Implementation of a multi-family autism transition program in the high school setting.

LAY ABSTRACT: Transitioning Together is an intervention that supports families of adolescents on the autism spectrum as they prepare for the transition to adulthood. While it has been delivered successfully and shown to result in positive outcomes for families in the university setting, questions remain about whether and how well it can be widely provided to families in real-world settings such as high schools. In this study, we analyzed predictors, facilitators, and barriers to providing Transitioning Together to families at 30 high schools across three US states, all of which received training from a team of researchers to deliver this intervention. Our findings highlight struggles and successes with real-world use of the intervention. Seventeen of the 30 schools were successful in providing Transitioning Together to families. Schools who had higher community socioeconomic status, higher quality family involvement, and higher quality transition planning programming before changing anything for this study were much more likely to provide this new intervention to families. Schools who used the intervention were mostly able to deliver it as designed and received positive feedback from families who participated. Common parts of the intervention that schools struggled with most included following the structure of the sessions, including group problem-solving and dialogue in the sessions, and collecting feedback from families. Future research is needed to learn how to make it even easier for public high schools and other service systems to provide this intervention to families, in a way that also maximizes its effectiveness and accessibility for historically underserved autism spectrum populations.

Patterns in reporting and participant inclusion related to race and ethnicity in autism intervention literature: Data from a large-scale systematic review of evidence-based practices.

LAY ABSTRACT: Researchers who study autism-related interventions do a poor job reporting data related to the race and ethnicity of autistic individuals who participate in their studies, and of those who do report these data, the participants are overwhelmingly White. This is problematic for many reasons, as we know little about how interventions are meeting the needs of culturally and linguistically diverse populations, and we assume that interventions are effective for all when they have been developed and validated primarily with and for White children. This study examined the reporting patterns of autism intervention researchers whose work was included in a large-scale systematic review of the intervention literature published between 1990 and 2017. We found that only 25% of studies (out of 1,013 included in the review) included data related to the race and ethnicity of their participants, with minimal change in reporting patterns across the years. In studies with reported data, White participants had the highest rate of participation, with a large gap between the next highest rates of participation among Hispanic/Latino, Black, and Asian participants. Other race and ethnicity groups had very low representation. This study includes additional analyses which examine how the reporting patterns and the inclusion of racially and ethnically diverse participants varies across study types, interventions, and outcome areas. Reporting this data is merely a starting point to begin to address the many disparities in autism-related healthcare, education, and research practices, and this article includes broader implications and next steps to ensure the field becomes more equitable and inclusive.

Use of the Children's Communication Checklist-2 in School-Aged Students with Autism: A Psychometric Analysis.

Measurement of social-pragmatic communication skills is essential for clinicians and researchers working with school-aged children on the autism spectrum. Many measures of these skills require time-intensive training and coding that is impractical for clinical assessment settings. Using a sample of 299 elementary school children (M = 8.6 years, sd = 1.7) with autism whose teachers completed the Children's Communication Checklist-2, we evaluated the psychometric properties of the CCC-2, a commonly used measure of social-pragmatic skills in order to assist researchers and clinicians in identifying the utility of this measure related to their assessment needs. Our results indicate strong psychometric properties for the CCC-2 with this population and a 3-factor model fit: Structural Language, Pragmatic Communication, and Pragmatic Social. Evidence of racial/ethnic bias was found for the structural language factor. Clinical recommendations are provided for using the CCC-2 with students with autism as reported by teachers.

Educational Interventions for Children and Youth with Autism: A 40-Year Perspective.

Commemorating the 40 th anniversary of the Diagnostic and Statistical Manual (DSM) III, the purpose of this commentary is to describe school-based and school-relevant interventions and instructional approaches for children and youth with autism that have been developed and employed during that time period. The commentary begins with a brief description of foundational research that provides an historical context. Research themes shaped by science, ethics, social policy, and the changes in the DSM provide an organization for describing the evolution of intervention and instructional practices over the four previous decades. The commentary concludes with a discussion of school-contextual variables that influence implementation and the promise of the "iSciences" for closing the research to practice gap in the future.

Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review.

This systematic review describes a set of practices that have evidence of positive effects with autistic children and youth. This is the third iteration of a review of the intervention literature (Odom et al. in J Autism Dev Disorders 40(4):425-436, 2010a; Prevent School Fail 54(4):275-282, 2010b; Wong et al. in https://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/imce/documents/2014-EBP-Report.pdf ; J Autism Dev Disorders 45(7):1951-1966, 2015), extending coverage to articles published between 1990 and 2017. A search initially yielded 31,779 articles, and the subsequent screening and evaluation process found 567 studies to include. Combined with the previous review, 972 articles were synthesized, from which the authors found 28 focused intervention practices that met the criteria for evidence-based practice (EBP). Former EBPs were recategorized and some manualized interventions were distinguished as meeting EBP criteria. The authors discuss implications for current practices and future research.

Student, Educator, and Parent Perspectives of Self-Determination in High School Students with Autism Spectrum Disorder.

