The Mystery Motivator intervention has been shown to increase prosocial behavior among school-age children by capitalizing on the anticipation afforded by reward concealment or randomization. Although numerous evaluations have supported the effectiveness of the Mystery Motivator, the overall status of this intervention is still unknown. The purpose of the current meta-analysis was to quantify the effects of the Mystery Motivator for improving behavior outcomes in school-age children and determine if participant, setting, and intervention components moderate intervention effects. A systematic review of academic databases was conducted that yielded a total of 24 studies. These studies were evaluated for methodological rigor and analyzed for effects using Tau-U. Results indicate a strong overall effect for this intervention (Tau-U = .77 (CI95 [.73 to .80]). The results discussed and practical issues are considered for future research on the use of the Mystery Motivator to promote the academic and social-emotional development of children and adolescents.

Despite the wide usage of technology in educational settings, the overall evidence base of technology-aided reading interventions for students with autism spectrum disorder (ASD) has not been fully investigated. The purpose of this meta-analysis was to quantify the effects of technology-aided reading interventions for students with ASD and determine if participant and intervention characteristics moderate intervention effects. Reviewed articles were systematically identified and evaluated for methodological rigor according to design standards suggested by What Works Clearinghouse (WWC). A total of 13 single-case studies that met the WWC standards (50%) were analyzed for effects using Tau-U and yielded 50 separate effect sizes with 33 participants. Results of this study found a moderate overall effect of .89 (CI95 [.83, .96]) for technology-aided reading interventions, and variables associated with using time delay moderated reading outcomes.

Purpose: Selecting targets for morphosyntactic intervention is a critical component of treatment planning. The complexity approach suggests that, by treating a complex morphosyntactic target, improvements will occur for the treated structure and for related, simpler structures. This study evaluated the efficacy of the complexity approach for treating morphosyntactic deficits by targeting a complex BE verb question structure for children with developmental language disorder (DLD) and children with Down syndrome (DS) and observing its impact on treated and untreated BE verb structures. We also explored whether etiology impacted our participants' treatment responses. Method: Three participants with DLD and three with DS received treatment for the BE verb question structure in the context of a single-case multiple-baseline design across participants. Accuracy of production for the treated structure and untreated BE verb structures was measured across baseline, treatment, and posttreatment phases. Results: Treatment of the complex BE verb question structure resulted in change on the treated structure for three participants (i.e., two with DLD and one with DS). Generalization of treatment to untreated, related BE verb structures occurred for all six participants. Outcomes indicated participants from both etiologies benefited from treatment. Conclusions: This study provides evidence supporting the use of a complexity-based approach for selecting morphosyntactic treatment targets for children with DLD and children with DS. Additional research is needed to identify specific characteristics that may influence individual treatment responses. Supplemental Material: https://doi.org/10.23641/asha.27018124

BackgroundIndividuals with developmental disabilities (DD) experience increased rates of emotional and behavioral crises that necessitate assessment and intervention. Psychiatric disorders can contribute to crises; however, screening measures developed for the general population are inadequate for those with DD. Medical conditions can exacerbate crises and merit evaluation. Screening tools using checklist formats, even when designed for DD, are too limited in depth and scope for crisis assessments. The Sources of Distress survey implements a web-based branching logic format to screen for common psychiatric and medical conditions experienced by individuals with DD by querying caregiver knowledge and observations. ObjectiveThis paper aims to (1) describe the initial survey development, (2) report on focus group and expert review processes and findings, and (3) present results from the survey’s clinical implementation and evaluation of validity. MethodsSources of Distress was reviewed by focus groups and clinical experts; this feedback informed survey revisions. The survey was subsequently implemented in clinical settings to augment providers’ psychiatric and medical history taking. Informal and formal consults followed the completion of Sources of Distress for a subset of individuals. A records review was performed to identify working diagnoses established during these consults. ResultsFocus group members (n=17) expressed positive feedback overall about the survey’s content and provided specific recommendations to add categories and items. The survey was completed for 231 individuals with DD in the clinical setting (n=161, 69.7% men and boys; mean age 17.7, SD 10.3; range 2-65 years). Consults were performed for 149 individuals (n=102, 68.5% men and boys; mean age 18.9, SD 10.9 years), generating working diagnoses to compare survey screening results. Sources of Distress accuracy rates were 91% (95% CI 85%-95%) for posttraumatic stress disorder, 87% (95% CI 81%-92%) for anxiety, 87% (95% CI 81%-92%) for episodic expansive mood and bipolar disorder, 82% (95% CI 75%-87%) for psychotic disorder, 79% (95% CI 71%-85%) for unipolar depression, and 76% (95% CI 69%-82%) for attention-deficit/hyperactivity disorder. While no specific survey items or screening algorithm existed for unspecified mood disorder and disruptive mood dysregulation disorder, these conditions were caregiver-reported and working diagnoses for 11.7% (27/231) and 16.8% (25/149) of individuals, respectively. ConclusionsCaregivers described Sources of Distress as an acceptable tool for sharing their knowledge and insights about individuals with DD who present in crisis. As a screening tool, this survey demonstrates good accuracy. However, better differentiation among mood disorders is needed, including the addition of items and screening algorithm for unspecified mood disorder and disruptive mood dysregulation disorder. Additional validation efforts are necessary to include a more geographically diverse population and reevaluate mood disorder differentiation. Future study is merited to investigate the survey’s impact on the psychiatric and medical management of distress in individuals with DD.

