CAST for Autism Spectrum Disorder

(CAST Trial)

Overseen By Lisa A Ruble, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Ball State University

Disqualifiers: Moving, Job change, others

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

Compensation: Varies

Number of Visits: Unknown

297 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial focuses on improving the transition to adulthood for autistic students through a program called COMPASS Across Settings (CAST). The goal is to enhance the skills of autistic youth in setting and achieving personal goals, potentially leading to better outcomes in employment and education. The trial will test CAST's effectiveness by providing coaching support to students, their families, and educators, aiming to align efforts at home, school, and in the community. Students with autism who have an Individualized Education Program (IEP), along with their supporting family members and teachers, are well-suited for this study. As an unphased trial, this study offers a unique opportunity to contribute to innovative educational strategies that could significantly improve life skills for autistic youth.

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 the CAST intervention is safe for autistic youth?

Previous studies have used the COMPASS Across Settings (CAST) program to assist autistic students in transitioning from school to life after school. These studies have shown that CAST improves students' goal-setting and success skills at home, school, and in the community.

CAST is not a drug or medical procedure, so it lacks the safety risks associated with medications. Instead, it provides coaching support to caregivers, students, and job specialists to help students achieve their goals.

As a behavioral program, CAST focuses on coordinating efforts to better support autistic students. No reports of negative effects have emerged from using CAST, suggesting it is well-received by participants. Its ongoing testing indicates potential to help students without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the CAST (COMPASS Across Settings) protocol for Autism Spectrum Disorder because it offers a holistic approach to integrating plans and services across various settings, like schools and workplaces. Unlike traditional treatments that focus mainly on behavior or therapy sessions, CAST aims to streamline support systems involving administrators, teachers, parents, and transition specialists, making it a comprehensive strategy. Additionally, its focus on improving postsecondary outcomes for students, including those from underserved communities, makes it a promising innovation in the field, with the potential for more inclusive and effective support.

What evidence suggests that the COMPASS Across Settings (CAST) intervention is effective for enhancing goal setting and attainment skills in autistic youth?

Research shows that COMPASS Across Settings (CAST) is designed to help autistic students transition more successfully. Previous studies have found that similar programs can improve social skills, communication, and independence, which are important for children with autism. This trial includes different approaches to evaluating CAST. One arm involves a pre-post study to test CAST's effectiveness, while another arm uses focus groups to gather insights for its development. Additionally, a randomized controlled study will assess CAST's impact on postsecondary outcomes. This approach includes coaching support for caregivers, students, and job specialists, working together at home, school, and in the community. Earlier research has shown that this collaboration leads to better goal achievement and teamwork between caregivers and teachers. These findings suggest that CAST could effectively help autistic students achieve better outcomes after high school. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for autistic students with Individualized Education Programs (IEPs), their caregivers, special education teachers, and pre-employment specialists. Participants should not be planning any major life changes like moving or job transitions during the school year.

Inclusion Criteria

Pre-employment specialists of students with autism

Caregivers of students with autism

Students with verified autism and IEPs that designate services for autism

Exclusion Criteria

Not planning to move or leave their job over the school year

Timeline for a Trial Participant

Development and Focus Groups

Focus groups with administrators, special education teachers, parents, students, and pre-employment transition specialists to integrate plans and services across settings

12 months

Field Test

Conduct a field test of CAST, making further revisions based on feedback

12 months

Randomized Controlled Trial

Conduct a small RCT and network analysis to evaluate CAST for improved postsecondary outcomes

12 months

Follow-up

Participants are monitored for postsecondary outcomes at 3 months and 1 year after high school

12 months

What Are the Treatments Tested in This Trial?

Interventions

• COMPASS Across Settings (CAST)

Trial Overview The COMPASS Across Settings (CAST) intervention is being tested to improve goal setting and attainment skills in autistic youth. CAST integrates three evidence-based interventions and provides coaching support across home, school, and community settings.

How Is the Trial Designed?

Group I: Pre-Post study of CAST Experimental Treatment 1 Intervention

The research team will then conduct a field test of CAST in year 2, making further revisions.

Group II: Focus Groups to Inform CAST Active Control 1 Intervention

For the year 1 development activities, the research team will conduct focus groups with administrators, special education teachers, parents, students, and pre-employment transition specialists about how to integrate plans and services across settings.

Group III: Randomized Controlled Study of CAST Active Control 1 Intervention

In year 3, they will use a mixed methods design using a small RCT and network analysis, oversampling African American students and students from rural areas, to evaluate CAST for improved postsecondary outcomes in employment, training, and education.

Who Is Running the Clinical Trial?

Ball State University

Lead Sponsor

Trials

10

Recruited

670+

University of Toledo

Collaborator

Trials

8

Recruited

640+

Indiana University

Collaborator

Trials

1,063

Recruited

1,182,000+

Published Research Related to This Trial

The COMPASS intervention, adapted for transition-age youth with autism spectrum disorder (ASD), significantly improved Individualized Education Program (IEP) outcomes compared to a placebo control group, with a large effect size (d = 2.1).

High fidelity in consultant implementation and improved teacher adherence over time highlight the effectiveness of ongoing coaching in enhancing educational outcomes for students with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized Control Trial of COMPASS for Improving Transition Outcomes of Students with Autism Spectrum Disorder. Ruble, LA., McGrew, JH., Toland, M., et al.[2020]

An inventory of 55 usual care practices for youth with autism spectrum disorder (ASD) was developed through input from 66 expert providers, highlighting the diverse approaches used in treatment.

