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IES Grant

Title: Efficacy Follow-Up Study of the CSESA Model
Center: NCSER Year: 2018
Principal Investigator: Hume, Kara Awardee: University of North Carolina, Chapel Hill
Program: Autism Spectrum Disorders      [Program Details]
Award Period: 2 years (07/01/2018-06/30/2020) Award Amount: $1,100,000
Type: Efficacy and Replication Award Number: R324A180091

Co-Principal Investigator: Odom, Samuel; Steinbrenner, Jessica Dykstra; Hall, Laura J.; Kraemer, Bonnie; DaWalt, Leeann

Purpose: The purpose of this project is to determine the longer-term outcomes for high school students with autism spectrum disorders (ASD) who participated in an efficacy study of a comprehensive treatment model developed by the IES-funded Center on Secondary Education for Students with Autism Spectrum Disorders (CSESA). Compared to other high school students with disabilities, students with ASD have significantly more difficulty with daily living activities, a lower sense of self direction, fewer planned activities and social engagement with friends, and are less likely to have paid employment outside of school. The majority of rigorous research on interventions for children with ASD has been conducted with preschool- and elementary-aged students, leaving a gap in research focused on secondary students with ASD. The CSESA model is a comprehensive intervention that was developed to fill this gap. Preliminary results from the initial efficacystudy of CSESA demonstrate improvement of school-wide ASD program quality, but the effects on student outcomes are unclear. Student outcomes may take longer to observe after model implementation. The current project will follow up with the students involved in the original efficacy study of CSESA to determine the longer-term intervention effects (both in-school and post-school outcomes) and whether there is evidence of factors that may mediate or moderate the impact of the intervention on youth with ASD.

Project Activities: This project will follow up with youth and young adults with ASD who participated in the initial efficacy study of the CSESA model to evaluate the model's impact on their longer-term in-school and post-school outcomes. The research team will also examine variables that may moderate or mediate long-term intervention effects. Multilevel modeling will be used to determine the efficacy of CSESA for improving students' employment, independent living, and community integration outcomes.

Products: The products of this project will include evidence of the efficacy of the CSESA model for improving the employment, independent living, and community integration outcomes of youth and young adults with ASD. Products will also include peer-reviewed publications and presentations.

Structured Abstract

Setting:Research will take place in high schools and communities in urban, suburban, and rural areas of North Carolina, Wisconsin, and California.

Sample: The 546 students with ASD who participated in the treatment and control groups of the original CSESA efficacy study and their families will participate in this follow-up study. Students were at different points in their secondary school careers when the original study took place (ages 13 - 20). Follow-up data collection will occur 2 years after the intervention ended, with some students still in high school and others who have exited school.

Intervention: The CSESA model is a comprehensive ASD intervention that was implemented in 30 high schools over a 2-year period. As part of the professional development foundation, school-based teams received training and ongoing coaching in the use of individualized assessments, goal writing, and the implementation of various interventions and evidence-based practices based on student needs and goals. The specific intervention practices focused on four domains — academic literacy, independence and behavior, peer and social competence, and transition and families.

Research Design and Methods: The original efficacy study of the CSESA model was a cluster randomized controlled trial in which 60 schools were stratified by school district (or demographic characteristics if there was only one school in a district) and randomly assigned to the intervention or control condition. Staff at each school then recruited students with ASD to participate in the program. Data were collected on school-wide ASD program quality, student outcomes, and family outcomes pre- and post-intervention. The current study will follow students who participated in the original study. In Year 1 of the project, the research team will collect follow-up data from the first CSESA cohort and in Year 2, from the second cohort. For students who are still in school, teachers and other school staff will assist in developing an assessment schedule within the school. For students who have exited high school, data collection will take place in their homes.

Control Condition: Students in the control condition of the original study received services as usual.

Key Measures: The research team will use a subset of the same standardized measures used in the original study to assess student and family outcomes for the sample of students who are still in high school. These include the Woodcock-Johnson-III, Vineland Adaptive Behavior Scale, AIR Self Determination Scale, Social Responsiveness Scale-2, Zanit Burden Inventory, and a researcher-developed assessment of work-based learning. For the students who are no longer in high school, measures will include questionnaires on employment, postsecondary education, and community integration. More specifically, the follow-up questionnaires for parents will assess adult life domains (i.e., employment, post-secondary education, access to adult services, community engagement, and independent behavior) and the questionnaire for former students will focus on the individuals' satisfaction with their current involvement in educational, vocational, and community activities. Potential moderators include student characteristics (e.g., IQ, ASD severity), family characteristics (e.g., socioeconomic status), and community characteristics (e.g., poverty level, availability of services). Student characteristics will be assessed using data derived from the original study, family characteristics will be measured using a parent-report demographic survey, and community characteristics will be gleaned from U.S. Census data. Potential mediators include student outcomes at the end of the original efficacy study and ASD program quality.

Data Analytic Strategy: For the primary analyses, the research team will use multilevel regression models with students nested within schools. To examine mediation and moderation, the researchers will use multilevel structural equation models.

Related IES Projects: Center on Secondary Education for Students with Autism Spectrum Disorders (R324C120006)