This study investigated the efficacy of the Superheroes Social Skills program in increasing social engagement of four elementary-aged children with autism spectrum disorder (ASD) in Pakistan, where English was spoken as a second language. The investigators implemented the first six lessons from the program in the classroom and assessed its efficacy through observations made during a recess period. Although the skills were trained in one context (i.e., the classroom), observations showed that the participants increased social engagement in a second environment (i.e., recess playground) in which the skills had not been taught. Social engagement effect sizes were in the moderate to large range with larger effect sizes for social responses than for social initiations. The authors discuss the implications and research needs for implementing social skills programs in diverse cultures.

OBJECTIVES The study objectives were to examine the contents of individualized education programs (IEPs) of adolescents with autism spectrum disorder (ASD), including postsecondary transition goals, services, and changes in special education classification over time.METHODS This study involved a longitudinal population-based surveillance cohort from the Autism Developmental Disabilities Monitoring Network from 2002 to 2018 in 3 catchment areas in the United States. The sample included 322 adolescents who were born in 2002, identified with ASD, and had an IEP available for review at ages 15-16 years.RESULTS We found that 297 (92%) adolescents with ASD had an IEP including a transition plan. Those without intellectual disability (ID) were more likely to have postsecondary education and employment goals and have those goals be to pursue higher education or competitive employment compared with those with ID. Forty-one percent of adolescents with ASD had a postsecondary living arrangement goal. Although 28% of adolescents with ASD received school-based mental health services, none of these adolescents were Black; additionally, 15% of those with ID received mental health services compared with 34% without ID. The percentage of adolescents with ASD served under an autism classification increased from 44% at age 8 years to 62% by age 16.CONCLUSIONS We identified gaps and disparities in school-based postsecondary transition planning. Working with education partners, families, and adolescents will be important to identify what challenges contribute to these findings and what supports are needed to improve the equity and quality of the transition planning process for adolescents with ASD so they are prepared for adulthood.

In two studies, three caregivers of neurotypical children were trained via telehealth to deliver two antecedent strategies to increase instruction following in the home. Dependent measures included initiation latency and task completion with high- and low-probability instructions. In Study 1, a modified pretrial delivery procedure was evaluated in which caregivers jointly engaged with their child in a moderately preferred activity prior to the issuance of a predetermined instruction. Results showed that initiation latencies for low-p instructions trended downward for two of three children, while latencies for high-p instructions remained low and stable for two of three children. In Study 2, the three low-p instructions with the highest initiation latencies in Study 1 were further targeted with the high-probability instructional sequence. Using a multiple baseline across behaviors design, results showed decreased initiation latencies and increased levels of task completion for all three children. The results of both evaluations are discussed and practical issues are considered for future research on the use of technology to support caregiver’s delivery of instruction-following programs in homes.

Sensory features (i.e., atypical responses to sensory stimuli) are included in the current diagnostic criteria for autism spectrum disorder. Yet, large population-based studies have not examined these features. This study aimed to determine the prevalence of sensory features among autistic children, and examine associations between sensory features, demographics, and co-occurring problems in other areas. Analysis for this study included a sample comprised of 25,627 four- or eight-year-old autistic children identified through the multistate Autism and Developmental Disabilities Monitoring Network (2006-2014). We calculated the prevalence of sensory features and applied multilevel logistic regression modeling. The majority (74%; 95% confidence interval: 73.5%-74.5%) of the children studied had documented sensory features. In a multivariable model, children who were male and those whose mothers had more years of education had higher odds of documented sensory features. Children from several racial and ethnic minority groups had lower odds of documented sensory features than White, non-Hispanic children. Cognitive problems were not significantly related to sensory features. Problems related to adaptive behavior, emotional states, aggression, attention, fear, motor development, eating, and sleeping were associated with higher odds of having documented sensory features. Results from a large, population-based sample indicate a high prevalence of sensory features in autistic children, as well as relationships between sensory features and co-occurring problems. This study also pointed to potential disparities in the identification of sensory features, which should be examined in future research. Disparities should also be considered clinically to avoid reduced access to supports for sensory features and related functional problems. LAY SUMMARY: In a large, population-based sample of 25,627 autistic children, 74% had documented differences in how they respond to sensation. We also identified significant associations of sensory features with adaptive behavior and problems in other domains. Sensory features were less common among girls, children of color, and children of mothers with fewer years of education, suggesting potential disparities in identification.

Challenging behavior tends to increase in levels during adolescence for individuals with developmental disabilities (DD). If not addressed, this can lead to negative post-school outcomes for adolescents with DD. The purposes of this meta-analysis were to examine the effects of behavioral intervention in reducing challenging behaviors of adolescents with DD and to identify variables that could potentially moderate these effects. This meta-analysis included thirty single-case design studies that met standards for methodological rigor and experimental control. Overall, behavioral interventions were found to yield moderate effects for adolescents with DD (overall Tau-U = 0.68, SD = 0.04, [0.62, 0.73]) across settings and types of challenging behaviors. With regards to participant and setting characteristics, verbal ability and classroom setting were found to moderate the effects of the intervention outcomes with statistical significance. No other variables produced similar findings. Furthermore, statistically significant differences were found between interventions that included or did not include planned reinforcement as an intervention component. Several implications for research and practice are discussed.

Background Autistic transition-aged youth and young adults face many societal barriers to competitive integrated employment (CIE). Existing evidence-based practices (EBPs) for autistic individuals, such as video modeling (VM), may be a viable on-the-job training method to enhance employment experiences and outcomes for this population. Methods The purpose of this meta-analysis was to synthesize VM studies to teach job skills for autistic individuals. We applied the Council for Exceptional Children's (CEC) Standards for Evidence-Based Practices in Special Education to evaluate the methodological rigor of included studies using a weighted coding scheme. We further evaluated methodologically sound studies by calculating an omnibus Tau-U effect size. Results Twenty articles met our inclusion criteria, and 11 of those studies were classified as methodologically sound according to the CEC's criteria. Results indicate that VM is an EBP to improve job skills of autistic individuals. The overall effect size for methodologically sound studies was strong (0.91), but most studies occurred in contrived or school-based employment settings rather than CIE settings in the local labor market. Conclusions Employers, transition professionals, and related service providers can consider VM a viable method to teach job skills to autistic employees. However, additional research conducted in CIE settings is needed to better understand the effects of VM in contexts where autistic employees earn regular wages. Lay summary Why was this study done?: Autistic adolescents and adults often experience barriers obtaining employment in their local communities. They may also benefit from on-the-job supports for successful employment. Video modeling is one intervention technique that has been used to teach a variety of skills to autistic individuals. Video modeling involves creating short video clips that show the person how to do specific skills or tasks. We wanted to learn about how video modeling has been used to teach job skills to autistic employees.What was the purpose of this study?: The purpose of this study was to evaluate the quality of research studies that used video modeling to teach job skills to autistic employees. Understanding how video modeling interventions can be used in employment settings may help autistic employees have more positive work experiences.What did the researchers do?: The researchers analyzed the video modeling research studies with autistic participants aged 14 years or older. We evaluated the quality of each study, type of employment setting, type of job skill, and how much the job skills improved. We used a criteria established by a professional organization, the Council for Exceptional Children, to evaluate the quality of the research studies.What were the results of the study?: We analyzed 20 research studies and found that video modeling was an overall effective intervention to teach job skills to autistic adolescents and adults. However, most of the studies focused on general job tasks rather than employment-related social skills. In addition, most of the studies were conducted in employment settings where the autistic employees did not earn regular wages, such as school settings or internships. We encourage future researchers to study how video modeling can be used to promote competitive integrated employment in community settings.What do these findings add to what was already known?: Prior research studies have used video modeling to teach skills such as academic, play, and social skills to autistic children and youth. This study showed us that video modeling is an effective intervention to teach job skills to autistic adolescents and adults.What are the potential weaknesses of the study?: There are disagreements about how to evaluate the quality of research studies in the field of special education. We used a popular criterion by the Council for Exceptional Children organization, but our results may be different from other researchers. We also did not find a large number of studies, so some of our findings should be considered with caution.How will these findings help autistic adults now or in the future?: These findings demonstrate that video modeling is an effective on-the-job training method for autistic employees. Autistic adults can use video modeling at work to learn new job skills. Employers, job coaches, and secondary transition professionals could use brief videos to support autistic employees.

