Educator and Student Response to a Social-Communication Intervention Translated for Public Preschool Classrooms

Background: There is a pressing need for efforts to translate efficacious lab-based interventions into accessible interventions for public school settings serving young students with ASD.  Bringing such effective interventions into early childhood classrooms could lead not only to improvement in child outcomes, but also to reductions in long-term education costs for the growing body of students with ASD.  The ‘Early Achievements’ (EA) intervention model was honed in the lab setting to improve interpersonal synchrony and communication functioning in toddlers with ASD. This model was proven effective through an RCT (Landa et al., 2011) and treatment gains were maintained for 6 months following the intervention period.  The EA model is now being translated for use in public preschools through funding from the Institute for Educational Science.

 Objectives:

(1) To describe the training and coaching procedures, as developed from a lab/clinic into community based model.

(2) To examine changes over time in trained educators’ fidelity of implementation of the EA intervention in response to training and coaching.

(3) To examine preliminary results reflecting student change.

Methods: Mixed methods were used to address the aims. Focus groups and structured participant feedback informed development of training and coaching procedures, as well as adaptations of the lab-based intervention model for use in public school classrooms. Quantitative longitudinal fidelity of implementation data were collected for teachers and instructional assistants from two participating classrooms over eight months. Videotaped data were coded by research staff blind to classroom characteristics and time point, with an average of 17 datapoints per educator. Data for 18 participating students with ASD were collected through the Mullen Scales of Early Learning and an experimental joint attention task at the beginning (prior to educator training) and end of the school year.

Results: Qualitative focus group results indicate multiple practical barriers to implementation of the lab-based EA intervention model. These barriers (e.g., limited resources, varying levels of pre-service training in ASD) will be outlined along with adaptations to the EA intervention that address each barrier and the resulting training and coaching procedures. Data reflecting fidelity of implementation of key aspects of the adapted EA model across the school year (before, during, and following training/coaching) indicate mean gains of 70% for teachers and 65% for instructional assistants, with all educators meeting fidelity criteria for the EA strategies. Pre-post student gains on the Mullen Scales of Early Learning were significant across scales (Visual Reception, p=.0021; Fine Motor, p=.0028; Receptive Language, p=.016; Expressive Language, p=.0185) and significant improvements in response to joint attention points were seen (p=.0222) during an experimental task.

Conclusions: Combined preliminary results indicate feasibility of the adapted EA intervention model, based on four educators’ uptake of the strategies in their classrooms. In addition, student data indicate the potential impact of the preschool educators’ use of the EA strategies during classroom instruction. Implications will be discussed in terms of next steps within this intervention development study, as well as for a future, larger-scale efficacy trial.