School-based Education for Autism

(SPEER Trial)

Recruiting at 2 trial locations

Overseen By Kemmerly Chipongian

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: Previous Remaking Recess participation

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

350 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if different training methods for educators can improve social skills among autistic students and their peers during recess. The study will test an intervention called Remaking Recess, which trains educators to better support social interactions among students. Schools will try two approaches: one provides direct coaching to educators, and the other adds extra resources to support implementation. The trial seeks elementary-aged autistic students or those with similar neurodevelopmental conditions, along with paraeducators or teachers in U.S. public schools who have not previously participated in a Remaking Recess study.

As an unphased trial, this study offers participants the chance to contribute to innovative educational strategies that could enhance social experiences for students.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this school-based intervention is safe for students?

Research shows that Remaking Recess, a program used in schools to help kids interact socially, receives positive feedback from students. Previous studies have examined its impact on children with autism during recess. These studies found no major negative effects from participating in the program. Instead, they demonstrated that it improved peer interactions without causing harm. The program emphasizes play and interaction with friends through everyday activities, ensuring its safety for children. Overall, Remaking Recess appears to be a safe and effective method for helping children with autism enhance their social skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these interventions because they aim to improve social engagement for children with autism in a school setting. Unlike traditional autism therapies that often occur in clinical environments, Remaking Recess is integrated into the school day, providing direct training and coaching to educators to enhance peer interactions during recess. The TEAM approach further supports this by developing a tailored implementation plan that empowers school staff to effectively apply the Remaking Recess techniques. Together, these strategies focus on creating a supportive and inclusive environment, which is crucial for the social development of children with autism.

What evidence suggests that the Remaking Recess intervention is effective for improving social skills in autistic students?

Studies have shown that Remaking Recess, an intervention in this trial, improves social skills in students with autism. Research indicates that this school-based program helps students engage more with classmates during recess. In earlier studies, participants in Remaking Recess demonstrated better social interactions with peers. Another intervention in this trial, the TEAM approach, supports Remaking Recess by helping teachers implement these strategies effectively. Overall, these programs aim to create a more supportive environment for students with autism during recess. ^{1 2 3 6 7}

Who Is on the Research Team?

Freda Liu, PhD

Principal Investigator

University of Washington

Are You a Good Fit for This Trial?

This trial is for paraeducators working with children who have Autism Spectrum Disorder or other neurodevelopmental disorders. It aims to improve social skills during recess. Paraeducators must be willing to participate in coaching and possibly work with school-based teams.

Inclusion Criteria

I am a student in grades K-5, aged 5-12, with autism or a neurodevelopmental disorder.

I work with K-5th grade students in a US public school and am over 18.

Exclusion Criteria

Students or educators that have previously participated in Remaking Recess studies will not be eligible to enroll in this study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training and Coaching

Paraeducators receive direct training and in vivo coaching on the Remaking Recess intervention

4 months

Regular in-person coaching sessions

Implementation and Monitoring

Implementation of Remaking Recess with ongoing monitoring of fidelity and sustainment

12 months

Periodic assessments at 4, 8, 12, and 16 months

Follow-up

Participants are monitored for the sustainment of the intervention and its impact on social skills

4 months

What Are the Treatments Tested in This Trial?

Interventions

• Remaking Recess

Trial Overview The study tests the 'Remaking Recess' intervention, which helps autistic students engage socially at recess. It examines if coaching paraeducators alone or combined with school-level team strategies can enhance the use of this program effectively.

How Is the Trial Designed?

Group I: TEAM Experimental Treatment 2 Interventions

Schools that are randomized to the TEAM condition will receive an additional implementation support intervention. TEAM will leverage existing human resources in the school to specifically focus on developing an implementation blueprint to foster a supportive implementation context for paraeducators to use Remaking Recess.

Group II: Remaking Recess Active Control 1 Intervention

Remaking Recess is a school-based social engagement intervention designed to enhance elementary school contextual factors to better support peer engagement during recess. Remaking Recess is delivered to educators through direct training and in vivo coaching by a certified Remaking Recess Coach.

Remaking Recess is already approved in United States for the following indications:

Approved in United States as Remaking Recess for:

• Improving peer engagement and social inclusion for children with autism spectrum disorder (ASD)

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

Published Research Related to This Trial

In a study involving 31 children with autism and 28 school personnel, providing implementation support alongside the Remaking Recess intervention led to significantly better social outcomes, such as increased social network inclusion and more friendship nominations, compared to training without support.

Both intervention groups showed improvements in social engagement, with reduced solitary play and increased joint engagement, indicating that while the intervention was beneficial, additional support may enhance its effectiveness in school settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of implementation support on the use of a social engagement intervention for children with autism in public schools. Locke, J., Shih, W., Kang-Yi, CD., et al.[2020]

The COMPASS intervention significantly improved educational outcomes for young children with autism, showing a very large effect size (d = 1.41) for face-to-face coaching and a large effect size (d = 1.12) for web-based coaching compared to a placebo control group.

