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Completed

NCT Number: NCT03634761

Early Intervention and Autism: Transformation From Research to Practice Through a Competency Based Model

This study evaluates the effect of a competency based model on program quality in Swedish preschools for Children with autism spectrum disorder (ASD). Half of the participating preschools will receive "treatment as usual" (Early Intensive Behavioral Intervention (EIBI) provided to a Child with ASD in the preschool, supervised by an external supervisor from a habilitation center), while the other half will receive the above as well as, in-service training and monthly on-site coaching sessions also involving preschool staff other than the paraprofessional (competency based model). It is hypothesized that the competency based model will improve program quality, child's engagement, preschool staff knowledge, allegiance and self-efficacy compared to the comparison group.

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Key information

Age range

2 year–5 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Autismcenter för Små Barn, Stockholm, Sweden

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About this study

Almost all children in Sweden between two and five years attend preschool including children with Autism spectrum disorder (ASD). High quality and structured early intervention programs grounded in the principles and procedures of applied behavior analysis have been found in numerous research studies and reviews to significantly improve developmental outcomes, adaptive behaviors and learning outcomes of preschool children with ASD.

A prerequisite of which is a high quality learning environment that includes both the physical set-up, learning climate and competence of staff. The primary purpose of this project is to improve program quality for preschool children with ASD through a competency based model grounded in ecological systems theory sustainable over time and applicable within the Swedish service support system. In total approximately 16 preschools will participate, half of which will receive "treatment as usual" EIBI to a Child with ASD in the preschool, supervised by an external supervisor from a habilitation center), while the other half will also receive obtain in-service training and monthly on-site coaching through habilitation. Involved habilitation specialists will obtain in-service training prior to the onset of the study on how to use the Autism Program Environment Rating Scale (APERS), the basic tenets of coaching based on the concept of reflective and collaborative dialogues in which the preschool teachers knowledge of the child and context are taken into account.

It is hypothesized that the competency based model will improve program quality, child's engagement, adaptive behavior, increase preschool staff knowledge, allegiance and self-efficacy compared to the comparison group only receiving supervision in implementing a comprehensive program.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Autism diagnosis
  • Receiving comprehensive program/EIBI implemented in preschool setting with supervision from habilitation center

Exclusion criteria

-

Treatment and study plan

Competency based model

Behavioral

Qualified Learning course and workshop to preschool staff combined with monthly on-site coaching at preschool sites to improve overall intervention setting quality and use of evidence bases practices, provided by external expert from habilitation center.

Comprehensive program

Behavioral

Comprehensive program of EIBI for Children with ASD supervised by external expert from habilitation center (treatment as usual)

Primary outcomes

  1. Change in overall program quality measured by the Autism Program Environment Rating Scale (APERS-P-SE)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    The APERS-P-SE is a rating scale designed to examine the preschool teaching environment of children with ASD in Sweden. It is used to assess overall intervention setting quality over 10 domains including areas such as Personal Independence and Functional Behavior. It consists of 56 items rated on a 5 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. Ethics, Values and Allegiance (EVA)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    A questionnaire used to assess attitude and allegiance to EIBI among preschool staff. 11 items/statements rated on a five point scale (I don't agree at all, to I highly agree)

  2. Evidence Based Practices (EBP)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    A questionnaire designed to assess knowledge, use and implementation skills of evidence based practices for Children with autism among preschool staff. 15 items rated on a 4 point Likert-scale (0 = no knowledge, 3 = high knowledge)

  3. Autism Knowledge Questionnaire (AKQ)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    A questionnaire designed to assess knowledge on ASD among preschool staff. 18 items/statements about autism, answered either yes/no/I dont know

  4. Self-Efficacy and Stress Questionnaire (SESQ)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    A questionnaire designed to assess stress and self-efficacy among preschool staff working with children with autism. A total of 34 items/statements rated on a 6 point Likert-scale (0 = i don't agree at all, 5 = i fully agree)

  5. Goal Attainment Scale (GAS)

    Time frame: Follow-up about 9 months after onset of study

    An ordinal scale designed to assess level of goal attainment for participating Children in the study rated from 0 (baseline), 1 (initial objective), 2 (secondary objective), 3 (annual goal), 4 (exceeds annual goal)

  6. Clinical Global Impression-autism (CGI-AUT)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    An instrument designed to assess the symptom severity of preschool aged children with ASD rated on a scale between 1 and 7 (1 = no autism symptoms, 7 = maximum symptom severity)

  7. Children's Engagement Questionnaire (CEQ)

    Time frame: Baseline and follow-up (about 9 months from baseline)

    A scale designed to assess children's level of engagement in various situations in and outside the preschool. It consists of 31 items/situations, rated on a 4 point scale (not at all typical, to very typical)

  8. Vineland Adaptive Behavior Scales - Second Edition (Vineland-II) - Teacher ratings

    Time frame: Baseline and follow-up (about 9 months from baseline)

    A scale designed to assess the adaptive functioning for children within various domains such as independence and Communication skills. Rated on a 3 point scale (0 = never occurs, 2 = occurs often)

Other outcomes

  1. Social validity scale

    Time frame: Follow-up about 9 months after onset of study

    A scale designed to asses the social validity of the goals targeted within the study

Sponsors and collaborators

Lead sponsor

Stockholm University

Other

Collaborators

  • Karolinska Institutet

Registry information

Acronym: AUT-TID

Important dates

Study start
2017
Primary completion
2019
Study completion
2019
First posted
Aug 16, 2018
Registry last updated
Sep 20, 2019

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

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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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