Treatment Intensity Factors Related to Efficient and Effective Communication Intervention for Individuals with ASD and Complex Communication Needs

Abstract

Setting: Resources including library resources, software, cloud storage, meeting software, advisory council, and graduate assistant support will reside at Texas A&M University unless specified in the subcontract agreement with University of Wisconsin. Population/Sample: Students 3 and 21 years of age with a SPED designation of ASD/ID with complex communicative needs, per the American Speech-Language-Hearing Association. 1 Research Design and Methods: Researchers will use meta-analysis, a method of quantitative research synthesis that uses results of previously reported research results to aggregate results across larger numbers of participants. First, the researchers will conduct a literature search that focuses on the use of communication interventions for individuals with ASD/ID and CCN. The team will search electronic databases and reference lists of identified articles, articles referencing the identified articles, and other articles published by the first authors of the included articles. Studies will be included if they (a) include at least one participant with ASD or documented moderate to severe intellectual disability and with CCNs; (b) report a study that uses a single-case experimental design or between-groups design that meets minimum design quality standards; (c) report the results of a vocal and/or gestural (unaided) and/or graphic (aided-including low- or high-tech application) communication interventions; (d) include social-communicative outcomes; (e) implement strategies for communication outcomes measured in natural settings; and (f) are written in English or a published translation. Published manuscripts and gray literature (unpublished) will be included. Studies will be reviewed for adherence to basic quality criteria for study design. The research team will conduct a meta-analysis to examine the effectiveness of early communication production interventions as a function of treatment intensity with consideration, to the extent possible, of the mediators/moderators that we have described. Potential outcomes of communication interventions related to maintenance, generalization, and collateral outcomes. Descriptive data on additional factors (e.g., AAC mode, feasibility) will be investigated. Control Condition: Due to the nature of this research design, there is no control condition. Key Measures: The outcomes of this meta-analysis are the effect sizes of each eligible study. For the single-case design studies, the following effect sizes will be calculated using available data: Tau-U index and between-case standardized mean difference effect sizes. Group designs will be analyzed using standardized mean difference effect sizes and associated sampling variances will be calculated from the reported summary statistics. Data Analytic Strategy: The research team will code included articles for potential mediating and moderating factors, including parameters of treatment intensity and related factors: (a) dosage rate, (b) dosage duration, (c) dosage form, (d) dose frequency, (e) total intervention duration, (f) degree that the treatment is implemented with integrity, and (g) implementation of generalization and maintenance strategies. Effect sizes will be calculated for each included study. The researchers will use mixed-effects meta-regression models with robust variance estimation to investigate the magnitude of effects, related to the intensity or implementation of treatment intensity parameters. Separate analyses will be calculated for each effect size, separately for between-group and single-case designs. The researchers will use multi-level modeling for the Tau-U analysis and mixed-effects meta-regression for the other effect size metrics.