Two-Stage E-Learning Coaching Practice: Description of a Teacher and Family Training Process

Editorial: Introduction to Special Section on Evidence-Based Practices for Persons With Intellectual and Developmental Disabilities

In this study, we investigated the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether child age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 level III certified pivotal response treatment therapists who recorded three 10-min pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. Results indicated that therapists’ attitude toward evidence-based practices, specifically openness to innovation, and therapists’ experience with pivotal response treatment significantly predicted fidelity of pivotal response treatment implementation. Cross-validation methods largely confirmed these findings. Therapist personality, therapist–child relationship, and child characteristics were not significantly related to pivotal response treatment fidelity. Implications for clinical practice and directions for future research are discussed.Lay abstractPivotal response treatment is a naturalistic behavioral intervention that teaches pivotal skills to children with autism spectrum disorder to produce widespread gains in other skills. Although most children with autism spectrum disorder benefit from pivotal response treatment, intervention outcomes vary considerably among children. Fidelity of intervention implementation (i.e. the extent to which an intervention is implemented as intended) may affect intervention outcomes. In this study, we studied the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether a child’s age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 pivotal response treatment therapists who videotaped three pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. This study found that therapists’ openness to innovation and their experience with pivotal response treatment predicted fidelity of implementation. Therapist personality, therapist–child relationship, and child characteristics were not related to pivotal response treatment fidelity. The results of this study emphasize that it is important (1) to target therapists’ attitudes toward innovation prior to or during training in pivotal response treatment and (2) to provide therapists with ongoing supervision and feedback after training to increase fidelity of implementation and thus to improve intervention outcomes for children with autism spectrum disorder.

Background: Early intervention will help children with autism spectrum disorder (ASD) to attain early learning reinforcement. This study focuses on exploring the ability of preschool teachers to identify children with ASD and their referral decision-making process. Method: This is a mixed-method study (qualitative and quantitative methods) involving 20 respondents. The qualitative study is based on an open question case study, while the quantitative study consists of questionnaire with demographic variables to identify the effect of the demographic variables on the preschool teachers’ ability to identify children with ASD. Sample: The sample was selected via convenience sampling among mainstream preschool teachers. The data was analyzed using SPSS software and thematic analysis. Results: The findings show that preschool teachers did not have skills at identifying children with ASD, and the majority of them labelled children with ASD as spoilt or hyperactive children. They also viewed children with ASD as having other disorders such as attention deficit hyperactivity disorder (ADHD) or communication disorders such as introversion. Moreover, preschool teachers expressed that the reason for the child’s behaviour could be due to the parents’ inability to properly educate their child. Additionally, the demographic variables of the preschool teachers, such as age, education level and teaching experience, were found not to affect their ASD identification skills. Conclusion: Preschool teachers need to improve their skills in identifying ASD among children via training.

The incidence of Autism Spectrum Disorders (ASD) has been increasing over the last two decades. Currently, 1 in 110 children are identified with ASD in the United States (CDC, 2009). ASD refers to a range of neurological disorders that involve some degree of difficulty with communication and interpersonal relationships. The range of the spectrum for autism disorders is wide with those at the higher functioning end often able to lead relatively independent lives and complete academic programs even while demonstrating social awkwardness. Those at the lower functioning end of the autism spectrum often demonstrate physical limitations, may lack speech, and have the inability to relate socially with others. As persons with ASD age, options such as employment become increasingly important as a consideration for long-term personal planning and quality of life. While many challenges exist for persons with ASD in obtaining and maintaining employment, some research is showing that, with effective behavioral and social interventions, employment can occur (Schaller & Yang, 2005). In fact, about 37% of individuals with ASD report having been employed for 12 months or more, four years after exiting high school (Newman, Wagner, Cameto, & Knokey, 2009). However, several studies show that individuals with ASD are more likely to lose their employment for behavioral and social interaction problems rather than their inability to perform assigned work tasks (Dew & Alan, 2007; Hurlbutt & Chalmers, 2004; Unger, 1999). Research has been conducted in the area of autism and employment, but such research has not been reported in a comprehensive evidence review format before. Thus, a systematic review on the effectiveness of adult employment assistance interventions for individuals with ASD would not only demonstrate the extent and magnitude of the interventions’ effects, but also provide ideas for further research that can inform implementation and refinement of related employment-focused programs.