Both face-to-face and web-based coaching were equally effective, indicating that videoconferencing technology can effectively connect teachers with autism specialists, making it a promising tool for enhancing educational practices in autism intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized controlled trial of COMPASS web-based and face-to-face teacher coaching in autism. Ruble, LA., McGrew, JH., Toland, MD., et al.[2022]

A social validation survey involving parents, teachers, and administrators highlighted strong support for five key components of effective autism interventions in school settings: individualized programming, data collection, empirically-based strategies, active collaboration, and a focus on long-term outcomes.

These validated components can guide the evaluation of current autism curricula and inform training for professionals and families, aiming to enhance the quality of autism programs in public schools.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social validation of evidence-based practices in autism by parents, teachers, and administrators. Callahan, K., Henson, RK., Cowan, AK.[2022]

This systematic review analyzed 108 studies to identify effective strategies for adapting educational settings to support autistic students, highlighting the importance of teachers' attitudes and social skills development.

A significant research gap was found regarding the perspectives of autistic students and the need for environmental adaptations, suggesting that professional development for educators should focus on autism-specific strategies to enhance inclusion and learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strategies in supporting inclusive education for autistic students-A systematic review of qualitative research results. Petersson-Bloom, L., Holmqvist, M.[2022]

A study involving 100 children with autism showed that a combination of structured institution-based teaching and family rehabilitation training significantly improved autism-related behaviors and skills compared to a control group that only received the teaching program.

After 12 months, the combination therapy group had lower scores on the Autism Behavior Checklist and Autism Treatment Evaluation Checklist, indicating reduced autism symptoms, and higher scores on the Psychoeducational Profile, suggesting improved developmental outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Clinical efficacy of structured institution-based teaching programme combined with family rehabilitation training in treatment of childhood autism]. Liu, C., Lu, B., Zhang, Y., et al.[2015]

The pilot study tested the 'Remaking Recess' social engagement intervention with four children with autism spectrum disorder (ASD) and school personnel in two urban public schools, showing promising results in improving peer engagement and social inclusion.

The findings suggest that this intervention can be effectively implemented in under-resourced schools, indicating its potential to enhance social outcomes for children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

It's Messy but Real: A Pilot Study of the Implementation a Social Engagement Intervention for Children with Autism in Schools. Locke, J., Kang-Yi, C., Pellecchia, M., et al.[2020]

The RUBI program, originally designed for parents of children with autism spectrum disorder (ASD), was successfully adapted for use by school staff, addressing their concerns about managing challenging behaviors in students with ASD.

Feedback from educators during the redesign process led to improved perceptions of the RUBI manual's appropriateness and usability in schools, suggesting it can effectively equip teachers with strategies to manage disruptive behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Iterative redesign of a caregiver-mediated intervention for use in educational settings. Bearss, K., Tagavi, D., Lyon, AR., et al.[2023]

Only 32% of evidence-based interventions for autism have been tested in K-12 educational settings, making it unclear how applicable these strategies are for educators.

Most research has focused on preschool children, leaving a gap in understanding how effective these interventions are for school-aged children, particularly regarding restricted and repetitive behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advances in School-Based Interventions for Students With Autism Spectrum Disorder: Introduction to the Special Issue. Anderson, CM., Smith, T., Wilczynski, SM.[2018]

The ASAP intervention, implemented in a 4-year study across 78 classrooms with 161 preschool-aged children with autism, did not significantly improve social-communication and play skills compared to standard practices.

However, children in the ASAP group demonstrated increased classroom engagement, and the intervention appeared to help reduce teacher burnout, suggesting potential benefits beyond the primary outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial. Boyd, BA., Watson, LR., Reszka, SS., et al.[2019]

Citations

1. asatonline.org asatonline.org/research-treatment/research-synopses/remaking-recess-intervention/

Remaking Recess intervention for improving peer ... In this synopsis, we review a research study that evaluates Remaking Recess,a school-based social skills intervention for students with autism spectrumdisorder.

2. tandfonline.com tandfonline.com/doi/abs/10.17105/SPR-2017-0113.V48-2

Remaking Recess Intervention for Improving Peer ... There is a prevailing need for social skills interventions that staff in public schools can deliver effectively to children with autism spectrum disorder (ASD).

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6502245/

It's Messy but Real: A Pilot Study of the Implementation a ... This pilot study examined the implementation and sustainment of a social engagement intervention, Remaking Recess, for four elementary-aged children with ASD.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT04972838

NCT04972838 | AIR-B4: Remaking Recess (RR) Remaking Recess is a flexible, school-based social engagement intervention for students with autism and their peers. The research team will work with school ...

5. remakingrecess.org remakingrecess.org/rr-research

Our Research This study aimed to test the effects of a psychosocial intervention, Remaking Recess, on peer engagement for children with autism spectrum disorder (ASD).

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7308214/

Individual and Organizational Characteristics Predicting ... One school-based intervention, Remaking Recess, combines both adult-facilitated and peer-mediated intervention strategies and has shown significant results in ...

7. researchgate.net researchgate.net/publication/337042859_Remaking_Recess_Intervention_for_Improving_Peer_Interactions_at_School_for_Children_With_Autism_Spectrum_Disorder_Multisite_Randomized_Trial

Remaking Recess Intervention for Improving Peer ... (2019) have explored the Remaking Recess (RR) intervention, which is a social skills invention geared towards improving peer relationships on the playground.