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

项目摘要/摘要 我们寻求在实施试验中进行一项试点有效性试验，以改善教育结果 患有自闭症谱系障碍(ASD)的儿童。我们的研究仿照混合试验类型2的设计[1]，旨在 (A)利用这些机制，制定有效的、适合当地情况的执行培训战略 干预效果的基础，并在位于城市和 服务不足的农村环境，同时(B)考虑影响执行和维护因素 培训，对机制的敏感性，以及对指南针的采用/吸收。这项研究涉及一个重要的 研究与实践的差距--只有不到10%的自闭症儿童教育战略是基于 证据[2，3]。重要的是，咨询方式在效率和广度上都有乘数效应 传播最佳做法。这项建议回应了机构间自闭症协会的建议。 利用“实施科学来测试改进方法”的研究协调委员会 实施循证治疗(临41)“并制定和评估”质量措施以帮助 监测在改善自闭症患者护理和预后方面的进展(第41页)[4]。我们的方法符合 医学研究所关于建立循证标准的框架的建议[5]和 本RFA的目标是对先前证明的治疗干预措施的有效性研究 在社区环境中使用的功效。这项拟议的研究建立在两个已完成的NIH随机资助的研究基础上 对照研究(RCT)[6，7]，最近出版的治疗手册[8]和一本专著长度的科学 回顾[9]。RCT为研究小组提供的咨询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帮助公立学校的特殊教育工作者和家长 技术[10]。高质量的生态评估、以研究为基础的目标制定和指导 对ASD儿童进行个体化循证干预的决策是使用 协商干预，促进能力和成功的合作模式(COMPASS) [8]。Compass包括最初的家长-教师会议(3个小时)，在学校开学前举行 一年，然后是四个1小时的教师辅导课程，均匀地分布在学年的剩余时间里。 指南针帮助创造(1)个性化的教育适合，结构良好，心理测量- 敏感目标和(2)有效的教育计划，以实现这些目标。目标和教学计划考虑到 说明将在其中提供基于证据的干预措施的个性化环境。这个 本提案的目标是评价培训当地顾问/培训员的成效， 包括培训与已确定的变化机制(例如，保真度)的配合程度，以及 在两个随机对照试验中复制[6，7]。我们的长远目标是改善服务质素和整体功能及 从业者提供指南针时自闭症儿童的社会后果。我们的目标框定在 在社区环境中实施的复制有效方案(REP)[11]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.