Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial
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The advancing social-communication and play (ASAP) intervention was designed as a classroom-based intervention, in which the educational teams serving preschool-aged children with autism spectrum disorder are trained to implement the intervention in order to improve these children’s social-communication and play skills. In this 4-year, multi-site efficacy trial, classrooms were randomly assigned to ASAP or a business-as-usual control condition. A total of 78 classrooms, including 161 children, enrolled in this study. No significant group differences were found for the primary outcomes of children’s social-communication and play. However, children in the ASAP group showed increased classroom engagement. Additionally, participation in ASAP seemed to have a protective effect for one indicator of teacher burnout. Implications for future research are discussed.
KeywordsAutism spectrum disorder ASAP Randomized controlled trial School interventions Engagement Social-communication
The research reported here was supported by the Institute of Education Sciences (IES), US Department of Education through Grant R324A110256 awarded to UNC-Chapel Hill. The opinions expressed represent those of the authors and do not represent views of the Institute or the US Department of Education. Because this was an IES-funded grant, the ASAP randomized controlled trial was registered with the What Works Clearinghouse’s Registry of Randomized Controlled Trials (Study ID: 342; registered on 10/19/2015 https://www.sree.org/pages/registry.php). In addition, we wish to thank all of the coaches and research staff who assisted with this project as well as the school personnel who participated in this study and the parents who agreed for their children to participate. Drs. Boyd, Watson, Crais and Baranek are developers of the ASAP manuals and accompanying intervention and training materials, but receive no royalties. Dr. Boyd receives royalties for a book published through the Springer International Publishing company.
BAB and LRW conceived of the study, participated in the design, and drafted the manuscript. SSR coordinated the study and drafted the manuscript. JS performed the statistical analysis and drafted the manuscript. GTB and ERC conceived of the study, participated in the design and provided editorial feedback. MA, AD, AG and LJ participated in the design of the study and provided editorial feedback. KB participated in the collection and analysis of data and provided editorial feedback.
The research reported here was supported by the Institute of Education Sciences (IES), US Department of Education through Grant R324A110256 awarded to UNC-Chapel Hill.
Compliance with Ethical Standards
Conflict of interest
Drs. Alessandri, Belardi, Donaldson, Gutierrez, Johnson, Reszka and Sideris declare that they have no conflict of interest to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Achenbach, T., & Rescorla, L. (2000). Manual for the ASEBA preschoool forms & profiles. Burlington: University of Vermont, Research Centre for Children, Youth, & Families.Google Scholar
- Adams, C., Lockton, C., Freed, J., Gaile, J., Earl, G., McBean, K., Nash, M., et al. (2012). The Social Communication Intervention Project: A randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with our without autism spectrum disorders. International Journal of Language and Communication Disorders, 47, 233–244.PubMedCrossRefGoogle Scholar
- Adamson, L. B., Bakeman, R., Russell, C. L., & Deckner, D. F. (1998). Coding symbol-infused engagement states, technical report 9. Atlanta: Developmental Laboratory at Georgia State University.Google Scholar
- Bates, E., Benigni, L., Bretherton, I., Camaioni, L., & Volterra, V. (1979). The Emergence of symbols: Cognition and communication in infancy. New York: Academic Press.Google Scholar
- Borrelli, B., Sepinwall, D., Ernst, D., Bellg, A. J., Czajkowski, S., Breger, R., … Resnick, B. (2005). A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. Journal of Consulting and Clinical Psychology, 73(5), 852–860.PubMedCrossRefGoogle Scholar
- Boyd, B. A., Hume, K., McBee, M. T., Alessandri, M., Gutierrez, A., Johnson, L., & Odom, S. L. (2014). Comparative efficacy of LEAP, TEACCH and non-model-specific special education programs for preschoolers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(2), 366–380.PubMedCrossRefGoogle Scholar
- Kover, S. T., Davidson, M. M., Sindberg, H. A., & Ellis Weismer, S. E. (2014). Use of the ADOS for assessment spontaneous expressive language in young children with ASD: A comparison of sampling contexts. Journal of Speech, Language, and Hearing Research, 57, 2221–2233.PubMedPubMedCentralCrossRefGoogle Scholar
- Laakso, M. L., Poikkeus, A. M., Eklund, K., & Lyytinen, P. (1999). Social interactional behaviors and symbolic play competence as predictors of language development and their associations with maternal attention-directing strategies. Infant Behavior and Development, 22, 541–556.CrossRefGoogle Scholar
- Lifter, K. (2000). Linking assessment to intervention for children with developmental disabilities or at-risk for developmental delay: The developmental play assessment (DPA) instrument. In K. Gitlin-Weiner, A. Sandgrund & C. F. Schaefer (Eds.), Play diagnosis and assessment (2nd ed., pp. 228–261). New York: Wiley.Google Scholar
- Lord, C., Rutter, M., Dilavore, P., & Risi, S. (1999). The autism diagnostic observation schedule (ADOS). Los Angeles: Western Psychological Corporation.Google Scholar
- Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach Burnout Inventory manual (3rd ed.). Palo Alto, CA: Consulting Psychologists Press.Google Scholar
- Professional Development in Autism Center. (2008). PDA program assessment. Seattle: PDA Center at University of Washington.Google Scholar
- SAS Institute. (2011). SAS/STAT software, version 9.3 [computer program]. North Carolina: SAS Institute.Google Scholar
- Shih, W., Chang, Y., Shire, S., & Kasari, C. (2017). Does join engagement mediate intervention outcomes of joint attention in young children with ASD in preschool classrooms. Presentation at Gatlinburg Conference, San Antonio, TX.Google Scholar
- Ungerer, J. A., Zelazo, P. R., Kearsley, R. B., & O’Leary, K. (1981). Developmental changes in the representation of objects in symbolic play from 18 to 34 months of age. Child Development, 186–195.Google Scholar
- Watson, L. R., Boyd, B., Baranek, G., & Crais, E. R. (2011). Advancing social-communication and play: An intervention program for preschoolers with autism manuals. Chapel Hill: The University of North Carolina at Chapel Hill.Google Scholar