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Coaching a School Team to Implement the Visual Immersion System™ in a Classroom for Children with Autism Spectrum Disorder: a Mixed-Methods Proof-of-Concept Study

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Abstract

Objectives

The Visual Immersion System™ (VIS) is a comprehensive approach aimed to meet the language and communication needs of children with autism spectrum disorder (ASD). This proof-of-concept study evaluated the effectiveness and social validity of a coaching intervention on implementing the VIS™ with an interdisciplinary school team supporting seven children with ASD in a self-contained classroom of an elementary school.

Methods

Using mixed methods with a pretest–posttest design, outcome measures were objective direct (i.e., goal attainment scaling), indirect quantitative (i.e., Communication Matrix, self-efficacy, and treatment acceptability), and indirect qualitative (i.e., focus groups).

Results

Goal attainment scaling results indicated significant improvement across participants and individually. Communication Matrix scores and self-efficacy scores improved as well and treatment acceptability was high. Focus groups corroborated outcomes, treatment acceptability, and self-efficacy data while revealing barriers to implementation.

Conclusions

This mixed-methods proof-of-concept study provides preliminary evidence for the effectiveness and social validity of this coaching-based intervention on implementing the VIS™ in a classroom serving children with ASD.

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Acknowledgments

We thank the parents of the participating students for their commitment to the project. Also, thanks goes to Ms. Dorcas Malahlela for transcribing the videotaped focus groups. Dorcas is a part-time research assistant at the Centre for Augmentative and Alternative Communication the University of Pretoria and PhD student at Witwatersrand University.

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Authors and Affiliations

  1. Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Ave., Boston, MA, 02115, USA

    Ralf W. Schlosser

  2. Department of Otolaryngology and Communication Enhancement, Center for Communication Enhancement, Boston Children’s Hospital, 9 Hope Ave., Waltham, MA, USA

    Ralf W. Schlosser, Howard C. Shane & Anna A. Allen

  3. Otolaryngology, Harvard Medical School, Boston, MA, USA

    Howard C. Shane

  4. Puddingstone Place, LLC, 152 Sylvan Street, Suite 210, Danvers, MA, USA

    Anna A. Allen

  5. Fayetteville-Manlius School District, 8199 East Seneca Turnpike, Manlius, NY, USA

    Andrea Benz, Jacqueline Cullen, Lindsay O’Neill, Laurel Chiesa & Lisa Miori-Dinneen

  6. Department of Communication Sciences and Disorders, University of Texas at Austin, 2504A Whitis Ave., Austin, TX, 78712-0114, US

    Rajinder Koul

  7. Department of Public Health, Texas Tech University Health Sciences Center, Abilene, TX, USA

    Rubini Pasupathy

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Contributions

RWS: designed and oversaw the implementation of the study, provided training and feedback on the development of treatment goals using goal attainment scaling, converted GAS raw scores into T-scores, led the development of the self-efficacy instrument and focus group interview guides, served as focus group moderator, applied the constant comparative method to the analysis of focus group transcripts, assisted with data analyses and interpretation, and wrote the paper. HCS: led the coaching-based intervention both via telehealth and in-person, contributed to data interpretation, and provided feedback on drafts of the paper. AAA: oversaw the VIS-specific assessments of each student; co-led the coaching intervention both via telehealth and in-person; assisted with feedback on the construction of goal matrices; supervised the implementation, data entry, and analysis of the communication matrix in particular with the parents; and reviewed drafts of the paper. AB and JC: participated as recipients of the coaching-based intervention, implemented VIS-specific assessments, developed draft goals, served as school-based SLPs implementing the coaching-based VIS intervention in the classroom, conducted the GAS-specific probes, and reviewed drafts of the paper. LO’N: participated as recipient of the coaching-based intervention, assisted with implementing VIS-specific assessments, provided input into the development of draft goals, implemented the VIS intervention in the classroom, and reviewed a draft of the paper. LC: served as the day-to-day technology support for the implementation of the VIS in the classroom, served as the assistant moderator of the focus groups, and read a draft of the paper. LM-D: led the administration that supported and enabled the implementation of the VIS in the classroom, served as a liaison to the parents of the participating children, and read a draft of the paper. RK: conducted all statistical analyses and contributed to their data interpretation and provided feedback on draft parts of the paper pertaining to statistical data analyses and interpretation. RP: provided input into the development, implementation, analysis and interpretation of the self-efficacy instrument; and reviewed a draft of parts of the paper pertaining to self-efficacy.

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Correspondence to Ralf W. Schlosser.

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Conflict of Interest

Authors Schlosser and Shane are co-authors on the book that introduces the Visual Immersion System™ as an assessment and treatment package (Shane et al. 2014). Drs. Schlosser, Shane, and Allen served as paid consultants to the Fayetteville-Manlius School District to provide input into educational services for children with severe disabilities.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Northeastern University IRB (#17-10-13) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Schlosser, R.W., Shane, H.C., Allen, A.A. et al. Coaching a School Team to Implement the Visual Immersion System™ in a Classroom for Children with Autism Spectrum Disorder: a Mixed-Methods Proof-of-Concept Study. Adv Neurodev Disord 4, 447–470 (2020). https://doi.org/10.1007/s41252-020-00176-5

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