The study identified 48 practices that experts considered familiar and useful, which can help standardize care and improve the implementation of evidence-based treatments for ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Multisite, Multidisciplinary Delphi Consensus Study Describing "Usual Care" Intervention Strategies for School-Age to Transition-Age Youth With Autism. Kerns, CM., Moskowitz, LJ., Rosen, T., et al.[2021]

The review highlights that many adults on the autism spectrum experience poor quality of life, emphasizing the need to understand the social-ecological factors that influence their transition outcomes.

Current research on autism outcomes is limited in scope, often focusing on a narrow range of social-ecological factors and relying heavily on a few national datasets, which suggests a need for more diverse and comprehensive studies to improve understanding and outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social-Ecological Correlates in Adult Autism Outcome Studies: A Scoping Review. Anderson, KA., Roux, AM., Kuo, A., et al.[2019]

The implementation of the ASD Care Pathway (ASD-CP) in a public hospital child psychiatric service led to a 40% reduction in the average length of hospital stays for youth with autism spectrum disorder, from 22.4 days to 13.4 days.

Crisis interventions, such as holds and restraints, decreased by 77% after the ASD-CP was implemented, indicating a potential improvement in the management of patients with ASD, although these results approached statistical significance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does an Autism Spectrum Disorder Care Pathway Improve Care for Children and Adolescents with ASD in Inpatient Psychiatric Units? Kuriakose, S., Filton, B., Marr, M., et al.[2018]

Emerging evidence suggests that social challenges in autistic individuals may stem more from difficulties in social performance rather than a lack of social knowledge, which could change how we assess and support these individuals.

Focusing on performance-related factors rather than just knowledge could lead to more effective interventions and better inclusion strategies for autistic people, addressing their social challenges in a more meaningful way.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social Knowledge & Performance in Autism: A Critical Review & Recommendations. Gates, JA., McNair, ML., Richards, JK., et al.[2023]

The ACT SMART Toolkit, designed to improve the implementation of evidence-based practices for autistic children in community settings, showed high adherence and responsiveness during its pilot study with six agencies in Southern California.

However, the preparation phase of the toolkit had notably lower adherence and dose, indicating that this more intensive phase may need additional support to enhance implementation fidelity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fidelity to the ACT SMART Toolkit: an instrumental case study of implementation strategy fidelity. Tschida, JE., Drahota, A.[2023]

The NECC Core Skills Assessment (NECC-CSA) was validated by 245 participants, including parents and professionals, who identified 47 core skills as foundational for individuals with autism, indicating its relevance and importance in skill development.

The assessment highlights differences in perspectives between parents and professionals, suggesting that the NECC-CSA can serve as a reliable framework for creating educational programs tailored to the needs of individuals with autism spectrum disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social validation of the New England Center For Children--Core Skills Assessment. Dickson, CA., MacDonald, RP., Mansfield, R., et al.[2021]

A study involving 53 expert providers revealed that familiarity with different intervention practices for autism spectrum disorder varies based on the provider's setting and experience, with those outside school settings more familiar with cognitive approaches.

Providers' familiarity with intervention strategies can influence the type of care children with autism receive, highlighting the need for families to understand these differences to ensure effective treatment and reduce disparities in care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors of expert providers' familiarity with intervention practices for school- and transition-age youth with autism spectrum disorder. Cooper, CM., Rosen, T., Kim, H., et al.[2023]

Group-based social skills interventions (GSSIs) for adolescents with higher-functioning autism spectrum disorder show considerable variability in participant and intervention characteristics, which may affect their effectiveness; future research should explore how these factors influence outcomes.

Current assessments of GSSIs yield largely inconclusive results, highlighting the need for more rigorous methodologies and improved measurement tools to accurately evaluate the efficacy of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group-based social skills interventions for adolescents with higher-functioning autism spectrum disorder: a review and looking to the future. McMahon, CM., Lerner, MD., Britton, N.[2021]

Citations

1. ies.ed.gov ies.ed.gov/use-work/awards/compass-across-settings-cast-integrating-school-home-and-community-services-and-improving-transition

COMPASS Across Settings (CAST) for Integrating School ... This project will result in a fully developed intervention, CAST, for improving IEP and postsecondary outcomes of autistic students.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06309160?cond=%22Autistic%20Disorder%22&aggFilters=status:not%20rec&rank=4

COMPASS Across Settings (CAST) for Improving Transition ... Purpose: The purpose of this project is to develop and test the COMPASS [Collaborative Model for Competence and Success] Across Settings (CAST) intervention ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6422695/

Adapting COMPASS for Youth with ASD to Improve Transition ... The purpose of this paper is to describe a process of adaptation that may be useful for other implementation science studies of consultation interventions.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3117578/

The Effects of Consultation on Individualized Education ... With COMPASS, we targeted three goal areas that have been identified as being critical for children with autism: social skills, communication, and independence.

5. autism.org autism.org/compass-webinar/

COMPASS: A Caregiver–Teacher Partnership Model for ... Empirical studies have shown that COMPASS improves intervention fidelity, child goal attainment, and collaborative engagement, making it a promising approach ...

6. compassforautism.org compassforautism.org/compass-across-settings-cast/

COMPASS Across Settings (CAST) – COMPASS for Life Our team is dedicated to improving transition outcomes for students with autism. We are running an intervention called COMPASS Across Settings (CAST) based ...

7. researchgate.net researchgate.net/publication/321525697_Collaborative_Model_for_Promoting_Competence_and_Success_for_Students_with_ASD

Collaborative Model for Promoting Competence and ... The COMPASS program—Collaborative Model for Promoting Competence and Success for Students with Autism Spectrum Disorders—has been developed to improve outcomes ...