Building Better Bridges Randomized Control Trial

Building Better Bridges (BBB), will evaluate an intervention designed to support the needs of
students with autism who are transitioning from either preschool to elementary school, or
from elementary to secondary school. In this randomized controlled trial, the investigators
will randomly assign a total of 160 families (40 families/site, across 4 sites, over 2 years)
to one of two intervention groups: BBB Transition Passport Only Group (Comparison) or BBB
Intervention Group. Both groups will receive the BBB Transition Passport, which include the
Transition Checklist, Student Snapshot, Parent/Caregiver Guide, and Student Guide. In
addition to receiving the Transition Passport, the BBB Intervention Group will also receive
coaching support to implement these resources. The coach will be a member of the research
team who will introduce the resources to the family, briefly teach them fundamental
information about the transition process, provide brief coaching phone calls, and help
parents identify an appropriate person at the school or district who can work with them to
complete the Student Snapshot.

The research staff will first recruit interested schools, and school administrators will
identify potential teachers who may have eligible students. If the teacher agrees to
participate, he/she will send the study flyer home to parents where parents can either call
the study phone line to learn more, or can fill out the study interest portion of the flyer
and turn it in to their teachers. Parents who fill out the interest sheet will be contacted
by the research staff. Interested parents can also contact research staff. All parents will
receive a screening over the telephone to determine eligibility, which will include an Social
Communication Questionnaire (SCQ) over the phone and will ask if their child has received a
diagnosis of Autism by the administration of an Autism Diagnostic Observation Schedule (ADOS)
or any other official diagnosis. The investigators will accept an ADOS diagnosis within one
year for children in preschool and within three years for students transitioning to secondary
school.. If an ADOS or any record of an official diagnosis is not provided, the research
staff will schedule a time to administer the ADOS to determine eligibility. We will also ask
if the child has a record of a cognitive test like the Stanford Binet-5. If parents do not
have a record or if it has been over a year since the pre-school child or over 3 years since
the older child has had one, the research staff will also schedule with the parents to
administer it around the same time as the ADOS.

After the initial phone screen and verification of autism diagnosis, the parent will be
consented and then will complete baseline T1 measures. Pre-transition teachers will complete
T1 measures as well. Schedule of measures can be found in the Outcome Measures Section.

Following enrollment into the study, the child will be randomized to one of two treatment
groups, BBB Comparison Group(Control) or BBB Intervention Group.

Families randomized to the control group will only have access to the BBB Transition
Passport, which consists of the Transition Checklist, Parent Guide, Student Guide, and the
Student Snapshot. A hard copy of these tools will be given to them. We will also provide them
with a link to download them online through LiveBinder (online website).

Families randomized to the BBB Intervention group will be enrolled in ParentSquare if they
agreed to it in the consent form. ParentSquare is an app that provides a safe and secure
platform for program-to-parent communication. ParentSquare is in compliance with Family
Educational Rights and Privacy Act (FERPA). Any school team members who want to use
ParentSquare will be consented to use it and agree to allow the de-identified data from
ParentSquare to be used for research purposes. The participants in this group will also have
access to download the tools and share them with each other.

Parents in the intervention group will also receive six, 1 hour, coaching sessions (one
session per month for six months), with a research staff coach, to discuss key information
about transitions (knowing parent's rights about special education services, communicating
effectively with school staff, knowing the roles of the school team members, preparing their
child over the summer, developing and sharing their Snapshot). These coaching sessions will
occur individually (in-person or by telephone) during the pre-transition school year.

In addition, parents will receive ongoing 1-2 monthly follow up phone calls (10 minutes each)
to see how the transition planning is going, to help the parent problem-solve around any
concerns about the transition, and to encourage the parent to implement all components of the
intervention (including conducting at least one school visit, working on the student guide,
and completing the Student Snapshot with the school team). These coaching calls are expected
to start in February during the pre-transition school year and continue through November of
the post-transition year. Coaching calls are designed to be flexible and brief and can occur
in person or by telephone, or by a secure internet-based platform (Zoom), depending on the
parent's preference.

The coach will encourage the parent to identify a school staff member to help with preparing
for the transition. This person can be the child's teacher, provider, or someone else from
the school or district who can assist with the child's transition. The coach will encourage
the parent to work with this school person to arrange a meeting prior to the transition (or
join an existing meeting), for the purpose of completing the Student Snapshot and meeting
with a post-transition teacher or staff from the receiving school, if possible. This school
staff person can also help to recruit other school team members working on the transition
process and to utilize Parent Square for all communication and sharing of transition
materials. Any team member involved in the transition will be offered to be consented and
given access to Parent Square. This meeting will occur at a time convenient for the school
team, likely in April or May. If the post-transition school personnel can attend the meeting
(if known prior to the transition), they will also be consented for the study form. During
this meeting, everyone will work together to complete the BBB Passport materials.

If the post transition school team is not able to participate in a pre-transition meeting,
then the coach will encourage the parent to share the Student Snapshot with the
post-transition teacher(s) and school team when the new school year begins in the Fall.

Inclusion Criteria:

- Children:

- Transitioning into kindergarten or secondary school (middle/high school)

- Parent-rated SCQ total score > 15 and AT LEAST one of the following:

- Positive ADOS-2 administered by research-reliable study personnel

- Expert medical diagnosis or educational classification of ASD

- Under-resourced, defined by:

- Attending or transitioning into a Title I school (a school that receives
federal funding to improve the performance of economically disadvantaged
students)or rural school

- Family income is under 250% of the federal guidelines for poverty rate
(i.e., meets federal requirements to qualify for free or reduced lunch)

- Parent/Caregiver willing to participate

(Site PIs may request eligibility review by PIs across all AIR-B sites if a school is not
Title I or rural but is demonstrably low-resource)

Adults:

- Must be a parent/caregiver of a child who meets criteria above

- Must be a provider/teacher/school administrator or other adult involved in either the
pre-transition process or the post transition process for a participating child.

Exclusion Criteria:

- Children:

- Not transitioning into kindergarten or secondary school

- No ASD diagnosis

- Not meeting study criteria for classification as under-resourced

- Parent/Caregiver unwilling to participate

Adults:

- Not a parent/guardian of a child with ASD

- Not part of a participating child with ASD's pre or post transition team