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IES Grant

Title: FLIP (Focusing on Learning, Interaction, and Play at) Recess for Students With Severe Disabilities
Center: NCSER Year: 2020
Principal Investigator: Brock, Matthew Awardee: Ohio State University
Program: Social, Emotional, and Behavioral Competence      [Program Details]
Award Period: 5 years (07/01/2020 – 06/30/2025) Award Amount: $3,299,986
Type: Efficacy Award Number: R324A200110

Purpose: For most elementary students, recess is a favorite time of the school day that is full of rich opportunities to play and socialize with friends. For students with severe disabilities (i.e., students with intellectual disability, autism, and/or multiple disabilities who qualify for their state's alternate assessment), recess often looks very different. These students are typically on the periphery, rarely interacting or playing with their peers. Recess represents a missed opportunity for building social connections and developing social competence. FLIP (Focusing on Learning, Interaction, and Play at) Recess was developed to address these challenges by training and coaching peers in practical strategies for engaging and responding to students with severe disabilities. FLIP Recess has demonstrated feasibility of implementation in elementary schools, as well as promise for improving social interaction and appropriate play with peers for students with severe disabilities, but the efficacy of the intervention has not yet been tested in a large-scale study.

Project Activities: In this project, the research team will examine the efficacy of FLIP Recess using a cluster randomized controlled trial, with schools randomized to FLIP Recess or a business as usual control condition. The team will conduct analyses of factors that mediate and moderate the effectiveness of FLIP Recess on student outcomes, and conduct cost and cost-effectiveness analyses.

Products: The primary product of this project will be evidence of the efficacy of FLIP Recess for improving social interactions and peer play for elementary school students with significant disabilities, and analysis of factors that mediate or moderate the impact of the intervention on student outcomes.The project will also result in a final dataset to be shared, peer-reviewed publications and presentations, and additional dissemination products that reach education stakeholders such as practitioners and policymakers.

Structured Abstract

Setting: A total of 36elementary schools across four districts in Ohio will participate. These four districts serve students from a combination of urban, suburban, and rural communities.

Sample: Participants include 288 students (8 students from each school) with significant disabilities in grades 1-5, their teachers, and the adults who supervise them at recess. Students must (a) be receiving special education services under the primary disability label of intellectual disability, autism, and/or multiple disabilities; (b) be eligible for their state's alternative assessment for students with significant cognitive disabilities; (c) attend recess with same-aged peers without disabilities; and (d) demonstrate low rates of peer play and/or low rates of interaction. Students will be excluded if they have frequent violent or aggressive behavior toward peers.

Intervention: FLIP Recess is an intervention for building social competence and social connections for students with severe disabilities. This approach involves a combination of two intervention components—peer-mediated intervention and social skills instruction—that will be implemented each day over the course of an academic semester. These two strategies work together. Through peer-mediated Pivotal Response Training (PRT) at recess, staff who supervise recess will coach peers without disabilities to support and interact with students with severe disabilities—increasing opportunities for these students to interact and play with peers. Through daily classroom-based social skills instruction, teachers systematically teach students five targeted social skills (i.e., appropriate greetings, socially appropriate questions, sharing materials, multiple conversational turns, and complimenting others) that will prepare them to be successful as they interact and play with peers.

Research Design and Method: This research design is a 2-level randomized cluster trial of 36 schools to two conditions (FLIP Recess or wait-list control) with 8 students nested within each school. The team will use a cohort model with six sequential cohorts of 6 schools, randomly assigning within each cohort.

Control Condition: Schools randomly assigned to the business as usual control condition will provide usual services and supports for students with significant disabilities. Typically, these supports do not include peer-mediated intervention at recess, or social skills instruction that is focused on a recess context.

Key Measures: Direct observations at recess will be used to assess peer interactions, targeted social skills, and play behavior with peers. Student social competence will be measured with the Social Skills Improvement Scales and the Autism Social Skills Profile, and social connections will be measured using classroom peer network analysis of peer nomination data.

Data Analytic Strategies: Analysis of main outcomes will involve multilevel analysis that accounts for students being clustered within schools, and the team will analyze the degree to which severity of intellectual disability and/or autism symptomology moderate the efficacy of the intervention. In addition, Structural Equation Modeling (SEM) will be used to evaluate whether peer interactions, social skills, and play behavior (proximal outcomes) mediate student social competence and social connections (distal outcomes).

Cost and Cost Effectiveness Analysis: The Ingredients Method will be used to document the economic cost of FLIP Recess. The costs will then be paired with the primary measures of effectiveness to create cost-effectiveness ratios for each outcome; these will not be divided by component, as the effectiveness cannot be causally attributed to any particular component of the intervention.