Teacher and child predictors of achieving IEP goals of children with autism

Unpacking the prevalence: A warning against overstating the recently narrowed gap for Black autistic youth

Recent findings from the Centers for Disease Control and Prevention's (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network's 2020 prevalence report indicate that disparities in autism diagnoses between Black and White youth have narrowed, reflecting improved screening, awareness, and access to services (Maenner et al., 2023. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 72, 1-14.). Claims of reducing disparities beyond prevalence rates, however, are not fully supported, as indicated by the reality that Black youth whose screenings indicate autistic traits are still not being referred for full evaluation or early intervention services at the same rate as their White peers (Major et al., 2020. Autism, 24, 1629-1638; Smith et al., 2020. Pediatrics, 145, S35-S46.). Black 8-year-olds identified as autistic still experience disparate educational placements (Waitoller et al., 2010. The Journal of Special Education. 44, 29-49.) where services may not be autism-specific or have Individual Education Plan goals only focused on "behavior problems" (Severini et al., 2018. Journal of Autism and Developmental Disorders, 48, 3261-3272.), are served in the most restrictive environments (Skiba et al., 2006. Exceptional Children, 72, 411-424.) and lack consistent augmentative and alternative communication support (Pope et al., 2022. American Journal of Speech-Language Pathology, 31, 2159-2174.). Additionally, ADMM researchers report consistent disparities in the identification of co-occurring intellectual disability where Black autistic children have significantly more co-occurrences than White autistic children. The purpose of this commentary is to first examine the assertion that the narrowed gap indicates, "…improved…access to services among historically underserved groups," (p. 9) (Maenner et al., 2023. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C.: 2002), 72, 1-14.). We will then recommend strategies to address the ongoing disparities.

Adaptation of COMPASS for use in Autism-Specific Schools in Australia: A Cluster Randomized Trial

Autistic students are educated in Australia across a variety of contexts and almost all educators use individualized goal-setting as a way of ensuring appropriate accommodations and curriculum modifications. Educators experience similar challenges when developing individualized goals for students, including lack of a standardized process for goal setting, inconsistent support networks, and challenges with data-driven goal-setting. The purpose of our research was to adapt and trial the Collaborative Model for Competence and Success (COMPASS), a research-based intervention aimed at improving the individualized goal-setting process for autistic students. Our primary hypothesis was that autistic students who participate in COMPASS would demonstrate more growth on their individualized outcomes relative to autistic students who receive services as usual (SAU). To answer our primary research question, we applied a single-blind cluster randomized trial. Participants were randomized into one of two groups: (a) a COMPASS intervention group and (b) a SAU group. Results indicate that students whose teachers received the intervention made more progress on their final individualized goals than those who received SAU, replicating previous findings regarding COMPASS in the US. Also, the adaptation of COMPASS for an Australian context showed high rates of satisfaction and fidelity. The success of this intervention in improving the progress that students make on their individualized goals demonstrates the benefits of a standardized intervention that supports teachers and families in this critical practice.

School-Based Speech-Language Pathologists' Stress and Burnout: A Cross-Sectional Survey at the Height of the COVID-19 Pandemic

PURPOSE

Low retention of school-based speech-language pathologists (SLPs) is a growing problem that can have drastic consequences at the school and student levels. Factors contributing to this shortage include features of the work environment, role ambiguity, low salaries, and a demanding workload with higher caseloads, which can result in limited time for paperwork and lesson planning for optimal service delivery models. The purpose of this study was to determine the current levels and predictors of occupational stress and burnout SLPs are experiencing in the school setting.

METHOD

Using a cross-sectional survey design, 453 school-based SLPs from across the United States reported their workload manageability, career intentions, access to social support, and their stress and burnout levels. Multiple linear regression was used to determine the relation between the variables of interest and the occupational stress and burnout scores. Data were collected in September to December of 2020, at the height of the COVID-19 pandemic.

