Randomized Study of Training in Autism

描述(由申请人提供)：本申请涉及广泛的挑战领域(04)临床研究和特定挑战主题，04-MH-101，自闭症：应对挑战。尽管近年来对早期识别工作的重视有效地大幅增加了自闭症儿童在学校接受服务的人数，但这些服务的质量参差不齐，迫切需要改善所有自闭症儿童获得和接受高质量早期干预服务的机会，无论家庭收入、种族或地理位置如何。由于所有特殊教育教师都需要为自闭症儿童的教育做好充分的准备，因此了解有效的培训方法以支持教师实施循证干预是我们这个领域的紧迫问题。本研究的目的是考察三种类型的专业发展培训模式，并比较它们对儿童和教师成果的影响。主要目的是前瞻性地产生咨询+课堂教师辅导与咨询+基于网络的教师辅导的影响的数据，跟踪调查25名儿童，他们的教师只接受基本的、非互动的在线自闭症培训，25名儿童的教师和父母也接受咨询，然后是课堂教师辅导，以及25名儿童，他们的教师和父母接受咨询，然后是基于网络的教师辅导。在线培训对咨询和教师辅导(课堂上和网络上)起到了安慰剂控制的作用。这项研究的设计将允许检查干预措施不同组成部分的相对优点。这两种条件(课堂和基于网络的教师辅导)都将接受的咨询模式是基于促进能力和成功的合作模式(Compass；Ruble&Dalrymple，2002)。我们已经从NIMH收到了一架R-34，以收集关于COMPASS有效性的初步数据(卢布，麦克格鲁和达尔林普尔，2009)。根据初步数据，我们假设，与安慰剂对照组相比，接受咨询和指导的两种情况下的儿童结局会更高。将衡量的儿童成果是实现预定的IEP目标。第二个目的是评估咨询类型对父母压力的影响。在初步研究的基础上，我们预计条件的类型会影响父母的压力，与主要目标下的假设相似。另一个次要目标是生成关于其他因素的数据，这些因素可能会解释儿童和教师成绩的差异。将收集的可能导致儿童和父母结果差异的变量包括：(A)儿童因素(自闭症的严重程度；发展参数--智商、语言水平、适应行为)；(B)教师因素(城市或农村；IEP的质量；自闭症儿童的教育年限；压力)；(C)父母/照顾者因素(社会经济地位；压力)。拟议的项目是结果研究，旨在满足机构间自闭症协调委员会的目标，即更多的“行为、发展和认知疗法的有效性的结果研究”。自闭症儿童患病率的上升是一个紧迫的公共卫生问题，也是教育部和卫生与公众服务部(国立精神卫生研究院，2003年)等机构的国家优先事项，迫切需要改善所有自闭症儿童获得和接受高质量早期干预服务的机会和接受情况，无论家庭收入、种族或地理位置如何(Liptak等人，2008年)。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (04) Clinical Research and specific Challenge Topic, 04-MH-101, Autism: Addressing the challenge. Although the focus on early identification efforts in recent years has been effective in sharply increasing the number of children with autism receiving services in schools, those services are of uneven quality, and there is a critical need to improve access to and receipt of high quality early intervention services that are available to all children with autism, regardless of family income, race or geographic location. Because all special education teachers need to be adequately prepared to educate children with autism, understanding effective training methods for supporting teachers' implementation of evidence-based interventions is an urgent issue for our field. The purpose of this study is to examine three types of professional development models of training and compare their effects on child and teacher outcomes. The primary aim is to generate data on the impact of consultation plus in-classroom teacher coaching vs. consultation plus web-based teacher coaching prospectively by following 25 children whose teachers receive only basic, noninteractive online autism training, 25 children whose teachers and parents also receive consultation followed by in-classroom teacher coaching, and 25 children whose teachers and parents receive consultation followed by web- based teacher coaching. The online training acts a placebo-control for the consultation plus teacher coaching (in-classroom vs. web-based). The design of the study will allow for examination of the relative merits of different components of the intervention. The consultation model that both conditions (in-classroom and web-based teacher coaching) will receive is based on the Collaborative Model for Promoting Competence and Success (COMPASS; Ruble & Dalrymple, 2002). We have received an R-34 from NIMH to collect preliminary data on the effectiveness of COMPASS (Ruble, McGrew, & Dalrymple, 2009). Based on preliminary data, we hypothesize that child outcomes will be higher for the two conditions that receive consultation and coaching compared to the placebo-control condition. The child outcome that will be measured is achievement of targeted IEP objectives. A secondary aim is to evaluate the impact of consultation type on parent stress. Based on the pilot study, we expect type of condition to influence parent stress similar to that hypothesized under the primary aim. Another secondary aim is to generate data on additional factors that may account for differences in child and teacher outcomes. Variables that may contribute to variance in child and parent outcomes that will be collected include: (a) Child factors (Severity of autism; Developmental parameters - IQ, language level, adaptive behavior); (b) Teacher factors (Urban or rural; Quality of IEP; Years of teaching children with autism; Stress); (c) Parent/caregiver factors (Socioeconomic status; Stress). The proposed project is outcome research that addresses the Interagency Autism Coordinating Committee's aim for more "outcome studies of the effectiveness of behavioral, developmental, and cognitive therapies." The epidemic rise in the number of children identified with ASD represents an urgent public health issue and national priority for agencies such as the Department of Education and the Department of Health and Human Services (National Institutes of Mental Health, 2003) and the critical need to improve access to and receipt of high quality early intervention services that are available to all children with autism, regardless of family income, race or geographic location (Liptak et al., 2008).