Running head: DRC WITH HFASD

EFFICACY OF THE DAILY REPORT CARD INTERVENTION FOR HIGH-FUNCTIONING

CHILDREN WITH AUTISM SPECTRUM DISORDER: A MULTIPLE BASELINE STUDY

by

Kellina Pyle

May 22, 2017

A dissertation submitted to the Faculty of the Graduate School of

the University at Buffalo, State University of New York
in partial fulfillment of the requirements for the

degree of

Doctor of Philosophy

Department of Counseling, School, and Educational Psychology

DRC WITH HFASD ii

Table of Contents

Description Page Number

Acknowledgments iii

Abstract iv

1. Introduction 1

2. Method 11

3. Results 30

4. Discussion 35

5. References 45

6. Tables 62

7. Figures 65

8. Appendices

8-1. Appendix A 70

8-2. Appendix B 75

8-3. Appendix C 81
DRC WITH HFASD iii

Acknowledgement
Working with children who have special needs is both challenging, and immensely

rewarding. This dissertation is dedicated to all the hard-working men and women who make a

new commitment every day to help their students be successful. When we have exceptional

schools, the world wins.

Many thanks go out to the Graduate Student Association and the Mark Diamond

Research Fund at the University at Buffalo, whose funding award allowed this project to move

forward.

An immense amount of gratitude goes out to my husband, who cleaned the house, took

out the dog, made dinner, created a completely new office for me, and so much more, just so I

could sit and write. Heroes come in all shapes and sizes. Mine is about 6’1” and has sandy-

blonde hair.

To the Institute for Autism Research, thank you for igniting a fire in me to work with

children who have high-functioning autism. Your work in our community is inspiring, and I feel

so fortunate to have stumbled into my first summer job in graduate school with you.

To Dr. Fabiano – I’m sure this project will just be one of many we work on together.

Thank you for being so supportive of my vision for this project, and for your valuable insight

into research, working with schools, and doing consultation with teachers.

Kumo, thank you for keeping me company through the long hours of writing. I will

always try and be cheerful enough when I’m done working to throw ducky really far down the

hallway for you.

DRC WITH HFASD iv

Abstract

The present study examined the Daily Report Card (DRC) intervention in high-

functioning students with autism spectrum disorder (ASD). The DRC is a commonly employed

behavioral intervention for treating children with disruptive and off-task behaviors in schools. To

implement a DRC, teachers and parents work collaboratively to create an operationalized list of a

child’s target behaviors (e.g., interrupting, noncompliance, academic productivity), set specific

criteria for meeting each behavioral goal (e.g., interrupts three or fewer times during math

instruction), and provide home- or school-based privileges contingent on the child’s

performance. Although high-functioning students with ASDs would likely benefit from this

structured intervention, it has never been examined as a stand-alone intervention with this

population. To address this gap, the present study utilized a multiple baseline design with four

students. Systematic direct observations were used before and after implementation to measure

academic engagement, disruption, and social engagement. Standard Mean Difference and Tau

effect sizes were calculated for each participant and target. Teachers also completed an

acceptability and feasibility measure of the intervention post-completion. In general, effect sizes

demonstrated significant improvement on both academic engagement and disruptive behavior

targets, but varied results for social engagement. Teachers rated the DRC as an acceptable and

feasible intervention for use with high-functioning students who have ASD. A discussion of the

use of this intervention in schools and future directions for research follows.

Keywords: daily report card; daily behavior report card; school-home note; high functioning

Autism Spectrum Disorder; hfASD

Running head: DRC WITH HFASD 1

Introduction
The Daily Report Card

Recent education initiatives in America have emphasized the adoption of early

identification and intervention practices, often within a multi-tiered problem-solving framework

such as Response to Intervention (RTI; Fuchs & Fuchs, 2006). Within a tiered problem-solving

framework, interventions range from universal (i.e. well-defined classroom rules) to more

restrictive (i.e. one-on-one aide), and focus on mitigating academic and behavioral challenges

with steadily increasing intensity, depending on the student’s success at each tier. This increasing

intensity is often depicted as a pyramid, with universal interventions forming the base tier (Tier

I), small group interventions forming the middle tier (Tier II), and targeted, individual

interventions forming the peak (Tier III; Fuchs & Fuchs, 2007; National Center on Response to

Intervention, 2010). Essential components of this tiered problem-solving model include

screening to determine risk, evidence-based interventions that range in intensity, and assessment

tools to monitor student progress and determine when students need to move from one tier to

another (Rathvon, 2008).

Although these problem-solving models are most often emphasized within efforts to

promote academic achievement, they have also garnered attention as a mechanism for

intervening with students who have behavioral difficulties (Gresham, Hunter, Corwin, & Fischer,

2013). When implemented appropriately, tiered problem-solving models result in decreased

referrals to special education, successful maintenance of students in their general education

classrooms, and improvements in ratings of disproportionality (VanDerHeyden, Witt, &

Gilbertson, 2007). These kinds of outcomes are especially important for students with behavioral

difficulties, as these students show significantly more impairment than their peers in academic,

behavioral, and social domains, including graduation rates, school attendance, substance use, and
DRC WITH HFASD 2

employment (Barkley, Fischer, Smallish, & Fletcher, 2006; Howlin, 2000; Loe & Feldman,

2007; Szatmari, Bartolucci, Bremner, Bond, & Rich, 1989).

One intervention commonly employed in schools to address behavioral challenges is the

Daily Report Card (DRC), sometimes called the Daily Behavior Report Card (DBRC) or Home-

School Note (Kelley, 1990; O’Leary, Pelham, Rosenbaum, & Price, 1976; Volpe & Fabiano,

2013). The DRC is an operationalized list of a child’s target behaviors (e.g., interrupting,

noncompliance, academic productivity), and includes specific criteria for meeting each

behavioral goal (e.g., interrupts three or fewer times during math instruction). Teachers provide

immediate feedback to the child regarding target behaviors, and parents provide home-based

privileges contingent on the child’s ability to meet his or her goals. Daily Report Cards are one

of the most commonly studied behavioral interventions for students (U.S Department of

Education, 2008), and demonstrate a unique ability to serve as both an intervention and a

progress-monitoring tool (Chafouleas, Riley-Tillman, & McDougal, 2002). Daily Report Cards

have proposed uses at all three tiers (Vujnovic, Holdaway, Owens, & Fabiano, 2014), although

they are historically a Tier II or Tier III intervention, with slight variations in intensity (e.g.,

rating the DRC once at the end of the day versus once at the end of every subject) determining

the tier.

Daily Report Cards have been discussed in the literature since the late 1960s, when

McKenzie and colleagues found that making children’s home allowances contingent on a weekly

grade report significantly increased students’ academic behaviors above and beyond classroom-

based rewards (McKenzie, Clark, Wolf, Kothera, & Benson, 1968). In their examination of the

use of Daily Report Cards among teachers, Chafouleas, Riley-Tillman, and Sassu (2006) found

that more than 60% of teachers have used some version of a DRC in their practice, and almost all
DRC WITH HFASD 3

teachers viewed the DRC as an acceptable tool for assessment (i.e. progress monitoring) and

intervention. The DRC is also efficient, requiring less training, time to implement, or resources

than other interventions (Chafouleas et al., 2006), and fits well within both general and special

education classrooms (Fabiano et al., 2010; Owens et al., 2012).

Research on the DRC has taken place in a number of formats. Notably, the DRC is often

used as a single component of a more complicated treatment design, such as the Summer

Treatment Program for children with Attention Deficit Hyperactivity Disorder (ADHD; Fabiano,

Schatz, & Pelham, 2014; MTA Cooperative Group, 1999), or the SchoolMAX treatment

program for high-functioning children with autism spectrum disorder (ASD; Lopata et al., 2012).

Although these “multi-modal” treatments display positive outcomes for their populations, it is

less clear which treatment components drive this efficacy. To establish the utility of the DRC

apart from these multi-modal studies, investigators have also examined the DRC as a “stand-

alone” intervention, that is, the DRC without any other treatment components (i.e. social skills

training).

The majority of these stand-alone intervention studies are case studies, with the behaviors

of small groups of students examined before and after using the DRC (e.g., Bailey, Wolf, &

Phillips, 1970; Burkwist, Mabee, & McLaughlin, 1987; Dolliver, Lewis, & McLaughlin, 1985;

McCain & Kelley, 1993). This research has supported the efficacy of daily report cards in a

number of formats, ranging from simple “yes-no” notes (e.g., Dougherty & Dougherty, 1970;

Jurbergs, Palcic, & Kelley, 2007), to more complicated interval-based notes with tiered home-

reward systems (e.g., Atkins, Pelham, & White, 1990). It has also demonstrated the broad

applicability of the DRC, helping alleviate difficulties from learning disabilities (Burkwist et al.,

1987) to conduct disorders (Trice, Parker, Furrow, & Iwata, 1983). In a recent meta-analysis of
DRC WITH HFASD 4

these single-case design studies, DRCs were shown to increase academic engagement and

decrease disruptive behaviors 60%, on average, following implementation (Pyle & Fabiano, in

press).

Although they are less common, group-design studies have also supported the efficacy of

the daily report card intervention. The most rigorous of these studies (e.g., Fabiano et al., 2010;

Murray, Rabiner, Schulte, & Newitt, 2008) have involved random assignment to treatment or

control groups, moderately sized samples, and well-documented evidence of behavioral

impairment. These studies have demonstrated that the DRC is not only effective at reducing

disruptive behaviors and increasing academic productivity, but that it fits well within the school

setting. For instance, in their examination of the DRC with students receiving special education

services, Fabiano et al. (2010) demonstrated that goals from a student’s individualized education

plan (IEP) can be successfully transformed into goals on the DRC, bridging a common gap

between procedure and practice (Heward, 2003; Spiel, Evans, & Langberg, 2014; Smith, 1990).

Between-group studies have also demonstrated that DRC effects may transcend the

individual student and grow to work at the class-level (Leach & Byrne, 1986). In their

investigation of the DRC, Leach and Byrne (1986) showed significant gains in work completion

and rule-following across the classroom, even though the DRC was used with only a few

students. They attributed these “spill-over” effects to decreases in the teacher’s level of stress.

