Classroom-based intervention for pupils with autism

Findings from a cluster randomised trial published in the Journal of Consulting and Clinical Psychology suggest that classroom teachers can effectively deliver a programme for young pupils with Autistic Spectrum Disorder (ASD) that results in better outcomes relative to usual school-based education.

Lindee Morgan and colleagues conducted a trial of the Social, Communication, Emotional Regulation and Transactional Support (SCERTS) intervention – a classroom-based, teacher-implemented intervention aimed at improving active engagement, adaptive communication, social skills, executive functioning and problem behaviour in elementary (primary) school pupils with ASD – to assess what improvement pupils in the intervention group made across a variety of measures compared to pupils in the control group. Sixty schools from three US states were randomly assigned to either the intervention or control groups. Teachers in the intervention group were trained in how to deliver the SCERTS programme and received coaching throughout the school year.

Results showed better outcomes for the intervention group than the control group on observed measures of classroom active engagement with respect to social interaction. The intervention group also had better outcomes on measures of adaptive communication, social skills and executive functioning (effect sizes ranged from +0.31 to +0.45).

Source: Cluster randomized trial of the classroom SCERTS intervention for elementary students with autism spectrum disorder (July 2018), Journal of Consulting and Clinical Psychology, Volume 86(7)

Interventions for children with autism spectrum disorder

The National Council for Special Education in Ireland has published a systematic literature review of the research evidence available on educational interventions for children with autism spectrum disorder (ASD).

Among other questions, the review, by Caroline Bond and colleagues from the University of Manchester, considered what works best in the provision of education for people with ASD. The literature review included 85 best-evidence studies published between 2008 and 2013. These studies were considered to be of at least medium standard for the quality of evidence, methodological appropriateness, and effectiveness of the intervention. Most studies focused on preschool children and children aged 5–8 years.

For preschool children, two interventions were rated as having the most evidence:

  • Interventions designed to increase joint attention skills, usually involving one-to-one delivery of a play-based/turn-taking intervention by a teacher or parent
  • Comprehensive preschool intervention programs, which offered a comprehensive educational experience for the child, targeting areas such as behaviour, social skills, communication, and learning

For school-aged children, three interventions were rated as having the most evidence:

  • Peer-mediated interventions – group interventions with peers to support the development of social skills in children with ASD and/or help peers to interact more successfully with children with ASD
  • Multi-component social skills interventions, which included several elements, such as social skills training, peer support in school, or the involvement of parents in supporting the child’s social skills
  • Behavioural interventions based on behavioural principles were also used to target challenging/interfering behaviours in children with ASD, often based on an initial functional assessment followed by specific interventions

Source: Educating Persons with Autistic Spectrum Disorder – A Systematic Literature Review (2016), The National Council for Special Education

Including restricted interests benefits autistic pupils

Children with autism spectrum disorder (ASD) often have interests restricted to particular topics. New research from the University of Strathclyde has found that accommodating these interests into classroom teaching leads to gains in educational achievement and/or social engagement.

Restricted Interests (RIs) are a component of the formal diagnosis for ASD, and teachers can be faced with the dilemma of whether to accommodate these interests or keep them out of the classroom. There are differing views about whether RIs are harmful or helpful, on one hand potentially obstructing opportunities to learn and peer interaction, but on the other hand generating self-motivated learning, and improving motivation, cognitive skills, and social-emotional well-being.

The authors of this study examined all peer-reviewed studies of teaching children with ASD with RIs published between 1990 and 2014. Of 91 children assessed in 20 published studies, all reported gains in educational achievement and/or social engagement. Negative consequences were limited to a decrease in task performance in one child and a transient increase in perseverative behaviours in two children.

The authors conclude that the RIs of children with ASD should be incorporated into the mainstream curriculum where reasonable to do so.

Source: Teaching Children With Autism Spectrum Disorder With Restricted Interests: A Review of Evidence for Best Practice (2015), Review of Educational Research.

Interventions for children with autism: what works?

This systematic review from the Campbell Collaboration examines research on the effectiveness of early intensive behavioural intervention (EIBI) in increasing the functional behaviours and skills of young children with autism spectrum disorders (ASD). The core elements of EIBI, which is one of the better-established treatments for ASD, involve (a) a specific teaching procedure referred to as discrete trial training, (b) the use of a 1:1 adult-to-child ratio in the early stages of the treatment, and (c) implementation in either home or school settings for a range of 20 to 40 hours per week across one to four years of the child’s life.

The researchers looked for randomised controlled trials (RCTs), quasi-randomised controlled trials, and clinical controlled trials (CCTs) in which EIBI was compared to a no-treatment or treatment-as-usual control condition. Another criterion was that study participants needed to be less than six years of age at treatment onset and assigned to their study condition prior to commencing treatment. One RCT and four CCTs with a total of 203 participants met the criteria and were included in the review.

After analysing the research, the authors concluded that there is some evidence that EIBI is an effective behavioural treatment for some children with ASD. However, they say that additional studies using RCT research designs are needed to make stronger conclusions.

Source: Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD): a systematic review (2015), The Campbell Library.