Interventions promoting academic engagement for children with ASD in general education classrooms : A systematic literature review

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Interventions promoting academic

engagement for children with ASD in

general education classrooms

A systematic literature review

Qi Meng

One year master thesis 15 credits Supervisor Karin Bertills

Interventions in Childhood

Examinator

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SCHOOL OF EDUCATION AND COMMUNICATION (HLK) Jönköping University

Master Thesis 15 credits Interventions in Childhood Spring Semester 2017

ABSTRACT

Author: Meng Qi

Interventions promoting academic engagement for children with ASD in inclusive settings A systematic literature review

Pages: 33

Facilitating the learning and participation of children with autism spectrum disorder (ASD) in inclusive settings has been poorly understood. Teachers often feel that they don’t have adequate knowledge to help these children when they disengage in classroom activities. Lack of academic engagement could impede children from achieving a positive academic outcome. The aim of this study is to identify evidence-based interventions that promote academic engagement of children with ASD in general education classrooms, so the educators could have an idea on what

interventions are effective and feasible in promoting academic engagement, what strategies could be applied by teachers in general education classrooms. A systematic literature review was performed, seven studies were included for final analysis and seven interventions were identified. Results show that video self-modeling, video social stories™, self-monitoring, peer support, antecedent physical activity, adult proximity and visual support interventions all can effectively enhance academic engagement of children with ASD in general education classrooms. It was found that academic engagement was promoted by increasing on-task behaviour in the classroom. The feedback from the teachers and students who participated in the studies all reported

positively. Future research will be needed in exploring more interventions in inclusive settings, and developing tools to accurately measure academic engagement.

Keywords: intervention, autism, ASD, children, academic engagement, inclusive, systematic literature review Postal address Högskolan för lärande och kommunikation (HLK) Box 1026 551 11 JÖNKÖPING Street address Gjuterigatan 5 Telephone 036–101000 Fax 036162585

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1 Introduction

The inclusion of children with disabilities has been promoted for years since Salamanca statement in 1994 (Falkmer, Oehlers, Granlund, & Falkmer, 2015). With the increased rate of diagnosis of Autism spectrum disorder (ASD), more and more children with ASD are now included and educated in general education classrooms. Many children with ASD often engage in repetitive, disruptive behaviours and they tend to have high levels of inattention. These characteristics of children with ASD may hinder them from being engaged in classroom activities and also decrease their learning opportunities, thus lead to poor academic performance (Sterling-Turner, Robinson, & Wilczynski, 2001). Although general education teachers are supportive to the principles of inclusive education, but they are not confident in teaching these children, as they lack necessary training (Deris & Di Carlo, 2013). How to facilitate learning and participation of children with ASD in general education classrooms is the key to help them achieving academic success.

1.1 Autism spectrum disorder

Autism Spectrum Disorder is deemed as one of the most complex developmental disorders (Bakken & Bock, 2001). It is characterized by core deficits in communication, social interaction, and restricted, repetitive patterns of behavior, interests or activities (American Psychiatric Association, 1994, as cited in Hodgetts, Zwaigenbaum, & Nicholas, 2015). The diagnosis of ASD can be difficult to make since there is no medical test. Doctors tend to make the diagnosis by observing the child’s behavior and development (“Autism Spectrum Disorder: Screening and Diagnosis”, 2015). ASD is generally diagnosed at the age of four on average. Most parents notice some symptoms before their children turning two years old. These early signs mainly include avoiding eye contact, lack of response when name is called, failure to show interests by pointing at things, and lack of language and social skills (Zwaigenbaum, 2001). The cause of ASD is due to genetic reasons, and environmental factors are also found to play a role. The exact cause is still unknown, and no medical cure has been found yet (Klein & Kemper, 2016).

The diagnosis of ASD include several disorders, such as Autistic Disorder, Asperger syndrome, and Pervasive Developmental Disorders - Not Otherwise Specified (PDD-NOS) (American Psychiatric Association, 1994, as cited in Kurth & Mastergeorge, 2010). The symptoms and features of every single disorder can be demonstrated in a variety of combinations, and the degree of impairments vary from mild to profound, this will affect individuals in very different ways (Ministry of Education, 2007). For example, regarding the general level of intelligence, about 75%-80% of individuals with ASD have significant delays in cognitive development. However, many individuals with Asperger Syndrome display average or even above average intellectual ability (Perry & Condillac, 2003). ASD is not an illness, the focus should not be put on how to change the child into a “normal” individual (Caruso, 2010). Instead, parents and

professionals should appreciate their perspectives, try to provide strategies or interventions to enable them to function better and participate in their everyday life situation (Jordan, Jones & Murray, 1998).

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1.2 Inclusion

Since the Salamanca Statement in 1994, inclusion has merged and been promoted in many countries as a key educational policy (Gibb, Tunbridge, Chua & Frederickson, 2007). Inclusion is not integration, and it is much more than mere placement (Malmqvist, n.d.). According to Ferguson (1995), inclusion is “a unified system of public education that incorporates all children and youths as active, fully participating members of the school community; that views diversity as the norm, and that ensures a high-quality education for each student by providing meaningful curriculum, effective teaching, and necessary support for each student” (p.14).

