Mediators of Student Success in a Randomized Controlled Study of Teacher Consultation in Autism: a Preliminary Investigation Establishing Proof of Concept

Background:

The increasing numbers of students with autism combined with the limited number of teachers with training in autism presents a serious issue in providing effective services and producing positive educational outcomes. Child-specific teacher consultation is often employed as an indirect method of influencing teacher behavior with the hope that it will positively impact educational quality and  child outcomes. Although consultation research is promising, very little has been targeted in autism. Moreover, the existing research is based on pre-post designs and has paid  little attention to examining potential mediators of change. Preliminary evidence suggests that one model of teacher consultation, the Collaborative Model for Promoting Competence and Success (COMPASS; Ruble & Dalrymple, 2002) can impact outcomes for children with autism; however, information is lacking on the active ingredients of the consultation.

Objectives:

To identify possible mediators of COMPASS consultation that may be useful in understanding the therapeutic mechanisms of action, and help in establishing proof of  concept of how COMPASS  causes change in teacher behavior and child outcomes.

Methods:

A randomized controlled design was used to determine the effectiveness of COMPASS consultation and teacher coaching sessions on teacher, parent, and child outcomes.  Thirty-five teachers were randomly assigned to (a) COMPASS and teacher coaching or (b) services as usual group (SAU; regular school program based on the child’s IEP). All participants completed a pre- and post-evaluation. Following the pre-evaluation, teachers were randomly assigned to either the experimental or the SAU condition. Eighteen teachers in the experimental condition participated in a half-day consultation that included the parent. Three skills were prioritized and specific teaching plans were generated. Following consultation, teachers also received four 1.5 hour teacher-coaching sessions. Two potential mediating variables, IEP quality and teacher adherence to the intervention, were examined to establish proof of concept.

Results:

Children in the treatment group (N=18) made significant progress on targeted IEP objectives based upon evaluation by an observer unaware of group assignment compared to control group children. Prior to the consultation, IEP quality was similar for the experimental and control conditions. After COMPASS consultation, however, IEP quality was higher in the experimental condition. Teacher adherence to the teaching plan was significantly higher at time 2 compared to time 1 and was significantly associated with child outcomes at time 4.

Conclusions:

Preliminary data suggest that IEP quality is important for ensuring child success in meeting educational goals. Also, teacher coaching and follow-up also appear to be  essential elements to ensure treatment implementation. These findings suggest critical areas for future research to improve teacher training efforts in autism.