Relief from the disruptive behaviors of the target students prompted the teacher to use classroom

management and positive reinforcement more effectively and “take control.” This work

demonstrates the flexibility of the DRC. Although used primarily with students who show

moderate levels of disruptive or off-task behavior, the DRC may also facilitate class-wide
DRC WITH HFASD 5

changes, as teachers become able to use classroom management skills and other universal

interventions more effectively.

To summarize, the DRC is a flexible tool, commonly employed in schools, which

requires little training to implement, is effective in both general and special education settings,

and fits well within the tiered problem-solving model currently used in many schools. Despite its

flexibility, research on the DRC has typically focused on students who show disruptive behaviors

or disruptive behavior disorders (e.g., ADHD). As a behavioral intervention, however, the DRC

has the capacity to address a wide range of behaviors, including those that occur within other

disorders, but present in a similar way to those in the disruptive behavior disorders. This raises

several questions, including: Can the DRC increase a student’s appropriate use of social skills?

Can it help students who are rigidly attached to routines become more flexible? These new

questions are particularly relevant for high-functioning students with ASDs, who have not been

widely investigated in the DRC literature.

Autism Spectrum Disorders and the DRC

Autism spectrum disorder diagnoses have risen dramatically over the years, as educators,

clinicians, and parents have become more aware of the disorder and how to screen for it (Kogan

et al., 2007). First identified in the 1940’s (Kanner, 1943), the disorder is characterized by

repetitive and stereotyped behaviors (e.g., hand flapping), deficits in communication (e.g.,

echolalia) and problems with social functioning (e.g., cooperative play; APA, 2013). Recently,

the diagnosis and identification of ASD has undergone large changes, as the psychological field

has shifted from using the DSM-IV to the DSM-5. This transition was marked by two significant

changes for autism spectrum disorder, specifically: (a) replacing the five distinct pervasive

developmental disorders of the DSM-IV (autistic disorder, Asperger’s syndrome, Rett’s disorder,
DRC WITH HFASD 6

childhood disintegration disorder, pervasive developmental disorder, not otherwise specified

[PDD-NOS]) with the single overarching category of autism spectrum disorder; and (b)

collapsing the three symptom categories of social, communication, and behavioral into two

categories of social/communication and behavioral (Volkmar, Reichow, Westphal, & Mandell,

2014).

In the DSM-5, the essential features of ASD are: (a) persistent impairment in reciprocal

social communication and social interaction; (b) restricted, repetitive patterns of behavior,

interests, or activities; and (c) the presence of these symptoms from childhood, which limit or

impair everyday functioning (APA, 2013). Manifestations of the disorder vary greatly, by

severity of symptoms, developmental level, and chronological age. Thus, the DSM-5 has also

included a table to help classify the level of severity for diagnosed individuals, ranging from “1:

Requiring Support,” to “3: Requiring Very Substantial Report.” These levels are determined by

the individual’s social communication and behavioral flexibility, with better communication and

greater flexibility resulting in a lower level of severity (APA, 2013). These changes may alter

common perceptions of ASD and increase the frequency with which ASD is diagnosed, as it now

represents a much broader “spectrum” of symptoms and abilities. The potential increase in

children diagnosed with ASD makes it imperative to examine those characteristics that define

this disorder, and to identify the interventions that are most effective with this population.

The best current estimate for the prevalence of ASD is 26/10,000, with rates ranging from

0.7 to 94 cases per 10,000 people (Presmanes Hill, Zuckerman, & Fombonne, 2014). In the

classroom, ASD is increasingly common, with the most recent estimates suggesting 1 out of

every 88 children affected (Centers for Disease Control and Prevention, 2012). On average, the

costs associated with treating a child with autism in the U.S. range between $35,000-90,000 per
DRC WITH HFASD 7

year, with costs across the lifespan amounting to over 3 million dollars per person (Bueschler,

Zuleya, Knapp, & Mandell, 2013; Ganz, 2007). These costs vary somewhat by intellectual ability

and comorbidity, with children having both ASD and Intellectual Disability (ID) showing the

highest costs. In sum, ASD can create massive costs for both families and school districts as they

try to help these children be academically and behaviorally successful. Given these high costs,

early identification and intervention are essential, as they may help to prevent future costs by

generating better outcomes for these students (Knapp & Buescher, 2014). Additionally, the

assessment and intervention techniques used must be rigorously examined to ensure that school

staff and other practitioners are using best practices when identifying and treating children with

ASD.

One factor that is essential to consider when determining best practices for these children

is the broad range in presentation and severity for individuals with ASD (APA, 2013; Lai,

Lombardo, Chakrabarti, & Baron-Cohen, 2013; Witwer & Lecavalier, 2008). In school-age

children with ASD, 38% show an intellectual deficit (Intelligence Quotient [IQ] < 70), 62% do

not reveal an intellectual deficit (IQ > 70), and 38% have an IQ greater than 85 (CDC, 2012).

Additionally, there are large differences in the language and communication abilities of children

with ASD, with some children never acquiring speech, and others showing typical, or even

advanced, linguistic abilities (Kim, Paul, Tager-Flusberg, & Lord, 2014). This wide range of

functional and cognitive abilities will likely impact the success with which certain interventions

have with individual students.

In some states, students with ASD account for the fastest growing group served through

special education (Cavagnaro, 2007). The services provided to these children vary greatly, from

more restrictive special education environments and 1:1 aids, to general education classes with
DRC WITH HFASD 8

universal classroom management strategies, such as a color-coded behavior chart. As a result of

policy changes (e.g., the Individuals with Disabilities Education Act) students qualifying for

special education are being increasingly moved into inclusive, less restrictive settings. Children

with ASD are no exception, with more than half of these students served in an inclusive

educational environment (Keen & Ward, 2004). These students may pose particular challenges to

general education teachers, who typically have less formal training in working with students who

have special needs. This disconnect may be more common for high-functioning students with

ASD, who are more frequently placed in inclusive education settings as a result of their higher

functional and academic abilities (Safran & Safran, 2001).

High-functioning children with ASD present both unique and familiar challenges to

school staff. Typically, these children show more advanced cognitive and linguistic abilities, but

continue to struggle with novel or pro-longed social situations when they are without support

(APA, 2013; Bauminger-Zviely, 2013; Lecavalier, 2006). For instance, these students often have

difficulty conversing appropriately, such as by talking too much and failing to take turns with

their conversation partner (Kim, Paul, Tager-Flusberg, & Lord, 2014). They also struggle to use

other students as a social reference, plan for academic tasks, switch attention from one task to

another, and cope with change (APA, 2013; Simmons, Lanter, & Lyons, 2014; Bauminger-

Zviely, 2014), all skills essential for success in the classroom. Interestingly, for high-functioning

students with ASD, these problem behaviors often manifest in ways that mirror those of children

with disruptive behavior disorders. For instance, in their discussion of managing challenging

behavior for students with ASD in the classroom, Simmons, Lanter, and Lyons (2014) listed the

following maladaptive behaviors as common: (a) inappropriate verbal behaviors, especially

shouting out; (b) aggression towards others, including hitting; (c) destruction of property; and (d)
DRC WITH HFASD 9

noncompliance. These students are also often described as “prompt-dependent,” requiring high

levels of management and assistance to complete assignments (Hume, Loftin, & Lantz, 2009). In

their failure to read and react to social cues appropriately and their frequent participation in

restricted or repetitive behaviors and interests, high-functioning children with ASD appear

disruptive and off-task. These disruptive and off-task behaviors may even differentiate these

children within the spectrum of ASD, with high-functioning children who have ASD showing

significantly more symptoms of disruptive and hyperactive behavior than low-functioning

children with ASD (Tonge et al., 1999) or typical peers (Macintosh & Dissanayake, 2006). The

similarity between these impairments and those seen in disorders like Attention Deficit

Hyperactivity Disorder (ADHD) may explain why a diagnosis of ADHD frequently precedes a

diagnosis of ASD, and rates of comorbidity of the two disorders is very high (Lecavalier, 2006;

Tsatsanis & Powell, 2014).

One of the most common interventions used in schools to address the deficits of high-

functioning students with ASD is the social skills group (Reichow, Steiner, & Volkmar, 2012;

White, Keonig, Scahill, 2007). In these groups, students develop social competencies, often

through direct instruction and role-play, with the hope that increases in knowledge will translate

to increases in use (Kaat & Lecavalier, 2014). Unfortunately, increasing social skill knowledge

may not increase social skill performance if the usage is not paired with a meaningful

consequence, creating motivation for the student to change. Indeed, reviews of social skills

groups show only small to moderate effect sizes, and benefits that are often limited or do not

translate across settings (DeRosier, Swick, Davis, McMillen, & Matthews, 2011; Rao, Beidel, &

Murray, 2008). Additionally, high-functioning students with ASD may know certain social
DRC WITH HFASD 10

skills, but fail to exhibit them in an appropriate way (Bellini, 2006), or engage in disruptive or

off-task behaviors that limit their ability to learn from a social skills group.

One way to address this gap between the knowledge of socially appropriate behavior and

the performance of socially appropriate behavior is with the DRC. The DRC is used in the

student’s classroom, creating direct links from the target behaviors to the student’s day-to-day

life. By making home-privileges (i.e. screen time) contingent on behavior change, a student

becomes motivated to express appropriate social and academic behaviors. Indeed, several studies

have examined the DRC as a component within a multi-modal treatment for ASD (e.g. Lopata et

al., 2012; Mrug & Hodgens, 2008; Wymbs et al., 2005), showing strong, positive effects for

these children, both socially and behaviorally (e.g., Lopata, Thomeer, Volker, Nida, & Lee,

2008). Unfortunately, these multi-modal studies do not allow consumers to differentiate between

the components, and may present complex programs that are difficult to implement in schools.

To address these challenges, components must be examined on a “stand-alone” basis. Assessing

the efficacy of stand-alone interventions is important as it will begin to elucidate whether these

components contribute to the positive effects within multi-modal studies, which fits within recent

initiatives to identify the effective components of treatment (e.g. National Center on Intensive

Intervention; What Works Clearinghouse).