RESULTS

SLPs, on average, reported overall stress levels in the somewhat noticeable range, moderate access to social support, high levels of emotional exhaustion, low-to-moderate feelings of depersonalization, and moderate-to-high feelings of personal accomplishments. Based on a standardized burnout scale, SLPs in this sample are characterized as feeling ineffective and overextended. Results of linear regression models suggest that the perception of work manageability was the best predictor of Total Stress score, Emotional Exhaustion score, and Depersonalization score, in this sample.

CONCLUSIONS

Data from this study offer the beginning steps to making an informed change for school-based SLPs' workplaces. Results indicated that SLPs in the school setting are feeling ineffective and overextended. The perception of their workload manageability was the most significant predictor for their reported stress and burnout levels. Suggestions for SLP supervisors, administrators, and other stakeholders are discussed.

Predictors of individual differences in minimally verbal peer communication exchanges following peer-oriented social intervention

School-age children on the autism spectrum who are minimally verbal (MVAS) use a limited repertoire of spontaneous communicative spoken words and reveal large heterogeneity in cognitive functioning. Despite the challenges to form peer social engagement posed by their unique social-communicative profile, few interventions have targeted peer interactions in the MVAS population. This study explored predictors of individual differences in treatment response among 54 school-age minimally verbal autistic children (8-16 years) following an RCT "school-based peer social intervention" (S-PSI) that compared two peer-oriented intervention modalities (conversation versus collaboration) versus a waitlisted control group. We examined autistic-symptom severity, age, verbal and nonverbal IQ, executive functions, and sensory-processing profile for their contribution to children's ability to form relevant spontaneous communication exchanges with a peer partner. Main findings revealed that larger deficits in sensory-processing (sensory-avoidance and sensory low-registration) and in executive functions contributed to greater growth in "relevant" (i.e., adequately attuned, participatory, reciprocal) communication following both interventions, but not for the waitlisted controls. Additionally, older participants with lower verbal and nonverbal IQ improved communication's relevancy more after the conversation intervention, whereas the collaboration intervention was more beneficial for younger participants. Lower autistic-symptom severity contributed to larger growth in relevancy for all groups. By identifying individual-level predictors of spontaneous, attuned, participatory, and reciprocal (i.e., "relevant") communication exchanges with peers, we optimized S-PSI personalization for this uniquely nonverbal, heterogeneous MVAS population. These new channels for tailoring peer interventions to better meet individuals' needs may result in reduced social isolation and loneliness and enhanced well-being.

Comparison of Verbal Performance of Children with Autism Spectrum Disorder on the WISC-V

Children with autism spectrum disorder (ASD) display variable verbal cognitive profiles despite a historical requirement for a language delay in autistic disorder. This study compared the Verbal Comprehension Index (VCI) to the newly created ancillary index score, the Verbal Expanded Crystallized Index (VECI) of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) in a group of children with ASD. Using the ASD sample from the standardization data of the WISC-V, results indicated the VCI and VECI were significantly different for the ASD group but not for the matched controls. Follow up analysis of the ASD group revealed the VCI and VECI were significantly different for those with language impairment but not for those without language impairment. Psychologists should consider administering all verbal subtests of the WISC-V to children with ASD given the VECI may better capture the language impairment seen in this population.

The effect of the Covid-19 pandemic on the mental health of students and teaching staff

In the past decade, mental health is embedded in the concept of health and teachers’ mental health has become the focus of surveys. In this study we examined the mental health of special educator-students compared to their lecturers and inspectors at the University Semmelweis Pető András Faculty.

We used the validated Hungarian language Mental Health Test (MHT) to assess the mental health. The MHT is linked to the concept of physical and mental wellbeing, it is ability-based approach, and examines 5 areas: wellbeing, savoring, creative-executive efficiency self-regulation resilience.

Altogether 237 questionnaires had been returned that were suitable for evaluation (19 lecturers, 16 instructors and 202 students).

