The Autism Intervention Research on Behavioral Health (AIR-B 2): Deploying Evidence Based Strategies to the School Setting

March 27, 2013

The Autism Intervention Research on Behavioral Health (AIR-B 2) designed a three-year study to examine the implementation of proven-efficacious interventions for students with ASD in under-resourced schools. The AIR-B 2 team of principal investigators includes Connie Kasari, Ph.D., at the University of California, Los Angeles, David Mandell, Sc.D., at the University of Pennsylvania, and Tristram Smith, Ph.D., at the University of Rochester. The first study year was devoted to improving our understanding of how public schools currently serve students with autism and to developing community partnerships with the school districts and community stakeholders at each of the three sites. The second and third year of the study evaluate the deployment of evidence-based practices into schools. 

In order to elucidate the strengths and challenges that school personnel and parents of students with ASD face, the AIR-B 2 team conducted focus groups with parents, paraprofessionals, and general and special education teachers of students with ASD. We also interviewed related service providers and school and district administrators about their experiences.  Based on preliminary analysis of these findings and discussions with stakeholders during community partnership meetings, the AIR-B 2 team identified two priorities for intervention: (1) increasing social engagement among students with ASD who are included in general education settings for most of the school day and (2) improving behavior during transitions among students with ASD in special education classrooms.

To address these priorities, we adapted and are implementing two interventions: Remaking Recess, which teaches school staff specific strategies to increase the quality and quantity of peer engagement during social times for children with ASD, and Schedules, Tools, and Activities for Transitions (STAT), which teaches classroom staff how to facilitate efficient, successful transitions between activities throughout the daily routine. 

In Remaking Recess, coaches collaborate with playground assistants on strategies to engage children during recess in 14-16 sessions over 8 weeks.  The strategies in the intervention are designed to be helpful not only for children with ASD but also for their peers.  For example, one key strategy is providing developmentally and school appropriate conversational supports in the cafeteria in the form of fun "social menus" made available to all students by the lunchroom staff.  Another important element is teaching staff how to interpret a child's level of peer engagement and then empowering them to provide individualized and group level support as needed.  Primary outcome measures in this arm of the study include direct observations of peer engagement using the Playground Observation of Peer Engagement (POPE) and a classroom survey of friendships from which a social network can be calculated and friendship reciprocity can be examined.  Both measures have captured positive change in playground peer engagement and social network status in previous intervention studies, particularly Kasari, et al. (2012).

In STAT, coaches work with classroom staff during ongoing school activities for 30-45 minutes at a time, with 12-16 visits over a 6-10 week period. Coaches and staff collaboratively identify which transitions (and which steps within a transition) are most challenging for the students with ASD in the classroom, and they select strategies to overcome these challenges. For example, they might determine that students have particular difficulty going from their primary classroom to specials (music, art, and physical education) and that the beginning of the transition (putting away materials and lining up) is especially time-consuming and stressful.  Potential solutions may include providing a clear and consistent warning that the transition is about to occur, choosing a signal that reliably gains the students' attention, and presenting a visual schedule that shows what the students are expected to do during the transition. Primary outcomes for this intervention include direct observations of engagement in classroom-based activities and rating scales of school-related adaptive functioning.

Our deployment strategy relies on a coaching and consultation model to train school personnel working with children with ASD during the school day. We are measuring student outcomes (social and classroom engagement), as well as school personnel implementation and uptake of evidence-based strategies learned during intervention. The overall goal is to determine the feasibility and sustainability of the practices in underserved and under resourced school settings.

Using a randomized wait-list control trial design, schools and classrooms were assigned to immediate treatment or waitlist conditions. We now are training teachers in the treatment arm. Ultimately, our goal is to learn not just whether these interventions are effective in public schools, but the best ways to work with classroom staff to ensure their effectiveness and sustainability once the research study ends.



Kasari, C., Rotheram‐Fuller, E., Locke, J., & Gulsrud, A. (2012). Making the connection: Randomized controlled trial of social skills at school for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 53(4), 431-439. doi:


 AIR-B team includes Connie Kasari, Nancy Huynh, Mark Kretzmann, and Michelle Dean at UCLA; David Mandell, Jill Locke, and Erica Reisinger at University of Pennsylvania; Tristram Smith, Christopher Clinton, Susan A. Hetherington, Suzannah Iadarola, and José Pérez-Ramos at the University of Rochester and the Partnership of Stakeholders in the Los Angeles Unified School District, Rochester City School District and School District of Philadelphia.