Given the common and accepted use of the DRC (Chafouleas, Riley-Tillman, & Sassu,

2006), its ability to address disruptive and off-task behaviors, and its presence in several multi-

modal treatment designs (e.g., Lopata et al., 2012), the DRC presents a logical first component

for examination. To date, there has not yet been a study examining the efficacy of the DRC as a

stand-alone intervention for high-functioning children who have ASD, although interventions

with similar principles have been discussed elsewhere (e.g., Tarbox, Ghezzi, & Wilson, 2006).
DRC WITH HFASD 11

The present study therefore proposes to use the DRC with high-functioning students who have

ASD, examining the efficacy, feasibility, and acceptability of this intervention when it is used to

address the disruptive, off-task, and social behaviors of these children.

Aims and Hypotheses

The present study aims to examine the feasibility, efficacy, and acceptability of the daily

report card intervention when it is used with high-functioning children who have ASD.

Specifically, the present study hypothesizes that: (a) the DRC will increase academic

engagement in high-functioning children with ASD from baseline to intervention, as measured

by direct observation; (b) the DRC will decrease disruptive behaviors in high-functioning

children with ASD, as measured by direct observation from baseline to intervention; (c) the DRC

will increase social engagement, as measured by direct observation; and (d) teachers will view

the DRC intervention as acceptable and feasible for high-functioning students with ASD, as

measured by scores on the Usage Rating Profile – Intervention, Revised (URP-IR; Chafouleas,

Briesch, Neugebauer, & Riley-Tillman, 2011).

Method

The present study investigated the daily report card with four high-functioning students

who were diagnosed with ASD. Participants were recruited from four suburban elementary

schools in the Northeastern United States. The following inclusion criteria applied to all

participants: (a) a score of 15 or higher on the Social Communication Questionnaire (SCQ); (b) a

diagnosis of autism, Asperger’s, or pervasive developmental disorder, not otherwise specified

(PDD-NOS), as determined by a pediatrician, psychologist, or local agency; (c) Intelligence

Quotient (IQ) greater than 80; (d) evidence of developmentally appropriate language abilities, as

indicated by the Comprehensive Assessment of Spoken Language (CASL; Carrow-Woolfolk,

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1999) or the Preschool Assessment of Spoken Language, 5th edition (PLS-5; Zimmerman,

Steiner, & Pond, 2011), (e) currently attending school in grades 1-8. The diagnosis of ASD, IQ

greater than 80, and language scores were confirmed through existing school and clinical

records. Exclusion criteria included: (a) individuals with medical conditions that better explain

their symptoms, including epilepsy or brain trauma; (b) individuals with an IQ less than 80; (c)

individuals with a primary diagnosis other than ASD; (d) individuals with a limited capacity to

comprehend the English language, to the extent that English is used on the DRC to communicate

goals, rewards, and progress; and (e) individuals who are home-schooled.

All procedures for the present study were approved by the University at Buffalo

Institutional Review Board (IRB). Following recruitment efforts, a short phone screen was given

to parents interested in having their children participate. This phone screen gathered information

about the child’s diagnoses, academic supports, and presenting symptoms. If the child met the

initial criteria, a school-based consultation meeting was scheduled. This meeting took place at

the child’s school, and typically included the parent, the child, the teacher, and the principal

investigator. At this meeting, informed consent was obtained from the parent and teacher, and

assent was obtained from the student. All study procedures were explained to the parent and

teacher, and a brief training was held if the parent and teacher were unfamiliar with the Daily

Report Card. This training involved a brief didactic lesson in the structure of the daily report card

and role plays to practice giving feedback to the student in the classroom or at home. Goals and

daily rewards for the DRC were briefly discussed with the parent and teacher. Additionally, if

the parent expressed concerns about behaviors at home that were not commonly seen in school, a

home-based DRC was suggested and created in a follow-up meeting with the parent alone.
DRC WITH HFASD 13

Participants

For detailed participant demographics, including specific scores on measures of IQ and

language, see Table 1.

Adam. Adam was a 6 year-old, white, male, first-grade student, enrolled in an integrated

classroom at a suburban, public school in Western New York. In New York, integrated

classrooms are considered general education classrooms, however they are typically co-taught,

with at least one of the teachers holding certification in special education. Adam was diagnosed

with ASD by a licensed clinical psychologist at a local agency. At intake, his SCQ score was a

16, which denotes a clinically significant level of ASD symptomatology. Approximately 6

months prior to enrolling in the present study, Adam had been given the Weschler Intelligence

Scale for Children, 4th edition (WISC-IV), and the Comprehensive Assessment of Spoken

Language (CASL) by a local agency. His scores on those measures indicated that he had an IQ

above 80 and expressive and receptive language scores indicative of high-functioning ASD.

Throughout the course of the study, Adam was not taking any form of medication. Adam resided

with his biological mother and father, who were separated but shared custody. Due to his

teachers’ concerns about his academic achievement and the impairment his disorder caused,

Adam was determined to need special education. He was identified as a student with autism, and

was given an Individualized Education Program (IEP). As part of his IEP, Adam received several

supports in school, including a 1:1 aide, counseling 3 times a week for 30 minutes, and speech

services 2 times a week for 30 minutes.

Patrick. Patrick was a 6 year-old, white, male, first grade student, enrolled in a general

education classroom at a suburban public school in Western New York. Patrick was diagnosed

with ASD by a licensed clinical psychologist at a local agency. At intake, his SCQ score was 24,
DRC WITH HFASD 14

which denotes a clinically significant level of ASD symptomatology. Approximately 6 months

prior to enrolling in the present study, Patrick had been given the WISC-IV and the CASL by a

local agency. His scores on those measures indicated that he had an IQ above 80 and expressive

and receptive language scores indicative of high-functioning ASD. Throughout the course of the

study, Patrick was not taking any form of medication. Patrick resided with his biological mother

and father. At the time of the study, Patrick was not identified as a student in need of special

education, and he did not have an IEP or 504 Plan.

Louie. Louie was an 11 year-old, white, male, fifth-grade student, enrolled in a self-

contained special education, 8:1:1 classroom at a suburban, public school in Western New York.

Louie was diagnosed with ASD by a licensed clinical psychologist at a local agency. At intake,

his SCQ score was 27, which denotes a clinically significant level of ASD symptomatology.

Approximately one year prior to enrolling in the present study, Louie had been given the WISC-

IV and the CASL by a local agency. His scores on those measures indicated that he had an IQ

above 80 and expressive and receptive language scores indicative of high-functioning ASD.

Throughout the course of the study, Louie was not taking any form of medication. Louie resided

with his biological mother and step-father. Due to his teachers’ concerns about his academic

achievement and the impairment his disorder caused, Louie was determined to need special

education. He was identified as a student with Autism, and was given an IEP. As part of his IEP,

Louie received several supports in school, including counseling 3 times a week for 30 minutes,

speech services 2 times a week for 30 minutes, and occupational therapy 2 times a week for 30

minutes.

Henry. Henry was a 10 year-old, white, male, fifth-grade student, enrolled in a general

education classroom at a suburban, public school in Western New York. Henry was diagnosed
DRC WITH HFASD 15

with ASD by a licensed clinical psychologist at a local agency. At intake, his SCQ score was 28,

which denotes a clinically significant level of ASD symptomatology. Approximately one year

prior to enrolling in the present study, Henry had been given the WISC-IV and the CASL by a

local agency. His scores on those measures indicated that he had an IQ above 80 and expressive

and receptive language scores indicative of high-functioning ASD. Throughout the course of the

study, Henry was not taking any form of medication. Henry resided with his biological mother

and father. At the time of the study, Henry was not identified as a student needing special

education, and he did not have an IEP or a 504 Plan.

Baseline Phase

After the initial consultation meeting, the principal investigator contacted the teacher and

arranged for at least 5 times when research assistants could come to the school and conduct

systematic direct observations of the student for baseline data. Each student moved from baseline

to intervention after at least five observations, and after meeting one of two criteria: (a) a stable

baseline was established, as defined by the last three data points collected falling within 15% of

their combined average, or (b) the baseline data moved in the direction opposite the expected

effect (i.e., if an increase in academic engagement was expected, baseline would be ended if the

most recent data point indicated that academic engagement had decreased). This resulted in

students beginning intervention in a step-wise fashion, with some students starting intervention

before others.

Study Design

This type of design is known as concurrent multiple-baseline, single-case design. This

design is commonly used in treatment outcome research, and is appropriate for use in an

experimental study (Horner et al., 2005; Riley-Tillman & Burns, 2009). The multiple baseline
DRC WITH HFASD 16

study starts all participants at baseline, and administers the intervention in a step-wise fashion to

participants, such that participant 2 begins intervention slightly after participant 1, and

participant 3 begins slightly after participant 2, etc. This step-wise baseline/intervention pathway

is illustrated below (see Figure 1). Multiple-baseline, single-case design studies demonstrate

acceptable experimental control by allowing the student to act as both the control and the

experimental participant. By collecting multiple data points across time and participants, both

within-subject and between-subject variability can be examined. This allows researchers to make

conclusions about the functional relationship between the independent variable (DRC) and

outcomes (disruptive and on-task behaviors).

Following What Works Clearinghouse standards, several other methodological steps

were taken to meet the most rigorous qualifications for a multiple-baseline, single-case design

study. These include: (a) collecting inter-assessor agreement on at least 20% of the outcome

observation measures, with a goal of at least 80% agreement; (b) finishing all procedures with at

least 3 students; and (c) collecting at least 5 data points in each phase (What Works

Clearinghouse, 2016).

Student outcomes were assessed using systematic direct observations (SDO).

Observations involved momentary time sampling in 10 second intervals for 20 minutes of three

behaviors: a) on-task, b) disruptive, and c) socially engaged. On-task behaviors are defined as:

“Participation in the classroom activity. Examples include: writing, raising hand, answering a

question, talking about a lesson, listening to the teacher, reading silently, or looking at

instructional materials.” Disruptive behaviors are defined as: “Actions that interrupt regular

school or classroom activity. Examples include: out of seat, fidgeting, playing with objects,

acting aggressively, or talking/yelling about things that are unrelated to classroom instruction.”
DRC WITH HFASD 17

Social Engagement was defined as: “Exhibiting verbal or nonverbal behaviors that suggest

positive, appropriate communication or cooperation with a peer in a group setting. Cooperation

includes any attempt to share objects with a peer, take turns with a peer, speak to a peer, or work

together to reach a common goal.” These behaviors were chosen due to their prevalence in the

DRC literature, and their representation of common behavioral struggles for high-functioning

students with ASD.