Recently, the identification and detection of children with autism spectrum disorder (ASD) has become an essential issue under ASD intervention services. The high percentage of ASD among children requires preschool teachers to recognizse children’s abnormal development and identify them at an early stage, followed by referral to specialists. Therefore, this identification calls for a specific ability among preschool teachers, identified as knowledge, belief, identification skills, and self-efficacy (KBISSE). This conceptual framework aims to utilize the current literature to present a discussion on preschool teachers’ KBISSE in identifying children with ASD and making decisions to refer children suspected with ASD to specialists. The conceptual framework is discussed based on social cognitive theory (SCT) and the health belief model (HBM). The conceptual framework emphasizes the need for preschool teachers to be educated in ASD via an educational module that could increase teachers’ self-efficacy in identifying children with ASD. Besides, knowledge in ASD, belief in ASD, and identification skills are also necessary variables for building the educational module. The educational module is useful for guiding future research on preschool teachers’ identification of children with any disability, one of which is ASD, and subsequent specialist referral at an early stage.

ABSTRACTThe use of serious games (SGs) to provide intervention for various skills to children with autism spectrum disorder (ASD) has increased in the recent years. However, the potential of these games has not been utilized to provide learning of vocabulary to children with ASD. In designing games for children with ASD, there is a need to consider components specifically from the perspectives of ASD and the generic components that can support from the theoretical, content, and game design aspects. In the absence of any existing framework to design games for children with ASD, this article first introduces a framework named serious game design framework (SGDF), constructed to provide support throughout the design process. This framework was constructed based on the extensive review of the literature on ASD and existing SGDFs. The article then focuses on the design and development of a SG prototype based on SGDF. An experimental evaluation prototype was conducted to examine the effectiveness using the withdrawal design of single-subject research design (SSRD) in improving the receptive identification of vocabulary items among children with autism before and after using the prototype. The receptive identification of vocabulary items is measured in terms of the number of correct responses given and the number of attempts made to identify the correct response. The pre- and post-evaluations of the SG prototype show that learning of vocabulary items among children with ASD improved after using the game and they retained items at the end of weeks 1 and 2 following the withdrawal of intervention.

We provide an overview of studies in the past 10 years (2004–2014) that have aimed to improve joint attention (JA) in young children at risk for, or with, autism spectrum disorder. Thirteen randomized controlled trial (RCT) interventions were found, which received particular focus. Three studies used intervention methods with a developmental orientation and focused on caregiver-mediated methods. Others used combined developmental and behavioral approaches and delivered intervention via trained interventionists, caregivers, and teachers. Interventions ranged widely in density, both with respect to the amount of intervention delivered weekly and the total duration of intervention. Fourteen single-subject research design (SSRD) studies and one quasi-experimental pre–post design study were also included. Notably absent in the RCTs were studies using only behavioral methods, while behavioral methods dominated in the SSRDs. The outcomes of the RCTs using combined behavioral and developmental methods generally demonstrate short-term social communication gains. While some studies demonstrated long-term maintenance and positive outcomes in related areas such as language, many did not. The mixed results for language outcomes indicate a need for further investigation. In addition, future studies should further examine participants’ developmental readiness and intervention dose in relation to outcome, as well as aim to isolate active ingredients of interventions.

This study examined the reliability and validity of the 13-item Classroom Observation Scale as used by teachers and non-clinically trained observers to identify children who more likely than their peers to have autism spectrum disorder in less-resourced preschools. A total of 534 children (ages 2;10 to 4;5, Mean = 3;8) from nine Chinese-language preschools serving families from lower-middle to middle socioeconomic backgrounds in Hong Kong were observed in their first preschool year using the Classroom Observation Scale. The 75 screen-positive children and 55 randomly selected typically developing peers were clinically assessed for autism spectrum disorder 1 year later. The Classroom Observation Scale as used by teachers and non-clinically trained researchers helped to identify preschoolers who were later diagnosed with autism spectrum disorder with odds ratios of 3.11 and 8.66, respectively. This study provided further evidence on the versatility and ecological validity of the Classroom Observation Scale for use by preschool teachers and observers with little or no clinical training in the early identification of children with autism spectrum disorder in community settings.Lay abstractThe 13-item Classroom Observation Scale is an autism spectrum disorder screening tool for teachers and non-clinically trained observers to make real-time observation of children’s peer interaction (or the lack thereof) in regular preschool classrooms. The Classroom Observation Scale was originally developed in English and validated with ethnically diverse preschoolers at English-speaking international schools serving families from middle to middle-upper socioeconomic backgrounds in Hong Kong. These private schools can usually afford a higher teacher–student ratio, which is not typical for most preschools. This study, therefore, investigated whether the Classroom Observation Scale is ecologically valid when used by Chinese teachers with teacher–student ratios typically found in less-resourced preschools. We found that the Classroom Observation Scale reliably helped observers with little or no clinical training—research assistants with just a few hours of Classroom Observation Scale training and preschool teachers with an hour of briefing—to identify children in their first year of Chinese-language preschool who were more likely than their peers to have autism spectrum disorder. Reliability estimates of Classroom Observation Scale-Teacher and Classroom Observation Scale-Researcher in this study were comparable to those for the original English Classroom Observation Scale. Our results provided further evidence on the versatility and ecological validity of the Classroom Observation Scale for use by preschool teachers and non-clinically trained observers in the early identification of children with autism spectrum disorder in community settings.

