Service Delivery

Study protocol: implementation of a computer-assisted intervention for autism in schools: a hybrid type II cluster randomized effectiveness-implementation trial.

Pellecchia et al. (2016) · Implementation Science : IS 2016
★ The Verdict

This is the roadmap for the first big test of whether TeachTown CAI helps or hurts autism classrooms.

✓ Read this if BCBAs working with elementary students with ASD in public schools.
✗ Skip if Clinicians who only serve preschoolers or adults.

01Research in Context

01

What this study did

The authors wrote a plan to test TeachTown: Basics in public autism classrooms. The plan is a hybrid type II trial. That means it will check if the program helps kids and if schools can actually run it.

Fifty-four elementary schools will join. Half will add TeachTown on tablets for 20 minutes, four days a week. The other half will keep their usual lessons. The team will watch for two years.

02

What they found

Nothing yet. This paper is only the recipe; no kids have been run. The authors list what they will measure: language scores, IQ, adaptive skills, and how well teachers stick to the plan.

03

How this fits with other research

Eikeseth et al. (2002) already showed that 28 hours of adult-led ABA each week in school lifts test scores. TeachTown now asks if 80 minutes of computer time can do part of that work without hurting the rest of the day.

Spaniol et al. (2018) tried another school-based computer program. Eight weeks of attention games gave small academic gains. Their study was short; TeachTown’s two-year plan will show if the boost lasts.

Reichow (2012) pooled five meta-analyses and agreed that full EIBI helps preschoolers. TeachTown could extend those gains into elementary grades, or it could accidentally replace stronger face-to-face hours.

04

Why it matters

You may soon face pressure to buy TeachTown or similar apps. This upcoming trial will tell you if the software adds value or just eats precious staff time. Watch for the results before you trade therapist-led lessons for tablet time.

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List how many minutes each student currently gets of adult-led DTT; keep that number safe if tablets arrive later.

02At a glance

Intervention
comprehensive aba program
Design
randomized controlled trial
Population
autism spectrum disorder
Finding
not reported

03Original abstract

The number of children diagnosed with autism has rapidly outpaced the capacities of many public school systems to serve them, especially under-resourced, urban school districts. The intensive nature of evidence-based autism interventions, which rely heavily on one-to-one delivery, has caused schools to turn to computer-assisted interventions (CAI). There is little evidence regarding the feasibility, effectiveness, and implementation of CAI in public schools. While CAI has the potential to increase instructional time for students with autism, it may also result in unintended consequences such as reduction in the amount of interpersonal (as opposed to computerized) instruction students receive. The purpose of this study is to test the effectiveness of one such CAI—TeachTown—its implementation, and its effects on teachers’ use of other evidence-based practices. This study protocol describes a type II hybrid cluster randomized effectiveness-implementation trial. We will train and coach 70 teachers in autism support classrooms in one large school district in the use of evidence-based practices for students with autism. Half of the teachers then will be randomly selected to receive training and access to TeachTown: Basics, a CAI for students with autism, for the students in their classrooms. The study examines: (1) the effectiveness of TeachTown for students with autism; (2) the extent to which teachers implement TeachTown the way it was designed (i.e., fidelity); and (3) whether its uptake increases or reduces the use of other evidence-based practices. This study will examine the implementation of new technology for children with ASD in public schools and will be the first to measure the effectiveness of CAI. As importantly, the study will investigate whether adding a new technology on top of existing practices increases or decreases their use. This study presents a unique method to studying both the implementation and exnovation of evidence-based practices for children with autism in school settings. NCT02695693. Retrospectively registered on July 8, 2016.

Implementation Science : IS, 2016 · doi:10.1186/s13012-016-0513-4