Development and Pilot Testing of the Students with Autism Accessing General Education (SAAGE) Model
Co-Principal Investigators: Cynthia Anderson (Appalachian State University) and Rose Iovannone (University of South Florida)
Purpose: This project will develop a comprehensive intervention to increase the quality of educational services and access to inclusive settings for students with co-occurring autism spectrum disorder (ASD) and intellectual disability (ID) in elementary school. Existing support systems in many schools do not sufficiently meet the needs of these students, and there is a wide gap between what is known from research regarding best practices and current educational practices. This intervention will be designed to reduce that gap to improve social and academic outcomes for students with ASD and ID.
Project Activities: In Year 1 of this project, researchers will conduct focus groups with stakeholders and obtain feedback from experts in the field to refine the initial modules and develop the complete and comprehensive Students with Autism Accessing General Education (SAAGE) intervention as well as all required implementation materials. In Year 2, feasibility testing and the assessment of parent and teacher satisfaction with the intervention will comprise the last stages of refining the model and finalizing implementation measures. In Year 3, researchers will conduct a pilot study to assess the promise of the intervention using a randomized controlled trial.
Products: The products of this project will include a fully developed intervention, SAAGE, along with companion training materials, modules, and manuals that will improve educational services and access to inclusive settings for students with autism spectrum disorder and co-occurring intellectual disability. In addition, products will include peer-reviewed publications and presentations, including outreach to districts and schools.
Setting: This research project will be conducted in elementary schools in New York, North Carolina, and Florida.
Sample: The sample for assessing feasibility and satisfaction of the intervention will consist of three to five students with ASD and ID, along with their intervention teams (approximately two educators per student) and the students' parents at each of the three sites. The pilot study will be conducted with 12 schools and include a sample of approximately 24 students with ASD and ID and 48 teachers.
Intervention: SAAGE includes professional development on identifying goals for individual students, selecting appropriate practices and teaching strategies, systematically monitoring student progress, and adjusting and tailoring strategies as student skills develop. SAAGE uses practice-based coaching and fosters collaborative school teams to build both school and individual capacity in the support of students with ASD and ID in elementary schools. Coaches assigned to each school help identify the SAAGE teams and guide them through modules focused on the core features of ASD and ID and the evidence-based practices emphasized by SAAGE. The SAAGE team is responsible for identifying students, reviewing student goals, ensuring each student is meeting social and academic goals, and monitoring progress for each student. The team ensures that students who are not making adequate progress receive additional day-to-day support.
Research Design and Methods: In Year 1, researchers will develop and refine the SAAGE intervention using feedback received from expert review and focus groups with stakeholders. In Year 2, researchers will implement the intervention with approximately 9-15 students and 18-30 teachers to collect feasibility and acceptability data. In Year 3, researchers will conduct a small cluster randomized controlled trial in 12 schools with approximately 24 students with ASD and ID and 48 teachers from those schools.
Control Condition: Schools in the control condition will be considered an enhanced services-as-usual group because they will receive the intervention manual for reference and in-service training on the topic of ASD, but no other services or intervention supports.
Key Measures: Eligibility for participation in the pilot will require a diagnosis by an expert in ASD and ID as well as results from the following: Autism Diagnostic Observation Schedule, the Stanford-Binet Intelligence Scale—5th Edition, and the General Adaptive Composite on the Adaptive Behavior Assessment System—2nd Edition. Researchers will use fidelity checklists and The Usage Rating Profile to examine usability, feasibility, social validity, and sustainability of the intervention. Costs associated with the intervention will be measured using the Cost Inventory for School-Based Mental Health Services. Distal student outcomes will be measured using the Developmental Disability—Clinical Global Assessment Scale, Social Skills Improvement System, Children's Yale-Brown Obsessive-Compulsive Scales, Academic Engaged Time, Self-Directed Scale, and the amount of time students spend in general education.
Data Analytic Strategy: Qualitative data analysis techniques will be used in Year 1 for focus group and expert feedback. Descriptive analyses of fidelity and implementation will be conducted in Years 2 and 3 and compared across years. Exploratory analyses will be conducted to examine trends in student performance using a linear mixed model to account for repeated measures and the nested structure of these data. Linear mixed models for repeated measures will be fit to assess the overall effect of the intervention on distal student outcomes.