Adult Employment Assistance Services for Persons with Autism Spectrum Disorders: Effects on Employment Outcomes

Assessing Diverse Students With Autism Spectrum Disorders

Come Play With Me

Objective Autism spectrum disorder is a neurodevelopmental disorder that affects communication, social skills, and behavior and can present in early childhood. The present study is aimed at investigating the effects of family-centered early intervention on the quality of social interaction and social interaction skills in infants with suspected autism spectrum disorder using a single-subject design. Method As a single-subject design study, evaluations were conducted at baseline phase A, intervention phase B, baseline phase A′, and follow-up phase. The family-centered early intervention program was implemented during the intervention phase. Family-centered early intervention programs included home environmental modification, play video recording and training, task and feedback, related information training, and question and answer. The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up and Evaluation of Social Interaction was used for evaluation. Result Three participants completed the study. After applying the family-centered early intervention program, the quality of social interaction and social interaction skills of all participants improved. In addition, the risk of autism spectrum disorder in all participants was reduced. Conclusion Family-centered early intervention was confirmed to have a positive effect on the improvement of social interaction skills in infants with suspected autism spectrum disorder.

Atypical executive functions (EF) have long been observed in individuals with autism spectrum disorders (ASD) of any age. To compensate for EF-related difficulties and to cope with the demands of daily life, assistive technology for cognition may represent a valid solution, but at present, no information is available on the range of accessible solutions nor on their effectiveness in ASD. This paper reports on a review conducted to identify assistive technologies that may compensate for EF-related difficulties in ASD. A systematic search was conducted following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) reporting guideline recommendations. Fifteen studies met inclusion criteria, with most studies following a single-subject research design (n = 11). The assistive technologies identified were grouped into two categories (context-aware, mobile) addressing four EF-related cognitive processes classified according to the taxonomy proposed by the International Classification of Functioning (i.e., organization and planning, time management, cognitive flexibility, and insight). Insight (e.g., self-monitoring) resulted as the only intervention that may be considered evidence-based. This review highlights that assistive technology may be effective in compensating for specific EF-related difficulties in ASD, but more rigorous research involving (a) a wider range of EF-related skills, (b) older participants, and (c) diverse settings (e.g., workplaces) is necessary.

In this study, we evaluated three lessons from a manualized social play skills intervention, Play20. Play20 is a focused intervention that is designed to improve early social skill development in children with autism spectrum disorder through naturalistic play. First, we evaluated the procedural fidelity of instructor implementation of Play20, and we also evaluated the effects of an added instructor self-monitoring checklist in further improving instructor behavior. Finally, we evaluated the effects of Play20 on child play outcomes. Instructor procedural fidelity increased in the presence of the Play20 lessons, and further improved in the presence of the instructor self-monitoring checklist. Child outcomes moderately improved as well. Implications and future directions are discussed.

This chapter explores the social impairments in students with Autism Spectrum Disorder (ASD), the importance of social interventions for students with ASD in inclusive settings, and a few evidence-based interventions to address the social challenges for these students. In order to address the social deficits in students with ASD and ameliorate the possible co-morbid risk factors faced by these students, it is imperative to provide social interventions. Research has documented that without appropriate social intervention, students with ASD have difficulty interacting with their peers and exhibit low responsiveness, limited or nonexistent initiations, reduced conversational reciprocity, and an overall difficulty sustaining social engagement. It is mandated, and best practice, that schools implement evidence-based programs. That is, schools must implement programs that are supported by research. It is mandated, and best practice, that schools implement evidence-based programs. A main challenge for students diagnosed with ASD is social deficits.