Objectives: To present preliminary data on the effects of ASAP, when implemented by preschool teachers and school-based therapists, on the social-communication and play behaviors of 3 preschool-aged children with ASD.
Methods: Single case design methodology was used to investigate the effects of ASAP on the child’s social-communication and play skills, as it allows experimental control to be established with small N studies. Specifically, a multiple baseline across participants design was used. Three participants (ages 3 – 5) diagnosed with ASD participated in the ASAP intervention. The ADOS was used to confirm diagnosis and the Mullen was used to determine baseline levels of cognitive functioning. For each child, the classroom teacher, classroom assistant, and/or the speech-language pathologist (SLP) participated in the treatment. The SLP implemented the 1:1 component of the intervention and the classroom teacher or assistant implemented the group component in the classroom. Prior to implementation, the classroom team attended an initial training and on-going coaching was provided by research staff to support fidelity of implementation. Behavioral raters coded intervention sessions in vivo to examine treatment effects. Coders used a hand-held computer to collect data during a 10 minute observation period. A 10 second partial interval coding system was used to collect data, whereby at the end of each interval coders indicated whether the target behavior occurred.
Results: Across the 3 children, the percentage of time children displayed social-communication (i.e. initiating behavior requests or joint attention) or play (i.e. functional or symbolic) skills in the baseline condition was low (soc-com M=6.2%, range= 4-10.4%; play M=3.9%, range=.4-10.9%). Mean rates of behavior for the group only intervention component were 3.8% (range=1.5-7.5%) for social-communication and 10.4% (range=.4-28.4%) for play. Mean rates of behavior for the group component when combined with the 1:1 component were 12.3% (range=5.4-17.6%) for social-communication and 17.3% (range=9.9-28.4%) for play. Interobserver agreement and fidelity data also will be reported.
Conclusions: As expected with single subject data, there was individual variability in treatment response to the ASAP intervention. In general, it appears that combining the group and 1:1 components resulted in better outcomes for the 3 children, although across conditions there were infrequent displays of the targeted behaviors. However, school-based personnel were able to implement the intervention with good fidelity, which shows promise of longer term sustainability.