Early Intervention and Autism: Transformation From Research to Practice Through a Competency Based Model
Condition: Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      This study evaluates the effect of a competency based model on program quality in Swedish
      preschools for Children with autism spectrum disorder (ASD). Half of the participating
      preschools will receive "treatment as usual" (Early Intensive Behavioral Intervention (EIBI)
      provided to a Child with ASD in the preschool, supervised by an external supervisor from a
      habilitation center), while the other half will receive the above as well as, in-service
      training and monthly on-site coaching sessions also involving preschool staff other than the
      paraprofessional (competency based model). It is hypothesized that the competency based model
      will improve program quality, child's engagement, preschool staff knowledge, allegiance and
      self-efficacy compared to the comparison group.
    

Detailed description: 
      Almost all children in Sweden between two and five years attend preschool including children
      with Autism spectrum disorder (ASD). High quality and structured early intervention programs
      grounded in the principles and procedures of applied behavior analysis have been found in
      numerous research studies and reviews to significantly improve developmental outcomes,
      adaptive behaviors and learning outcomes of preschool children with ASD.

      A prerequisite of which is a high quality learning environment that includes both the
      physical set-up, learning climate and competence of staff. The primary purpose of this
      project is to improve program quality for preschool children with ASD through a competency
      based model grounded in ecological systems theory sustainable over time and applicable within
      the Swedish service support system. In total approximately 16 preschools will participate,
      half of which will receive "treatment as usual" EIBI to a Child with ASD in the preschool,
      supervised by an external supervisor from a habilitation center), while the other half will
      also receive obtain in-service training and monthly on-site coaching through habilitation.
      Involved habilitation specialists will obtain in-service training prior to the onset of the
      study on how to use the Autism Program Environment Rating Scale (APERS), the basic tenets of
      coaching based on the concept of reflective and collaborative dialogues in which the
      preschool teachers knowledge of the child and context are taken into account.

      It is hypothesized that the competency based model will improve program quality, child's
      engagement, adaptive behavior, increase preschool staff knowledge, allegiance and
      self-efficacy compared to the comparison group only receiving supervision in implementing a
      comprehensive program.
    

Intervention name(s): Competency based model; Comprehensive program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Qualified Learning course and workshop to preschool staff combined with monthly on-site coaching at preschool sites to improve overall intervention setting quality and use of evidence bases practices, provided by external expert from habilitation center.; Comprehensive program of EIBI for Children with ASD supervised by external expert from habilitation center (treatment as usual)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study used a staggered design where three waves of preschools were recruited and assigned to either the experimental or the control group. The first wave of preschools (n = 6) were divided into two groups, where group assignment was made to make the two groups comparable in regards to three variables: supervisors' experience of comprehensive programs, APERS-P-SE baseline scores, and children's adaptive behavior (Vineland II ratings). Originally, the plan was to then randomize which of these two matched groups would be the experimental group, but because of unforeseen circumstances one of the groups was made the control group because there was a lack of resources for one of the preschools to be able to be in the experimental group. However, for the following two waves of recruitment, the participating preschools (n = 11) were divided into matched pairs (based only on supervisor experience), which were then randomly assigned either as the control or the experimental group.
Masking: None (Open Label)
Primary purpose: Other
Keywords: Program Quality; Intervention Setting; Autism