Development of an Intervention to Enhance the Social Competencies of Children with Aspergerís/High Functioning Autism Spectrum Disorders
Co-Principal Investigator: Chris Lopata
Purpose: Students with high functioning autism spectrum disorders pose a significant challenge in education settings due to their unique patterns of strengths and weaknesses. Despite relative strengths in verbal and cognitive skills, there is a significant need for intensive and individualized educational programming. Social interaction impairments, communication impairments, and restricted, repetitive, and stereotyped patterns of interests, activities, or behavior have been linked to a range of school-based difficulties. At present, comprehensive school-based group interventions are lacking for students with high functioning autism spectrum disorders.
To address this need, researchers are adapting a manualized summer treatment program for use in a school setting to address the cognitive, communicative, social and behavioral needs of elementary school age students with high functioning autism spectrum disorder. A parent training and school-based consultation component will be adapted as well. The intervention targets (1) social skills, (2) face and emotion recognition, (3) interest expansion, and (4) interpretation of non-literal language and idioms. The purpose of this study is to adapt a summer treatment program for a school setting and document intervention feasibility.
Project Activities: The research team will use an iterative process to develop the intervention. In the first phase, input will be solicited from parents, school teachers and related service personnel on the core curriculum and instructional procedures and the usability and acceptability of the intervention materials. In the second phase, 4-week trials will be conducted to examine components of the intervention to assess whether they are procedurally feasible and to determine whether the components are functioning as intended. The intervention will be revised based on the data gathered during the two 4-week component feasibility trials and input from parent and school personnel. In the third phase, the research team will implement the 10 month intervention and assess treatment response and feasibility using fidelity data, acceptability ratings, and interview with school personnel and parents. The final phase will consist of the research team implementing the refined complete intervention. Content analyses will be used to analyze information from focus groups and meetings. Fidelity and feasibility measures will be used to monitor development of the intervention, document completion of prototype materials, and evaluate intervention fidelity. Studentís response to treatment will be assessed using social skills, social communication, and face and emotion recognition measures in order to inform curricular revisions during the feasibility trials. Repeated measures analysis of variance will be used to assess intervention related changes in parent measures and dependent-samples t-tests will be used to assess intervention related changes in teacher measures.
Products: The expected outcomes from this study include a fully developed intervention program including materials, products, instructional procedures, and a system for monitoring fidelity as well as published reports and presentations.
Setting: Participating students will be from New York school districts.
Population: Children with a high functioning autism spectrum disorder in grades 1-5 will participate. In Phase 2, six children and their parents will participate. It is anticipated that both the general education and special education teacher for each child (12 total) and other school related personnel (16 total) will participate as well. In Phases 3 and 4, twelve children will participate as well as their parents and teachers (both general and special education).
Intervention: An intervention for social and behavioral skills for children with high functioning autism spectrum disorders that was developed for use in a specialized setting will be adapted for use in a school setting. Core components of the intervention include (1) intensive social skills instruction, (2) face and emotion recognition, (3) interest expansion, and (4) interpretation of non-literal language and idioms. The intervention will be administered through small group instruction and by individual computer instruction. Each small group session will begin with a review of the rules, followed by direct instruction, modeling, role-playing, performance feedback, and identification of ways the skill can be used outside the group. School personnel will administer the intervention 2 to 3 days per week for a total of 60-90 minutes. Individual computer instruction will be structured around the school and studentís schedule and be administered approximately 60 minutes each week. A Daily Report Card will also be implemented by both teachers and parents in conjunction with the intervention containing 3 operationally defined target skills/behaviors.
Research Design and Methods: The project consists of four phases. In Phase 1, the first draft of the manual will be created. Monthly structured focus groups involving parents and school staff will be conducted by research team members to assess the anticipated needs, core curriculum and instructional procedures, views of model acceptability, and potential barriers to implementation and provide initial insight into overall feasibility. A classroom observation tool and surveys will be used to assess the process and outcome of the manual development. In Phase 2, feasibility trials of the different components of the intervention will take place. Feasibility will be evaluated using focus groups, interviews, and surveys, and fidelity data. The intervention will be revised based on the data gathered during the component feasibility trials. In Phase 3, a 10 month feasibility trial of the initial version of the complete intervention will be implemented. Feasibility in Phase 3 will be assessed using process and fidelity data reviewed monthly by the research team, as well as at bi-annual meetings with the school staff and parents. Acceptability and satisfaction data will also be collected using surveys as well as recommendations for procedural or curricular improvements. Changes in parent and teacher ratings will be assessed using a pre-test/post test design. will be a The initial version of the complete intervention will be revised based on the data gathered during Phase 3. Phase 4 will consist of another 10 month feasibility trial of the revised intervention. Feasibility in Phase 4 will be assessed using the same procedures as in Phase 3.
