The Advancing Social-Communication and Play (ASAP) Intervention in Elementary School Settings: A Single Case Design Study

Background:

With the rising prevalence of autism spectrum disorder (ASD), school programs are in need of evidence-based interventions to target core deficits in this growing population of children. Social-communication and engagement are key areas of need for children with ASD. These pivotal skills have been shown to positively impact development in other areas such as peer relationships, language abilities, and academic abilities. However, there are few interventions designed to address social-communication and engagement in school-age children with ASD with the most significant needs (e.g., Franco et al., 2013), and the research for interventions implemented by educators in school settings with this population is even more limited. The Advancing Social-Communication and Play (ASAP, Watson et al., 2011) intervention was designed for public preschools, and shows promise as an effective intervention in real-world settings. The ASAP intervention addresses a hierarchy of social-communication and play skills embedded in one-to-one and group settings within a classroom.

Objectives:  

The purpose of this student is to examine the impact of the ASAP intervention on school-age children with ASD, and adapt the intervention for elementary school settings with the following specific aims:

1. Does implementation of the ASAP intervention improve social-communication and engagement of elementary school children with ASD?
2. Is the ASAP intervention feasible and acceptable in elementary school classrooms serving children with ASD?

Methods:  

The study is using a multiple baseline, single case design across four elementary school students with emerging communication skills.  The students range in age from 5 to 9 years old, with expressive language abilities ranging from 7 – 25 months based on the Receptive Expressive Emergent Language test (REEL-3). Teacher-student dyads are videotaped in 10-minute one-to-one sessions two times per week, first in the baseline phase, with staggered entry into the intervention phase. The videos of one-to-one sessions are being coded for joint engagement states (passive, single and joint) and social-communication behaviors (social interaction, requesting, and joint attention) using coding systems adapted from previous research (e.g., Adamson et al, 1998; Dykstra et al., 2012). Additionally, group sessions are being coded live one time per week to look for generalization of engagement into the group setting.

Results:  

The study is currently in progress, with two of the four teacher-student dyads having moved into the intervention phase. Thus far, the first student showed increased time joint engagement with some decrease in recent sessions, as his teacher is targeting social interaction and requesting. The second student has just moved into the intervention phase, and has increased time in single engagement as his teacher focused on social interactions and pretend play skills. See Figure 1 for engagement data. Social-communication data is currently being coded.

Conclusions:  

The study will offer valuable information about interventions for students with ASD with the most significant interventions that are implemented in school settings by school personnel. The data for the study so far suggests that the intervention is improving engagement in the students, and the training and coaching sessions have been well-received by teachers and teaching assistants.