Observations were conducted by trained graduate research assistants unaware of the

purposes of the study. Inter-rater reliability was calculated between two observers for

approximately 20% of the observations, with a goal of 80% agreement. If less than 80%

agreement was found, coders were asked to immediately notify the principal investigator, who

gave additional training and follow-up tests to ensure reliable coding.

Intervention Creation

Following the baseline classroom observations, a second consultation meeting was held

with the parent and the teacher to firm up the DRC targets, criteria for meeting each target, and

the home-based reward menu. The behavioral goals discussed in the initial consultation were

operationally defined to create 2-3 targets for the DRC. These targets contained both a behavior

(such as being out of seat or area) and a criterion (such as needing 4 or fewer reminders to be in

your seat or area). To help the teacher consistently rate the DRC targets, operational definitions

were created for each behavior. For instance, if the student had trouble staying in his or her seat

or area, this was defined as: “the student will remain in his assigned seat or area until he is given

permission to move to another location. ’In seat’ is defined as sitting in the chair, facing forward,

with all four legs on the floor. ‘Assigned area’ refers to the area that is designated by an adult at

a particular point in time.”

DRC WITH HFASD 18

Beyond the 2-3 behavioral targets created for each student, an additional target was

placed on the DRC specifically addressing the use of social skills. This target said: “The student

used social skills during the period. Social skills include asking for help, listening, having a

conversation, using self-control, contributing to a discussion, and ignoring distractions,” or

something similar. For instance, one teacher wanted to specifically focus on active social skills,

such as “asking for help,” because her student had particular trouble in that area. Each of these

social skills was taken from the Skillstreaming social skill curriculum (McGinnis, 2011), and

was operationally defined for the teacher, so that they knew which specific behaviors qualified.

After creating the behavioral targets for the DRC, the research team discussed the criteria

for meeting each target. Teachers were asked how frequently the student exhibited the target

behavior within a subject (or a time frame specified by the teacher). The numbers teachers

suggested were corroborated with data from the baseline observations. To make the goal

challenging but realistic for the student, the criteria for meeting the behavioral target was set at

20% improvement below the level given by the teacher, which was consistent with previous

recommendations for implementing the DRC (Vujnovic, Fabiano, Pariseau, & Naylor, 2013).

For instance, if the teacher said the student was out of his seat 5 times within a class period, his

criteria was set at 4 reminders: a 20% reduction in behavior. In sum, the targets were worded on

the DRC as follows: “Stays in Seat or Area. The student needs no more than 4 reminders to stay

in his seat or area.” The operational definitions for the target behaviors were given to the

teachers, but were not printed directly on the DRC.

Each target was rated at the end of each class period, or at the end of a time period

decided upon by the principal investigator and the teacher (see Appendix A for copies of each

student’s DRC). For instance, using the “stays in seat” target given above, the student recieved a
DRC WITH HFASD 19

“Yes” at the end of the period if he had 4 or fewer reminders, and a “No,” if he needed 5 or more

reminders. The number of “Yeses” and the number of “Nos” were totaled at the end of the day.

The number of “Yeses” received was divided by the number of “Nos” plus the number of

“Yeses” to yield a daily percentage. For instance, if the student had 30 “Yeses” and 5 “Nos,” he

had a final percentage on his DRC of 30/35, or 86%. To earn a daily reward, the student had to

earn a 75% or greater on his DRC.

Reward menus were created collaboratively with the parent. Rewards were determined by

considering the student’s interests, things the student had received previously for “free,”

(noncontingently), and things that the parent felt comfortable giving or restricting on a daily

basis (Vujnovic et al., 2013). Examples of common rewards included screen time (i.e. TV, video

games, tablet), one-on-one time with the parent, time to play outside, or time to play with a

favorite toy (such as Lego). The reward list was called a “menu,” because students were allowed

to choose from a number of different options when they came home with a “passing” DRC. To

check for reward fidelity, a short “top goal” was placed on each DRC. This top goal stated: “My

reward last night was _____________.” The teacher was given a copy of the reward menu, and

asked the student to indicate which reward he received the night before, each morning before

starting the DRC for the day. DRCs were collected weekly from the school. If the top section

discussing rewards was left blank for 2 or more days, the principal investigator called the parent

to discuss reward fidelity.

Daily Report Cards

Adam. In the initial consultation meeting with Adam’s teachers, the school psychologist,

speech therapist, and Adam’s parents, Academic Engagement was identified as the primary

target in need of adjustment using the DRC. After baseline observations, it was determined that
DRC WITH HFASD 20

Adam needed approximately 3 reminders every 30 minutes to stay actively involved in the

ongoing activity. To set a realistic but challenging goal for Adam, his DRC target was therefore

to receive 2 or fewer reminders to stay actively involved. Actively involved was defined as

“passively or actively engaged in the ongoing activity. Examples include: finishing seatwork,

listening to the teacher, following adult directions, or completing a center activity.” In addition to

his behavioral goal to remain actively involved, Adam also had a goal throughout the day to use

his social skills, which stated that Adam would use his social skills “At least 2 instances per

period. Social skills include Having a Conversation, Asking for Help, Listening, Using Self-

Control, and Contributing to a Discussion.” A list of these social skills, with steps, was provided

to the teachers and Adam’s aide (see Appendix C). At the initial consultation meeting, Adam’s

teachers and parents also identified some concerns they had for Adam to complete tasks

independently, particularly his morning routine (bookbag hung up, folder and homework out,

signing up for lunch and snack), afternoon routine (chair up, homework and water bottle in

bookbag), and bathroom visits. These were added as “top” and “bottom” goals on Adam’s DRC,

on which he could earn one “Yes” or “No” depending on his completion of the task

independently. A copy of Adam’s DRC is included in Appendix A.

Patrick. In the initial consultation meeting with Patrick’s teacher and parents, Academic

Engagement was identified as the primary target in need of adjustment using the DRC. After

baseline observations, it was determined that Patrick had a low frequency of off-task behavior,

which varied greatly depending on the activity. Due to the low frequency of reminding needed,

Patrick’s DRC was designed with only two broad intervals – morning and afternoon. To set

realistic but challenging goals for Patrick, his DRC targets were therefore to receive 2 or fewer

reminders to have appropriate eye contact, especially when the teacher was speaking directly to
DRC WITH HFASD 21

him, to have 2 or fewer reminders to follow classroom rules, including following class-wide

directions, and to use at least 1 instance of an active social skill for each half of the day. Patrick’s

social skill goal was worded to include “active” social skills, which included skills such as

“Asking for Help,” because Patrick’s teacher noted that he would often sit at his desk quietly,

staring at his work when he did not know what to do. A list of social skills, with steps, was

provided to Patrick’s teacher (see Appendix C). At the initial consultation meeting, Patrick’s

teachers and parents also identified some concerns they had for Patrick to complete tasks

independently, including his morning routine (coat hung up, homework out, signing up for lunch,

going to the bathroom), and tying his shoes. These were added as “top” and “bottom” goals on

Patrick’s DRC, on which he could earn one “Yes” or “No” depending on his completion of the

task independently. A copy of Patrick’s DRC is included in Appendix A.

Of the four participants, only Patrick’s parents expressed an interest in establishing a

home-based DRC. They had specific concerns about behaviors that occurred at home, but not in

the classroom, including frequent hitting. Patrick’s home DRC included the following targets:

“No more than 3 reminders to follow directions;” “No more than 3 reminders to pay attention or

stay actively involved;” “No more than 3 reminders to use hands safely.” Patrick could earn extra

rewards at home if he earned both his school and home DRCs. A copy of Patrick’s home DRC is

included in Appendix A. Patrick’s mother completed an online DBR each evening both before

the DRC was in use, and after, allowing for a comparison of baseline and intervention scores,

similar to those collected from the systematic observations in the classroom. The targets of the

DBR aligned directly with the targets of the home-based DRC, and included: (a) “Following

Directions - How often did Patrick need reminders to follow directions today? Following

directions means complying with an adult request within 5-10 seconds;” (b) “Actively Involved -
DRC WITH HFASD 22

How often did Patrick need reminders to stay actively involved, or listen to what you are saying?

Not being actively involved can be: not looking at the speaker, not paying attention to what the

speaker says, or not being able to repeat instructions;” and (c) “Safe Hands - How often did

Patrick need reminders to use safe hands and feet? Not using safe hands can include hitting,

slapping, or pushing someone else.”

Louie. In the initial consultation meeting with Louie’s teacher, Academic Engagement

and Disruption were identified as the primary targets in need of adjustment using the DRC.