Students' mean values are lower than the instructors' and lecturers’ mean values, and students presented significant lower scores in three scales: self-regulation, creative-executive efficiency, and resilience subscales. In the wellbeing scale we found significant correlation with the existence of the separate room to learn/work during the home-office.

These results point to the need for the university to pay attention to the mental health of students, who will be able to consciously monitor their mental health, and who are able to provide effective support to their students.

Individualized Education Program Quality for Transition Age Students with Autism

BACKGROUND

Students with ASD have some of the worst postsecondary outcomes when compared to other students with disabilities indicating transition planning may not be working effectively. One source of support for postsecondary planning is development of the transition Individualized Education Program (IEP). However, little research is available to describe the current contents of transition IEPs for students with ASD. This study aimed to describe IEP and postsecondary planning quality for students with autism in their final year of high school.

METHOD

IEPs for 20 students with autism (Mage = 18.2 years; SD = 1.1) from two mid-southern states were analyzed. Descriptive analyses were used to identify strengths and weaknesses of IEPs and postsecondary goals based on federal law requirements and best practice recommendations.

RESULTS

IEPs contained an average of 3.1 IEP goals and 1.6 postsecondary goals. IEP goals were most frequently related to academic, learning/work, or communication skills. All IEPs contained an employment postsecondary goal while less than half of the IEPs included an independent living postsecondary goal. Key findings include lack of goals related to social skills and the lack of alignment between present levels of performance, IEP goals, and postsecondary goals.

CONCLUSIONS

IEPs for students with ASD in their final year of school do not consistently meet standards outlined by federal law or best practice recommendations necessary for successful transition from high school.

Quality of Educational Programs for Elementary School-Age Students With Autism

The purpose of this study was to assess the quality of educational programs for school-aged children with autism in the United States. Investigators completed the Autism Program Environment Quality Rating Systems-Preschool/Elementary (APERS-PE) in 60 elementary schools enrolling children with autism. The mean total rating scores were near the midpoint rating, indicating schools were providing educational program environments classified as adequate but not of high quality. Domains of the APERS-PE reflecting structural quality tended to be significantly above average and domains reflecting process quality tended to be significantly below average. With a few exceptions, inclusive and special education program did not differ significantly in total program quality ratings and reflected the same pattern of domain quality ratings.

Special education for students with autism during the COVID-19 pandemic: "Each day brings new challenges"

LAY ABSTRACT

The novel coronavirus (COVID-19) disrupted how special educators provided supports and services for students with autism spectrum disorder. School closures and the related pivoting between learning modalities (i.e. virtual, hybrid, and face-to-face) were difficult for all students, but especially for students with autism, who rely on routine and require individualized instruction. In this study, we surveyed 106 special education teachers, behavior specialists, and speech pathologists who work with autistic students to learn about how they adapted instruction to comply with the complex social distancing rules and changing expectations of the pandemic. Participants reported "making the best out of a bad situation" and "constantly using 'trial & error' to find the best way for our students to eLearn." They emphasized the importance of collaboration with parents, who helped deliver intervention and monitor progress across settings. They made alterations to Individualized Education Programs, by adding individualized contingency learning plans, adjusting service minutes, and sometimes eliminating social goals. Participants were surprised that while students with more intense needs struggled, others actually preferred virtual instruction. This raises concerns for what will happen in the future, when social expectations resume. Despite the overwhelming challenges posed by COVID-19, participants demonstrated remarkable resiliency and an innovative ability to adapt instruction.