Educating children with ASD in inclusive settings is proved to be vital (Lindsay, Proulx, Scott & Thomson, 2014). Improvement has been found in social development of children with ASD (Schreibman, 2005, as cited in Goodman & Williams, 2007). When children with ASD are placed in general education classroom, it provides the opportunity for them to socialize, and learn how to function with different people in different settings. When placing them in self-contained or special education classroom, they tend to interact with instructors instead of developing relationships with peers (Goodman & Williams, 2007). Besides the social benefit of inclusion, researchers have found academic gains of children with ASD in inclusive settings. They demonstrate increased classroom engagement, more time spent on classroom assignments, and positive academic outcomes (Lynch & Irvine, 2009). Inclusion is not only beneficial to children in need of special support, but also helpful to typically developing children. They will gain a better understanding of the diversity of society, a greater recognition of social justice and equality, furthermore, a more caring attitude (Mitchell, 2008).

Though the Individuals with Disabilities Education Act (IDEA) mandates that children with disabilities be educated in general education classroom, it also allows to remove the child from inclusive settings if school services cannot meet the needs of the child due to the nature and severity of the child’s disability (Merrell, Ervin, & Peacock, 2011). When it comes to ASD, IQ and severity of autistic symptoms often affect placement decisions (Eaves & Ho, 1997). Children with ASD who demonstrate problem behaviour and frequently disengage in classroom activities put themselves at risk of being excluded from inclusive settings (Strain, Wilson, & Dunlap, 2011). It seems children with ASD face many challenges to get the opportunity of being educated in general education classroom. Even if they are included, the mere placement is far from enough to help them achieving a successful education (Harrower & Dunlap, 2001).

1.3 Academic engagement

Academic engagement is a composite of specific classroom behaviours, which include attending to the academic materials and the task, making appropriate motor responses, ask assistant from the teacher in a proper manner (Walker, Severson, & Feil, 2010). When children are engaged, they will

actively follow the classroom instructions. This is apparent through making eye contact with the instructor, directly answering questions from the teacher, and engaging in relevant academic materials

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5 (Schatz, Peterson & Bellini, 2016). Academic engagement is the most visible engagement within the classroom and teachers check on it constantly during instructional classes (Christenson et. al, 2008). Years of researches have demonstrated that there is a positive correlation between academic engagement and academic achievement. The prediction model of DiPerna, Volpe & Elliott (2002) also illustrated that levels of engagement would have moderate to large effect on academic achievement. Children who have high rates of engagement tend to have more opportunities to respond, practice, interact with teachers and educational materials, and this may lead to increased learning and eventually a positive academic outcome (DiPerna, Volpe & Elliott, 2002). Conversely, lack of engagement would put children at risk for negative outcomes such as attending school unmotivated, developing disruptive behaviour, and withdrawing from school (Appleton, Christenson & Furlong, 2008). In addition, researchers have found that motivation, study skills, and communication techniques could all have influences on academic engagement (Greenwood, Horton & Utley, 2002).

Active engagement in the surrounding environment is one of the major difficulties for children with ASD. They easily lose their critical learning opportunities since they often go into their “own world” (Leach & Duffy, 2009). Due to the significant social and communication deficits, children with ASD present a unique set of learning difficulties, which would inhibit them from being actively engaged in classroom activities (Leekam, Prior, & Uljarevic, 2011). Specifically, the emotion regulation deficit of children with ASD would cause problems in maintaining psychological and emotion arousal for high levels of classroom engagement, this deficit also creates challenges for filtering irrelevant information and staying on task (Laurent & Rubin, 2004). With deficit in joint attention, children with ASD are less likely to make eye contact or look at faces. Thus, they have less opportunity to respond or attend to classroom instructions than their typically developing peers. Furthermore, deficits in verbal and nonverbal

communicative behaviours would impede children with ASD from participating in group discussions. In addition, repetitive behaviours, restricted interests may also hinder their engagement in academic activities (Sparapani, Morgan, Reinhardt, Schatschneider & Wetherby, 2016).

1.4 Bronfenbrenner’s bioecological model

Bronfenbrenner’s bioecological model shows that a child’s world consists of five systems of interaction: microsystem, mesosystem, exosystem, macrosystem, and chronosystem (Bronfenbrenner, 1979). Microsystem consists of the child’s most direct environment such as home, school, peer and religious groups (Bronfenbrenner & Evans, 2000). Classroom is a primary setting of children’s microsystem where academic engagement happens via interaction with elements within the classroom environment. The interactions could occur between teacher and student, student and peers, student and objects, etc. The quality of interactions would affect children’s engagement in learning and influence the academic outcomes (Reyes, Brackett, Rivers, White, & Salovey, 2012).

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1.5 Rationale

Children with ASD often present unique and challenging behaviors that impede them from engaging in classroom activities. Those behaviors not only jeopardize the learning of the children with ASD, but also interfere with the academic environment for other typically developing students (Goodman & Williams, 2007). Teachers work with children with ASD in general education classrooms must be well equipped with effective interventions or strategies, so they could facilitate learning and participation of children with ASD (Harrower & Dunlap, 2001). Therefore, it is important to provide educators with interventions that are evidence-based, and practical for use in general education classrooms.

1.6 Aim

The purpose of this study is to identify evidence-based interventions for promoting academic engagement of children with ASD in general education classrooms.

