Description:

Previous Award Number: R324A130349
Previous Awardee: University of California, San Diego

Previous Award Number: R324A120054
Previous Awardee: Rady Children’s Hospital, San Diego

Purpose: With increasing rates of autism spectrum disorders (ASD), public schools are straining to provide high-quality, evidence-based programs for these students. Most current evidence-based practices for students with ASD were designed for use in one-on-one or highly controlled settings. Little research to date has examined the effectiveness of specific techniques in the context of school systems.

The purpose of this project is to conduct a randomized trial of an intervention called Classroom Pivotal Response Teaching (CPRT), an intervention specifically adapted for use in classrooms for children with ASD. The trial will study children in preschool through fifth-grade classrooms to determine whether the program improves students' communication, object play, academic and social skills, on-task behavior, and progress toward IEP goals, including an examination of moderators and mediators of outcomes. The study will also examine teacher fidelity of implementation, moderators and mediators of teacher fidelity, and sustainability of program components.

Project Activities: A randomized design, with 108 classrooms randomized to 3 groups, will be used to study the efficacy of the CPRT intervention over 4 years. In the first year, there will be a treatment group (A) and control group (B), as well as a waitlist group (C) who will not participate in the first year. In the second year of the study, the former control group (B) will be the treatment group, and the former waitlist group (C) will be a new control group. By the end of year 3, all groups will have received treatment and entered the follow-up phase. Teachers will receive a coaching "booster" each year after their training year. Assessment data will be collected for groups A and B in the first year and for all three groups in the remaining years.

Products: Products from this project will include published reports and presentations on the efficacy of the CPRT intervention for students with autism, teacher success at obtaining and maintaining fidelity over time, and classroom- and student-level moderators of intervention efficacy.

Structured Abstract

Setting: This research will take place in preschool and elementary schools in California serving students with autism spectrum disorder (ASD).

Sample: The participants will consist of 216 children aged 3–10 years old who have a primary educational classification of ASD. In addition, the students' teachers (108) and paraprofessional staff (108) will also participate, with 2 students with ASD per classroom.

Intervention: Classroom Pivotal Response Teaching (CPRT) is an intervention adapted from Pivotal Response Training (PRT) for use in school classrooms. With this approach, teachers provide cues using student-preferred materials aimed at eliciting an appropriate student response. The CPRT components focus on child attention, clear instruction, shared control among child and teacher, maintenance of previously mastered tasks, broadening attention (responsivity to multiple cues), reinforcement of goal-directed attempts, and contingent consequences. Teacher training will consist of 12 hours of didactic instruction and coaching over the course of 6 weeks, with continued observation and coaching over the remaining course of the academic year.

Research Design and Methods: This study will use a randomized, wait-list controlled design. Classrooms will be randomized into three groups: A (treatment in first year), B (treatment in second year) and C (treatment in third year). In year 1, Group B serves as the control group; in year 2, group C serves as the control group.

Control Condition: The control condition will consist of current classroom ASD practices.

Key Measures: Key outcome measures include direct observation of classroom practices, teacher reports (intervention satisfaction and classroom climate), direct assessments of student's progress toward attaining IEP goals, and parent and teacher reports of children's adaptive behavior and autism symptoms. Classrooms will be videotaped for direct observation of teacher fidelity of implementation and student classroom performance during CPRT. Potential moderators include teacher reports of education/experience and classroom climate, the Autism Diagnostic Observation Schedule (symptom severity), age-appropriate standardized measures of cognitive ability, and parent reports of family demographics and ongoing services received.

Data Analytic Strategy: Hierarchical linear modeling will be used to account for the nested nature of the data, including students nested within classrooms, nested within schools, as well as repeated measures over time.

Project Website: https://www.classroomprt.org/

Related IES Projects: Translating Pivotal Response Training Into Classroom Environments (R324B070027)

Products and Publications

Book chapter

Suhrheinrich, J., Hall, L. J., Reed, S., Stahmer, A. C., & Schreibman, L. (2014). Evidence-basedintervention for autism. In L. Wilkenson (Ed.) Autism Spectrum Disorders in Children and Adolescents: Evidence-based Assessment and Intervention in Schools. American Psychological Association Press.

Walker, H.M., Severson, H., Seeley, J., Feil, E., Small, J., Golly, A., Frey, A., Lee, J., Sumi, W.C., Woodbridge, M., Wagner, M., and Forness, S. (2014). The Evidence Base of the First Step to Success Early Intervention for Preventing Emerging Antisocial Behavior Patterns. In H.M. Walker, and F.M. Gresham (Eds.), Handbook of Evidence-Based Practices for Emotional and Behavioral Disorders: Applications in Schools (pp. 518–537). New York: Guilford.

Journal article, monograph, or newsletter

Beard, K.Y., and Sugai, G. (2004). First Step to Success: An Early Intervention for Elementary Children at Risk for Antisocial Behavior. Behavioral Disorders, 29(4): 396–409.

Carter, D., and Horner, R. (2007). Adding Functional Behavioral Assessment to First Step to Success: A Case Study. Journal of Positive Behavior Interventions, 9(4): 229–238 . doi:10.1177/10983007070090040501

Carter, D., and Horner, R. (2009). Adding Function-Based Behavioral Support to First Step to Success: Integrating Individualized and Manualized Practices. Journal of Positive Behavior Interventions, 11(1): 22–34. doi:10.1177/1098300708319125

Donaldson, A.L., and Stahmer, A.C. (2014). Team Collaboration: The Use of Behavior Principles for Serving Students with ASD. Language, Speech, and Hearing Services in Schools, 45(4): 261–276. doi:10.1044/2014_LSHSS-14–0038

Feil, E.G., Frey, A., Walker, H.M., Small, J.W., Seeley, J.R., Golly, A., and Forness, S.R. (2015). The Efficacy of a Home-School Intervention for Preschoolers With Challenging Behaviors: A Randomized Controlled Trial of Preschool First Step to Success. Journal of Early Intervention . doi:10.1177/1053815114566090

Loman, S., Rodriguez, B., and Horner, R. (2010). Sustainability of a Targeted Intervention Package: First Step to Success in Oregon. Journal of Emotional and Behavioral Disorders, 18(3): 178–191. doi:10.1177/1063426610362899

Reed, S., Stahmer, A.C., Suhrheinrich, J., and Schreibman, L. (2013). Stimulus Overselectivity in Typical Development: Implications for Teaching Children With Autism. Journal of Autism and Developmental Disorders, 43(6): 1249–1257. doi:10.1007/s10803–012–1658–x

Rieth, S.R., Stahmer, A.C., Suhrheinrich, J., and Schreibman, L. (2015). Examination of the Prevalence of Stimulus Overselectivity in Children With ASD. Journal of Applied Behavior Analysis, 48(1): 71–84. doi:10.1002/jaba.165

Rieth, S.R., Stahmer, A.C., Suhrheinrich, J., Schreibman, L., Kennedy, J., and Ross, B. (2014). Identifying Critical Elements of Treatment: Examining the Use of Turn Taking in Autism Intervention. Focus on Autism and Other Developmental Disabilities, 29(3): 168–179. doi:10.1177/1088357613513792

Rodriguez, B., Loman, S., and Horner, R. (in press). The Effects of Coaching Feedback on Teacher Implementation Fidelity for First Step to Success. Behavior Analysis in Practice, 2(2): 11–21.

Seeley, J.R., Small, J.W., Walker, H.M., Feil, E.G., Severson, H.H., Golly, A.M., and Forness, S.R. (2009). Efficacy of the First Step to Success Intervention for Students With Attention-Deficit/Hyperactivity Disorder. School Mental Health, 1(1): 37–48. doi:10.1007/s12310–008–9003–4

Stahmer, A.C., Suhrheinrich, J., Reed, S., and Schreibman, L. (2012). What Works for You? Using Teacher Feedback to Inform Adaptations of Pivotal Response Training for Classroom Use. Autism Research and Treatment, Article ID 709861, 2012: 1–11. doi:10.1155/2012/709861 Full text

Stahmer, A.C., Suhrheinrich, J., Reed, S., Bolduc, C., and Schreibman, L. (2010). Pivotal Response Teaching in the Classroom Setting. Preventing School Failure, 54(4): 265–274. doi:10.1080/10459881003800743

Sumi, W.C., Woodbridge, M.W., Javitz, H.S., Thornton, S.P., Wagner, M., Rouspil, K., Yu, J.W., Seeley, J.R., Walker, H.M., Golly, A.M., Small, J.W., Feil, E.G., and Severson, H.H. (2013). Assessing the Effectiveness of First Step to Success: Are Short-Term Results the First Step to Long-Term Behavioral Improvements?. Journal of Emotional and Behavioral Disorders, 21(1): 66–78. doi:10.1177/1063426611429571

Vejnoska, S.A., Chan, J., Reith, S.R., Suhrheinrich, J., and Stahmer, A. (2015). Naturalistic Intervention in Classrooms: A Look at Classroom Pivotal Response Teaching. Autism Spectrum News, 7(3): 11. Full text

Walker, H., Seeley, J., Small, J., Golly, A., Severson, H., and Feil, E. (2008). The First Step to Success Program for Preventing Antisocial Behavior in Young Children: Update on Past, Current, and Planned Research. Report on Emotional and Behavioral Disorders in Youth, 8(1): 17–24.

Walker, H.M., Seeley, J.R., Small, J., Severson, H.H., Graham, B., Feil, E.G., Serna, L., Golly, A.M., and Forness, S.R. (2009). A Randomized Controlled Trial of the First Step to Success Early Intervention: Demonstration of Program Efficacy Outcomes in a Diverse, Urban School District. Journal of Emotional and Behavioral Disorders, 17(4): 197–212. doi:10.1177/1063426609341645

Woodbridge, M., Sumi, W., Yu, J., Rouispil, K., Javitz, H., Seeley, J., and Walker, H.M. (2014). Implementation and Sustainability of an Evidence-Based Program: Lessons Learned From the Prism Applied to "First Step to Success". Journal of Emotional and Behavioral Disorders, 22(2): 95–106. doi:10.1177/1063426613520456

Woodbridge, M.W., Sumi, W.C., Wagner, M.M., Javitz, H.S., Seeley, J.R., Walker, H.M., Small, J.W., Golly, A., Feil, E.G., and Severson, H.H. (2014). Does First Step to Success Have Long-Term Impacts on Student Behavior? An Analysis of Efficacy Trial Data.