Development of a Social and Communication Intervention for Preschoolers with Autism

Principal Investigator: Rebecca Landa

RFA topic and goal:  Autism Spectrum Disorders, Development and Innovation Goal Two

Purpose:  Develop and document feasibility and promise of a social and communication curriculum, and guidelines for intervention materials, activities and instructional strategies for preschoolers with autism spectrum disorders (ASD) that can be feasibly implemented in authentic educational delivery settings. 

Setting:  Suburban public school district, central Maryland (Baltimore County Public Schools).

Population from which participants will be sampled: Racial/ethnic representation of Baltimore County Public Schools’ (BCPS) ASD preschool classes:  51% Caucasian; 1% American Indian; 39% African American; 5% Asian; 3% Hispanic.  Ages: 3 years, 0 months-5 years, 11 months.  Twenty-eight of these students are eligible for reduced cost/free meals.

Intervention to be developed: Interpersonal Synchrony and Communication curriculum (ISCC) supplement, lesson plans, and guidelines for selecting instructional materials and activities, engineering the environment to enhance social and communication development and generalization, and implementing Pivotal Response Training plus Interpersonal Synchrony instructional strategies, as well as a fidelity measurement system.   

Control or comparison condition:  In year 3, one inclusive and one non-inclusive ASD class (n=15 preschoolers; n=6 educators) in which the new intervention will not be implemented.

Primary research method:  Through an iterative process, the intervention will be developed in years 1, 2 and part of year 3.  During this time, the intervention will be implemented in two non-inclusive and one inclusive ASD preschool classes (9 educators, 30 children), permitting assessment of intervention feasibility and appropriate modifications.  Data collected from educators and children as well as input from educators, speech-language pathologists, parents, researchers, and administrators will contribute to the intervention development.  To assess promise in year 3, a comparison of educator practices and child social and communication behavior will be made between two classes in which the new intervention is implemented (6 educators, 15 children) and two in which it will not (6 educators, 15 children). 

Measures and key outcomes:  Educators:  Fidelity; Self-Efficacy Scale; Perceived Barriers Scale; data from analysis of transcribed discussions about barriers to feasibility and value of the intervention.  Children: ISC Curricular Goal Summary; Classroom-based Social Communication Performance; ADOS-G; Mullen Scales of Early Learning; Reynell Developmental Language Scales III; Imitation task; and Early Social Communication Scales.  Key outcomes: (a) evidence to support feasibility of the intervention accompanied by an analysis of required refinements identified through defining barriers to feasibility; (b) data indicating promise of the intervention to improve performance of preschoolers with ASD in authentic educational settings; and (c) a completed intervention manual (based on an iterative process). 

Data analytic strategy:  Descriptive analyses, paired t-tests, McNemar’s test, and random effects models will be used to assess change in educators’ fidelity and self-efficacy with increased experience with the intervention, and to assess whether educators trained in the intervention exhibit greater intervention fidelity than non-trained educators. Data will reveal whether the intervention is operating as intended.  Similar analyses will be used with child data to preliminarily assess whether children receiving the intervention make measurable social and communication gains.  In Year 3, similar statistical models (with classroom-level random effects) will be used to compare children receiving versus not receiving the intervention to examine the promise of the intervention.