1.7 Research questions

1. What interventions are reported to promote academic engagement of children with ASD in general education classrooms?

2. How is academic engagement of children with ASD promoted?

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2 Method

A systematic literature review was performed. Search strategy, selection criteria, selection process, quality assessment and data extraction will be elaborated in this section. The whole process can be seen in Figure 2.1.

Figure 2.1. The methodological process.

2.1 Search strategy

The search was performed in March 2017 in the database of ERIC, PsycINFO, ScienceDirect and Scopus. These databases integrate information from the field of Pedagogy and psychology. Each database was tried out for several times by using different search terms in order to catch maximum relevant articles in accordance with the aim of this study. Different search strategies were applied according to the feature of each database. Truncations (*) were used to yield more results. The searches were limited in all four databases for articles that were peer reviewed, written in English, published from 2000 to 2017. The search procedure and search strings used in each database are presented in Appendix A.

In the database of ERIC and PsycINFO, the term “academic engagement” was not chosen since it yielded very few results. When using Thesaurus, “learner engagement” was recommended for the term “engagement” in ERIC; “student engagement” was recommended for the term “academic engagement” in PsycINFO. Neither “academic performance” nor “academic achievement” was used in the search as performance and achievement indicate the outcome, which is not the focus of this study.

This study originally intended to focus on children aged 6-12, but very limited articles were found. Therefore, the age range was not set during the search, it was added as one of the inclusion and exclusion criteria for article selection. “Inclusive classroom” or “mainstream school” or “general education

classroom” was not used as search terms in case related articles would be missed. Database search Full text screening Title/abstract screening Quality assessment Data extraction Article selection

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2.2 Selection criteria

Inclusion and exclusion criteria for selection of articles at title/abstract and full-text level are displayed in table 2.1. Age range from 6-18 and general education classroom as research setting will be applied as inclusion criteria on the title/abstract and full-text level screening.

Table 2.1

Inclusion and exclusion criteria for selection of articles

Inclusion criteria Exclusion criteria

Population

Children aged 6-18 with a diagnosis of ASD Adults, children aged 0-5 and older than 18. Typically developing children

Children with other health conditions Focus

Children’s academic engagement Social engagement, peer engagement

Interventions or strategies Intervention in specific subject (e.g. art, music) General education classroom Special school, self-contained classroom Publication type

Article Books, abstracts, conference papers, other Peer reviewed literatures

Published from 2000 to 2017

In English

Full text available for free

Design

Empirical study, Quantitative, qualitative or mixed method

Systematic literature review

2.3 Selection process

234 articles were found in total and they were transferred to Zotero. 14 articles were excluded as duplicates. Then, the left of 220 articles were exported to Covidence for screening. Covidence is a web-based program to keep your references organized and is eligible for systematic reviews (Alving, n.d.). All the articles were sorted with an inclusion criteria and exclusion criteria in Covidence. According to the design, articles can be put in different categories labeled as “Yes”, “No” and “Maybe”. Articles which partly met with the inclusion criteria (e.g. the age range is birth-12) were put as “Maybe” and moved into

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9 full-text screening, just to make sure no relevant articles were missed. The entire search and extraction procedure is presented in a flow chart (Figure 2.2).

2.3.1 Title and abstract screening

A protocol of inclusion criteria was used for title and abstract screening (see Appendix B). The inclusion criteria comprised of article, abstract available, diagnosis of ASD, age from 6-18, academic engagement, interventions, and general education classrooms. When in doubt, the article will be labelled as “Maybe” and automatically included in the full-text screening. 207 out of 220 were excluded due to the following reasons: duplicate (n=1), not an article (n=3), systematic reviews (n=3), not ASD (n=35), not aged from 6-18 (n=26), not focused on academic engagement (n=57), not mentioned academic

engagement (n=34), not focused on intervention or strategy (n=27), not in inclusive classrooms (n=21). 2.3.2 Full-text screening

After the title and abstract screening, there was still not enough information about the articles that have been included. Thus, 13 left articles were moved onto full-text screening by using a detailed protocol (see Appendix C). It contained information about the chosen method, participants, research setting, intervention procedure etc. If one of the participants fitted all the inclusion criteria, the analysis and the results towards him was done separately from other participants, the article would be included. Five articles were excluded due to: no full-text available (n=1), not ASD (n=1), not inclusive classrooms (n=4). Hand search were done by checking the reference list of the remaining seven articles. They were firstly selected by title and abstract screening, and only four articles went through full-text screening, but none of them fitted the inclusion criteria completely. Therefore, seven articles in total were included for data analysis.

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10 Figure 2.2 Flow chart displaying the selection process.

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11 2.3.3 Quality assessment

A quality assessment tool was used to evaluate the quality of included studies. The tool was adopted from Evaluative Tool for Mixed Method Studies (Long, 2005). With modification, the tool consisted of 17 items and four major themes (see Appendix D). The scale was set from 0-25. The articles were rated as low quality (0-8), medium (9-17), and high (18-25). The results showed that one study had low quality, four studies were rated as medium and two studies were assessed as high quality. The

assessment result can be seen in table 2.2. The low-quality article was not excluded due to the very limited number of included studies.

