  • While the Picture Exchange Communication System® (PECS®) is one of the most researched AAC systems, limited research has focused on how best to train caregivers. The PECS®perts Collaborative—comprising Bethesda, Brock University, and Pyramid Educational Consultants (the creators of PECS®)—addresses this gap through innovative caregiver-mediated models.

    Key Objectives:

    • Increase access to evidence-based communication training for children

    • Strengthen caregiver capacity to support communication at home

    • Build community and professional capacity, including for Francophone and Indigenous partners

    • Provide experiential learning opportunities for university students

    Research Outcomes:
    Two models of caregiver training were developed and tested:

    • 5-week model (12 hours)

    • 12-week model (under 20 hours)

    Each combines online caregiver training with in-person or virtual caregiver-child coaching. Over 60 children and their families have benefited, with expansion continuing across Ontario, Canada, and internationally.

    The team has presented findings at leading conferences, including:

    • Association for Behavior Analysis International (Dublin, 2022)

    • Ontario Association for Behaviour Analysis Annual Conference (2022–2024)

    • Association of Professional Behavior Analysts Convention (New Orleans, 2024)

    Their first peer-reviewed article, “Feasibility and Pilot Evaluation of a Telehealth Picture Exchange Communication System Caregiver Training”, was published in the Journal of Developmental and Physical Disabilities in March 2025. Authors: Julie Koudys, Jeffrey Esteves, Melissa Elliott, Krysten Spottiswood, Alyssa Treszl, Aman-preet Randhawa, Adrienne Perry

    A second article, “Telehealth Picture Exchange Communication System Caregiver Training: A Multi-Site Community Evaluation” was published in Journal of Autism and Developmental Disabilities in May 2025. Authors: Julie Koudys, Melissa Elliott, Hannah Floyd, Taylor McNeely, Ethan Rinaldo, Adrienne Perry

Trauma-Informed Care Research and Implementation - Partnering with the Institute on Trauma and Trauma-Informed Care (ITTIC), University at Buffalo

Bethesda has partnered with the Institute on Trauma and Trauma-Informed Care (ITTIC) at the University at Buffalo’s School of Social Work to guide the organization’s transformation into a fully Trauma-Informed system.

  • Using ITTIC’s 2019 Trauma-Informed Organizational Manual, this partnership bridges research and practice to embed trauma-informed principles—Safety, Trustworthiness, Collaboration, Choice, and Empowerment—across all Bethesda programs.

    Initiative Highlights:

    • Trauma-Informed Care 101 training for all staff by March 2025

    • Review of organizational policies and procedures through a trauma-informed lens

    • Environmental Assessments to ensure physical and psychological safety

    • Integration of trauma-informed principles into hiring, orientation, and HR practices

    • Enhanced staff wellness strategies to reduce burnout and secondary traumatic stress

    This research-driven transformation strengthens Bethesda’s capacity to create safer, more compassionate environments for both clients and staff, directly improving outcomes and quality of life.

Evaluating Adult Clinical Services - A Research Partnership with Brock University

In collaboration with Dr. Michelle Vine of Brock University, Bethesda launched an interdisciplinary evaluation of its Adult Clinical Services to measure their effectiveness, efficiency, and social validity.

  • The study combines quantitative and qualitative research methods—including surveys, interviews, and focus groups—to capture client and caregiver perspectives across psychology, speech-language, and behavioural services.

    Preliminary Findings:

    • High satisfaction with service effectiveness and goal achievement

    • Participants reported improved communication, coping skills, and daily functioning

    • Areas identified for growth include service accessibility and resource utilization

    This ongoing collaboration continues to inform service improvements, ensuring Bethesda’s clinical supports remain responsive, evidence-based, and person-centered.

Our Commitment to Research

Through partnerships with universities, clinicians, and community organizations, Bethesda continues to contribute to the broader knowledge base in developmental services. Our research initiatives help shape best practices, inform policy, and enhance the quality of life for individuals with intellectual and developmental disabilities.