Specifically, Louie’s teacher was concerned about his tendency to shout out in class and interrupt

others, and his tendency to use materials inappropriately, such as taking a pencil and dropping it

through the rings of a binder over and over. Louie’s teacher felt that these disruptive behaviors

were directly affecting his ability to stay actively involved, and that if the disruptive behaviors

lessened, his ability to attend to the ongoing lessons would improve. After baseline observations,

it was determined that Louie needed approximately 3 reminders in each subject (each subject

lasted approximately an hour) to raise his hand before speaking (not interrupt) and use his things

appropriately. To set realistic but challenging goals for Louie, his DRC targets were therefore to

receive 2 or fewer reminders to raise his hand before speaking and 2 or fewer reminders to use

his materials appropriately. In addition to these behavioral goals, Louie also had a goal

throughout the day to use his social skills, which stated that Louie would use his social skills “At

least 2 instances per period. Social skills include Having a Conversation, Asking for Help,

Listening, Using Self-Control, and Contributing to a Discussion.” A list of these social skills,

with steps, was provided to Louie’s teacher (see Appendix C). A copy of Louie’s DRC is

included in Appendix A.
DRC WITH HFASD 23

Henry. In the initial consultation meeting with Henry’s teacher, Academic Engagement

was identified as the primary target in need of adjustment using the DRC. Specifically, Henry’s

teacher was concerned about his tendency to shout out in class. Like Louie’s teacher, Henry’s

teacher felt that if these disruptive behaviors were lessened, his ability to attend to and participate

in the ongoing lessons would improve. After baseline observations, it was determined that Henry

needed approximately 3 reminders in each subject to raise his hand before speaking (not

interrupt). To set a realistic but challenging goal for Henry, his behavioral DRC target was

therefore to receive 2 or fewer reminders to raise his hand before speaking. In addition to this

behavioral goals, Henry also had a goal throughout the day to use his social skills, which stated

that Henry would use his social skills “At least 2 instances per period. Social skills include

Having a Conversation, Asking for Help, Listening, Using Self-Control, and Contributing to a

Discussion.” A list of these social skills, with steps, was provided to Henry’s teacher (see

Appendix C). Henry’s teacher also noted that Henry had some difficulty remaining quiet in the

hallways. To address this behavior, a bottom goal stating “In the hallways, I walked quietly and

used an appropriate voice” was added. Henry could obtain a single “Yes” or “No” on this goal,

depending on his behavior in the hallways throughout the day. A copy of Henry’s DRC is

included in Appendix A.

Intervention Phase

Following baseline data collection and the creation of the targets and reward menus, the

student, teacher, and parent began using the daily report card. To ease the transmission of the

DRC from school to home, DRCs were printed on triplicate carbonless copy paper. One copy

was sent home with the student, one copy was retained for the teacher’s records, and one copy

was saved in a pre-determined location (often a folder near the teacher’s desk) for the research
DRC WITH HFASD 24

staff to collect at the end of the week. Bi-weekly consultation meetings were held with the

teacher to assess goal progress. Weekly phone calls to parents were made to ensure fidelity with

home-rewards and to answer questions or concerns once the DRC was implemented. While the

DRC was in use, trained observers continued to visit the classrooms and collect observation data.

Additionally, an intervention fidelity sheet was completed by the principal investigator at least

once for each case.

Termination. After collecting at least 5 data points in the intervention phase for each

student, teachers were asked to fill out a Usage Rating Profile (URP) to assess the feasibility and

acceptability of the DRC intervention for high-functioning students with ASD. Once the URP-IR

was returned, teachers received a gift card worth $100 as compensation for participation in the

project. Finally, teachers and parents were asked if they would like to continue or phase out the

DRC intervention, with support provided as needed if they desired to continue.

Measures
Measures were collected for several different purposes, including screening, intervention

creation, and dependent outcome measures. Sections detailing the measures collected for each of

these separate purposes are included below.

Screening

Screening form. Included in the supplemental documents, this brief form asked about

age, grade, diagnosis, special education status, and parent contact information.

Social Communication Questionnaire (SCQ). The SCQ (Rutter, Bailey, & Lord, 2003)

is a brief (40 item) instrument that evaluates communication skills and social functioning for

children who may have an autism spectrum disorder. The SCQ can be used with anyone over the

age of 4.0 years, and has both Current and Lifetime versions. The measure yields several scores;
DRC WITH HFASD 25

only the total score was used in the present study. The SCQ was derived from the Autism

Diagnostic Interview-Revised, which is considered the gold standard in autism diagnosis, and

shows acceptable sensitivity (.88-.90) and specificity (.72-.86; Chandler et al., 2007). A score of

15 or higher is indicative of the presence of an ASD.

Intervention Creation
Conjoint behavioral consultation guide. This brief worksheet outlined important

information to be collected at the first meeting, particularly about the student’s presenting

behavioral concerns. An example of this form, which was created specifically for the present

study, is included in Appendix B.

Dependent Measures

Systematic direct observation. An example of this observation form is included in

Appendix B. Systematic Direct Observations (SDOs) are organized behavioral observations in

which coders watch students for the occurrence of certain target behaviors. Momentary time

sampling was used for the SDOs in the present study, as this technique has shown advantages

compared to others (e.g., Kelly, 1977, Meany-Daboul, Roscoe, Bourret, & Ahearn, 2007; Powell,

1984). In momentary time sampling, observers rate students as showing a behavior only if the

behavior is currently being displayed at a beep. Beeps were given every 10 seconds via an audio-

recording. These procedures have been used elsewhere to measure similar behaviors (e.g. Riley-

Tillman, Chafouleas, Sassu, Chanese, & Glazer, 2008), and show acceptable levels of interrater

reliability (.60-.90; Hintze & Matthews, 2004).

In the present study, 21% of observations (13 out of 67) were coded by two raters in

order to calculate inter-rater reliability (IRR). IRR was assessed using two-way mixed, absolute,
DRC WITH HFASD 26

average-measures intra-class correlation coefficients (ICCs; McGraw & Wong, 1996). ICCs

were calculated for each target (academic engagement, social engagement, and disruptive

behavior) and case, and then averaged across cases. Average ICCs for each target showed high

reliability, with averages for academic engagement (ICC = 0.75), disruptive behavior (ICC =

0.75), and social engagement (ICC = 0.69) all in the good to excellent range (Ciccetti, 1994).

Direct behavior ratings (DBRs). An example of this type of measure is included in

Appendix B. Daily or Direct Behavior Ratings (DBRs) are organized behavior rating tools, used

to evaluate child behavior and guide decisions in the classroom. They can be flexibly applied (for

instance, they can be used for screening and progress monitoring; Chafouleas et al., 2013;

Chafouleas, Riley-Tillman, Sassu, LaFrance, & Patwa, 2007) and they are sensitive to behavior

change (Chafouleas, Sanetti, Kilgus, & Maggin, 2012). DBRs were used in situations where a

systematic observation was not feasible, such as a home-based DRC. For the present study, each

DBR item was rated on a scale from 0 to 10, with 0 representing “No reminders,” and 10

representing “Constant Reminding,” such that higher scores were less desirable for all items.

Google Forms were used to prepare DBRs for the present study. This allowed the authors to send

a simple link to any person completing the DBR, which they could re-click each day to fill out

the form again.

Daily report card fidelity. Staff filled out a researcher-created fidelity rating during

observations in the treatment phase. The form assessed which intervention components (e.g.,

feedback, rating at the end of an interval) were completed, with a total percentage calculated for

steps implemented appropriately. Intervention fidelity was collected during one observation for

Patrick and Henry, and twice for Louie and Adam. Intervention fidelity for all cases was found to

be 100%, with all teachers giving appropriate feedback, recording their prompting accurately,
DRC WITH HFASD 27

and reviewing the DRC at the end of each interval. An example of this form is included in

Appendix B.

To check if parents were providing rewards appropriately, each morning when the

student returned to school, the teacher would check if the student had received his reward, and

write what it was on the sheet. The researcher collected copies of the DRCs weekly and

calculated a percentage for how many days the reward was implemented appropriately (i.e., the

percentage the night before was high enough to merit a reward). Average appropriate reward

implementation was 91% across all four participants for the duration of the study. The collected

sheets also yielded a percentage for how many days the DRC was used (and not forgotten), with

an average implementation of 97% throughout the study.

Usage Rating Profile – Intervention Revised (URP-IR; Chafouleas, Briesch,

Neugebauer, & Riley-Tillman, 2011). The URP-IR is a brief (29-item) rating scale given to

teachers. Items on the URP-IR are rated from 1 (“Strongly Disagree”) to 6 (“Strongly Agree”).

The URP-IR has several subscales including: (a) intervention acceptability, (b) teacher

intervention understanding, (c) the level of home-school collaboration, (d) intervention

feasibility, (e) the school system climate, and (f) school system support. The subscales of the

URP-IR demonstrate acceptable internal consistency (.67 - .95; Briesch, Chafouleas,

Neugebauer, & Riley-Tillman, 2013). Each subscale is outlined in more detail below, using

descriptions provided in the factor analysis of the URP-IR (Briesch et al., 2013).

Acceptability. The Acceptability subscale examines whether teachers feel that the

intervention is generally appropriate, fair, and effective for addressing student problems. It also

examines a teacher’s personal interest in, enthusiasm for, and commitment to carrying out the

procedures of the intervention.

DRC WITH HFASD 28

Understanding. The Understanding subscale examines whether the teacher understands

the intervention procedures, and includes items such as: “I am knowledgeable about the

intervention procedures.” Assessing this scale is important, as intervention usage can be low or

inappropriate if teachers do not possess sufficient knowledge or skill to carry it out (Durlak &

DuPre, 2008).

Home-school collaboration. The Home-School Collaboration subscale assesses whether

collaboration and communication with the student’s family would be needed for effective

implementation of the intervention. In the case of the DRC, which often relies on home-based

rewards and has built in home-school collaboration, this scale is particularly relevant.

Feasibility. Items in this subscale examine whether the time and resources needed to

carry out the intervention were reasonable. This subscale also examines whether the intervention

is simple enough to be carried out accurately, or whether teachers view it as too complicated.

System climate. The system climate subscale examines the philosophical aspects of

support within the school, such as whether the intervention fits within the culture and priorities

of the school system.

System support. This subscale examines the practical aspects of support within the

school, such as the need for professional development, ongoing consultation, or additional

resources to implement the intervention effectively. Low scores on this subscale are not

necessarily bad; these scores may indicate that teachers feel the intervention is simple enough to

implement without substantial consultative or professional support from their school system.
DRC WITH HFASD 29

Data Analysis

Observation data were graphed and analyzed using visual analysis (e.g., What Works

Clearinghouse, 2016), the standard mean difference effect size (SMD; Busk & Serlin, 1992), and

the Tau-U effect size (Parker, Vannest, Davis, & Sauber, 2010). Visual analysis of graphed time-

series data is a commonly used technique, although primarily to judge whether an effect has

occurred, and less about the magnitude of that effect. Visual analysis involves a number of

strategies, including: (a) visual inspection of the overlap of the data, with a goal of having little

overlap from baseline to intervention; (b) visual inspection of the rapidity of change (i.e. going

from low percentages of academic engagement to high percentages of academic engagement

very quickly after implementing the DRC); and (c) visual inspection of the consistency of the

data within phases and across participants (What Works Clearinghouse, 2016).

