RCT of TeachTown in Autism Support Classrooms: Innovation and Exnovation
Condition: Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      Computer assisted interventions are becoming very popular as an intervention strategy for
      students with autism. There is little data on how effective they are or how their
      implementation affects teachers' use of other evidence-based practices. The proposed study
      would be the first to examine these questions in a community setting.
    

Detailed description: 
      This study comprises a randomized controlled trial to examine 1) the effectiveness of
      TeachTown: Basics, one of the only evidence-based computer-assisted intervention (CAI)
      packages for students with autism; 2) the extent to which teachers implement TeachTown the
      way it was designed; 3) the effects of its use on other evidence-based practices; and 4)
      organizational and teacher variables that mediate changes in the use of evidence-based
      practices when TeachTown is introduced. While there has been a rush to take advantage of CAI,
      there is little research on whether it will result in better outcomes for student with
      autism, and be feasible or sustainable in community settings. While CAI has the potential to
      increase instructional time for students with autism, it may result instead in teachers
      reducing their use of other evidence-based practices, including the amount of interpersonal
      (as opposed to computer) instruction students receive. While the related constructs of
      exnovation, de-implementation and de-adoption have been used to describe this phenomenon for
      more than 30 years, they rarely have been systematically studied. The proposed study takes
      advantage of an ongoing rollout of TeachTown in the School District of Philadelphia.
      TeachTown includes a computerized instruction component, combined with offline, interpersonal
      instruction between the student and teacher. It is not known whether public schools have the
      resources to implement programs like this, regardless of their efficacy, or whether or how
      teachers will incorporate them into the instructional day. An especially important question
      is whether existing evidence-based practices are exnovated as TeachTown is implemented. To
      address these questions, we rely on our longstanding collaboration with the School District
      of Philadelphia, the 8th largest school district in the US. At the beginning of the school
      year, we will inventory relevant technology and observe how it is used in the District's 83
      kindergarten-through-second-grade autism support classrooms. We also will survey teachers and
      school administrators about expectations, support and rewards for using these technologies
      and attitudes, norms and self-efficacy regarding the use of these technologies. We then will
      use a waitlist-control randomized design to examine TeachTown's effects on student outcomes
      and use of other practices. We will unpack the impact of the implementation of TeachTown on
      existing evidence-based practices using direct observation and through qualitative
      interviews. The waitlist design allows the district to roll out the intervention to all
      classrooms, which is their intent. It also allows s to increase our sample to study
      moderators of sustainment of existing EBPs when a new technology is introduced. The proposed
      study would be one of the first to examine longitudinally the uptake of new technology for
      children with ASD in school settings, and the first to address use of CAI. Successful
      completion of this study will identify malleable targets for intervention to increase the use
      of CAI, should that appear warranted, while sustaining existing EBPs for children with autism
      in community settings.
    

Intervention name(s): TeachTown; Discrete Trial Training; Pivotal Response Training; Teaching in Functional Routines
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): TeachTown is an online program for students with autism that uses an applied behavior analysis framework to provide intervention in academic and pre-academic areas; Discrete trial training is a one-on-one didactic behavioral intervention in which the teacher or therapist uses specific behavioral methods based on principles of operant conditioning, to help students gain skills; Pivotal response training is a one-on-one child-lead behavioral intervention in which the teacher or therapist uses specific behavioral methods, leveraging the students interests, to help students gain skills; Functional routines are sets of chained behaviors that students are taught that help them complete and manage specific activities in the classroom
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment