Early Achievements for Education Settings: An Embedded Teacher-Implemented Social Communication Intervention for Preschoolers With Autism Spectrum Disorder

Abstract

Purpose Early Achievements for Education Settings (EA-ES) is a teacher-implemented naturalistic developmental behavioral intervention for preschoolers with autism spectrum disorder (ASD) targeting core social communication impairments. The purpose of this pilot randomized controlled clinical trial (RCT) was to examine promise of efficacy of this iteratively developed intervention when implemented in authentic education settings. We examined (1a) whether a high level of implementation fidelity was attained by EA-ES trained teachers and (1b) whether their fidelity attainment differed from that of untrained teachers; and (2) whether the EA-ES intervention showed promise of improving child social, communication, and cognitive outcomes as determined by within- and between-group comparisons of children in EA-ES classrooms and children in classrooms randomized to the business as usual condition. Method Participants included six preschool teachers and 43 eligible preschoolers with ASD. Classrooms were randomized to EA-ES or business as usual. Analyses of intervention effects using baseline and postintervention data were conducted on teachers' fidelity of EA-ES implementation and children's performance on a proximal measure of social and communication behavior and on a distal standardized measure of verbal and nonverbal functioning. Results Teachers trained to implement EA-ES attained a high level of implementation fidelity, with significantly greater gains compared to untrained teachers. Children receiving EA-ES showed significantly greater gain from baseline to postintervention in frequency of produced initiation of joint attention and nonverbal cognitive functioning compared to children in business-as-usual classrooms. A trend toward significance for Group × Time effects was detected for frequency of spontaneous verbalizations produced, favoring the EA-ES group. Conclusions EA-ES shows promise of feasibility for teacher implementation in group contexts and for improving social communication and cognitive skills in preschoolers with ASD. Implications of results for future research and speech-language pathologist–teacher collaboration to increase language intervention dosage are discussed.

Assessing Generalization During Professional Development in Child Care: A Pilot Randomized Controlled Trial

“…The PD program targeted providers’ implementation of selected NDBI strategies and use of book-related props to create embodied child social-communication learning experiences (Landa et al, 2011 ) embedded within book reading instruction (Schreibman et al, 2015 ). This intervention was translated for use in inclusive child care classrooms from its initial iteration in preschool classrooms serving children with ASD (Engelstad et al, 2020 ) and in a clinic-based intervention for toddlers with ASD (Landa et al, 2011 ). The EA-CP PD consisted of a combination of workshops and coaching.…”

“…To promote high-fidelity implementation, our PD program focused on a key instructional context in early childhood curricula (Lorio & Woods, 2020 ): shared book reading. Shared book reading provides an enriching context for teaching vocabulary (Toub et al, 2018 ; Wasik et al, 2016 ), which can be enhanced with opportunities for adult-supported play with book-related props (Toub et al, 2018 ) to increase engagement and language use, even in children with DD (Engelstad, Holingue, & Landa, 2020 ; Feuerstein & Landa, 2020 ). Further, book reading is often enjoyable (thus motivating and reinforcing) for both adults and children (Sim & Berthelsen, 2014 ).…”

Bridging Priorities Between Naturalistic Developmental Behavioral Interventions for Autism and Educational Practice in Inclusive Early Childhood Education

“…However, this paper was developed by the members of a research network that used snowball-sampling procedures to identify leading programs (Siller et al, 2021). These programs include the Walden Early Childhood Center at Emory University (now the Early Emory Center for Child Development and Enrichment;McGee et al, 1999), Project DATA at the University of Washington (Boulware et al, 2006), Early Achievements at the Kennedy Krieger Institute (Engelstad et al, 2020;Feuerstein & Landa, 2020), Samsky Preschool at Marcus Autism Center/ Emory University (Siller et al, 2022), the Victorian Autism Specific Early Learning and Care Center affiliated with the Olga Tennison Autism Research Center at La Trobe University in Australia (Capes et al, 2019;Vivanti et al, 2019Vivanti et al, , 2022, the Children's Toddler School (now Alexa's PLAYC; Stahmer et al, 2011;Stahmer & Ingersoll, 2004), and the Susan Gray School at Vanderbilt University (Hine & Wolery, 2006).…”

“…( 2) NDBIs emphasize embedding learning activities within childchosen or child-preferred activities, which allows children to connect learning experiences to situations/materials that are relevant and interesting to them (Vivanti et al, 2022). ( 3) NDBIs leverage environmental arrangement, where adults arrange the learning environment to facilitate child initiation and allow children to experience the natural contingencies of their self-initiated behavior (Engelstad et al, 2020;Feuerstein & Landa, 2020). For example, NDBIs may create communication temptations by giving the child access to only half of the blocks in a container to facilitate initiations of requests to a peer for objects or assistance (Bruinsma et al, 2020).…”

Teacher-Implemented Parent Coaching in Inclusive Preschool Settings for Children With Autism

“…Aligned with this emerging consensus from ECE professionals, researchers, and policy leaders, parent coaching is considered an essential element of successful early intervention for children with autism spectrum disorder (ASD; Nevill et al, 2018; Siller & Morgan, 2018). However, despite increased interest in adapting evidence-based interventions for children with ASD to school settings (Engelstad et al, 2020; Stahmer et al, 2015), to date, only two studies reported integrating ASD-specific parent coaching methods in center-based pre-K settings (Ingersoll & Dvortcsak, 2006; Ingersoll & Wainer, 2013). In both studies, Project ImPACT was implemented as part of children’s publicly funded, school-based early childhood special education (ECSE) program.…”