Educational classifications of autism spectrum disorder and intellectual disability among school‐aged children in North Carolina: Associations with race, rurality, and resource availability

Disparities exist in the recognition of autism spectrum disorder (ASD) and intellectual disability (ID) in racial/ethnic minorities in the United States. This study examined whether rurality, race/ethnicity, and low resource availability are associated with disparities in primary educational classifications of ASD and ID in North Carolina (NC). Descriptive maps were created. Multilevel logistic regression models examined two separate outcomes (mild ID vs. ASD; moderate/severe ID vs. ASD). For the interaction term included in the model (race/ethnicity and residence), predicted probabilities were estimated and plotted. The effects of other covariates were also estimated. Rural counties had fewer students with ASD and a greater number of students with ID compared to urban counties. The majority of students with ASD were non-Hispanic Whites, while the majority of students with ID were non-Hispanic Blacks. Compared to non-Hispanic White students, non-Hispanic Black students were overrepresented in the ID classification and underrepresented in the ASD classification across urban and rural areas. Indicators of low resource availability were also associated with higher probabilities of ID vs. ASD classification. Differences in primary educational classification based on urban-rural divide, race/ethnicity, and resource availability are important to understand as they may point to disparities that could have significant policy and service implications. Because disparities manifest through complex interactions between environmental, socioeconomic and system-level factors, reduction in these disparities will require broader approaches that address structural determinants. Future research should utilize disparity frameworks to understand differences in primary educational classifications of ASD and ID in the context of race/ethnicity and rurality. LAY SUMMARY: Rural counties in North Carolina had fewer students with ASD and a greater number of students with ID compared to urban counties. Compared to non-Hispanic White students, non-Hispanic Black students were over-represented in the ID educational classification and underrepresented in the ASD classification. Differences in classification of ASD and ID based on urban-rural divide, race/ethnicity, and resource availability may point to disparities that could have significant policy and service implications. Autism Res 2021, 14: 1046-1060. © 2021 International Society for Autism Research, Wiley Periodicals LLC.

Educating Students with Autism Spectrum Disorders: Is Teacher Certification Area Associated with Academic Outcomes?

Although typically taught by special educators, few studies have examined if certification area is associated with academic outcomes for students with autism spectrum disorders (ASDs). The purpose of this study was to determine whether students with ASD scored better on language arts and mathematics state assessments depending on teacher certification, and whether these associations varied by assessment type. We analyzed 3 years of state administrative data from students with ASD in grades 4-8 receiving special education services. Results showed students taking the regular or alternate assessment had similar academic outcomes regardless of teacher certification. Students who were taught by special education certified teachers and took the modified assessment had lower academic outcomes. Implications for practice, policy, and research are discussed.

Implementation Fidelity and Common Elements of High Quality Teaching Sequences for Students with Autism Spectrum Disorder in COMPASS

BACKGROUND

Evidence-based educational instruction includes teaching elements common across different approaches as well as specific elements of the chosen evidence-based practice. We were interested in evaluating the use and impact of common elements of teaching. Specifically, we adopted a model of elements of high quality teaching sequences and developed and tested an instructional quality index to capture evidence-based features within teaching sequences (Grisham-Brown & Ruble, 2014).

METHOD

The current investigation examined 29 special education teachers who received a consultation intervention called the Collaborative Model for Promoting Competence and Success (COMPASS; Ruble, Dalrymple & McGrew, 2012) that results in personalized teaching plans for young students with ASD and embeds elements of evidence-based teacher coaching of self-reflection and performance-based feedback. We analyzed the teaching plans to understand which of the common elements were present, and if teachers demonstrated improved performance after coaching.

RESULTS

Analysis of the use of common elements during the first and fourth coaching session demonstrated that all teachers showed improvement. Most importantly, the use of common elements correlated with student goal attainment outcomes.

CONCLUSIONS

These results suggest that common elements of teaching sequences which we view as core features of teaching quality, can be improved as a result of coaching, and most importantly, are associated with students' educational outcomes.

The mediating effect of perceived social support on the relationship between mindfulness and burnout in special education teachers

This study aimed to explore the mediating effect of perceived social support on the relationship between mindfulness and burnout in Chinese special education teachers. Three hundred and seven teachers completed the Five-Facet Mindfulness Questionnaire, Multi-dimensional Scale of Perceived Social Support Scale, and Teacher Burnout Inventory. The results showed that burnout was negatively correlated with mindfulness and perceived social support, while perceived social support was positively correlated with mindfulness. Moreover, perceived social support partially mediated the effect of mindfulness on special education teachers' burnout. These results suggest that the use of mindfulness combined with perceived social support may be beneficial for preventing and mitigating burnout among special education teachers.