Table 2.2

Result of Quality assessment of the included articles

SIN Articles High Quality Medium Quality Low Quality

1 Schatz et al. (2016) x 2 Cihak et al. (2012) x 3 Clemons et al. (2016) x 4 McCurdy et al. (2014) x 5 Nicholson et al. (2011) x 6 Conroy et al. (2004) x 7 Brown et al. (2015) x

Note. SIN = Study Identification Number

2.4 Data extraction

Data was extracted and analyzed by using an extraction protocol (see Appendix E), which contains the information about general introduction of the study, participants, description of the intervention, and outcome of the intervention. Information about interventions was gathered in the section of what was the intervention, what was the basic procedure of intervention, where did the intervention take place, how long for each session of the intervention, how long did the intervention last, who implemented the intervention, Is there an aide during the intervention, and any follow-ups after the intervention. Regarding the implementation of intervention, ethical considerations like informed consent of the parents must be obtained and appropriately documented (Burns, Jacob, & Wagner, 2008). Therefore, parental consent was taken into account when doing the data extraction.

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3 Results

Seven articles were included in final data analysis, and seven interventions were identified through reviewing these articles. The outcome, and procedure of the interventions, promotion of academic engagement, and the acceptability of intervention from teachers and participants will be presented in this section. An overview of the included studies can be seen in table 3.1.

Table 3.1

Overview of the included studies SIN Number of

participants

Age of participants

Diagnosis Intervention Parental consent

1 3 10.4/11.9/9.7 ASD & AS VSM Yes

2 4 13/14/12/11 AS & HFA Video Social Stories™ Not mentioned

3 1 17 ASD Self-Monitoring Yes

4 3 8/7/11 ASD Peer Support Not mentioned

5 1 9 HFA Antecedent physical

activity

Yes

6 3 6/6/7 ASD Adult Proximity Not mentioned

7 1 6 ASD Visual support Not mentioned

Note. SIN = Study Identification Number, see table 2.2. VSM = Video Self-Modeling, ASD = Autism Spectrum Disorder, AS = Asperger Syndrome, HFA = High-Functioning Autism.

3.1 Basic procedure of the intervention

Video self-modeling was identified as an effective intervention in increasing task engagement for Children with ASD. VSM is when a student watches himself or herself in the video with expected behaviours. (Schatz, Peterson & Bellini, 2016). Participants’ behaviours were videotaped during the baseline phase, the off-task behaviours were deleted and the on-task behaviours were edited into three short different videos. The videos were presented to participants before the class three times a week in an alternative fashion and teachers also reminded them of expected behaviour during the lesson.

Video Social StoriesTM is an intervention which combined the use of video self-modeling and Social StoriesTM. Social StoriesTMprovided a “written, sometimes illustrated, vignette that a student can reference as needed when encountering situations in which they feel uncertain” (Cihak, Kildare, Smith, McMahon & Quinn-Brown, 2012). The intervention was introduced with a brief-FA (functional assessment) was

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13 conducted through teacher interview, in order to identify the contextual factors that triggered and

maintained the off-task behaviour. Teachers created all materials including social stories. Participants were videotaped when reading these stories and displaying appropriate on-task behaviours. Each participant made two videos and each video lasted 30-35 seconds. Participants were prompted to watch the video before the beginning of the class. They were provided with headphones so they wouldn’t distract other students.

Self-monitoring used the I-Connect application to increase the on-task behaviour of the participants (Clemons, Mason, Garrison-Kane & Wills, 2016). Baseline was set without using any behavioural support in the classroom, and there was no modification of classroom environment. I-Connect training was conducted after the baseline setting. The participants were trained for three days (total training time one hour approximately) on how to use this application. During the intervention phase, participants

monitored their on-task behaviours by using the I-Connect application at one-minute intervals.

Participants were prompted by the question “Am I on-task?”, “yes” and “no” options were displayed with the question as well. If the participants meet the dual criteria, they would be provided with reinforcement.

Peer support intervention involved typically developing peers as supporters for the children with ASD. During the baseline phase, peer supporters were seated next to the children with ASD. Selected seating was the only modification made in the typical classroom condition. Initially an interview was conducted to map/conclude peer supporters’ perspectives of the children with ASD before the peer training. Off-task behaviour was defined individually for each target student. Peers were informed about the definition of off-task behaviours during class, and taught how to prompt the target students. During the intervention when the class was about to begin, the peer supporters reminded the target students of the desired behaviours and gave them verbal encouragement. When they displayed off-task behaviours, peer supporters prompted them in accordance with previous training. When the target students stayed on task, peers gave nonverbal positive feedback such as a smile, head nod or thumb up as an encouragement. At the end of each session, peer supporters provided verbal feedback to the target student about how to perform better in the next session.

Antecedent physical activity proved to be an effective intervention in promoting academic

engagement for children with ASD (Nicholson, Kehle, Bray & Heest, 2011). This intervention argued that with the proof of physical activity results in increased transmission of monoamines in the brain which affect the attention may increase academic engagement of Children with ASD. Before the intervention, parental consent was obtained with a confirmation that they had the ability to participate in physical education class. Multiple baselines were set by observing participant during both academic and physical activities. Baseline data was collected over a period of two weeks. The intervention and classroom observation were carried out three times each week. Physical activity sessions were conducted in the gymnasium. These sessions contained 12 minutes of jogging followed by a five-minute walk and

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14 stretching. A paraprofessional and/or a gym teacher was predisposed to jog with the participant if needed. The data of running distance and engaged time was collected. The participant returned to the classroom after the jogging session and behaviour was recorded for 15 minutes within one hour.

Adult proximity is simply how close an adult (teacher or paraprofessional) is physically to a child in the classroom. This intervention was evaluated and demonstrated to have an effect on academic

engagement of children with ASD (Conroy, Asmus, Ladwig, Sellers & Valcante, 2004). Participants, teachers and assistants were observed for 15-20 minutes every session over a period of five weeks. All the sessions were videotaped during natural classroom activities, and target behaviours were identified individually for each participant. In addition to problem behaviours, engagement was recorded for all participants as well. Classroom adults used verbal communication or gestures to direct the target student in performing a specific behaviour. Besides this, adult proximity and no adult proximity were recorded as independent variables to see the changes in academic engagement.

Visual Support intervention proved to be effective in increasing academic engagement for children with ASD who displayed circumscribed interests (CI). children with ASD usually have visuospatial strengths. Visual cues help students stay focused, understand transition in activities and reduce repetitive behaviours. Teachers designed visual cues and task cards according to the participant’s cognitive abilities and personal interests. Teachers also discussed with the participant about when it is appropriate to talk about her personal interest and when it is not. For example, if the participant’s CI was airplane, the teacher developed visual cue and task cards of airplanes for every letter of the alphabet. For the sound of the letter (e.g. letter “L”), teacher made a card showing an airplane landing with a letter “L” on its wing. The visual cue and task cards allowed participant to review the letter and its corresponding sound whenever she needed during school time.

3.2 Outcome of the intervention

Successful outcomes were reported for all seven interventions. They were evaluated by the measurement of academic engagement and maintenance effects. Four studies measured and presented the percentage of on-task behaviour and four studies had follow-up phases. six studies reported either increased on-task behaviour or improved academic engagement. One study measured the off-task behaviour and reported the increased work completion. Five interventions were proved to be effective to all the participants, two interventions were tested effective to only part of the participants. Regarding the acceptability of the interventions, four studies tested social validity, and both teachers and participants reported positively, considered the intervention as acceptable, while three other studies didn’t mention this. Detailed results are presented in table 3.2.

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15 Table 3.2

Results of the interventions

SIN Intervention Measurement of academic engagement Results Maintenance effect (After removal of intervention) Feedback 1 VSM On-task engagement Increased on-task engagement on two participants Engagement level maintained Comfortable to participate 2 Video Social Stories™

Task engagement Improved task engagement and task completion Engagement level maintained for two participants Comfortable to participate 3 Self-Monitoring

On-task behaviour Improved on-task behaviour

Engagement level maintained

Comfortable to participate 4 Peer Support Off-task behaviour Decreased off-task

behaviour, increased work completion

Not measured Comfortable to participate 5 Antecedent physical activity Academic engaged time Improved academic engagement Engagement level maintained Not mentioned 6 Adult Proximity Academic engagement Increased rate of academic engagement

Not measured Not mentioned 7 Visual

support

Not measured Increased attention Not measured Not mentioned Note. SIN = Study Identification Number, see table 2.2.

3.3 Promotion of academic engagement

Six out of seven interventions all aimed at increasing on-task behaviours to promote academic engagement of children with ASD. Only one intervention focused on decreasing off-task behaviours to improve academic engagement. VSM is a form of observational learning. Children with ASD tend to be visual learners, they watched themselves perform expected behaviours in the video, and then they engaged more in the academic activities by imitating the targeted behaviours. The combination of VSM and social

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16 stories focused on decreasing off-task behaviour to promote on-task behaviours. Self-monitoring and peer support intervention both worked in a way of prompting student to engage. Self-monitoring prompted student with technical application while peer support used typically developing peers to remind the target students to stay on task. Antecedent physical activity aimed at increasing transmission of monoamines in the brain, so student could be more focused on the subsequent classroom activities. Intervention of adult proximity believed that the presence of adult (either teacher or paraprofessional) would help decreasing the problem behaviours or even prevent the occurrence of these behaviours. The visual support intervention utilized unique visual strengths of children with ASD, integrated with their circumscribed interests to elicit their attention to educational materials and instructions from teachers.

3.4 Acceptability of the intervention

Acceptability of an intervention to the participants is one of the standards of a successful intervention. Thus, social validity should be tested to find out the feelings of participants towards the intervention. Social validity was tested in four studies. Regarding video self-modeling intervention,

teachers were provided with a questionnaire after the intervention. They reported that participants enjoyed watching the video, the intervention was easy to carry out, helpful to target students, and teachers enjoyed being a part of the intervention. As to the intervention of video Social StoriesTM, special education

teachers, general education teachers, as well as participants, were interviewed following completion of the study. Both special and general education teachers reported that they liked the procedure and they agreed it was an beneficial intervention that they would use in the classroom by themselves. Participating students reported that the intervention increased their academic engagement and task completion. They indicated that it was an appropriate intervention and they liked it. In respect of self-monitoring intervention, teacher reported it was an effective intervention for the target student. Participant indicated that the intervention helped him stay on focus. With regard to peer support intervention, questionnaires were sent to all teachers, target students and peer supporters after the intervention. All of them reported the intervention was appropriate and acceptable.

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4 Discussion

This systematic literature review aimed at identifying evidence-based interventions that promote academic engagement of children with ASD in general education classrooms. Results showed that academic engagement was measured through evaluating on-task behaviour. The goal of intervention was to increase on-task behaviour to help students engaging more in academic classroom activities. Video self-modeling, video social stories™, self-monitoring, peer support, antecedent physical activity, adult

proximity, and visual support were all effective interventions in increasing academic engagement of child with ASD in general education classrooms. Out of 16 participants, there are two with Asperger syndrome (AS), four with high-functioning autism (HFA), and ten with average intellectual abilities (IQ>70). All interventions included in this study were effective on children with ASD who have average to high intellectual ability.

4.1 Reflections on findings

4.1.1 Academic engagement

While analyzing the interventions, it seemed as though the interventions were more focused on promoting on-task behaviour of children with ASD, and the measurement of academic engagement was to observe and calculate how much time each participant stayed on task. On-task behaviour was defined as the amount of time students actually engaged in a particular task such as writing assignment, reading quietly, raise a hand to answer questions or ask for assistance (Berliner, 1990; Reeves, Umbreit, Ferro, & Liaupsin, 2013). However, measuring academic engagement solely depend on observing on-task behaviour may not precisely capture the engagement of children with ASD (Ruble & Robson, 2007).

Research found that participation in school helps fostering the development of children’s self-confidence and self-esteem (John-Akinola & Nic-Gabhainn, 2014). Academic engagement would help building strong motivation in learning, preventing school dropout, achieving positive student outcomes (Keen, 2009). According to Bronfenbrenner’s bioecological model, a child’s development occurs via interactions with people and objects in the child’s surrounding environment, of which family, school, and peer groups constitute the most important microsystem of the child (Adolfsson, 2011; Bronfenbrenner, 1979). The educational experience of a child occurs in the microsystem of school context. How students interact with people (e.g. teachers and peers) and objects (e.g. educational materials, classroom activities) in the school, would deeply influence the academic development of a child (Johnson, Crosnoe, & Elder, 2001). Academic engagement is a multidimensional concept and comprises of three components: emotional, cognitive, and behavioural. Emotional engagement is related to the child’s interest to participate in the activity; cognitive engagement incorporates child’s willingness to put effort in learning different skills; behavioural engagement is closely related to on-task behaviour, it encompasses

participation and involvement in the child’s academic activities (Fredricks, Blumenfeld, & Paris, 2004). The quality of how children interact with teachers, peers, and academics in emotional, cognitive and

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18 behavioural components is the key for true academic engagement to happen. However, study shows that research on academic engagement of school-aged children with ASD primarily quantified engagement by focusing only on on-task behaviours (Steinbrenner & Watson, 2015). In order to provide high quality interventions to children with ASD, to help them achieve a positive academic development, it is critical to understand true academic engagement and measure it accurately.

4.1.2 Application of the identified interventions

All seven interventions were reported to have positive outcomes in promoting academic engagement of children with ASD. It is important to understand the strength and the focus of each intervention, so the educators and teachers could apply the intervention accordingly. Video self-modeling is simple to implement by using smartphone or iPad or any kind of recording technology. Students tend to be more motivated to attend class when applying this intervention (Clare, Jenson, Kehle, & Bray, 2000). Video Social Stories™ provides students access to information regarding expected classroom behaviours via a portable handheld device. Students could put the device in their pocket or on the desk, and review the “dos and don’ts” whenever they need (Cihak et al., 2012). Self-monitoring has been proved to be effective in bringing about positive behaviour change, motivating students, and helping to develop independence (Wolfe, Heron, & Goddard, 2000). The use of the application (I-Connect) allows for unobtrusive prompt such as flashing, rather than buzzing or tuning that are commonly used in other self-monitoring interventions (Clemons et al., 2016; Rock & Thead, 2007). Peer support intervention is also simple and easy to use. It promotes active engagement for students with and without disabilities, increases social interactions between peers and targeted students, decreases problem behaviour and improve academic performance (Carter, Cushing, Clark, & Kennedy, 2005). Antecedent physical activity could decrease off-task behaviour, and increase on-task behaviour as well. Using physical activity before the instructional class is feasible in most of the inclusive schools. It is critical for teachers and

paraprofessionals to monitor the engagement of targeted students to ensure the effectiveness of the physical activity (Luke, Vail, & Ayres, 2014). Adult proximity focuses on decreasing challenging behaviour and increasing academic engagement of children with ASD. It is suggested that the target child is more likely to respond properly if provided with a specific directive instead of a general directive (Conroy et al., 2004). Visual support aims at attracting the student’s attention, enabling the student to focus on the message and reduce anxiety, improving positive behaviour (Rao & Gagie, 2006).

