Training Programs for Autism

(TEAMS Trial)

Recruiting at 2 trial locations

Overseen By Lauren Brookman-Frazee, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Davis

Disqualifiers: AIM HI or CPRT study participation

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

Compensation: Varies

Number of Visits: Unknown

1206 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to test the effectiveness of the "Translating Evidence-based Interventions (EBI) for ASD: Multi-Level Implementation Strategy" (TEAMS) model on provider-level implementation outcomes when used to enhance provider training in two evidence-based interventions for children with autism spectrum disorder (ASD). The TEAMS- Leadership Institute (TLI) module includes training to program/school district leaders in implementation of EBI, and the TEAMS Individualized Provider Strategy for Training (TIPS) module applies Motivational Interviewing strategies to facilitate individual provider behavior change. TEAMS will be tested in combination with two clinical interventions in two community service setting contexts (1) AIM HI intervention in mental health programs and (2) CPRT intervention in schools. It is expected that the addition of TLI and / or TIPS will improve use of EBI by community providers.

Will I have to stop taking my current medications?

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

Is Pivotal Response Treatment (PRT) safe for humans?

The research on Pivotal Response Treatment (PRT) for autism does not report any safety concerns, suggesting it is generally safe for use in humans. ^{1 2 3 4 5}

How does the AIM HI and CPRT treatment for autism differ from other treatments?

The AIM HI treatment is unique because it involves training therapists to use evidence-based strategies tailored to each child's needs, enhancing caregiver engagement and session structure. CPRT, a form of Pivotal Response Treatment, focuses on improving social communication in a naturalistic setting, using strategies to boost children's motivation, which is different from more traditional, structured interventions. ^{3 5 6 7 8}

Eligibility Criteria

This trial is for leaders, providers, and parents involved in mental health programs or public education services for children with Autism Spectrum Disorder (ASD) in certain California counties. Leaders must manage enrolled sites; providers need an eligible child on their caseload and commit to at least 7 months of employment; parents are paired with participating providers.

Inclusion Criteria

Leaders: Identified as Program Managers at an enrolled site or identified as Program Specialist in an enrolled program/district

Providers: Employed at a participating program/district, Employed for at least the next 7 months, Has an eligible child on current caseload/classroom, Did not participate in the AIM HI or CPRT effectiveness studies

I have a child aged 3-13 with an autism diagnosis.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training and Implementation

Providers and leaders receive training in evidence-based interventions and implementation strategies, including TEAMS modules (TLI and TIPS).

6 months

Regular training sessions and workshops

Follow-up

Participants are monitored for implementation outcomes and child improvements post-training.

6 months

Assessments at PRE and POST intervention

Treatment Details

Interventions

• An Individualized Mental Health Intervention for ASD (AIM HI)
• Classroom Pivotal Response Teaching (CPRT)
• Motivational Enhancement (TIPS for Training)
• Teams Leadership Institute (TLI)

Trial Overview The study tests the TEAMS model's effectiveness in improving ASD interventions. It combines Team-Enhanced Teams Leadership Institute (TLI) training for leaders and Motivational Interviewing strategies (TIPS) for providers, alongside AIM HI intervention in mental health settings or CPRT intervention in schools.

Participant Groups

Group I: TIPS + TLI Experimental Treatment 4 Interventions

Programs assigned to the TIPS + TLI condition will receive TIPS EBI training for providers and leaders will participate in TLI

Group II: TEAMS Leadership Institute (TLI) ONLY Experimental Treatment 4 Interventions

Programs assigned to the TLI ONLY condition will receive standard EBI training for providers and leaders will participate in TLI.

Group III: Motivational Enhancement (TIPS for Training) ONLY Experimental Treatment 3 Interventions

Programs assigned to the TIPS ONLY condition will receive enhanced TIPS EBI training for providers.

Group IV: Standard Active Control 2 Interventions

Programs assigned to the Standard condition will receive standard EBI training only

Who Is Running the Clinical Trial?

University of California, Davis

Lead Sponsor

Trials

958

Recruited

4,816,000+

University of California, San Diego

Collaborator

Trials

1,215

Recruited

1,593,000+

University of California, Los Angeles

Collaborator

Trials

1,594

Recruited

10,430,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

A pilot study tested a developmental adaptation of Pivotal Response Treatment (PRT) with three infants at-risk for autism, showing promising results in enhancing their functional communication skills.

The introduction of PRT also improved parents' ability to implement the treatment effectively, suggesting that this approach could be a feasible intervention for very young children at-risk for autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal response treatment for infants at-risk for autism spectrum disorders: a pilot study. Steiner, AM., Gengoux, GW., Klin, A., et al.[2021]

The pilot study involving seven teachers and students with autism spectrum disorder (ASD) found that training in classroom pivotal response teaching (CPRT) did not significantly improve teachers' implementation fidelity or students' communication skills and maladaptive behaviors.

Despite the lack of measurable improvements in student outcomes, teachers expressed high satisfaction with the CPRT training, suggesting that while the training may not have led to immediate changes, it could still be valuable for educators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training Teachers to Implement Classroom Pivotal Response Teaching during Small-group Instruction: A Pilot Study. Verschuur, R., Huskens, B., Didden, R.[2021]

In a randomized controlled trial involving 44 children with Autism Spectrum Disorder (ASD), Pivotal Response Treatment (PRT) led to significant improvements in social-communicative skills after 12 weeks compared to treatment-as-usual (TAU).

PRT also showed larger gains in global functioning and adaptive socialization skills, indicating its potential effectiveness as a therapeutic intervention for children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal Response Treatment for School-Aged Children and Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial. de Korte, MWP., van den Berk-Smeekens, I., Buitelaar, JK., et al.[2021]

Pivotal response treatment (PRT) has been shown to be an effective intervention for improving communication and social functioning in children with autism spectrum disorder (ASD), based on a systematic evaluation of 17 studies.

The studies demonstrated strong adherence to several research quality standards, such as using standardized protocols and objective evaluators, but showed variability in treatment fidelity and the use of longitudinal designs, indicating areas for improvement in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pivotal response treatment for children with autism spectrum disorder: a systematic review of research quality. Cadogan, S., McCrimmon, AW.[2018]

Pivotal Response Treatment (PRT) has been shown to be effective for preschool-aged children with autism spectrum disorders (ASD), leading to significant improvements in social communication and adaptive skills over a 4-month treatment period.

While the children demonstrated substantial gains, the degree of improvement varied across different measures, indicating that while PRT is beneficial, responses may differ among individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvements in social and adaptive functioning following short-duration PRT program: a clinical replication. Ventola, P., Friedman, HE., Anderson, LC., et al.[2021]

References

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

Pivotal response treatment for autism: A brief report on training for rural communities. [2021]

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

Pivotal response treatment for infants at-risk for autism spectrum disorders: a pilot study. [2021]

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

Training Teachers to Implement Classroom Pivotal Response Teaching during Small-group Instruction: A Pilot Study. [2021]

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

Pivotal Response Treatment for School-Aged Children and Adolescents with Autism Spectrum Disorder: A Randomized Controlled Trial. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Pivotal response treatment for children with autism spectrum disorder: a systematic review of research quality. [2018]

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

Improvements in social and adaptive functioning following short-duration PRT program: a clinical replication. [2021]

7. England pubmed.ncbi.nlm.nih.gov

The effectiveness of training community mental health therapists in an evidence-based intervention for ASD: Findings from a hybrid effectiveness-implementation trial in outpatient and school-based mental health services. [2022]

8. New Zealand pubmed.ncbi.nlm.nih.gov

Pivotal response treatment for autism spectrum disorder: current perspectives. [2022]