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NCT Number: NCT07830160

Improving Autism Program Quality in Special Education Units: The Use of an APERS-based Model to Support Student Learning and Participation

This study assesses the effect of using the Autism Program Environment Rating Scale (APERS) as a tool for providing feedback, in-service training, and coaching to school staff in order to improve program quality in special education units (SEUs) for children with autism or related sociocommunicative challenges (SCCs). APERS is used in its culturally validated Swedish version (APERS-Primary-SE). Using a quasi-randomized parallel-group design, SEUs will be allocated to either an experimental (APERS+) or control (TAU) condition. In the APERS+ condition, school staff receive continuous and systematic feedback provided by trained coaches based on the initial APERS assessment. In the TAU condition, schools will also receive feedback based on the initial APERS assessment, but no continuous coaching.

It is hypothesized that the APERS based intervention will improve overall program quality for children with autism or related SCCs as compared to TAU. Additionally, we also expect the intervention to improve student functioning, students' individual goal attainment, students' perception of their schools, and teacher self-efficacy as compared to TAU.

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Key information

Conditions

Autism Autism Spectrum Disorder Autistic Disorder Child Development Disorders, Pervasive Mental Disorders Neurodevelopmental Disorders Sociocommunicative Challenges

Age range

5 year–13 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Stockholm University

Stockholm, Sweden

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for schools:

  • Located within the Stockholm Region
  • To have one or more SEUs for preschool class, primary school, or middle school students

Inclusion criteria

for students:

  • To be enrolled in a SEU in preschool class, primary school, or middle school
  • To have a documented formal community diagnosis of autism according to ICD-10, DSM-IV or DSM-5 or having related challenges with social communication and interaction as assessed by school staff and guardians.

Exclusion criteria

  • No exclusion criteria not already mentioned.

Treatment and study plan

APERS+

Behavioral

APERS assessments with written and oral feedback. Creation of an action plan that is continuously followed up by specially trained coaches weekly or bi-weekly in coaching sessions designed to support the use of evidence-based practices in school settings. Half-day lecture about autism and related SCCs.

Primary outcomes

  1. Change from baseline in autism program quality as assessed with the Swedish Autism Program Environment Rating Scale - Primary school (APERS-Primary-SE)

    Time frame: Baseline and about 8 months from baseline

    The APERS-Primary-SE is a rating scale designed to examine primary school program quality for students with autism or related sociocommunicative challenges in Sweden. It contains 10 domains including areas such as students' personal independence and competence, and challenging behaviors. The scale consists of 58 items rated on a five-point Likert scale (1= low quality, 5 = high quality) resulting in individual item scores, subdomain scores, domain scores, and a total score.

Secondary outcomes

  1. Change from baseline in how students feel about their school as assessed with How I Feel About My School (HIFAMS)

    Time frame: Baseline and about 8 months from baseline

    The HIFAMS is a questionnaire designed to assess the happiness and subjective well-being of children in school. It will be completed by all participating children in the study. The questionnaire consists of 8 items where the child is asked how they feel about their school life. The items are scored using a three-point facial Likert scale (sad face, neutral face, happy face). The faces are converted into numerical scores (0-2).

  2. Change from baseline in parent ratings on their child's bodily functions, activities, and participation and contextual factors as assessed with the International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism

    Time frame: At baseline and 8 months follow-up.

    The ICF Core Sets for Autism is a questionnaire where parents rate their child's functioning. It contains 37 items pertaining bodily functions, activities and participation as well as contextual factors that may affect the child's functioning. Responses are given on a Likert scale ranging from either 0 to 10 (individual factors) or -5 to 5 (contextual factors), where higher ratings indicate higher levels of functioning and/or participation.

  3. Change in teachers' perceived self-efficacy in supporting students with autism using the Autism Self-Efficacy Scale for Teachers (ASSET)

    Time frame: At baseline and 8 months follow-up.

    The Autism Self-Efficacy Scale for Teachers is a questionnaire where teachers rate their perceived self-efficacy in supporting students with autism and related SCCs in their classroom. It consists of 28 items and is rated on a six-point Likert scale from 0 to 5. Higher ratings indicate higher self-efficacy.

  4. Individual goal attainment as assessed with a Goal Attainment Scale (GAS)

    Time frame: At baseline and 8 months follow-up

    The Goal Attainment Scale is a scale used to support, monitor and assess individual goal attainment in children with autism. Goals are created collaboratively by teachers and coaches at baseline and tailored to each child's individual needs and capacity. Goal attainment is assessed by coaches at follow-up on a five-step Likert scale, where 0 is baseline and 4 is exceeding goals.

Other outcomes

  1. Social validity as assessed with the Social Validity Scale

    Time frame: Rated at follow-up approximately 8 months after study start

    A scale designed to asses the social validity of the procedures, goals, and outcomes of the study by participating school staff and coaches. It consists of 12 items rated on a Likert scale from 0 to 5, where higher ratings indicate higher levels of perceived social validity.

  2. Social responsiveness as assessed with the Social Responsiveness Scale 2 (SRS-2)

    Time frame: Baseline assessment

    The SRS-2 is a scale designed to identify the presence and severity of social impairment within the autism spectrum and to differentiate it from difficulties associated with other conditions. Used in the current study to assess the level of social challenges for the participating children. The scale contains 65 items and is rated by the children's parents or guardians. Each item is rated on a 4-point Likert scale ranging from 1 to 4, where 1 is "not true" and 4 is "almost always true". Higher scores indicate more severe social impairment associated with autism.

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Sponsors and collaborators

Lead sponsor

Stockholm University

Other

Collaborators

  • Karolinska Institutet

Registry information

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Sep 21, 2026
Registry last updated
Sep 21, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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