Self-determination refers to an individual being a causal agent in their daily activities, including the ability to express their own needs, interests, and wants, make choices, and set goals. Self-determination is critical during adolescence and has been linked to positive educational outcomes in individuals with disabilities. Few studies have characterized the measurement of self-determination in adolescents with autism spectrum disorder (ASD). The purpose of the current study was to (a) examine the agreement across the American Institutes for Research Self-Determination Scale (Wolman et al., AIR Self-determination scale and user guide. Palo Alto, CA: American Institute for Research, 1994) student, educator, and parent forms for high school students with ASD, and (b) examine student and family predictors of self-determination. Participants included adolescents with ASD (N = 547, mean chronological age = 16.1 years, SD = 1.4 years), their parents, and educators. Student reports did not correspond to parent or educator reports, and parent and educator reports were in moderate agreement. Adaptive behavior was a significant predictor of self-determination across reporters, highlighting the significance of adaptive behavior skills during high school. In addition to promoting adaptive behavior, supporting family empowerment, and reducing family burden may help to increase self-determination in high school students with ASD. LAY SUMMARY: Self-determination refers to the abilities and opportunities for students to make choices, plans, and set goals. The current study examined self-determination from multiple perspectives in a large, diverse sample of high school students with ASD. Students, parents, and their teachers each completed a questionnaire on self-determination and had little to some agreement across reporters. Providing support to families and help for students to increase independent skills may promote self-determination.

Quality of high school programs for students with autism spectrum disorder.

The purpose of the study was to examine the quality of high school programs for students with autism spectrum disorder in the United States. The Autism Program Environment Rating Scale-Middle/High School was used to rate the quality of programs for students with autism spectrum disorder in 60 high schools located in three geographic locations in the United States (CA, NC, and WI). Findings indicated that the total quality rating across schools was slightly above the adequate criterion. Higher quality ratings occurred for program environment, learning climate, family participation, and teaming domains. However, quality ratings for intervention domains related to the characteristics of autism spectrum disorder (e.g. communication, social, independence, functional behavior, and transition) were below the adequate quality rating level. Also, quality ratings for transition were significantly higher for modified (primarily self-contained) programs than standard diploma (primarily served in general education) programs. School urbanicity was a significant predictor of program quality, with suburban schools having higher quality ratings than urban or rural schools, controlling for race, school enrollment size, and Title 1 eligibility status. Implications for working with teachers and school teams that support high school students with autism spectrum disorder should include a targeted focus on transition programming that includes a breadth of work-based learning experiences and activities that support social-communication domains.

Interventions Targeting Expressive Communication in Adults With Autism Spectrum Disorders: A Systematic Review.

Purpose The aims of this systematic review are to (a) synthesize the literature on interventions targeting expressive communication in adults with autism spectrum disorder and (b) evaluate the effectiveness of the interventions. Method The literature search resulted in 7,196 articles. The research team used 2 reviewers and consensus for title/abstract review, full-text review, and quality review. To be included, studies had to (a) include at least 1 adult (18 years of age and above) with an autism spectrum disorder; (b) examine an intervention, treatment, or model of care; (c) provide outcome data related to expressive communication modalities/domains; (d) be experimental or quasi-experimental; and (e) be published in English. Twenty-two studies (14 single-case design and 8 group design), with a total of 256 participants and varied interventions and outcome variables, met criteria for inclusion. Effect sizes are presented for group design studies, and visual analysis results are outlined for single-case design studies. Results Examination of treatment effects in the included studies showed positive effects, overall; however, there was great variability between studies. Single-case design studies showed evidence of functional relations in all but 1 study, with most showing medium to large effects, as well as maintenance and generalization of gains. Group design studies showed a wide range of effects from near-zero to large effects. Differences in intervention strategies and durations, as well as in participant characteristics and outcome measures, presented barriers to aggregation. Conclusions This review highlights the need for increased high-quality research examining interventions targeting expressive communication in adults with autism spectrum disorder and also pinpoints interventions with potential for future study and use in this population.

Fostering Communication in Elementary School Children on the Autism Spectrum Who Are Minimally Verbal.

Around 30% of elementary school students with autism spectrum disorder (ASD) are considered minimally verbal, yet there is limited research addressing the needs of this group of students. Several recent studies have demonstrated successful improvement of the communication skills of elementary school students with limited verbal skills. Additionally, there are focused intervention practices that are evidence based and may be useful in targeting communication skills for children with ASD who are minimally verbal. This article will review existing information about interventions to target communication skills in elementary school children with ASD who are minimally verbal, identify potential target skills, and provide case examples of how to embed communication interventions in elementary school classroom settings from a pilot intervention study.

Student Engagement in the Classroom: The Impact of Classroom, Teacher, and Student Factors.

Researchers have highlighted engagement as a critical component of effective interventions for students with autism spectrum disorder (ASD), yet there is limited research related to engagement in school-age children with ASD. This descriptive study was designed to examine joint engagement and its relationship with classroom factors and student characteristics. The sample included 25 elementary and middle school students with ASD. Mixed level modeling was used to examine relationships between joint engagement and classroom factors and student characteristics. Joint engagement was significantly related to group size, use of student-directed practices, autism severity, and expressive communication skills. These findings have important implications for educational policies and practices and future research related to engagement and effective interventions for students with ASD.