School-based Education for Autism

(SPEER Trial)

Recruiting at2 trial locations

Overseen by Jill Locke, PhD

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Washington

Disqualifiers: Previous Remaking Recess participation

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

The purpose of the proposed three-site study is to test whether an educator-level implementation strategy, coaching, with or without a school-level implementation strategy, school-based teams, will maximize paraeducators' use (fidelity and sustainment) of an evidence-based social engagement intervention, Remaking Recess (RR). RR aims to improve peer related social skills for autistic students and their non-autistic peers who are socially isolated or peripheral and need support during recess.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Remaking Recess for autism?

Research shows that Remaking Recess, a social engagement intervention, improved peer engagement and social network inclusion for children with autism in schools. Additionally, when combined with implementation support, children experienced higher social network inclusion and received more friendship nominations. ^{1 2 3 4 5}

Is the Remaking Recess intervention safe for use in schools for children with autism?

The available research on the Remaking Recess intervention, used in schools for children with autism, does not report any safety concerns. It has been implemented in schools with positive outcomes for social engagement and peer interactions. ^{1 2 6 7 8}

How is the Remaking Recess treatment for autism different from other treatments?

Remaking Recess is unique because it is a school-based social engagement intervention specifically designed to improve peer interactions and social inclusion for children with autism in public schools, which is not commonly addressed by other treatments that are often conducted in clinical settings. ^{1 2 5 8 9}

Research Team

Jill Locke, PhD

Principal Investigator

University of Washington

Eligibility Criteria

This trial is for paraeducators working with children who have Autism Spectrum Disorder or other neurodevelopmental disorders. It aims to improve social skills during recess. Paraeducators must be willing to participate in coaching and possibly work with school-based teams.

Inclusion Criteria

I am a student in grades K-5, aged 5-12, with autism or a neurodevelopmental disorder.

I work with K-5th grade students in a US public school and am over 18.

Exclusion Criteria

Students or educators that have previously participated in Remaking Recess studies will not be eligible to enroll in this study.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training and Coaching

Paraeducators receive direct training and in vivo coaching on the Remaking Recess intervention

4 months

Regular in-person coaching sessions

Implementation and Monitoring

Implementation of Remaking Recess with ongoing monitoring of fidelity and sustainment

12 months

Periodic assessments at 4, 8, 12, and 16 months

Follow-up

Participants are monitored for the sustainment of the intervention and its impact on social skills

4 months

Treatment Details

Interventions

• Remaking Recess (Behavioral Intervention)

Trial Overview The study tests the 'Remaking Recess' intervention, which helps autistic students engage socially at recess. It examines if coaching paraeducators alone or combined with school-level team strategies can enhance the use of this program effectively.

Participant Groups

Group I: TEAM Experimental Treatment 2 Interventions

Schools that are randomized to the TEAM condition will receive an additional implementation support intervention. TEAM will leverage existing human resources in the school to specifically focus on developing an implementation blueprint to foster a supportive implementation context for paraeducators to use Remaking Recess.

Group II: Remaking Recess Active Control 1 Intervention

Remaking Recess is a school-based social engagement intervention designed to enhance elementary school contextual factors to better support peer engagement during recess. Remaking Recess is delivered to educators through direct training and in vivo coaching by a certified Remaking Recess Coach.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

Dr. Timothy H. Dellit

University of Washington

Chief Executive Officer since 2023

MD from University of Washington

Dr. Anneliese Schleyer

University of Washington

Chief Medical Officer since 2023

MD, MHA

Findings from Research

In a study involving 31 children with autism and 28 school personnel, providing implementation support alongside the Remaking Recess intervention led to significantly better social outcomes, such as increased social network inclusion and more friendship nominations, compared to training without support.

Both intervention groups showed improvements in social engagement, with reduced solitary play and increased joint engagement, indicating that while the intervention was beneficial, additional support may enhance its effectiveness in school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of implementation support on the use of a social engagement intervention for children with autism in public schools. Locke, J., Shih, W., Kang-Yi, CD., et al.[2020]

A study involving 100 children with autism showed that a combination of structured institution-based teaching and family rehabilitation training significantly improved autism-related behaviors and skills compared to a control group that only received the teaching program.

