Department of Pediatrics, University of Rochester Medical Center, Rochester, NY.
Department of Pediatrics, University of Rochester Medical Center, Rochester, NY.
Acad Pediatr. 2017 Aug;17(6):614-619. doi: 10.1016/j.acap.2017.04.017. Epub 2017 Apr 25.
To illustrate the process of community-partnered participatory research to develop and evaluate interventions for children with autism in urban school districts.
We formed partnerships of school personnel, parents, and researchers to guide the project. We then conducted focus groups, key informant interviews, and town halls to explore how public schools currently serve students with autism. We used findings from these activities to adapt interventions for public schools. We then tested interventions in randomized clinical trials (RCTs).
Community input indicated a particular need for interventions to improve children's social interaction and instructional supports to promote their success throughout the day. On the basis of this input, we adapted 2 interventions: Remaking Recess for improving peer engagement during social times; and Schedules, Tools, and Activities for Transition (STAT) for facilitating successful transitions between activities throughout the daily routine. Results of the RCT of Remaking Recess are not yet available. The RCT of STAT involved 150 children and 56 teachers. Teachers reported high buy-in and increased their proficiency at implementing STAT; children with ASD reduced their disruptive behavior and made progress toward teacher-nominated goals. However, teachers' implementation remained inconsistent, and children did not reliably improve in academic engagement or independence.
The findings suggest that although community-partnered participatory research has limitations, it can assist in selecting interventions to address community priorities and produce some favorable outcomes for children with autism in public schools. An important next step is to evaluate the sustainability of the interventions introduced in this project.
说明社区伙伴参与式研究的过程，以开发和评估城市学区自闭症儿童的干预措施。
我们组建了学校人员、家长和研究人员的伙伴关系来指导项目。然后，我们进行了焦点小组、关键知情人访谈和市政厅会议，以探讨公立学校目前如何为自闭症学生提供服务。我们利用这些活动的发现来调整适用于公立学校的干预措施。然后，我们在随机临床试验 (RCT) 中测试干预措施。
社区的投入表明，特别需要干预措施来改善儿童的社交互动和教学支持，以促进他们全天的成功。基于这些投入，我们调整了 2 种干预措施：改造课间休息时间以提高同伴参与社交时间的机会；以及时间表、工具和活动转换 (STAT)，以促进日常活动之间的顺利转换。改造课间休息时间的 RCT 结果尚未公布。STAT 的 RCT 涉及 150 名儿童和 56 名教师。教师报告说参与度很高，并提高了他们实施 STAT 的熟练程度；自闭症儿童的破坏性行为减少，并且朝着教师提名的目标取得了进展。然而，教师的实施仍然不一致，儿童在学业参与度或独立性方面没有可靠的提高。
研究结果表明，尽管社区伙伴参与式研究存在局限性，但它可以帮助选择干预措施来解决社区的优先事项，并为公立学校的自闭症儿童带来一些有利的结果。下一步重要的是评估本项目中引入的干预措施的可持续性。
