Project Activities
The research team examined effects of EA-ASD using a cluster randomized controlled trial to determine teacher fidelity and child language, communication, cognitive, and social outcomes over time. Follow-up assessments into the following school year examined sustainability of impacts.
Structured Abstract
Setting
The research took place in public preschool classrooms in Maryland, Delaware, Pennsylvania, and Minnesota, representing rural, suburban, and urban settings, diverse racial/ethnic groups, and diverse socio-economic income levels.
Sample
Participants included 62 teachers (early childhood educators and special education teachers) and 159 children with ASD ages 33 months to 5 years.
The EA-ASD instruction targets the learning challenges of ASD and cognitive development. The goals are taught using Meaning-Enhancement and Naturalistic Developmental Behavioral Intervention strategies, which blend evidence-based principles and approaches from applied behavior analysis and the developmental sciences. EA-ASD is intended to be implemented in natural settings (in this case, group-based classroom contexts). The professional development program for EA-ASD consists of workshops and explicit job-embedded coaching, with the aim of helping teachers implement the EA-ASD intervention as intended.
Research design and methods
A cluster randomized controlled trial design was used to evaluate the efficacy of EA-ASD with randomization at the school level. Teachers in the EA-ASD intervention condition received the EA professional development (PD) program, with interactive workshops as well as job-embedded coaching. Teachers in the control condition attended a 5-day PD workshop unrelated to EA-ASD. A new cohort of teachers and their students enrolled each of the implementation years. Child behaviors were coded from classroom observations at pre-training, training months 2 and 6, and post-training to assess intervention effects. Testing at pre- and post-intervention assessed the effect of EA-ASD on distal measures of children's language, communication, cognitive, and social development. Teacher fidelity of implementation data were obtained at pre-training; training months 2, 4, and 6; post-training; and, to assess sustainability, month 2 of the following school year.
Control condition
Teachers in the comparison condition received non-EA-ASD PD workshops but no training or coaching related to the EA-ASD intervention.
Key measures
Primary child outcome measures included the Mullen Scales of Early Learning Visual Reception subscale to assess cognitive skills; the Peabody Picture Vocabulary Test and Expressive One-Word Picture Vocabulary Test to assess language (vocabulary); and the Early Social-Communication Scales (Joint Attention tasks only)and Motor Imitation assessment for social skills. A secondary outcome measure, the Pervasive Developmental Disorder Behavior Inventory, was completed by parents and teachers to assess children's autism-related behaviors and problem behaviors. Other proximal measures included production of the following child behaviors during classroom instruction: peer-to-peer engagement, directed communicative verbalizations, imitation, joint attention, and gestures. Teacher fidelity of EA-ASD intervention implementation was coded from videotapes collected monthly. Teachers also completed forms to indicate their frequency of intervention use and their satisfaction with and feasibility of the intervention. Coach fidelity was coded from audio recording of the training sessions using a checklist.
Data analytic strategy
The research team examined the effect of EA-ASD using hierarchical linear models (HLM) to compare outcomes of children in the EA-ASD and comparison conditions. This 3-level model, with students clustered within classrooms and classrooms within schools, controlled for baseline student characteristics that were found to differ significantly between groups. An analysis of moderating variables was conducted using HLM and path analyses with structural equation models. Fidelity data were analyzed descriptively and used to investigate associations with outcomes and determine which practices were similar or different across conditions.
Key outcomes
The main findings of this study, as reported by the principal investigator, are as follows:
- Teachers randomized to the EA-ASD intervention group quickly learned to implement the intervention with high fidelity and sustained high levels of fidelity of implementation into the following school year.
- Children receiving the EA-ASD intervention showed significantly greater improvements in motor imitation than children whose teachers were in the control group. This was true on proximal measures of motor imitation obtained during classroom observation as well as distal measures of motor imitation conducted by an unfamiliar examiner at the beginning and end of the school year.
- Children receiving the EA-ASD intervention showed significantly greater improvement in joint attention (social attention sharing) during classroom activities than children whose teachers were in the control group.
- Children receiving the EA-ASD intervention showed significantly greater improvement in initiating interactions with peers during classroom activities than children whose teachers were in the control group.
People and institutions involved
IES program contact(s)
Products and publications
ERIC Citations: Find available citations in ERIC for this award here.
Project website:
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Supplemental information
Pre-registration site: https://clinicaltrials.gov/
Publicly available data: Researchers interested in obtaining access to the database should contact the PI, Rebecca Landa.
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