Language Barriers Impact Access to Services for Children with Autism Spectrum Disorders

Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents' abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.

An empirical study of multidimensional fidelity of COMPASS consultation

Consultation is essential to the daily practice of school psychologists (National Association of School Psychologist, 2010). Successful consultation requires fidelity at both the consultant (implementation) and consultee (intervention) levels. We applied a multidimensional, multilevel conception of fidelity (Dunst, Trivette, & Raab, 2013) to a consultative intervention called the Collaborative Model for Promoting Competence and Success (COMPASS) for students with autism. The study provided 3 main findings. First, multidimensional, multilevel fidelity is a stable construct and increases over time with consultation support. Second, mediation analyses revealed that implementation-level fidelity components had distant, indirect effects on student Individualized Education Program (IEP) outcomes. Third, 3 fidelity components correlated with IEP outcomes: teacher coaching responsiveness at the implementation level, and teacher quality of delivery and student responsiveness at the intervention levels. Implications and future directions are discussed. (PsycINFO Database Record

Special Education Teachers' Perceptions and Intentions Toward Data Collection

Although data-based decision making is an evidence-based practice, many special educators have difficulty applying the practice within daily routines. We applied the Theory of Planned Behavior (TPB) to understand the influences that promote or hinder early childhood special educators' intentions to collect data. We assessed three influences on behavioral intention to collect data derived from the TPB: (a) attitude toward collecting data, (b) social norms for collecting data, and (c) perceived behavioral control for collecting data. All three influences correlated positively with teachers' reported intention to collect data; however, only perceived behavioral control of barriers correlated positively with actual data collection. Additional measures of teacher self-efficacy and administrative support correlated positively with intention to collect data, but not with actual data collection behaviors. Perceived behavior control accounted for the most variance in actual data collection behavior. Implications of the findings for data collection practices in educational settings are discussed.

Too Stressed to Teach? Teaching Quality, Student Engagement, and IEP Outcomes

Teacher stress and burnout have a detrimental effect on the stability of the teaching workforce. However, the possible consequences of teacher burnout on teaching quality and on student learning outcomes are less clear, especially in special education settings. We applied Maslach and Leiter's model (1999) to understand the direct effects of burnout on teaching in general and stress arising from interaction with a specific student on the IEP outcomes of young children with autism spectrum disorder. We also examined indirect effects through teaching quality and student engagement. The results indicated that one of the three components of burnout-teacher personal accomplishment-was directly related to IEP outcomes, a distal effect, whereas stress was directly related to teaching quality and student engagement, which were more proximal effects. Additionally, teacher stress, emotional exhaustion, and depersonalization had indirect effects on IEP outcomes through teaching quality and student engagement.

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.

Coping strategies of Taiwanese children with autism spectrum disorders

AIMS AND OBJECTIVES

To explore and describe the coping experiences of children with autism spectrum disorders in Taiwan.

BACKGROUND

Children with autism spectrum disorders are faced with daily social and living challenges, which can cause stress. Chinese culture emphasises discipline and obedience, which may influence coping strategies of children with autism spectrum disorders in Taiwan.

DESIGN

This qualitative study employed an exploratory descriptive design.

METHOD

Data were collected from in-depth, face-to-face structured interviews. Interviews explored coping strategies of Taiwanese school-aged children (aged 6-19) with autism spectrum disorders. Children (N = 17) and their caregivers were recruited by purposive sampling. Transcribed interview data were thematically analysed using the procedure of Miles and Huberman.

RESULT

Five themes emerged from the analysis of the data, which described the coping strategies of the children: (1) problem-solving, (2) acting-out, (3) avoidance, (4) seeking help and (5) self-regulation. These themes included multiple coping strategies, which employed the concepts of engagement and disengagement.