After 12 months, the combination therapy group had lower scores on the Autism Behavior Checklist and Autism Treatment Evaluation Checklist, indicating reduced autism symptoms, and higher scores on the Psychoeducational Profile, suggesting improved developmental outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Clinical efficacy of structured institution-based teaching programme combined with family rehabilitation training in treatment of childhood autism]. Liu, C., Lu, B., Zhang, Y., et al.[2015]

A social validation survey involving parents, teachers, and administrators highlighted strong support for five key components of effective autism interventions in school settings: individualized programming, data collection, empirically-based strategies, active collaboration, and a focus on long-term outcomes.

These validated components can guide the evaluation of current autism curricula and inform training for professionals and families, aiming to enhance the quality of autism programs in public schools.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social validation of evidence-based practices in autism by parents, teachers, and administrators. Callahan, K., Henson, RK., Cowan, AK.[2022]

The COMPASS intervention significantly improved educational outcomes for young children with autism, showing a very large effect size (d = 1.41) for face-to-face coaching and a large effect size (d = 1.12) for web-based coaching compared to a placebo control group.

Both face-to-face and web-based coaching were equally effective, indicating that videoconferencing technology can effectively connect teachers with autism specialists, making it a promising tool for enhancing educational practices in autism intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of COMPASS web-based and face-to-face teacher coaching in autism. Ruble, LA., McGrew, JH., Toland, MD., et al.[2022]

The RUBI program, originally designed for parents of children with autism spectrum disorder (ASD), was successfully adapted for use by school staff, addressing their concerns about managing challenging behaviors in students with ASD.

Feedback from educators during the redesign process led to improved perceptions of the RUBI manual's appropriateness and usability in schools, suggesting it can effectively equip teachers with strategies to manage disruptive behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Iterative redesign of a caregiver-mediated intervention for use in educational settings. Bearss, K., Tagavi, D., Lyon, AR., et al.[2023]

The ASAP intervention, implemented in a 4-year study across 78 classrooms with 161 preschool-aged children with autism, did not significantly improve social-communication and play skills compared to standard practices.

However, children in the ASAP group demonstrated increased classroom engagement, and the intervention appeared to help reduce teacher burnout, suggesting potential benefits beyond the primary outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial. Boyd, BA., Watson, LR., Reszka, SS., et al.[2019]

Only 32% of evidence-based interventions for autism have been tested in K-12 educational settings, making it unclear how applicable these strategies are for educators.

Most research has focused on preschool children, leaving a gap in understanding how effective these interventions are for school-aged children, particularly regarding restricted and repetitive behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advances in School-Based Interventions for Students With Autism Spectrum Disorder: Introduction to the Special Issue. Anderson, CM., Smith, T., Wilczynski, SM.[2018]

This systematic review analyzed 108 studies to identify effective strategies for adapting educational settings to support autistic students, highlighting the importance of teachers' attitudes and social skills development.

A significant research gap was found regarding the perspectives of autistic students and the need for environmental adaptations, suggesting that professional development for educators should focus on autism-specific strategies to enhance inclusion and learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strategies in supporting inclusive education for autistic students-A systematic review of qualitative research results. Petersson-Bloom, L., Holmqvist, M.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

It's Messy but Real: A Pilot Study of the Implementation a Social Engagement Intervention for Children with Autism in Schools. [2020]

2. England pubmed.ncbi.nlm.nih.gov

The impact of implementation support on the use of a social engagement intervention for children with autism in public schools. [2020]

3. China pubmed.ncbi.nlm.nih.gov

[Clinical efficacy of structured institution-based teaching programme combined with family rehabilitation training in treatment of childhood autism]. [2015]

4. United States pubmed.ncbi.nlm.nih.gov

Social validation of evidence-based practices in autism by parents, teachers, and administrators. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of COMPASS web-based and face-to-face teacher coaching in autism. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Iterative redesign of a caregiver-mediated intervention for use in educational settings. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Advances in School-Based Interventions for Students With Autism Spectrum Disorder: Introduction to the Special Issue. [2018]

9. United States pubmed.ncbi.nlm.nih.gov

Strategies in supporting inclusive education for autistic students-A systematic review of qualitative research results. [2022]