The Development of an Empirically Based Adaptation and Training Model for Intervention Scale Up of Classroom Pivotal Response Teaching (CPRT)
Purpose: The purpose of this project is to develop an empirical method for adapting an evidence-based practice (EBP) for individual students and settings and to develop and innovative distance training and coaching model focused on key ingredients of an EBP for students with autism spectrum disorders (ASD). There are multiple evidence-based practices (EBPs) available for students with ASD that teachers can select from; however, teachers report insufficient access to effective training and data-based recommendations for adaptation of these practices. This project will address these needs through the planned development work.
Project Activities: The researchers will iteratively develop an empirically-based method for individualizing Classroom Pivotal Response Teaching (CPRT), an interactive decision tree, and an innovative educator training designed to support successful scale up of CPRT. Two methods of training will be compared to inform optimal methods of distance training and contribute to the literature. The project will be conducted in collaboration with an advisory board of educators and paraprofessionals. The development will also include usability and feasibility testing and a culminating pilot study.
Products: Products include a fully developed decision tree and distance training and coaching model for implementing EBPs for students with ASD. Additional products include a project website, cost analysis and cost effectiveness reports based on data collected in the pilot. The project will also result in peer-reviewed publications and presentations as well as additional dissemination products that reach education stakeholders such as practitioners and policymakers.
Setting: The research will take place in public preschool and elementary school classrooms serving students with ASD.
Sample: The sample for the pilot project will include 20 teachers and the paraprofessional staff in their classrooms and 20 students with ASD (ages 3–11 years).
Intervention: The CPRT interactive Decision Tree Tool will help teachers adapt CPRT key components to the needs of their students. The Decision Tree Tool will support individualization of components based on student characteristics, learning goal and teaching activity, which will result in personalized data sheets and fidelity of implementation checklists. CPRT Distance Training will focus on teaching key ingredients of CPRT utilizing adult learning strategies and new methods of web-based interactive training and coaching. Interactive web-based training tools and immersive technology will be used to in a distance learning program that will include didactic training and coaching to facilitate scale up of CPRT.
Research Design and Methods: The project will be conducted in 4 phases. In phase 1, researchers will conduct an analysis of educator use of CPRT with students with ASD from a recent randomized trial to identify components associated with improved student outcomes and how outcomes are mediated by characteristics of the student, learning goals and teaching activity. In phase 2, researchers will use an iterative process to develop an evidence-based, interactive decision tree based on phase 1 results. In phase 3, researchers will develop the distance learning materials and procedures. The final fourth phase will include a pilot study of the decision tree and training materials in a small randomized trial.
Control Condition: In the pilot study, distance training and coaching will be compared to a combination of in-person training and distance coaching to determine if in person contact facilitates the coaching relationship and therefore uptake and sustainment of the intervention.
Key Measures: The teacher measures include a measure of fidelity of CPRT; feasibility, usability and engagement in training and the CPRT decision tree; and frequency of use of CPRT. The student measures include progress on identified goals (Goal Attainment Scaling); adaptive behavior (Vineland Adaptive Behavior Scales– II), and challenging behavior and attendance (administrative records). Person-level cost data will be collected for each study participant.
Data Analytic Strategy: Researchers will use multilevel modeling and latent profile analysis to examine the key ingredients of CPRT and their relationship to student outcomes. Analyses of variance and t-tests will be used to examine differences between training models in the pilot study. Cost effectiveness analysis on person-level cost and effect data will be conducted using net benefit regression.