Clinical trial NCT03634761: Early Intervention and Autism: Transformation From Research to Practice Through a Competency Based Model
Official title: Early Intervention and Autism: Transformation From Research to Practice Through a Competency Based Model
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Autism Spectrum Disorder
Keywords: Program Quality
Intervention Setting
Autism
Lead sponsor: Stockholm University
Sponsor class: OTHER
Collaborators: name: Karolinska Institutet
First posted: 2018-08-16
Enrollment: 17
Sex: ALL
Minimum age (years): 2
Maximum age (years): 5
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
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.
Primary purpose: OTHER

Brief 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.

Eligibility criteria: Inclusion Criteria:

* Autism diagnosis
* Receiving comprehensive program/EIBI implemented in preschool setting with supervision from habilitation center

Exclusion Criteria:

-

Primary outcomes:
measure: Change in overall program quality measured by the Autism Program Environment Rating Scale (APERS-P-SE)
timeFrame: Baseline and follow-up (about 9 months from baseline)
Secondary outcomes:
measure: Ethics, Values and Allegiance (EVA)
timeFrame: Baseline and follow-up (about 9 months from baseline)
measure: Evidence Based Practices (EBP)
timeFrame: Baseline and follow-up (about 9 months from baseline)
measure: Autism Knowledge Questionnaire (AKQ)
timeFrame: Baseline and follow-up (about 9 months from baseline)
measure: Self-Efficacy and Stress Questionnaire (SESQ)
timeFrame: Baseline and follow-up (about 9 months from baseline)
measure: Goal Attainment Scale (GAS)
timeFrame: Follow-up about 9 months after onset of study
measure: Clinical Global Impression-autism (CGI-AUT)
timeFrame: Baseline and follow-up (about 9 months from baseline)
measure: Children's Engagement Questionnaire (CEQ)
timeFrame: Baseline and follow-up (about 9 months from baseline)
measure: Vineland Adaptive Behavior Scales - Second Edition (Vineland-II) - Teacher ratings
timeFrame: Baseline and follow-up (about 9 months from baseline)
Other outcomes:
measure: Social validity scale
timeFrame: Follow-up about 9 months after onset of study
Locations:
city: Stockholm
country: Sweden
facility: BanyanCenter
city: Stockholm
country: Sweden
facility: Autismcenter för Små Barn
Study officials:
References: