Validation of an Implementation Strategy of COMPASS for School Trainers of Children with Autism

项目总结/摘要 我们寻求在实施试验中进行试点有效性试验，以改善教育成果 自闭症谱系障碍（ASD）的儿童。在混合试验类型2设计之后建模[1]，我们的研究目的是 （a）制定一个有效的、适合当地情况的执行培训战略， 在城市和农村地区的优先教育环境中提供 服务不足的农村环境，同时还（B）考虑影响实施和维护的因素 培训、对机制的敏感性以及采用/吸收COMPASS。该研究涉及一个重要的 研究与实践的差距，不到10%的ASD儿童教育策略是基于 证据[2，3]。重要的是，协商方法在有效和广泛的 传播最佳做法。该提案是对跨机构自闭症协会（Interagency Autism） 协调委员会的研究，利用“执行科学测试方法，以改善 实施循证治疗（第41页）”并制定和评估“质量措施，以帮助 监测改善ASD患者护理和结果的进展（p.41）[4]。我们的方法符合 医学研究所关于建立循证标准框架的建议[5]， 本RFA的目标是对先前证明的治疗干预措施进行有效性研究， 在社区环境中使用的功效。这项拟议的研究建立在两个完成的NIH资助的随机 对照研究（RCT）[6，7]，最近出版的治疗手册[8]和专著长度的科学 评论[9]。随机对照试验为研究团队提供的咨询的有效性提供了强有力的支持， 通过面对面的互动和视频会议协助公立学校特殊教育工作者和家长 技术[10]。高质量的生态评估，研究知情的目标制定，并指导 为ASD儿童进行个性化循证干预的决策是使用 咨询干预，促进能力和成功的合作模式（COMPASS） [8]的一项建议。COMPASS包括在学校开始时进行的最初的家长-教师会议（3小时） 一年，其次是四个1小时的教师辅导会议均匀间隔通过学年的其余部分。 指南针协助创造（1）个性化的教育适当的，结构良好的，心理测量- 敏感的目标和（2）有效的教育计划，以实现目标。目标和教学计划考虑到 考虑将提供基于证据的干预措施的个性化背景。的 本建议的目标是评价培训当地顾问/培训员的效果， 包括培训如何很好地参与改变机制（例如，忠诚度）已被确定， 在两项RCT中重复[6，7]。长期目标是提高服务质量和整体功能， 当COMPASS由从业者提供时，ASD儿童的社会结果。我们的目标是 复制有效方案（REP）[11]在社区环境中实施的框架。

Project Summary/Abstract We seek to conduct a pilot effectiveness trial within an implementation trial for improving educational outcomes of children with autism spectrum disorder (ASD). Modeled after a Hybrid Trial Type 2 design [1], our study aims to (a) to create a valid, and locally adapted implementation training strategy leveraging the mechanisms underlying the intervention effects and delivered in priority educational settings located in urban and underserved rural contexts while also (b) considering implementation and maintenance factors impacting training, sensitivity to mechanisms, and adoption/uptake of COMPASS. The study addresses a significant research-to-practice gap that less than 10% of educational strategies for children with ASD are based on evidence [2, 3]. Importantly, consultation methods have a multiplier effect in the efficient and broad dissemination of best practices. This proposal responds to recommendations from the Interagency Autism Coordinating Committee for studies that utilize “implementation science to test methods to improve implementation of evidence-based treatments (p.41)” and develop and evaluate “quality measures to help monitor progress in improving care and outcomes for people with ASD (p.41) [4].” Our approach aligns with recommendations from the Institute of Medicine framework for establishing evidence based standards [5] and the goals of this RFA for effectiveness research on therapeutic interventions with previously demonstrated efficacy for use in community settings. The proposed study builds on two completed NIH funded randomized controlled studies (RCTs) [6, 7], a recently published treatment manual [8] and a monograph-length scientific review [9]. The RCTs provided strong support for the efficacy of consulting delivered by the research team to assist public school special educators and parents via face-to-face interactions and through videoconferencing technology [10]. High quality ecological assessments, research-informed goal development, and guided decision-making for individualizing evidence-based interventions for children with ASD are accomplished using the consultation intervention, the Collaborative Model for Promoting Competence and Success (COMPASS) [8]. COMPASS consists of an initial parent-teacher session (3 hours) occurring near the start of the school year, followed by four 1-hour teacher coaching sessions evenly spaced through the rest of the school year. COMPASS assists in creating (1) individualized educationally appropriate, well-constructed, psychometrically- sensitive goals and (2) effective educational plans to meet the goals. Goals and teaching plans take into account the personalized context within which the evidence based interventions will be delivered. The objectives of the current proposal are to evaluate the effectiveness of training local consultants/trainers, including how well the training engages the mechanisms of change (e.g., fidelity) that have been identified and replicated in two RCTs [6,7]. The long-term goal is to improve the quality of services and overall functional and social outcomes of children with ASD when COMPASS is delivered by practitioners. Our aims are framed with the Replicating Effective Programs (REP) [11] Framework for implementation in community settings.