The main weakness of visual inspection is that it produces a judgment on the presence of

an effect, but not on the magnitude of the effect. To address this weakness, a number of

quantitative effect sizes (ESs) for single-case design data have been developed (see Parker,

Vannest, & Davis, 2011 for a review). In the present study, the standard mean difference (SMD),

Tau, and Tau-U effect sizes were calculated. The standard mean difference is sometimes referred

to as the “No Assumptions Effect Size” (NAES; Busk & Serlin, 1992), and is calculated by

subtracting the mean of the baseline from the mean of the intervention data, and dividing by the

standard deviation of the baseline. There is currently no set standard for interpreting the SMD

within single-case designs, as it often produces very large effect sizes inconsistent with current

standards (i.e. Cohen’s effect size standards; Cohen, 1988). Despite these limitations, this effect

size was chosen due to its previous use in studies of single-case design data (Gage & Lewis,

2014; Gresham et al., 2004; Marquis et al., 2000), and the ease with which it is interpreted.
DRC WITH HFASD 30

Tau and Tau-U are more conservative estimates compared to the SMD, and produce

effect sizes that more closely resemble those proposed by Cohen (1988). Tau and Tau-U

examine the percentage of data that shows improvement across phases by comparing pairs of

data points. By comparing the amount of non-overlap (desired) to the amount of overlap (not

desired) a conservative effect size can be calculated. Tau-U is distinct from Tau in that Tau-U

also controls for baseline trend, when present. Both tests show more statistical power than other

nonoverlap-based effect sizes (Parker, Vannest, & Davis, 2011), and allow for the calculation of

p-values and confidence intervals. Tau and Tau-U are calculated by submitting the individual’s

data points and a coded phase variable to a Kendall Rank Correlation (KRC) test, the results of

which are used in the following formula:

𝐾𝑒𝑛𝑑𝑎𝑙𝑙 ′ 𝑠 𝑆𝑐𝑜𝑟𝑒 "𝑆"

𝑇𝑎𝑢𝑈 =
𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑃𝑎𝑖𝑟𝑠 (𝑁𝐵𝑎𝑠𝑒𝑙𝑖𝑛𝑒 ∗ 𝑁𝐼𝑛𝑡𝑒𝑟𝑣𝑒𝑛𝑡𝑖𝑜𝑛 )

Tau, and Tau-U were found using an online calculator (Vannest, Parker, & Gonen, 2011),

with Tau-U used when significant positive baseline trend was present.

The URP-IR was scored according to guidelines given by Briesch, Chafouleas,

Neugebauer, and Riley-Tillman (2013). The URP-IR yields six factor scores, including: (a)

acceptability, (b) understanding, (c) home-school collaboration, (d) feasibility, (e) system

climate, and (f) system support. Higher scores on each scale are considered more favorable.

Results

Visual Analysis

All systematic observations and direct behavior ratings were graphed by observation

target. Figure 1 depicts the combined graphs of all participants across baseline and intervention

phases for the academic engagement target, Figure 2 depicts the combined graphs of all
DRC WITH HFASD 31

participants across phases for the disruptive target, and Figure 3 depicts the combined graphs of

all participants across phases for the social engagement target. Figures 4-6 depict the graphed

DBR scores from Patrick’s home-based DRC. Visual analysis was conducted for each target, and

the results of that analysis are given by target below. Specifically, visual analysis examined the:

(a) overlap of the data from baseline to intervention; (b) rapidity of change from baseline to

intervention; and (c) consistency of data within each phase and across participants.

Academic engagement. For many of the participants, there is significant overlap from

baseline to intervention. Often, this appears due to a single, very high peak during baseline, such

as the one that occurred in mid-October for Louie. All participants showed immediate

improvement upon implementation of the DRC on the academic engagement target.

Additionally, the intervention phases for all participants appear significantly more stable during

the intervention phase (fewer peaks and valleys) than during the baseline phase, and this effect is

consistently seen across participants.

Disruptive behavior. Low baseline data on the disruptive behavior target significantly

increased overlap, similar to the effect seen for academic engagement. For some participants,

such as Louie, this appears due to deep valleys that overlap with the more consistently low

intervention data points. For participants like Patrick, this is due to floor effects, where on at

least one occasion he was disruptive 0% of the time during baseline. Due to these floor effects in

the baseline phase, there does not appear to be a rapid change from baseline to intervention for

most participants, and when a more notable change occurs, it is sometimes in the direction

opposite what was expected. For example, Louie’s disruptive behavior decreases immediately

before intervention, and then jumps back up following intervention. One positive result of

implementing the DRC appears to be stability, as the data following implementation are much
DRC WITH HFASD 32

more consistent (fewer peaks and valleys) than during baseline. Additionally, the stabilizing

trend in the intervention phase was seen across participants, supporting the introduction of the

DRC as the trigger for the observed change.

Social engagement. The social engagement target produced scattered data, often with an

effect opposite what was expected. For instance, Louie and Henry both showed a decrease in

social engagement following implementation of the DRC, with the typical amount of social

engagement being 0%. Similar to the targets above, low scores during baseline (where there was

often 0% engagement) resulted in a significant amount of overlap across both phases. Change

from baseline to intervention appeared rapid for only one participant (Patrick), but was in the

direction opposite what was expected (social engagement decreased). Intervention phase data

appeared consistently more stable across Louie, Henry, and Adam, but again, in the direction

opposite what was expected (consistently less social engagement).

Standard Mean Difference

The standard mean difference was calculated for each participant, by target. Additionally,

an aggregate standard mean difference effect size was calculated by pooling means and standard

deviations across participants for each target (see Table 2).

Academic engagement. In general, all participants demonstrated large changes from

baseline to intervention using the SMD method, with effect sizes ranging from 0.64 to 2.03. For

academic engagement, Adam showed the largest SMD effect size, at 2.03. This is due in part to

an increase in his average academic engagement, from 71% during baseline to 94% during the

intervention phase, but also to a decrease in the standard deviation of the data (suggesting

increased stability), which went from 13.5 at baseline to 4.6 during intervention. The aggregate
DRC WITH HFASD 33

SMD effect size demonstrates a similar change, at 1.19, suggesting an increase in academic

engagement from baseline to intervention across participants.

Disruptive behavior. SMD effect sizes for the disruptive behavior target in general

suggest a decrease across participants, with effect sizes ranging from -0.35 to -0.89. Patrick and

Louie showed the greatest decreases from baseline to intervention, with SMD effect sizes of -

0.89 and -0.81, respectively. Louie, whose teacher had specifically identified disruptive behavior

as an area of concern, decreased from an average of 27% disruptive behavior during baseline

(SD = 21.45) to an average of 13% disruptive behavior (SD = 7.61) following implementation of

the DRC. The aggregate SMD for disruptive behavior followed a similar pattern, at -0.57,

suggesting a decrease in disruptive behavior from baseline to intervention across participants.

Social engagement. SMD effect sizes ranged widely for the social engagement target,

from -0.65 to 0.52. For most participants, SMD effect sizes reflected a decrease in social

engagement from baseline to intervention, an effect opposite what was expected. Henry showed

the largest decrease from baseline to intervention, at -0.65. However, this statistic is likely an

artifact of the lack of variability in the intervention data, where Henry consistently scored 0% on

the social engagement target, and less a reflection of the magnitude of his change from baseline

to intervention, where he went from an average of 2% socially engaged to an average of 0%

socially engaged. The aggregate SMD effect size reflected the variability in these results, and

was very small, at -0.07.

Tau/Tau-U

The Tau and Tau-U effect sizes demonstrated similar patterns of results to the SMD

effect size, but have the advantage of confidence intervals (CIs) and p-values, allowing for a

more detailed interpretation of the effect.

DRC WITH HFASD 34

Academic engagement. In general, Tau effect sizes demonstrated improvement from

baseline to intervention for the academic engagement target, with effect sizes ranging from 0.52

(p = 0.11; 90% CI [-0.02, 1.00]) to 1.00 (p < .001; 90% CI [0.50, 1.00]). Adam’s effect size of

1.00, (p < .001, 90% CI [0.50, 1.00]) is particularly large, and represents a complete lack of

overlap from baseline to intervention. A weighted average Tau effect size was also calculated

across participants for the academic engagement target, and demonstrated a significant

improvement from baseline to intervention, ES = 0.69 (p < .001; 90% CI [0.38, 1.00]).

Disruptive behavior. In general, Tau effect sizes demonstrated a decrease in disruptive

behavior from baseline to intervention, with effect sizes ranging from -0.12 (p = 0.71; 90% CI [-

0.66, 0.42]) to -0.64 (p = 0.04; 90% CI [-1.00, -0.10]). A weighted Tau effect size was calculated

across participants for the disruptive behavior target, and also demonstrated improvement from

baseline to intervention, with participants decreasing their levels of disruption, ES = -0.41, p =

0.01, 90% CI (-0.73, -0.10).

Social engagement. Tau effect sizes were varied, but most demonstrated a decrease in

social engagement from baseline to intervention. Effect sizes ranged from -0.38 (p = 0.24; 90%

CI [-0.92, 0.16]) to 0.00 (p = 1.00; 90% CI [-0.54, 0.54]). A weighted Tau effect size across

participants was calculated to be -0.20, and was not significant (p = 0.21; 90% CI [-0.52, 0.11]).

URP-IR

Following completion of the intervention data collection, all four teachers completed a

Usage Rating Profile, Intervention Revised (URP-IR) for the DRC, which yielded factor scores

for acceptability, understanding, home-school collaboration, feasibility, system climate, and

system support. On the Acceptability subscale, the teachers rated the DRC with an average score

of 4.86, suggesting that, in general, they agreed that the DRC was generally fair, effective, and
DRC WITH HFASD 35

appropriate at addressing the behavioral concerns of high-functioning students with ASD. On the

Understanding subscale, teachers rated the DRC with an average score of 5.25, suggesting they

understood in the intervention procedures. For the Home-School Collaboration subscale, teachers

gave an average rating of 5.33, suggesting that collaboration and communication were needed

for effective implementation of the DRC. Ratings on the Feasibility subscale had an average of

4.75, suggesting that the time, resources, and effort required to implement the DRC were

reasonable. Teachers rated the system climate subscale items with an average of 4.9, suggesting

that the DRC intervention fit well within the culture of their schools, but rated system support

with an average score of 2.7, suggesting that they did not require significant professional

development or consultative support to carry out the intervention effectively.

Following the completion of data collection for the present study, all four teachers

continued to use the daily report card. As desired, bi-weekly consultation with graphed data from

the DRCs was provided to all teachers. After approximately one month of continued

consultation, Alex and Louie’s teams took complete ownership of the DRC, asking for digital

copies they could edit on their own, and using Excel to continue tracking the daily percentages

on the DRCs without support from the principal investigator. Patrick and Henry’s teachers have

also continued to use the DRC, but with support from the principal investigator.

Discussion

As a behavioral intervention, the Daily Report Card has a long history of success in

addressing disruptive and off-task behaviors in the classroom (Chafouleas, Riley-Tillman, &

McDougal, 2002; Kelley, 1990; O’Leary, Pelham, Rosenbaum, & Price, 1976; Pyle & Fabiano,

under review; Vannest, Davis, Davis, Mason, & Burke, 2010). What is less clear is whether the
DRC WITH HFASD 36

daily report card can be flexibly applied to students with similar but distinct concerns, such as

high-functioning students identified as having ASD.

High-functioning students with ASD often present challenges to school staff that mirror

those of children with disruptive behavior disorders such as ADHD (Holtmann, Bolte, &

Poustka, 2005). In the present study, for instance, all four teachers identified academic

engagement as a primary target for concern, due to their students’ frequent gazing off,

wandering, and unfocused behavior. Louie and Henry’s teachers also noted concerns about

shouting out and being out of seat, disruptive behaviors commonly seen in children with ADHD.

Although the motivations may be different – for instance, a child with ADHD might engage in

out of seat behavior due to the drive of an “internal motor” (APA, 2013) whereas a high-

functioning child with ASD may not pick up on the unspoken classroom rule to stay seated – the

manifestation is similar, and can theoretically be addressed through similar behavioral

intervention.

In general, visual analysis, SMD, and Tau effect sizes demonstrated improvement on the

academic engagement and disruptive behavior targets. Academic engagement increased from

baseline to intervention, while disruptive behaviors decreased across phases. Conversely, these

same tests showed varied results with regard to the social engagement target, often

demonstrating a decrease in the amount of social engagement from baseline to intervention.

Finally, teachers found the DRC to be an acceptable and feasible intervention for high-

functioning students with ASD, which supports the continued examination of the DRC as a

stand-alone intervention with this population. Each of these results, and their implications, is

discussed in more detail below.

DRC WITH HFASD 37

Academic Engagement

On the academic engagement target, visual analysis suggested improvement for all cases,

with low overlap from baseline to intervention, rapid improvement in the intervention phase, and

consistently more stable data in the intervention phase across participants. Effect sizes also

demonstrated significant improvement on the academic engagement target, with a weighted

aggregate Tau effect size of 0.69 (p < .001). Although there are no “gold standard” benchmarks

to interpret non-overlap based effect sizes, suggested criteria list effect sizes of 0.70 - 0.90 as

denoting moderately to highly effective interventions (Ma, 2006; Parker & Vannest, 2009;

Scruggs & Mastropieri, 2001). These standards suggest that the DRC is an effective intervention

for increasing academic engagement in high-functioning children with ASD, helping students

attend to and engage with the classroom activities significantly more.

Given the increasing social and academic demands that are placed on students in the

school years, high-functioning students with ASD can often find themselves falling further and

further behind their peers as they fail to comprehend and participate in interpersonal situations

effectively (Fabes et al., 2009). This pattern is highlighted by the work of Estes and colleagues

(2011), which examined the discrepancies between academic achievement and intellectual ability

for high-functioning students with ASD. Their work found that 60% of high-functioning students

with ASD had lower academic achievement than would be predicted based solely on their

intellectual ability. This result should not be surprising to anyone familiar with a school: grades

and success on assignments are determined by much more than ability. Organization, planning,

attention, task initiation, and working memory all play a role in successful work completion in

school. These cognitive skills are often significantly impaired in students with autism (Hughes,

1994; Ozonoff, 1995; Russell, Jarold, & Hood, 1999) which may lead to students who, though
DRC WITH HFASD 38

intellectually able to complete certain assignments, fail to do so for a variety of other reasons.

Utilizing interventions such as the DRC can alleviate some of these challenges, resulting in

greater academic success for high-functioning students with ASD.

Disruptive Behavior

Similar improvement was shown for the disruptive behavior target, with students

decreasing from baseline to intervention, however this improvement was less clear than the result

for academic engagement. Due to floor effects in baseline, where several participants were

observed to have 0 intervals with disruptive behavior, there is significant overlap between the

baseline and intervention phases. This unpredictable pattern of “good-day” “bad-day” was

something frequently mentioned by teachers in the initial behavioral consultation interview.

Thus, although there was more overlap between the baseline and intervention phases for the

disruptive behavior target, the consistency of behavior in the intervention phase was likely a

welcome change for teachers, who could more accurately predict how a child would behave on

any given day. Additionally, only two teachers (Henry and Louie) identified disruptive behavior

as a significant concern. Thus, for Adam and Patrick, low effect sizes were expected, as this

behavior was not problematic at baseline. However, the low levels of disruptive behavior at

baseline for these participants resulted in decreased aggregate effect sizes for the disruptive

behavior target overall, possibly making the DRC look less effective at modifying this behavior

than it actually was.

This difference, between a quantitative effect size and a clinically significant effect,

frequently plagues single-case design intervention research (Manolov, Jamieson, Evans, &

Sierra, 2016). In their article discussing the evaluation of intervention effects in studies like

these, Vannest and Ninci (2015) state that an effect size is not small, medium, or large in and of
DRC WITH HFASD 39

itself, but must be described in relationship to the client’s needs, goals, and history, as well as the

intervention used. Thus, while the weighted aggregate Tau effect size for disruptive behavior

(0.41) falls in the “questionable” range for efficacy, it may still demonstrate a clinically

significant effect. Further research in this area, using measures aimed at gathering teacher and

parent’s perceptions, will be helpful in elucidating this difference, and will inform future

research that seeks to find a balance between a statistically significant effect and a clinically

significant one.

Social Engagement
The social engagement target produced varied results, with visual analysis and effect

sizes suggesting a decrease in social engagement from baseline to intervention. Although social

communication is a key deficit in ASD, it can be hard to measure accurately in real-world

settings, where social relationships and the way children speak to one another change rapidly and

represent a complex interaction of social turns (Gottman, Gonso, & Rasmussen, 1975; Pelham &

Bender, 1982). Researchers have struggled with the question of how best to measure social

interactions between students for decades, with various teams suggesting systematic observations

such as the Social Interaction Observation System (SIOS; Voeltz, Kishi, & Brennan, 1981;

Lopata et al., 2012), questionnaires asking about specific social skill use (Lerner & Mikami,

2012; Lopata et al., 2006; Lopata et al., 2012), or peer sociometrics (Lerner & Mikami, 2012;

Pelham & Bender, 1982).

A social engagement target on the systematic direct observation was chosen for the

present study because it fit easily within the pre-existing observation system, and was similar to

approaches used elsewhere (Lerner & Mikami, 2012; Lopata et al., 2012). Unfortunately,

opportunities to observe social engagement in the typical classroom setting were limited, and
DRC WITH HFASD 40

rarely occurred during the observations for the present study. Additionally, social interaction was

often very brief when it did occur. For instance, Adam’s teacher frequently used a “Turn-and-

talk” approach to facilitate discussion during her lessons, but these interactions were so brief that

they were not always captured using the momentary time sampling procedure, and when they

were captured, only accounted for 2 or 3 intervals out of the 120 observed. Conversely, some

observations happened to fall on days when teachers were facilitating very socially interactive

lessons, such as the day Patrick’s teacher arranged a partner reading/discussion session (which

happened to fall in the intervention phase). Although a comparison between a student’s social

engagement before the DRC in such a social situation and after the DRC in such a social

situation would have been interesting, that comparison cannot be made with the present data, as

the observers were unable to collect data during such a socially interactive lesson at baseline.

These random lesson changes are reflected in the data, which do not show many clear,

identifiable trends.

Additionally, instances of social engagement were hard to separate from instances of

disruption, which may explain the trend of social engagement decreasing in the intervention

phase. Although the definition of social engagement was written to specify “appropriate”

interactions, it was often hard to determine if a student’s interaction was appropriate or not,

especially given that many students were often speaking or out of their seats at the same time

(but did not technically have permission to do so). Interestingly, the tendency of high-

functioning students with ASD to engage in some disruptive behaviors (such as speaking to peers

when they are not supposed to) may actually suggest a high level of social awareness and

engagement, especially if the peers collude with them to continue the conversation. This type of
DRC WITH HFASD 41

informal social interaction is typical of students at a certain age, and may be a precursor to

establishing more formal, officially recognized relationships in the future (Fabes et al., 2009).

Due to the central role that social engagement plays in autism, it is disappointing that the

results of the present study do not offer a clear answer on the influence of DRCs in this area.

However, given the difficulty of measuring the presence of social engagement in this study, the

fault likely lies less with the DRC and more with the method of assessment. Future research

examining the ability of the DRC to influence social engagement would benefit from using

alternative assessments and contexts. For instance, much of the research on social skills

examines the frequency of social skill use before and after intervention in unstructured play

environments (Rao, Beidel, & Murray, 2008). Perhaps in a less structured environment, such as

recess, there would be a clearer result from the effectiveness of the DRC. Lastly, the present

study did not provide any form of social skills instruction, which is commonly used with high-

functioning children who have ASD, and has shown strong, positive effects (Wong et al., 2015).

It may benefit future research to examine the use of the daily report card in combination with

other interventions, such as social skill instruction.

