Contextual Coaching Versus Training Workshop for Assistants in Special Education.

Study Overview
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Brief Summary
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Special Need Assistants/paraprofessionals serve an essential role in special education to support children with multiple disabilities, but they often lack adequate training and supervision. The study aims to examine the effects of the coaching program for assistants compared to a workshop outside working hours and evaluate the outcomes in students and assistants. The second aim is to measure fidelity implementation of coaching practices and if the intervention was participation-based.

Detailed Description
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This study addresses the training needs of assistants to minimize participation barriers of the students. The schools will be assigned to one of two groups: both groups will receive a 10 hours training workshop; only the intervention group will receive coaching one-to-one. The duration and number of coaching sessions will depend on the caregivers' time available, daily routines, and goals. Coaching sessions will be recorded for the assessment of treatment fidelity.

Official Title
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Improving Students' Participation in Daily Living Skills Through Contextual Coaching One-on-one for Special Needs Assistants.

Conditions
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Disabled Persons, Caregiver

Intervention / Treatment
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* Behavioral: contextual one-on-one coaching
* Behavioral: Trainig workshop


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria assistants: Special Need Assistant of students between 4-21 years of age. Speak, read and comprehend Spanish. Be available for workshop and one-on-one coaching. Able to verbalize changes in their own performance or their students' participation. Written consent. Exclusion Criteria assistants: Have no students involved in the program. Inclusion Criteria students: Present difficulties in Activities of Daily Living (ADLs). Have an assistant involved in the study. Informed consent signature (parents or legal tutors). Exclusion Criteria students: Independence in activities of daily living. 70 or more points in the Care Dependency Scale for Pediatrics (CDS-P).
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This study is a quasi-experimental pretest-posttest design. Repeated measures on participants in both arms (as in an RCT) enable assessment of both within-person changes over time and between-arm differences.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Trainig workshop and Coaching one-on-one<br>Ten-hour training workshop that was divided into three sessions outside working hours. Coaching one-on-one in the daily routines and natural environment. | Behavioral: contextual one-on-one coaching<br>* Training workshop and coaching one-on-one<br>|
| Active Comparator: Trainig workshop<br>Assistants receive ten-hour training workshop that was divided into three sessions outside working hours. | Behavioral: Trainig workshop<br>* Ten-hour training workshop.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in The Canadian Occupational Performance Measure (COPM). Students | Caregivers identify activities that are problematic for the child. The caregiver rates the child's performance and satisfaction for each participation goal on a 10-point scale, (1=unable to perform, unsatisfied; 10= performs exceptionally well, extremely satisfied). Differences in scores pre-and post-intervention for both performance and satisfaction are determined independently. A 2-points change in these values is considered clinically meaningful. | baseline- 3 month after intervention | 
| Change in Goal Attainment Scaling (GAS). Assistants. | Clients identify goals and rate their performance on a 5-point Likert scale ranging from -2 (much less than expected) to +2 (much better than expected). In the baseline, clients can score -1 or -2, and the score 0 is the expected level of success. The 4-point Likert scale is used for quantifying importance (ranging from 0= nothing important to 3= really important) and difficulty (ranging from 0= easy to 3= very difficult). Afterwards, the goal's weight is calculated (importance*difficulty). A mathematical formula allows computation to T-score with a mean of 50 and a standard deviation of 10. | Baseline - 3 month after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Coaching Practices Rating Scale. | The Coaching Practices Rating Scale was utilized as a secondary outcome to measure the fidelity of coaching. Its 14 items are based on adults' learning characteristics and coaching practices to determine how the coach use these practices, on a 5-point Likert scale. The scale accepts the rating through video-tapes and has a high degree of construct validity and internal consistency. | 12 month after intervention | 
| Natural Environments Rating Scale (NERS) | The NERS describes eight categories: 1) setting; 2) activity; 3) type of activity; 4) engagement of child; 5) activity leader; 6) materials; 7) role of the caregiver; 8) the role of the professional. If there is no child-centred activity, grading is discontinued for the remaining categories. Only the last four categories are rated for an overall score that differentiated traditional or participation-based services. | 12 month after intervention | 
| Change in learning. Social validity | Paraprofessionals were invited to reply to a writing questionnaire. This survey collected information about their training preferences and satisfaction with received training. | 6 month | 
| Change in transfer and generalization of learning | All paraprofessionals were invited to reply to a semi-structured interview through a phone. This interview collected information about their current employment, the degree in which they had been able to put into practice the skills learned and the challenges for their professional development. | 19-20 mounths after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Coaching, Occupational therapy, Self-care skills, Special Need Assistants/paraprofessionals