IntroductionIndividuals with autism spectrum disorder (ASD) who also exhibit severe-to-moderate ranges of intellectual disability (ID) still face many challenges (i.e., less evidence-based trials, less inclusion in school with peers).MethodsWe implemented a novel model called the âDevelopmental and Sequenced One-to-One Educational Interventionâ (DS1-EI) in 5- to 9-year-old children with co-occurring ASD and ID. The treatment protocol was adapted for school implementation by designing it using an educational agenda. The intervention was based on intensity, regular assessments, updating objectives, encouraging spontaneous communication, promoting skills through play with peers, supporting positive behaviors, providing supervision, capitalizing on teachersâ unique skills, and providing developmental and sequenced learning. Developmental learning implies that the focus of training is what is close to the developmental expectations given a childâs development in a specific domain. Sequenced learning means that the teacher changes the learning activities every 10â15âmin to maintain the childâs attention in the context of an anticipated time agenda. We selected 11 French institutions in which we implemented the model in small classrooms. Each institution recruited participants per dyads matched by age, sex, and developmental quotient. Patients from each dyad were then randomized to a DS1-EI group or a Treatment as usual (TAU) group for 36âmonths. The primary variables â the Childhood Autism Rating scale (CARS) and the psychoeducational profile (PEP-3) â will be blindly assessed by independent raters at the 18-month and 36-month follow-up.Discussion and baseline descriptionWe enrolled 75 participants: 38 were randomized to the DS1-EI and 37 to the TAU groups. At enrollment, we found no significant differences in participantsâ characteristics between groups. As expected, exposure to school was the only significant difference [9.4 (±4.1) h/week in the DS1-EI group vs. 3.4 (±4.5) h/week in the TAU group, Studentâs t-test, tâ=â5.83, pâ<â0.001].Ethics and disseminationThe protocol was authorized by the competent national regulatory authority (Agence nationale de sĂ©curitĂ© du mĂ©dicament et des produits de santĂ©) and approved by the local Ethics Committee (ComitĂ© de Protection des Personnes) at the University Hospital Saint-Antoine (May 7, 2013). The findings will be disseminated through peer-reviewed journals and national and international conferences.Trial registration numbersANSM130282B-31 (April 16 2013) and ACTRN12616000592448 (May 6 2016).