Improving Transition Outcomes in ASD using COMPASS

描述(由申请人提供)：本申请回应了为自闭症谱系障碍(ASD)患者开发和测试过渡到成人支持和服务的模式的确定需求，以防止服务失误并提高功能生活结果。该提案还解决了机构间自闭症协调委员会提出的关切，即“严重缺乏针对青少年和年轻人的经过测试的干预措施。”尽管联邦教育法要求公立学校作为个性化教育计划(IEP)的一部分提供过渡服务，但良好协调和有计划的过渡的承诺和潜力并未实现。这项拟议的研究建立在两个随机对照试验的基础上，即针对患有自闭症的幼儿的名为促进能力和成功的合作模式(COMPASS)的家长-教师协商干预试验，关于传统面对面和视频会议技术交付方法的有效性的数据，以及一本书长的治疗手册。COMPASS是一项实施战略，帮助将循证方法转化为课堂，并协助公立学校特殊教育工作者和家长进行生态评估、基于研究的目标制定和以人为中心的决策，以使ASD儿童的循证干预措施个人化。COMPASS干预措施包括在学年开始前进行最初的家长-教师会议(3小时)，然后是四次1小时的教师辅导。第一个目标是与政策制定者、家长、教师、服务提供者和自闭症患者等利益攸关方组成焦点小组，以获得关于以下方面的反馈：(1)国家政策和服务的长处和弱点，以及支持有效实施过渡年龄青少年自闭症最佳做法的现有或需要的资源；(2)其他 影响成人服务的问题，如住房、社会保障、医疗保险、交通；以及(3)COMPASS的具体方面，需要进行调整/修订，以满足过渡年龄青年的需要。根据这些结果，我们将确定需要调整/制定的措施，并从重点小组成员中的一个小样本获得对这些措施的反馈。我们的第二个目标是使用新的程序和措施(n=32名参与者三人组-顾问、教师、患有自闭症的学生)采用混合方法对适应的COMPASS进行两波随机对照试验以进行过渡规划。我们将获得关于干预措施(可接受性、可行性、结果)的定性反馈，并使用数据来修改/调整第二波实施，以及帮助为成人环境中的进一步应用提供信息。最后，我们将根据自闭症患者的低绩效和高绩效进行定性的案例研究，以了解可能解释干预反应差异的因素，并利用这些因素来修改/适应第二波实施。

DESCRIPTION (provided by applicant): This application responds to the identified need for developing and testing a model for transition to adult supports and services for individuals with autism spectrum disorders (ASD) that prevents lapses in services and enhances functional life outcomes. The proposal also addresses concerns raised by the Interagency Autism Coordinating Committee of a "critical lack of tested interventions for adolescents and young adults." Although federal education law mandates that public schools provide transition services as part of the Individualized Education Program (IEP), the promise and potential for a well-coordinated and planned transition is not being met. The proposed study builds on two randomized controlled trials of a parent-teacher consultation intervention called the Collaborative Model for Promoting Competence and Success (COMPASS) for young children with ASD, data on efficacy for both traditional face-to-face and videoconferencing technology delivery methods, and a book-length treatment manual. COMPASS is an implementation strategy that assists in transferring evidence based approaches into classrooms and assists public school special educators and parents in ecological assessment, research-informed goal development, and person-centered decision-making for individualizing evidence-based interventions for children with ASD. The COMPASS intervention consists of an initial parent-teacher session (3 hours) occurring near the start of the school year, followed by four 1-hour teacher coaching. The first aim is to conduct focus groups with stakeholders including policy makers, parents, teachers, service providers, and persons with ASD to get feedback on (i) strengths and weaknesses of state policies and services and resources that exist or are needed to support effective implementation of best practices for transition age youth with ASD; (ii) other concerns impacting adult services such as housing, social security, health insurance, transportation; and (iii) specific aspects of COMPASS that would need to be adapted/revised to meet the needs of transition age youth. Based on these results, we will identify measures that would need to be adapted/developed and obtain feedback from a subsample of focus group members on the measures. Our second aim is to conduct a two wave pilot randomized controlled trial of the adapted COMPASS for transition planning using the new procedures and measures (n = 32 participant triads-consultant, teacher, student with ASD) using a mixed methods approach. We will obtain qualitative feedback on the intervention (acceptability, feasibility, outcomes) and use data to revise/adapt second wave implementation as well as to help inform further applications in adult settings. Lastly, we will conduct qualitative case studie based on individuals with ASD who have low and high performing outcomes to understand factors that might explain differential response to the intervention and use to revise/adapt second wave implementation.