Classroom observations are frequently conducted with the purpose of comparing the behavior of a target student to that of other peers within the same classroom. A variety of procedures may be utilized by researchers and practitioners to collect such data; however, little is known of the accuracy of estimates of behavior produced by such procedures relative to continuous behavior recording for the target student, peers sampled as a representation of the class, and the class as a whole. The purpose of the present study was to evaluate the accuracy of estimates of frequently utilized peer comparison observation procedures relative to duration recording. Data were simulated for 4,000 classroom observations, with variations in level of classroom behavior and length of observation being simulated. Results indicated that an Every Fifth interval procedure resulted in the lowest levels of absolute error during single observations for target students, with planned activity checks resulting in the most accurate estimates of class-wide behavior. Despite differences being apparent in level of accuracy of single observations, differences in accuracy across procedures were not apparent when all observations of the same type (i.e., duration, level of classroom behavior, and observation procedure) were compared.

Challenging behavior is a significant barrier in accessing the general education curriculum for students with developmental disabilities. This necessitates the identification of evidence-based practices for addressing challenging behavior in inclusive settings. The purpose of our meta-analysis is to (a) quantify the magnitude of effect of interventions targeting the reduction of challenging behavior in students with developmental disabilities in inclusive educational settings and (b) determine if participant and intervention characteristics moderate intervention effects. A systematic search of academic databases was conducted to identify studies, which were evaluated for methodological rigor and analyzed for effects using Tau-U. Results indicate a strong overall effect of .94 (95% CI [.87, 1]) and moderating variables associated with behavior topography, interventionist, and intervention components were identified.

Educators are beginning to consider the physical learning environment as an additional resource in meeting learning outcomes in modern classrooms. In order to better utilise classroom space, schools have begun to eliminate desks and chairs and to replace 'traditional' furniture with 'flexible' furniture that is capable of multiple reconfigurations to facilitate teaching and learning. The impact of flexible furniture in elementary classrooms has had little exploration. We investigated the various impacts of flexible furniture paired with teacher professional development (PD) on the elementary classroom. A total of 10 classrooms were included in the study of 3rd and 4th graders (N = 206 students). Classrooms were observed biweekly for 8 weeks and assigned to one of two groups: Group A received PD and flexible furniture, whereas Group B maintained traditional furniture. During observations, three students were randomly selected from each classroom and continuously monitored throughout each observation (n = 30 students). First, a between-groups design and analysis of covariance (ANCOVA) was employed to assess the effect of the intervention using pre-intervention self-assessment results as the covariate. As predicted, students who experienced flexible furniture reported greater satisfaction with the learning environment than did peers with traditional furniture. Secondly, a series of independent samples t test demonstrated that classrooms with flexible furniture provided more opportunities for student autonomy and use of furniture for learning. Insight on flexible furniture, its impact in the elementary classroom, implications and future research are discussed.

This single-case meta-analysis is the first to provide a quantitative synthesis of the published literature on mathematics word problem-solving intervention studies for English learners with learning disabilities and mathematics difficulties. A total of ten single-subject studies were included for analysis. The current study investigated the magnitude of the effect of mathematics interventions targeting the improvement of students' mathematics word problem-solving performance, and analyzed variables that moderated this effect. Results indicate a moderate overall effect size of 0.81 (95% CI [0.71, 0.90]) on word problem-solving performance for English learners with learning disabilities and mathematics difficulties. Moderator variables such as the implementer of the interventions, instructional focus, and word problem-solving content significantly moderated the mathematics intervention effects.

This meta-analysis analyzed 39 studies that met the inclusion criteria for employment-related interventions for individuals with developmental disabilities. Each experiment included in this analysis either met or met with reservations all of the basic design standards (Kratochwill et al. 2010 , 2013 ). Tau- U effect sizes were calculated for each A–B contrast extracted from the included experiments, and moderator analyses were conducted for dependent variables, participant characteristics, setting characteristics, and implementer characteristics for all video modeling interventions. Moderate to strong effects were seen across almost all moderator levels, and few significant differences were determined between the levels. According to overall effect sizes, all interventions were effective, but video modeling interventions were considered not only to be effective but also evidence-based interventions in teaching employment skills to individuals with developmental disabilities.

