Clinical trial NCT06309160: COMPASS Across Settings (CAST) for Improving Transition Outcomes for Students With ASD
Official title: COMPASS Across Settings (CAST) for Integrating School, Home, and Community Services and Improving Transition Outcomes for Students With ASD
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Autism
Autism Spectrum Disorder
Autistic Disorder
Lead sponsor: Ball State University
Sponsor class: OTHER
Collaborators: name: University of Toledo
name: Indiana University
First posted: 2024-03-13
Enrollment: 297
Sex: ALL
Minimum age (years): 16
Maximum age (years): 99
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Pre-post; randomized control
Primary purpose: TREATMENT

Brief summary: Purpose: The purpose of this project is to develop and test the COMPASS \[Collaborative Model for Competence and Success\] Across Settings (CAST) intervention to enhance the goal setting and attainment skills of autistic youth. Despite federal education law mandating transition services as part of the Individualized Education Program (IEP) for ensuring good outcomes for students with disabilities, current educational practices have been unable to demonstrate that autistic students experience positive postsecondary outcomes. There are existing, evidence-based interventions aimed at supporting positive outcomes for these students. However, these interventions have not systematically provided coaching support to the caregivers, students, and employment specialists. To address these issues, CAST will integrate three evidence-based interventions for supporting student transitions while providing this critical coaching support. By doing so, CAST aims to align the priorities and goals of interventions across home, school, and community settings to better support positive postsecondary outcomes for autistic students.

Detailed description: Project Activities: The research team will use an iterative approach for integrating the three interventions into CAST, obtaining feedback from focus groups and stakeholder members along the way, and running a field trial after development. The research team will then conduct a randomized controlled trial (RCT) of CAST to examine postsecondary outcomes at both 3 months and 1 year after high school. Social network analysis will be used to understand the integration of services and a cost analysis will be conducted.

Products: This project will result in a fully developed intervention, CAST, for improving IEP and postsecondary outcomes of autistic students. The project will also result in peer-reviewed publications, information on the costs of CAST implementation, an updated intervention manual with fidelity checklists, and other dissemination products aimed at stakeholders.

STRUCTURED ABSTRACT

Setting: This project will take place in public high schools in Indiana.

Sample: Approximately 38 administrators, special education teachers, caregivers, pre-employment transition specialists, and autistic youth will participate in focus groups and interviews in the first year. The field test in year 2 will include five autistic youth and their parents, five classroom special education teachers, and five employment transition specialists. Approximately 140 participants (40 autistic youth and young adults, 40 caregivers, 40 special education teachers, and 20 pre-employment specialists who serve autistic youth) will participate in the pilot RCT in year 3.

Intervention: CAST will integrate three evidence-based interventions- COMPASS, C-HOPE, and COMPASS-T. COMPASS is the original intervention designed for preschool and elementary age students. COMPASS-T is the adaptation of COMPASS for transition-aged youth. Lastly, C-HOPE is based on COMPASS and is a parent-mediated intervention designed to decrease child problem behavior, increase parent competency, and decrease parent stress. CAST will begin with an initial joint session with the student, caregiver, special education teacher, and pre-employment transition specialist that allows for discussion on the student's postsecondary goals, preferences, frustrations, challenges, and strengths related to social skills, adaptive/self-management, communication, problem behaviors, learning skills, and sensory sensitivities and preferences. This discussion will pinpoint critical social, communication, and work behavior/learning goals related to postsecondary goals and inform the intervention plans that are generated for each goal. Following this initial consultation, there will be four additional 1-hour sessions that incorporate evidence-based coaching, provided by the investigators, including performance feedback monitoring and instructional support. Each session is standardized and allows for assessment of student progress and intervention modification/self-reflection on the implementation of the intervention plans.

Research Design and Methods: For the year 1 development activities, the research team will conduct focus groups with administrators, special education teachers, parents, students, and pre-employment transition specialists about how to integrate plans and services across settings. The research team will then conduct a field test of CAST in year 2, making further revisions. In year 3, they will use a mixed methods design using a small RCT and network analysis, oversampling African American students and students from rural areas, to evaluate CAST for improved postsecondary outcomes in employment, training, and education. The secondary aims of the project are to obtain (a) information on how well CAST improves integration and alignment of services across settings and thus student IEP and postsecondary outcomes; (b) information on feasibility, usability, and fidelity; and (c) estimates of costs.

Control Condition: Students in the control condition will receive services as usual.

Key Measures: The primary outcome data will be student goal attainment (GAS) of IEP goals and postsecondary goals. IEP goal attainment is assessed using psychometric equivalence goal attainment scaling (PET-GAS). Postsecondary outcomes will be assessed by parent report of attainment in goals (such as enrolling in a training or college program and living independently). Additional measures completed by all CAST participants (caregivers, students, special education teachers, and pre-employment specialists) include assessment of transition plan quality, organizational connectedness, and fidelity assessments.

Data Analytic Strategy: Focus groups and interviews will be recorded, transcribed, checked for accuracy, and analyzed using a consensual coding technique that will be used to provide a multi-dimensional picture for refining CAST. For the field test, the research team will use a dependent sample t-test to examine whether there is a significant improvement in GAS scores at the end of the year and whether there is a change in students' postsecondary outcomes from end of high school to 3 months out from high school. For the RCT, the research team will use a multilevel model on GAS scores at the end of year and postsecondary outcomes at both post-school time points. Pearson correlations will be used to examine associations in student outcomes and intervention fidelity measures with the CAST participants. Social network analysis will be used to understand integration of services.

Cost Analysis: For the cost analysis, individual ingredients associated with CAST will be identified through a discussion with participants, administrators, and other stakeholders. The costs of each ingredient will then be determined through a review of official records, where possible. Using these various sources, the total cost of implementation will be calculated.

Eligibility criteria: Inclusion Criteria:

* Students with verified autism and IEPs that designate services for autism
* Caregivers of students with autism
* Special education teachers of students with autism
* Pre-employment specialists of students with autism

Exclusion Criteria:

* Not planning to move or leave their job over the school year

Primary outcomes:
measure: Goal Attainment of IEP progress (Ruble et al., 2012; 2018).
timeFrame: Outcomes are assessed at the end of the school year (9 months from start of intervention)
measure: Attainment of Postsecondary Goals (Ruble et al., 2019)
timeFrame: Once a year (3 months following school graduation)
Secondary outcomes:
measure: Fidelity Assessment of Initial CAST consultation (Ruble et al., 2018)
timeFrame: One time after the initial consultation (within 2 months of the start of the school year).
measure: Fidelity Assessment of CAST Coaching (Ruble et al., 2018)
timeFrame: At each coaching session (four timepoints) from fall through spring of school year (about every 4-6 weeks following the initial consulation)
measure: Organizational Connectedness
timeFrame: At 2 time points; start of the intervention and at the end of the intervention (over a 9 month period or school year)
measure: Transition Plan Quality (Ruble et al., 2019)
timeFrame: Once per year; at the end of the school year
Other outcomes:
Locations:
city: Muncie
country: United States
facility: Ball State University
state: Indiana
Study officials:
References: