A Manualized Program to Support Transitions within Classroom Routines for Students with ASD: Child and Teacher Outcomes

Background:  Over the past decade, children with autism spectrum disorder (ASD) have been included in public education settings at swiftly increasing rates (National Center for Education Statistics, n.d.). Students in these settings frequently experience difficulties with transitions that occur during their daily routines. Transition-related difficulties often result in challenging behavior, including disruption, noncompliance, tantrums, aggression, and self-injury (Schreibman, Whalen, & Stahmer, 2000). Specific behavioral techniques to support transitions have been identified through single-subject research studies, but this research should be extended to include packaged interventions that are easily implemented in school settings and that are associated with more global child and teacher outcomes.

Objectives:  This project aimed to develop and evaluate the Schedules, Tools, and Activities for Transitions (STAT) program, a short-term, manualized package intervention of behavioral supports relevant to facilitating successful transitions within the daily routine for students with ASD (K-5) in self-contained educational settings. 

Methods:  Across three sites (UCLA, University of Pennsylvania, University of Rochester), a cluster-randomized group comparison design with matched pairs was used to assign self-contained classrooms to treatment (STAT program) or waitlist control. STAT involved a 12-16 session, collaborative, coaching model between research staff and school staff that encouraged educators to use 9 steps to facilitate successful classroom transitions, thereby resulting in a teacher-mediated intervention program. Intervention components included antecedent-based strategies (e.g., warnings, visual supports), teaching strategies (e.g., prompt hierarchies), and reinforcement. Student outcomes included academic engagement, independence (ABAS self-direction domain) and problem behavior (School Situations Questionnaire) during school routines, and teacher-nominated target problems. Teacher outcomes included fidelity and generalization. Data on intervention implementation and buy-in were also collected.

Results:  n total, 153 students and 76 educators participated. No group differences were noted for academic engagement, as baseline academic engagement was quite high (.80%) at baseline across sites. For teacher-nominated target problems, STAT showed a significant positive effect over waitlist, with a larger proportion of classrooms indicating improvements in the identified behaviors (χ²=13.996, p=0.003). Positive effects of the STAT program were also found on the SSQ (SSQ; M_control = .67; M_treatment = .72), but not on the ABAS (ABAS; M_control = 4.51; M_treatment = 4.32).

Conclusions:  The use of a teacher-mediated, behavioral intervention program was successfully implemented in self-contained classrooms across three under-resourced school districts. The results preliminarily suggest the utility of implementing a behavioral intervention package that can be beneficial for aspects of student behavior, feasible for educators to implement with high fidelity, and perceived as sustainable in real-world settings.