The authors examined the effectiveness of the electronic home note program (EHNP). The program features an emailed version of the traditional home note intervention. In addition, the program uses motivational strategies for increasing rates of on-task behavior, academic productivity, and parent involvement. The authors used a multiple-probe, multiple-baseline design to evaluate implementation effects of the EHNP with four elementary grade participants. Across all participants, there was an average Tau-U of 0.76 for on-task behavior, with gains maintained at two weeks postintervention. Inconsistent academic gains were found. Parent involvement was high, as most reviewed behavioral ratings data over the course of the intervention. Results also reflect high acceptability of the intervention program from parents, teachers, and participants.

Background: Despite positive effects of and established empirical evidence for tablet-based interventions for individuals with autism spectrum disorder (ASD), it is not known whether such findings can be applicable to maintenance and generalization effects of those interventions. Aims: This systematic review evaluated peer-reviewed single-case experimental design (SCED) studies concerning evidence of generalization and maintenance effects of tablet-based interventions for individuals with ASD. Methods: To evaluate the methodological rigor of the literature in terms of generalization and maintenance effects, the authors adopted four of the basic design standards developed by What Works Clearinghouse (WWC; Kratochwill et al., 2010/2014). In addition, the authors used Tau-U effect size measure and attempted to calculate effect sizes differentiated by the type of generalization and maintenance teaching strategies. Results: A total of 21 studies assessed generalization and/or maintenance effects. In the first evaluation of evidence of generalization and maintenance effects, it was found that more than half of the studies included in this review collected interobserver agreement (IOA) on at least 20% of sessions across all generalization and maintenance conditions and met the minimum quality thresholds of IOA. Meanwhile, less than one third of the studies included more than three data points in each generalization and maintenance condition. With regard to maintenance of effects, about half of the reviewed studies did not report the latency to the maintenance measure, which may hamper the assessment of the clinical and practical significance of the effect of the tablet-based intervention. In the second evaluation, the omnibus Tau-U effect size for baseline to generalization comparisons resulted in a moderate effect. For the contrasts between intervention and generalization comparisons resulted in a small effect. The omnibus Tau-U effect size for baseline and maintenance comparisons resulted in a strong effect. For the contrasts between intervention to maintenance comparisons, the omnibus Tau-U effect size resulted in a small effect. Conclusions and implication: Findings in this review suggest that efforts should be made to establish a system for appraising generalization and maintenance procedures in SCED studies. In addition, future studies should investigate if tablet-based interventions are truly effective in creating sustainable behavioral change in individuals with ASD.

This study utilized secondary analyses of a randomized controlled trial and investigated the extent to which prestest word identification efficiency, reading fluency, and vocabulary knowledge moderated the effects of an intervention on reading comprehension outcomes for struggling readers in sixth through eighth grades. Given that the experimental intervention included components that targeted word reading, reading fluency, and vocabulary, we hypothesized that students with lower pretest performance in those skill domains would benefit more from the intervention compared to students with relatively stronger pretest performance or students who received school-implemented (business-as-usual) intervention. Results indicated that pretest word identification efficiency and vocabulary did not moderate the effects of the intervention; however, moderation effects were observed for pretest oral reading fluency such that reading comprehension gains of students with lower pretest fluency were greater in the experimental intervention compared to students with higher pretest fluency or in the comparison condition. Reasons for the moderation effect are discussed. Findings underscore the use of moderation analyses when evaluating multicomponent interventions.

The current study examined the efficacy of the Electronic Home Note Program (EHNP) for improving on-task behavior, math performance, and home-school collaboration. The EHNP is a package-ready web-based home note that utilizes Google Drive. The study was conducted in a public elementary school serving predominantly low-income ethnic minority students. Student participants were four males in either the fourth or fifth grade with lower rates of on-task behavior and math performance in comparison to classroom peers. The intervention phase was 4 to 5 weeks in duration. Results indicate large effects (Tau-U = 0.90) for on-task behavior, which were maintained for all students when compared with baseline at a 3-week follow-up. During the intervention phase, three of four student’s on-task rates improved to a level that approximated that of classroom peers. Results indicate medium effects (Tau-U = 0.65) for math problem completion and large effects in math accuracy (Tau-U = 0.70). Parents consistently reviewed electronic home note (EHN) data with their child 84% at home. Parent, student, and teacher ratings indicate acceptable social validity of the EHNP. All parents and teachers reported the EHNP improved their home-school collaboration. The utility of using a web-based package-ready EHN is discussed.