Remaking Recess for Autism

(RR Trial)

Recruiting at 2 trial locations

Overseen By Consuelo Garcia, BS

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Health Resources and Services Administration (HRSA)

Disqualifiers: No ASD/NDD diagnosis, Not under-resourced, Others

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

Compensation: Varies

Number of Visits: 3

264 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests Remaking Recess, a program that helps children with autism or developmental disorders engage socially during school recess. It targets children aged 5-12 and involves training school staff to support these children in social interactions through structured play activities. Remaking Recess is designed to improve peer engagement for children with autism spectrum disorder (ASD) during recess.

Do I need to stop my current medications for the trial?

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

What data supports the effectiveness of the treatment Remaking Recess for Autism?

Research shows that Remaking Recess can improve social engagement and inclusion for children with autism in schools, especially when combined with implementation support. Children in this program had better social network inclusion and received more friendship nominations compared to those without additional support. ^{1 2 3 4 5}

Is Remaking Recess safe for children with autism?

The studies on Remaking Recess focus on its effectiveness in improving social engagement for children with autism, but they do not report any safety concerns or adverse effects, suggesting it is generally safe for use in schools. ^{1 2 5 6 7}

How is the Remaking Recess treatment different from other treatments for autism?

Remaking Recess is unique because it focuses on improving social engagement for children with autism during school recess, using peer-mediated social skills and support from school staff. Unlike other treatments, it is specifically designed to be implemented in school settings, making it accessible and practical for everyday use in under-resourced public schools. ^{1 3 5 8 9}

Eligibility Criteria

This trial is for children aged 5-12 with Autism Spectrum Disorder (ASD) or other neurodevelopmental disorders who spend most of their day in general education and come from under-resourced families. Eligible schools are those receiving Title I funding or located in rural areas, and the family income must be below 250% of federal poverty guidelines. School personnel involved with these children can also participate.

Inclusion Criteria

Spend majority of the day (51%) in a general education classroom

I work at an elementary school, possibly as a teacher, aide, or playground staff.

Expert medical diagnosis or educational classification of ASD

Exclusion Criteria

No official ASD/NDD diagnosis

My child is either under 5 years old or over 12.

Does not spend majority of the day (51%) in general education classroom

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training and Coaching

School personnel receive remote training and active coaching for implementing the Remaking Recess intervention

10-12 weeks

Weekly remote coaching sessions

Implementation

Implementation of the Remaking Recess intervention during school recess periods

School year

Ongoing during recess

Follow-up

Participants are monitored for effectiveness and social functioning after intervention

6 months

3 assessment points (baseline, midpoint, end of school year)

Treatment Details

Interventions

• Remaking Recess (RR)

Trial Overview The AIR-B4 study tests the 'Remaking Recess' intervention aimed at improving social engagement during recess for kids with ASD. It involves training school staff to implement play-based activities over approximately five hours throughout the school year, assessing effectiveness when combined with an implementation strategy called UNITED.

Participant Groups

Group I: UNITED Experimental Treatment 1 Intervention

UNITED is premised on the idea that successful implementation in organizations like schools and early intervention systems requires a team-based approach, in which the team is thoughtfully assembled, develops a plan for implementation, assigns roles and responsibilities, and carefully tracks and supports implementation and sustainment in all its stages within a few meetings and ongoing coaching from the research staff.

Group II: Implementation as Usual (IAU) Active Control 1 Intervention

The organizations will implement RR as usual. The research team will be available to provide support on the RR intervention as needed.

Who Is Running the Clinical Trial?

Health Resources and Services Administration (HRSA)

Lead Sponsor

Trials

88

Recruited

152,000+

University of Rochester

Collaborator

Trials

883

Recruited

555,000+

Drexel University

Collaborator

Trials

160

Recruited

48,600+

University of California, Davis

Collaborator

Trials

958

Recruited

4,816,000+

University of Kansas

Collaborator

Trials

157

Recruited

332,000+

University of Washington

Collaborator

Trials

1,858

Recruited

2,023,000+

University of Pennsylvania

Collaborator

Trials

2,118

Recruited

45,270,000+

Findings from Research

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]

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 JASPER intervention, which focuses on joint attention, play skills, and language development, showed significant improvements in these areas for children with autism spectrum disorder compared to those who did not receive the intervention, based on a review of 19 studies.

While parents and educators generally found the JASPER techniques effective, the studies reviewed did not meet all quality indicators, indicating a need for further research to explore the broader impacts of JASPER on children with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of JASPER intervention for children with autism spectrum disorder: A systematic review. Waddington, H., Reynolds, JE., Macaskill, E., et al.[2021]

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]

References

1. England 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. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

The Effects of Stability Ball Seating on the Behavior of Children with Autism During Instructional Activities. [2020]

3. England pubmed.ncbi.nlm.nih.gov

Examining playground engagement between elementary school children with and without autism spectrum disorder. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Alternative seating for young children with Autism Spectrum Disorder: effects on classroom behavior. [2019]

5. England 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. [2020]

6. England pubmed.ncbi.nlm.nih.gov

The effects of JASPER intervention for children with autism spectrum disorder: A systematic review. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Efficacy of the ASAP Intervention for Preschoolers with ASD: A Cluster Randomized Controlled Trial. [2019]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Peer Mediation to Increase Communication and Interaction at Recess for Students with Autism Spectrum Disorders. [2020]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Promoting Social Learning at Recess for Children with ASD and Related Social Challenges. [2020]