CONCLUSIONS

The children with autism spectrum disorder used many strategies to cope with the stresses resulting from behaviours and symptoms associated with the disorder. Most of the Taiwanese children use both problem-solving and emotional-focused coping strategies.

RELEVANCE TO CLINICAL PRACTICE

Understanding coping strategies of children with autism spectrum disorder could help caregivers (parents, teachers) and medical professionals develop interventions to reduce these challenges, which could alleviate stress and improve social functioning for these children.

A systematic review to investigate the measurement properties of goal attainment scaling, towards use in drug trials

Background

One of the main challenges for drug evaluation in rare diseases is the often heterogeneous course of these diseases. Traditional outcome measures may not be applicable for all patients, when they are in different stages of their disease. For instance, in Duchenne Muscular Dystrophy, the Six Minute Walk Test is often used to evaluate potential new treatments, whereas this outcome is irrelevant for patients who are already in a wheelchair. A measurement instrument such as Goal Attainment Scaling (GAS) can evaluate the effect of an intervention on an individual basis, and may be able to include patients even when they are in different stages of their disease. It allows patients to set individual goals, together with their treating professional. However, the validity of GAS as a measurement instrument in drug studies has never been systematically reviewed. Therefore, we have performed a systematic review to answer two questions: 1. Has GAS been used as a measurement instrument in drug studies? 2: What is known of the validity, responsiveness and inter- and intra-rater reliability of GAS, particularly in drug trials?

Methods

We set up a sensitive search that yielded 3818 abstracts. After careful screening, data-extraction was executed for 58 selected articles.

Results

Of the 58 selected articles, 38 articles described drug studies where GAS was used as an outcome measure, and 20 articles described measurement properties of GAS in other settings. The results show that validity, responsiveness and reliability of GAS in drug studies have hardly been investigated. The quality of the reporting of validity in studies in which GAS was used to evaluate a non-drug intervention also leaves much room for improvement.

Conclusions

We conclude that there is insufficient information to assess the validity of GAS, due to the poor quality of the validity studies. Therefore, we think that GAS needs further validation in drug studies, especially since GAS can be a potential solution when a small heterogeneous patient group is all there is to test a promising new drug.

Trial registration

The protocol has been registered in the PROSPERO international prospective register for systematic reviews, with registration number CRD42014010619. http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014010619.

Electronic supplementary material

The online version of this article (doi:10.1186/s12874-016-0205-4) contains supplementary material, which is available to authorized users.

IEP goals for school-age children with speech sound disorders

PURPOSE

The purpose of the current study was to describe the current state of practice for writing Individualized Education Program (IEP) goals for children with speech sound disorders (SSDs).

METHOD

IEP goals for 146 children receiving services for SSDs within public school systems across two states were coded for their dominant theoretical framework and overall quality. A dichotomous scheme was used for theoretical framework coding: cognitive-linguistic or sensory-motor. Goal quality was determined by examining 7 specific indicators outlined by an empirically tested rating tool. In total, 147 long-term and 490 short-term goals were coded.

RESULTS

The results revealed no dominant theoretical framework for long-term goals, whereas short-term goals largely reflected a sensory-motor framework. In terms of quality, the majority of speech production goals were functional and generalizable in nature, but were not able to be easily targeted during common daily tasks or by other members of the IEP team. Short-term goals were consistently rated higher in quality domains when compared to long-term goals.

CONCLUSIONS

The current state of practice for writing IEP goals for children with SSDs indicates that theoretical framework may be eclectic in nature and likely written to support the individual needs of children with speech sound disorders. Further investigation is warranted to determine the relations between goal quality and child outcomes.

LEARNING OUTCOMES

(1) Identify two predominant theoretical frameworks and discuss how they apply to IEP goal writing. (2) Discuss quality indicators as they relate to IEP goals for children with speech sound disorders. (3) Discuss the relationship between long-term goals level of quality and related theoretical frameworks. (4) Identify the areas in which business-as-usual IEP goals exhibit strong quality.