News and Knowledge

In 2013, OAR funded a one-year study of the Advancing Social-Communication and Play (ASAP) intervention. Intended to improve the social-communication and engagement skills of elementary school-age children who are severely affected by ASD, the program was tested in four elementary school classrooms in the Chapel Hill-Carrboro, N.C. school district. Four children who ranged from kindergarten to fifth grade, all of whom had difficulty with social-communication and engagement, participated in the study.

Designed to be led by trained elementary school teachers, ASAP focuses on a set of target objectives in the areas of communication (e.g. social interaction, joint attention, requesting) and play (e.g. exploratory, functional, relational, symbolic). ASAP was designed as a supplemental intervention that can be used in a comprehensive intervention program. Classroom teachers were expected to work on ASAP objectives with individual students for 40 minutes per day, using at least three activities per day that address ASAP objectives as a group. Each student received a minimum of 10 weeks of the ASAP treatment.

Goals

Principal investigator, Jessica Dykstra, Ph.D., an investigator at the Frank Porter Graham Child Development Center at the University of North Carolina at Chapel Hill, led the study, Improving Social-Communication and Engagement of Elementary Students with Autism Spectrum Disorders. She planned to answer these questions:

• Does implementation of the ASAP intervention improve social-communication of elementary school children with ASD?
• Does implementation of the ASAP intervention improve the engagement of elementary school children with ASD?
• Is the ASAP intervention feasible and acceptable in elementary school classrooms serving children with ASD?

Results

What she and her research team discovered was that the intervention was successful in improving social-communication in at least one area for three of the four children and made positive changes in at least one area of engagement for two of the four children. For social-communication, the first child made gains in social interaction and requesting, the second child made gains in requesting and joint attention, the third child made gains in social interaction, and the fourth child did not make notable gains. For engagement, the first child had a slight increase in joint engagement and the second child had a decrease in passive/non-engagement and an increase in single engagement. The third and fourth children did not show any notable changes in engagement.

The school personnel who implemented the intervention completed surveys and semi-structured interventions, and rated and spoke highly of the value and feasibility of the ASAP intervention for elementary school students with autism with significant communication needs. However, school personnel also noted in interviews that they felt they would need ongoing coaching to implement the intervention.

The school personnel survey and interview data suggest that ASAP is a feasible and acceptable intervention for elementary school classrooms, but would require some modifications to promote ease of use in elementary school classrooms.

There have been very few intervention studies for individuals with autism who are minimally verbal, and the intervention studies that do exist have been implemented by research teams, rather than school teams. This study demonstrates that school personnel can feasibly and successfully implement an intervention to target early social-communication and play skills among elementary school students with autism with the most significant communication needs. It also sets the stage for future adaptations to existing interventions to target this population of students.