Improving Autism Program Quality in Special Education Units: The Use of an APERS-based Model to Support Student Learning and Participation

Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age5-13
SponsorStockholm University

About this trial

This study assesses the effect of using the Autism Program Environment Rating Scale (APERS) as a tool for providing feedback, in-service training, and coaching to school staff in order to improve program quality in special education units (SEUs) for children with autism or related sociocommunicative challenges (SCCs). APERS is used in its culturally validated Swedish version (APERS-Primary-SE). Using a quasi-randomized parallel-group design, SEUs will be allocated to either an experimental (APERS+) or control (TAU) condition. In the APERS+ condition, school staff receive continuous and systematic feedback provided by trained coaches based on the initial APERS assessment. In the TAU condition, schools will also receive feedback based on the initial APERS assessment, but no continuous coaching.

It is hypothesized that the APERS based intervention will improve overall program quality for children with autism or related SCCs as compared to TAU. Additionally, we also expect the intervention to improve student functioning, students' individual goal attainment, students' perception of their schools, and teacher self-efficacy as compared to TAU.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Located within the Stockholm Region

To have one or more SEUs for preschool class, primary school, or middle school students

To be enrolled in a SEU in preschool class, primary school, or middle school

To have a documented formal community diagnosis of autism according to ICD-10, DSM-IV or DSM-5 or having related challenges with social communication and interaction as assessed by school staff and guardians.

Disqualifiers

None

Trial design

Design model

Parallel

Treatments tested in this trial

  • APERS+

    Behavioral

    APERS assessments with written and oral feedback. Creation of an action plan that is continuously followed up by specially trained coaches weekly or bi-weekly in coaching sessions designed to support the use of evidence-based practices in school settings. Half-day lecture about autism and related SCCs.

Treatment groups

200 Participants
are divided into 2 treatment groups
Group A: Experimental groupExperimental treatment 1 intervention
Group B: Control groupNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Change from baseline in autism program quality as assessed with the Swedish Autism Program Environment Rating Scale - Primary school (APERS-Primary-SE)

The APERS-Primary-SE is a rating scale designed to examine primary school program quality for students with autism or related sociocommunicative challenges in Sweden. It contains 10 domains including areas such as students' personal independence and competence, and challenging behaviors. The scale consists of 58 items rated on a five-point Likert scale (1= low quality, 5 = high quality) resulting in individual item scores, subdomain scores, domain scores, and a total score.

Time frame
Baseline and about 8 months from baseline

Secondary outcomes

1

Change from baseline in how students feel about their school as assessed with How I Feel About My School (HIFAMS)

The HIFAMS is a questionnaire designed to assess the happiness and subjective well-being of children in school. It will be completed by all participating children in the study. The questionnaire consists of 8 items where the child is asked how they feel about their school life. The items are scored using a three-point facial Likert scale (sad face, neutral face, happy face). The faces are converted into numerical scores (0-2).

Time frame
Baseline and about 8 months from baseline
2

Change from baseline in parent ratings on their child's bodily functions, activities, and participation and contextual factors as assessed with the International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism

The ICF Core Sets for Autism is a questionnaire where parents rate their child's functioning. It contains 37 items pertaining bodily functions, activities and participation as well as contextual factors that may affect the child's functioning. Responses are given on a Likert scale ranging from either 0 to 10 (individual factors) or -5 to 5 (contextual factors), where higher ratings indicate higher levels of functioning and/or participation.

Time frame
At baseline and 8 months follow-up.
3

Change in teachers' perceived self-efficacy in supporting students with autism using the Autism Self-Efficacy Scale for Teachers (ASSET)

The Autism Self-Efficacy Scale for Teachers is a questionnaire where teachers rate their perceived self-efficacy in supporting students with autism and related SCCs in their classroom. It consists of 28 items and is rated on a six-point Likert scale from 0 to 5. Higher ratings indicate higher self-efficacy.

Time frame
At baseline and 8 months follow-up.
4

Individual goal attainment as assessed with a Goal Attainment Scale (GAS)

The Goal Attainment Scale is a scale used to support, monitor and assess individual goal attainment in children with autism. Goals are created collaboratively by teachers and coaches at baseline and tailored to each child's individual needs and capacity. Goal attainment is assessed by coaches at follow-up on a five-step Likert scale, where 0 is baseline and 4 is exceeding goals.

Time frame
At baseline and 8 months follow-up

Other outcomes

1

Social validity as assessed with the Social Validity Scale

A scale designed to asses the social validity of the procedures, goals, and outcomes of the study by participating school staff and coaches. It consists of 12 items rated on a Likert scale from 0 to 5, where higher ratings indicate higher levels of perceived social validity.

Time frame
Rated at follow-up approximately 8 months after study start
2

Social responsiveness as assessed with the Social Responsiveness Scale 2 (SRS-2)

The SRS-2 is a scale designed to identify the presence and severity of social impairment within the autism spectrum and to differentiate it from difficulties associated with other conditions. Used in the current study to assess the level of social challenges for the participating children. The scale contains 65 items and is rated by the children's parents or guardians. Each item is rated on a 4-point Likert scale ranging from 1 to 4, where 1 is "not true" and 4 is "almost always true". Higher scores indicate more severe social impairment associated with autism.

Time frame
Baseline assessment

Sponsors and contacts

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Stockholm University

Lead sponsor

Karolinska Institutet

Collaborator

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