4.1.3 Involvement of parents and professionals

In all seven identified interventions in this study, there is no involvement of parents in any of them. Involvement of the parents in the goal setting process of intervention has been proved to contribute to the positive outcome for children with disabilities (Ylvén & Granlund, 2015). However, research indicates that parents’ involvement in school-based interventions are often scarce (Spann, Kohler, & Soenksen, 2003). It is important to include parents as competent members when planning an intervention (Björck-Åckeson, 2015). Parents may have effective strategies work in other settings that

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19 could be helpful for teacher in the classroom environment. Furthermore, children with ASD tend to need behavioural, academic and social interventions, professionals like special education teacher, language therapist, psychologist, occupational therapist, as well as parents, should all be included in the problem-solving process in order to provide the best possible interventions for children with ASD (Leach & Duffy, 2009).

4.1.4 Ethical consideration

In all seven studies, three of them mentioned that parental consent and child assent were

obtained before the intervention (Clemons, Mason, Garrison-Kane & Wills, 2016; Nicholson, Kehle, Bray & Heest, 2011; Schatz, Peterson & Bellini, 2016). Only one study stated that participants were given the options to decline the participation (Schatz, Peterson & Bellini, 2016). The remaining four articles didn’t mention any ethical consideration at all. If participants are research subjects in a study, there are critical ethical issues in need of thorough consideration. Fundamental principles such as confidentiality, anonymity, and especially informed consent can be very important (Long & Johnson, 2007). First, participants have the right to be informed. Information about the aim and the procedure of the research, how data will be collected, stored confidentially and applied in publication should be explained to the parents (All participants were under 18 in this study). Second, participants have the right to withdraw. They could choose not to do the interview or answer any kind of questions, and withdraw themselves from the study. No explanation will be needed for such actions, and researchers have to make sure both parents and participants are aware of this. Frequent observations took place in all seven studies, consents from schools, teachers and students should be obtained. Since children with ASD are a vulnerable group, the possible anxiety and stress that could be provoked in the research process should be seriously

considered.

4.2 Methodological issues and limitations

This study strictly followed every step of a systematic literature review, and the whole procedure was well documented. The articles included were all published after the year of 2000. One of them published in 2004, and the others published after 2010, this ensured the information of interventions are up to date.

The search procedure was challenging for this systematic literature review. Articles were searched in four databases. Different search strings were used in each database to yield relevant articles. Different search procedures were tried many times to ensure a maximum number of articles, yet there might have been more articles with other interventions. Second, there is a risk of bias since article selection process, quality assessment, and analysis of results was performed by one researcher. A second reviewer would have contributed to the validity of this study. Third, quality assessment was performed to increase reliability of this study. However, the quality assessment tool was developed by the researcher, with a risk of being subjective.

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20 The age range of participants was expanded to 6-18 years old since very limited results were found with the original age set (6-12). Interventions that work on children who are six years old may not be effective on children who are 18. This made the result less generalizable. In addition, all seven studies were from an American perspective, interventions may differ in another cultural context. Furthermore, all the studies included had small sample size from one to four students, a bigger sample would increase the generalization of the interventions.

4.3 Implications for future research

Research related to academic engagement of children with ASD in general education classrooms seems very limited. During the screening process, it is noteworthy that the research settings of many interventions were either in special education or self-contained classroom. This study only identified seven interventions. Therefore, future studies are required to focus more on developing effective interventions that enhance academic engagement of children with ASD in inclusive settings. By having more access to typically developing peers, children with ASD would have more opportunities to achieve academic success and develop positive health and well-being.

This study indicates that the effectiveness of the identified interventions may be limited to children with HFA. Participants of all included studies were either diagnosed with Asperger syndrome or high-functioning autism. Individuals with AS and HFA normally have an IQ of 70 or more, they

commonly have deficits in the area of social interaction and communication, and frequently engage in repetitive and stereotypic patterns of behaviours (Chiang & Lin, 2007; Whitby & Mancil, 2009). Those who are defined as having the lowest level of severity are more likely to be included in general education classroom (Nicholson et al., 2011). Future research will be needed in interventions focusing on children with ASD on different spectrum.

Seven different interventions were identified in this systematic literature review. This has very practical implications for teachers who teach children with ASD in general education classrooms. To be aware of what strategies or interventions are available, teacher could apply them to meet the needs of children with ASD in their classrooms. However, there is no universal intervention for all children with ASD. In order to come up with the most suitable intervention plan, teachers need to be trained, so they could understand the characteristic of ASD, accurately interpret the behaviours of their students, provide appropriate interventions or strategies to these targeted students.

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5 Conclusion

With an increasing number of diagnosis in autism spectrum disorder, more and more children with ASD are included and educated in general education classroom now. Children with ASD often have deficits in emotion regulation, joint attention, verbal and nonverbal communication, repetitive behaviour and restricted interests. All these characteristics could impede them from engaging in classroom activities. Lack of academic engagement would increase the occurrence of disruptive behaviour, decrease the motivation in learning, result in poor academic performance and lead to school withdrawn. Unfortunately, how to improve their learning and participation is still poorly understood in the area of education. It is necessary for educators to get the knowledge of effective interventions or strategies, in order to facilitate the learning of children with ASD in general education classroom, so they could engage more to enhance motivations, develop academic skills and achieve academic success eventually.

All seven interventions in this study were authenticated to be effective on promoting academic engagement of children with ASD in general education classrooms. They worked in different mechanisms such as observational learning, prompt, proximity, transmission of dopamine, and circumscribed interests. It is noteworthy that most of the interventions targeted at increasing on-task behaviour to promote academic engagement. Each of the interventions has its own strength and focus, educators should be aware of it so they could apply the intervention accordingly. Knowledge about academic engagement could be extended by focusing on the emotional, cognitive and behavioural components. Based on the findings, future research is suggested to develop more effective interventions for children with ASD in inclusive settings, and to serve not only children with high-functioning autism, but also children on other spectrums of ASD. More importantly, equipping educators with the concept of collaborative problem solving, including professionals and parents in the planning of interventions.

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Appendix A

Appendix A. Search procedure and search strings

Database Search technique

Search strings Number of

Articles

ERIC Combination of

both Thesaurus and free text in advanced search

SU.EXACT("Pervasive Developmental Disorders") OR SU.EXACT("Asperger Syndrome") OR SU.EXACT("ASD") AND SU.EXACT("Student Participation") OR SU.EXACT("Learner Engagement") AND (intervention OR practice OR strateg* OR method OR approach)

84

PsycINFO Combination of both Thesaurus and free text in advanced search

SU.EXACT("ASD Spectrum Disorders") AND SU.EXACT("Participation") OR SU.EXACT("Student Engagement") AND (intervention OR practice OR strateg* OR method OR approach)

53

ScienceDirect Free text in expert search

"ASD" AND intervention OR practice OR strateg* OR method OR approach AND "academic engagement"

28

Scopus Free text in

advanced search

"Pervasive Developmental Disorders" OR "Asperger Syndrome" OR "ASD" AND "academic engagement" OR "Student Participation" OR "Learner Engagement" AND intervention OR practice OR strategy OR method OR approach AND inclusive OR mainstream

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Appendix B

Appendix B. Protocol for inclusion on title/abstract level

Questions Comments

An article Y / N / ? Abstract of the article available Y / N / ? Participants have a diagnosis of ASD Y / N / ? Participants aged from 6-18 Y / N / ? Focus on academic engagement Y / N / ? Focus on interventions or strategies Y / N / ? Research setting in inclusive classrooms Y / N / ?

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Appendix C

Appendix C. Protocol for inclusion on full-text level

Questions Comments

Full-text available Yes No Have ASD participants Yes No Participants aged from 6-18 Yes No Participants spend at least 50% of school day in general education classroom Yes No Focus on academic engagement Yes No Focus on interventions or strategies Yes No Research setting in inclusive classrooms Yes No Purpose of study clearly stated Yes No Intervention procedure described Yes No Limitation of the study stated Yes No

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Appendix D

Appendix D. Quality assessment tool

Quality assessment tool

Study evaluative overview Bibliographic

details

Does the article has clear information about the author, title, year and place of publication?

(2) Yes (1) Partly (0) No

Purpose Are the aim and research questions stated clearly in the study? (2) Both the aim and research questions were stated clearly.

(1) Only the aim was stated clearly and there are no research questions. (0) There were no aim and research questions stated in the article. Key findings Are the findings clearly described?

(2) Yes (1) Partly (0) No Evaluative

summary

Are the strength, limitation of the study and future research discussed? (2) Yes

(1) Partly (0) No

Study and context

The study Does the article have sufficient information about the intervention? Was the information enough to understand the intervention?

(2) The information about the intervention was sufficient and clear. (1) The article had insufficient information about the intervention. (0) The article didn’t have any information about the intervention. What is the study design?

(2) Randomized controlled trial (1) Case study

(0) No information was provided.

Setting Is sufficient detail given about the setting? (1) Yes

(0) No

Does the study have a follow-up phase to check for intervention maintenance? (1) Yes

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32 (0) No

Sample How was the participants selected? (2) Random selection

(1) Non-random selection (0) Not stated

Is the sample size sufficient for the study aims and to draw the conclusions? (2) Yes

(1) Not entirely (0) No

Outcome measurement

Is there an instrument to measure the outcome? (1) Yes

(0) No

Is there a description of the instrument? (1) Yes

(0) No

Ethics

Is there informed consent before the intervention? (1) Yes

(0) No

Data collection and analysis

Data collection Is the process of fieldwork adequately described? (For example, account of how the data were elicited; type and range of questions; interview guide; length and timing of observation work; note taking)

(1) Yes (0) No

Is Interobserver agreement applied during data collection? (1) Yes

(0) No

Data analysis Is the description of the data analysis adequate? (1) Yes

(0) No

Is social validity tested? (1) Yes

(0) No

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Appendix E

Appendix E. Extraction protocol

Extraction protocol Comments

General information

Title of article Year of publication Authors Type of publication Country Research aim Research questions Study design

Participants

Sample size Age Disability Time in general education classrooms

Recruitment Informed consent

Description of the intervention What was the intervention?

What was the basic procedure of intervention? Where did the intervention take place?

How long for each session? How long did the intervention last? Who implemented the intervention? Is there an aide during the intervention? Any follow-ups?

Outcome of the intervention What was the measurement tool for measuring effectiveness? What was the result after intervention?

Was academic engagement measured?

How was the maintenance of the intervention? What was the conclusion of the study?

Interventions promoting academic engagement for children with ASD in general education classrooms : A systematic literature review