Student, Teacher and Classroom-Level Mediators of Outcomes for Children with Autism Spectrum Disorders

Background: Current studies show that intensive behavioral interventions are effective in improving cognitive and behavioral functioning for young children diagnosed with autism spectrum disorders.  Little research has been conducted, however, for elementary school-age children. Even less has examined the impact of these interventions in community-based educational settings.  With more than 250,000 students diagnosed with autism in the US served through the public education system, and some states’ projections showing a doubling of this number by 2011, examining the best strategies to move evidence-based intervention into the public educational system is critical. The current study examined the effectiveness of an evidence-based intervention for children with autism in a large public school setting.

Objectives:

This study compares the effectiveness of the Strategies for Teaching based on Autism Research program (STAR) with that of Structured Teaching in kindergarten-through-second-grade autism support classrooms. In addition, we examine the moderating effects of student, teacher and classroom-level variables on student outcomes. 

Methods:

178 students enrolled in 39 Kindergarten-2^nd grade autism support classrooms in the Philadelphia public school district comprised the study sample.  Subjects were administered an assessment battery in September and again in June, which included the Autism Diagnosis Observation Schedule as a general measure of symptom severity and the and theDifferential Abilities Scale-II—Early Childhood Core Battery (DAS) as an outcome measure.  Secondary outcome measures included the Adaptive Behavior Assessment System-II (parent report), PDD Behavior Inventory (teacher report), Aberrant Behavior Checklist (parent report), and Social Responsiveness Scale (parent and teacher reports).

Staff in each participating classroom was randomly assigned to training and ongoing support in STAR or Structured Teaching.  STAR is an ABA-based classroom program which includes daily 1:1 sessions with each child using discrete trial and pivotal response training while integrating functional routines into academic curricula.  The Structured Teaching instructional strategy emphasizes whole-class routines and setting up a structured physical classroom environment.

Results:

Overall, 16% of the sample experienced a gain of >10 points on the DAS, while 10% experienced a loss of 10 points during the study period.  Students in STAR group showed an average increase of 9 points, compared with 6 points for students in the Structured Teaching group (p=.16).  There was a significant interaction between intervention arm and teacher experience. In classrooms in which the teacher had <3 years experience teaching children with autism, there was little change in DAS score between groups (STAR = 7.8, ST = 8.6, p>.05). In classrooms with more experienced teachers, students in STAR classrooms experienced a 12.6-point gain in DAS score, compared with 3.5 points for students in Structured Teaching classrooms (p = .02). Additional analyses are ongoing to examine the effect of classroom characteristics, program fidelity and student characteristics on outcome.

Conclusions: Results will be used to discuss the importance of context, program fidelity and teacher experience in examining the effectiveness of evidence-based interventions as they move from research to community settings.