Improving Autism Program Quality in Special Education Units: The Use of an APERS-based Model to Support Student Learning and Participation
This study assesses the effect of using the Autism Program Environment Rating Scale (APERS) as a tool for providing feedback, in-service training, and coaching to school staff in order to improve program quality in special education units (SEUs) for children with autism or related sociocommunicative challenges (SCCs). APERS is used in its culturally validated Swedish version (APERS-Primary-SE). Using a quasi-randomized parallel-group design, SEUs will be allocated to either an experimental (APERS+) or control (TAU) condition. In the APERS+ condition, school staff receive continuous and systematic feedback provided by trained coaches based on the initial APERS assessment. In the TAU condition, schools will also receive feedback based on the initial APERS assessment, but no continuous coaching.
It is hypothesized that the APERS based intervention will improve overall program quality for children with autism or related SCCs as compared to TAU. Additionally, we also expect the intervention to improve student functioning, students' individual goal attainment, students' perception of their schools, and teacher self-efficacy as compared to TAU.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hampus Bejnö, PhD
- Phone Number: +46(0)8-12076264
- Email: hampus.bejno@specped.su.se
Study Locations
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Stockholm, Sweden
- Stockholm University
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Contact:
- Hampus Bejnö, PhD
- Phone Number: +468-12076264
- Email: hampus.bejno@specped.su.se
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Sub-Investigator:
- Isak Laghem, Doctoral student
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Principal Investigator:
- Hampus Bejnö, PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria for schools:
- Located within the Stockholm Region
- To have one or more SEUs for preschool class, primary school, or middle school students
Inclusion Criteria for students:
- To be enrolled in a SEU in preschool class, primary school, or middle school
- To have a documented formal community diagnosis of autism according to ICD-10, DSM-IV or DSM-5 or having related challenges with social communication and interaction as assessed by school staff and guardians.
Exclusion Criteria:
- No exclusion criteria not already mentioned.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: Experimental group
In the experimental group, labeled APERS+, APERS assessments will be carried out to rate the overall program quality for students with autism/SCCs within the SEUs. These ratings will be made by researchers (PI and doctoral candidate) and a team of specially trained coaches consisting of 5-6 special educators working for the educational administration unit (Utbildningsförvaltningen) of Stockholm Municipality. The SEUs will be provided written and oral feedback based on the ratings In the APERS+ contingency, the coaches then develop an action plan in order to improve program quality of the SEUs. Staff in the participating SEUs will also participate in a half-day of lectures and workshops about autism and other SCCs. Coaches will lastly provide weekly or bi-weekly coaching sessions in the SEUs based on the action plan to promote program quality and implement evidence-based practices. The intervention for each SEU will last for approximately 7-8 months. |
APERS assessments with written and oral feedback. Creation of an action plan that is continuously followed up by specially trained coaches weekly or bi-weekly in coaching sessions designed to support the use of evidence-based practices in school settings. Half-day lecture about autism and related SCCs. |
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No Intervention: Control group
In the control group, APERS assessments will also be carried out by researchers and/or coaches. Written and oral feedback will be provided, but no further coaching will be given and no action plan will be created. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change from baseline in autism program quality as assessed with the Swedish Autism Program Environment Rating Scale - Primary school (APERS-Primary-SE)
Time Frame: Baseline and about 8 months from baseline
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The APERS-Primary-SE is a rating scale designed to examine primary school program quality for students with autism or related sociocommunicative challenges in Sweden. It contains 10 domains including areas such as students' personal independence and competence, and challenging behaviors. The scale consists of 58 items rated on a five-point Likert scale (1= low quality, 5 = high quality) resulting in individual item scores, subdomain scores, domain scores, and a total score. |
Baseline and about 8 months from baseline
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change from baseline in how students feel about their school as assessed with How I Feel About My School (HIFAMS)
Time Frame: Baseline and about 8 months from baseline
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The HIFAMS is a questionnaire designed to assess the happiness and subjective well-being of children in school. It will be completed by all participating children in the study. The questionnaire consists of 8 items where the child is asked how they feel about their school life. The items are scored using a three-point facial Likert scale (sad face, neutral face, happy face). The faces are converted into numerical scores (0-2). |
Baseline and about 8 months from baseline
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Change from baseline in parent ratings on their child's bodily functions, activities, and participation and contextual factors as assessed with the International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism
Time Frame: At baseline and 8 months follow-up.
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The ICF Core Sets for Autism is a questionnaire where parents rate their child's functioning. It contains 37 items pertaining bodily functions, activities and participation as well as contextual factors that may affect the child's functioning. Responses are given on a Likert scale ranging from either 0 to 10 (individual factors) or -5 to 5 (contextual factors), where higher ratings indicate higher levels of functioning and/or participation. |
At baseline and 8 months follow-up.
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Change in teachers' perceived self-efficacy in supporting students with autism using the Autism Self-Efficacy Scale for Teachers (ASSET)
Time Frame: At baseline and 8 months follow-up.
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The Autism Self-Efficacy Scale for Teachers is a questionnaire where teachers rate their perceived self-efficacy in supporting students with autism and related SCCs in their classroom. It consists of 28 items and is rated on a six-point Likert scale from 0 to 5. Higher ratings indicate higher self-efficacy. |
At baseline and 8 months follow-up.
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Individual goal attainment as assessed with a Goal Attainment Scale (GAS)
Time Frame: At baseline and 8 months follow-up
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The Goal Attainment Scale is a scale used to support, monitor and assess individual goal attainment in children with autism. Goals are created collaboratively by teachers and coaches at baseline and tailored to each child's individual needs and capacity. Goal attainment is assessed by coaches at follow-up on a five-step Likert scale, where 0 is baseline and 4 is exceeding goals. |
At baseline and 8 months follow-up
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Social validity as assessed with the Social Validity Scale
Time Frame: Rated at follow-up approximately 8 months after study start
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A scale designed to asses the social validity of the procedures, goals, and outcomes of the study by participating school staff and coaches. It consists of 12 items rated on a Likert scale from 0 to 5, where higher ratings indicate higher levels of perceived social validity. |
Rated at follow-up approximately 8 months after study start
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Social responsiveness as assessed with the Social Responsiveness Scale 2 (SRS-2)
Time Frame: Baseline assessment
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The SRS-2 is a scale designed to identify the presence and severity of social impairment within the autism spectrum and to differentiate it from difficulties associated with other conditions. Used in the current study to assess the level of social challenges for the participating children. The scale contains 65 items and is rated by the children's parents or guardians. Each item is rated on a 4-point Likert scale ranging from 1 to 4, where 1 is "not true" and 4 is "almost always true". Higher scores indicate more severe social impairment associated with autism. |
Baseline assessment
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Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- VR 2025-04676
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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