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
Spring Semester 2017 Margareta Adolfsson
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
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Table of Contents
1 Introduction.................................................................................................................................................... 3
1.1 Autism spectrum disorder .................................................................................................................. 3
1.2 Inclusion ............................................................................................................................................... 4
1.3 Academic engagement......................................................................................................................... 4
1.4 Bronfenbrenner’s bioecological model .............................................................................................. 5
1.5 Rationale ............................................................................................................................................... 6
1.6 Aim........................................................................................................................................................ 6
1.7 Research questions .............................................................................................................................. 6
2 Method ............................................................................................................................................................ 7
2.1 Search strategy...................................................................................................................................... 7
2.2 Selection criteria ................................................................................................................................... 8
2.3 Selection process .................................................................................................................................. 8
2.3.1 Title and abstract screening ........................................................................................................... 9
2.3.2 Full-text screening........................................................................................................................... 9
2.3.3 Quality assessment ........................................................................................................................ 11
2.4 Data extraction................................................................................................................................... 11
3 Results ........................................................................................................................................................... 12
3.1 Basic procedure of the intervention................................................................................................. 12
3.2 Outcome of the intervention ............................................................................................................ 14
3.3 Promotion of academic engagement ............................................................................................... 15
3.4 Acceptability of the intervention ...................................................................................................... 16
4 Discussion ..................................................................................................................................................... 17
4.1 Reflections on findings ..................................................................................................................... 17
4.1.1 Academic engagement .................................................................................................................. 17
4.1.2 Application of the identified interventions ................................................................................ 18
4.1.3 Involvement of parents and professionals ................................................................................. 18
4.1.4 Ethical consideration .................................................................................................................... 19
2
4.2 Methodological issues and limitations ............................................................................................. 19
4.3 Implications for future research ....................................................................................................... 20
5 Conclusion .................................................................................................................................................... 21
References ............................................................................................................................................................. 22
Appendix A ........................................................................................................................................................... 28
Appendix B............................................................................................................................................................ 29
Appendix C ........................................................................................................................................................... 30
Appendix D ........................................................................................................................................................... 31
Appendix E ........................................................................................................................................................... 33
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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).
4
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
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).
6
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?
3. What is the acceptability of the intervention to both teachers and participants?
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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
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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Figure 2.2 Flow chart displaying the selection process.
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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 StoriesTM
provided 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
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
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.
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
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.
17
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
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
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.
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.
21
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.
22
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Note. * indicates the included articles in this systematic literature review.
28
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
69
29
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 / ?
Note: Yes=Y, No=N, Not clearly stated=?
30
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
31
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
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
Note. The tool is adapted from Evaluative Tool for Mixed Method Studies (2005)
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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?
What were the limitation and recommendation of the study?