Control Condition: There is no control condition.
Key Measures: The intervention will be evaluated using a battery of commercial and non-commercial measures. Screening measures include Woodcock-Johnson III Tests of Cognitive Abilities-Extended Battery, Comprehensive Assessment of Spoken Language, and Autism Diagnostic Interview-Revised. Treatment sensitivity measures include Social Responsiveness Scale, Adapted Skillstreaming Survey, Skillstreaming Knowledge Assessment, and Diagnostic Analysis of Nonverbal Accuracy. Measures of fidelity and surveys will also be used.
Data Analytic Strategy: The data analysis will include both quantitative and qualitative analyses to inform revision of the intervention and outcome measures. Repeated measures analysis of variance will be used to assess intervention related changes in parent measures and dependent-samples t-tests will be used to assess intervention related changes in teacher measures.
Journal article, monograph, or newsletter
Church, B.A., Rice, C.L., Dovgopoly, A., Lopata, C., Thomeer, M.L., Nelson, A., and Mercado, E. (2015). Learning, Plasticity, and Atypical Generalization in Children With Autism. Psychonomic Bulletin and Review, 22(5): 1342–1348. doi:10.3758/s13423–014–0797–9
Lopata, C., Fox, J.D., Thomeer, M.L., Smith, R.A., Volker, M. A., Kessel, C.M., McDonald, C.A., and Lee, G.K. (2012). ABAS-II Ratings and Correlates of Adaptive Behavior in Children With HFASDs. Journal of Developmental and Physical Disabilities, 24: 391–402. doi:10.1007/s10882–012–9277–1
Lopata, C., Smith, R.A., Volker, M.A., Thomeer, M.L., Lee, G. K., and McDonald, C.A. (2013). Comparison of Adaptive Behavior Measures for Children With HFASDs. Autism Research and Treatment, 2013: 1–10. Full text
Lopata, C., Thomeer, M.L., Volker, M.A., Lee, G.K., Smith, T.H., Rodgers, J.D., Smith, R.A., Gullo, G., McDonald, C.A., Mirwis, J., and Toomey, J.A. (2013). Open-Trial Pilot Study of a Comprehensive School-Based Intervention for High-Functioning Autism Spectrum Disorders. Remedial and Special Education, 34(5): 269–281. doi:10.1177/0741932512450518
Lopata, C., Thomeer, M.L., Volker, M.A., Lee, G.K., Smith, T.H., Smith, R.A., McDonald, C.A., Rodgers, J.D., Lipinski, A.M., and Toomey, J.A. (2012). Feasibility and Initial Efficacy of a Comprehensive School-Based Intervention for Students With High-Functioning Autism Spectrum Disorders. Psychology in the Schools, 49(10): 963–974. doi:10.1002/pits.21649
Lopata, C., Toomey, J.A., Fox, J.D., Thomeer, M. L., Volker, M.A., and Lee, G.K. (2013). Prevalence and Predicators of Psychotropic Use in Children With High Functioning ASDs. Autism Research and Treatment. Full text
Lopata, C., Toomey, J.A., Fox, J.D., Volker, M.A., Chow, S.Y., Thomeer, M.L., Lee, G.K., Rodgers, J.D., McDonald, C.A., and Smerbeck, A.M. (2010). Anxiety and Depression in Children With HFASDs: Symptom Levels and Source Differences. Journal of Abnormal Child Psychology, 38(6): 765–776. doi:10.1007/s10802–010–9406–1
Putnam, S.K., Lopata, C., Fox, J.D., Thomeer, M.L., Rodgers, J.D., Volker, M.A., Lee, G.K., Neilans, E.G., and Werth, J. (2012). Comparison of Saliva Collection Methods in Children With High-Functioning Autism Spectrum Disorders: Acceptability and Recovery of Cortisol. Child Psychiatry and Human Development, 43(4): 560–573. doi:10.1007/s10578–012–0284–3
Thomeer, M.L. (2012). Collaborative Development and Component Trials of a Comprehensive School-Based Intervention for Students With High-Functioning Autism Spectrum Disorders (HFASDS). Psychology in the Schools, 49(10): 955–962. doi:10.1002/pits.21648