Teacher Evaluation of the DRC

On the URP-IR, teachers rated the DRC as acceptable, feasible, easy to understand, and

requiring little additional training. True to the nature of the DRC, teachers also gave high ratings

to the need for collaboration and communication with the home in order for the intervention to

be effective. Informally, teachers noted their satisfaction with the DRC in emails and at

meetings, with all teachers appearing pleased with the progress their students were making.

Parents also reported seeing effects of the daily report card at home, especially in Patrick’s case,

where his family implemented a home-based DRC. Unfortunately, these results were not
DRC WITH HFASD 42

quantifiable, due to the lack of direct measures of teacher and parent-rated symptoms or

impairment. Future research would benefit from including measures of parent and teacher report,

both before and after implementation of the DRC.

It is important to note that teachers in this study varied widely in their training, from

general education teachers to special education teachers in small, self-contained classrooms.

Despite these differences, all teachers found the DRC relatively easy to use and felt the DRC

successfully addressed their student’s problem behaviors. These results support the efficiency

and flexibility of the DRC, which takes only a few minutes to use (between giving prompts and

end-of-interval feedback), and is capable of addressing a broad range of behaviors, regardless of

diagnosis or classification.

Limitations

The present study suffered from several limitations, which can be grouped into the

following categories: (a) participant characteristics, and (b) methodological issues.

Participant characteristics. The present study included a sample of four boys, all in

elementary school. Although ASD is more commonly diagnosed in males (APA, 2013), it occurs

in females as well, and gender may play a role in the efficacy of interventions used. Additionally,

the age of the participants, while broad across the elementary school context (1st versus 5th

graders) does not reveal whether the DRC would also be effective with a middle- or high-school

student with high-functioning ASD. Given the paucity of research on the effectiveness of

interventions for adolescents with ASDs (Maglione et al., 2012) there is a significant need for

research in this area. Finally, there was very little diversity in the racial, ethnic or socio-
DRC WITH HFASD 43

economic background of participants, which does not reflect the existence of ASD across

populations; this should be addressed in future research.

Methodological issues. Although the present study attempted to complete a multiple-

baseline study using rigorous single-case design standards (Kratochwill et al., 2013; WWC,

2016), a single multiple-baseline study cannot provide sufficient evidence for an intervention.

Recent criteria for evidence-based practices released by the National Professional Development

Center include: (a) having at least two high-quality experimental or quasi-experimental design

articles, conducted by at least two different researchers or groups; or (b) having at least five high

quality single-case design articles, conducted by at least three different researchers or groups; or

(c) a combination of at least one high-quality experimental or quasi-experimental group design

article, with at least three high-quality single-case design articles, conducted by at least two

research groups (Odom, Collet-Klingenberg, Rogers, & Hatton, 2010). To place the DRC among

the ranks of other evidence-based interventions, such as Social Narratives or Prompting (Wong

et al., 2015), more research is needed.

Additionally, two of the outcomes for the present study – social engagement and

disruptive behavior – suffered from significant floor effects at baseline, which ultimately led to

lower effect sizes for those targets. These outcomes might have been better served with different

methods of assessment, including frequency counts (rather than momentary time sampling) for

disruptive behaviors, and observations during unstructured play times for social engagement.

Finally, the present study did not collect a direct measure of teacher or parent-rated

behavior or opinion of the intervention. Thus, the conclusions that can be drawn about parent or

teacher’s satisfaction with the intervention are limited. Future research would benefit from

including these direct measures, both before and after implementation.

DRC WITH HFASD 44

Conclusion

The Daily Report Card has a substantial track-record when it comes to improving

disruptive and off-task behaviors in school-age children, particularly in children with disruptive

behavior disorders. The present study sought to determine whether this intervention could be

flexibly applied to a new population, particularly students with high-functioning autism

Spectrum Disorder. The present study supports the use of this intervention with high-functioning

students who have ASD, demonstrating that these students significantly increase their academic

engagement and decrease their disruptive behaviors when the DRC is employed. It is less clear

whether the DRC can be used to change the social engagement of high-functioning students with

ASD. Teachers found the DRC to be a feasible and acceptable intervention, regardless of their

level of training. Future research must examine the DRC in more diverse populations, and with

different assessment techniques and procedures to measure changes in social engagement.

Although the DRC is similar to other behavioral mechanisms employed with high-

functioning children who have ASD, it is unique in that it presents a way to combine these

techniques in an acceptable, feasible, relatively easy-to-implement package. Many teachers may

find this type of intervention package, which combines behavior assessment and reinforcement

techniques, beneficial in their educational practice. By demonstrating that the DRC can have

direct, measurable effects in the classroom, the present study encourages the adoption of this

intervention, especially by school professionals looking for tools to help their high-functioning

students with ASD.

DRC WITH HFASD 45

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders: DSM-5. Washington, D.C: American Psychiatric Association.

Bailey, J. S., Wolf, M. M., & Phillips, E. L. (1970). Home-based reinforcement and the

modification of pre-delinquents’ classroom behavior. Journal of Applied Behavior

Analysis, 3(3), 223-233. doi: 10.1901/jaba.1970.3-223

Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2006). Young adult outcome of

hyperactive children: adaptive functioning in major life activities. Journal of the

American Academy of Child & Adolescent Psychiatry, 45(2), 192-202. doi:

10.1097/01.chi.0000189134.97436.e2

Bauminger-Zviely, N. (2013). Cognitive-behavioral-ecological intervention to facilitate social-

emotional understanding and social interaction in youth with high-functioning ASD. In

A. Scarpa, S. W. White, & T. Attwood (Eds.), CBT for children and adolescents with

high-functioning autism spectrum disorders (pp. 226–255). New York: Guilford.

Bauminger-Zviely, N. (2014). School-Age Children with ASD. In Volkmar, F.R., Rogers, S. J.,

Paul, R., & Pelphrey, K. A. (Eds.), Handbook of Autism and Pervasive Developmental

Disorders (pp. 230-262). Hoboken, NJ: John Wiley and Sons, Inc.

Bellini, S. (2006). The development of social anxiety in high functioning adolescents with autism

spectrum disorders. Focus on Autism and Other Developmental Disabilities, 21, 138–

145. doi: 10.1177/10883576060210030201

DRC WITH HFASD 46

Bellini, S., Peters, J. K., Benner, L., & Hopf, A. (2007). A meta-analysis of school-based social

skills interventions for children with autism spectrum disorders. Remedial and Special

Education, 28(3), 153-162. doi: 10.1177/07419325070280030401

Briesch, A. M., Chafouleas, S. M., Neugebauer, S. R., & Riley-Tillman, T. C. (2013). Assessing

influences on intervention implementation: Revision of the Usage Rating Profile-

Intervention. Journal of school psychology, 51(1), 81-96. doi: 10.1016/j.jsp.2012.08.006

Buescher, A. V., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum

disorders in the United Kingdom and the United States. JAMA pediatrics, 168(8), 721-

728. doi: 10.1001/jamapediatrics.2014.210

Burkwist, B. J., Mabee, W. S., & McLaughlin, T. F. (1987). The effect of a daily report card

system on inappropriate classroom verbalizations with a junior high school learning-

disabled student. Techniques, 3(4), 265-272. Retrieved from

http://psycnet.apa.org/psycinfo/1988-37346-001

Busk, P.L., & Serlin, R.C. (1992). Meta-analysis for single-case research. In T.R. Kratochwill &

J.R. Levinn (Eds.) Single-case research design and data analysis: New directions for

psychology and education (pp. 187-212). Hillsdale, NJ: Erlbaum.

Cavagnaro, A. (2007). Autism spectrum disorders: Changes in the California caseload – An

Update, June 1987 – June 2007. Sacramento, CA: Health and Human Services Agency.

Carrow-Woolfolk, E. (1999). Comprehensive assessment of spoken language. Circle Pines, MN:

American Guidance Service.

DRC WITH HFASD 47

Chafouleas, S. M., Briesch, A. M., Neugebauer, S. R., & Riley-Tillman, T. C. (2011). Usage

Rating Profile – Intervention (Revised). Storrs, CT: University of Connecticut.

Chafouleas, S. M., Kilgus, S. P., Jaffery, R., Riley-Tillman, T. C., Welsh, M. E., & Christ, T. J.

(2013). Direct Behavior Rating as a school-based behavior screener for elementary and

middle grades. Journal of School Psychology, 51, 367-385. doi:10.1016/j.jsp.2013.04.002

Chafouleas, S.M., Riley-Tillman, T.C., & McDougal, J.L. (2002). Good, bad, or in- between:

How does the daily behavior report card rate? Psychology in the Schools, 39, 157-169.

doi:10.1002/pits.10027

Chafouleas, S. M., Riley-Tillman, T. C., & Sassu, K. A. (2006). Acceptability and reported use

of daily behavior report cards among teachers. Journal of Positive Behavior

Interventions, 8(3), 174-182. doi: 10.1177/10983007060080030601

Chafouleas, S.M., Riley-Tillman, T.C., Sassu, K.A., LaFrance, M.J., & Patwa, S.S. (2007). The

consistency of Daily Behavior Report Cards in monitoring interventions. Journal of

Positive Behavior Interventions, 9, 30-37. doi:10.1177/10983007070090010401

Chandler, S., Charman, T., Baird, G., Simonoff, E., Loucas, T., Meldrum, D., ... & Pickles, A.

(2007). Validation of the social communication questionnaire in a population cohort of

children with autism spectrum disorders. Journal of the American Academy of Child &

Adolescent Psychiatry, 46(10), 1324-1332. doi: 10.1097/chi.0b013e31812f7d8d

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ:

Lawrence Erlbaum.
DRC WITH HFASD 48

DeRosier, M. E., Swick, D. C., Davis, N. O., McMillen, J. S., & Matthews, R. (2011). The

efficacy of a social skills group intervention for improving social behaviors in children

with high functioning autism spectrum disorders. Journal of Autism and Developmental

Disorders, 41(8), 1033–1043. doi: 10.1007/ s10803-010-1128-2

Dolliver, P., Lewis, A. F., & McLaughlin, T. F. (1985). Effects of a daily report card on

academic performance and classroom behavior. RASE: Remedial & Special Education,

6(1), 51-52. doi: 10.1177/074193258500600112

Dougherty, E. H., & Dougherty, A. (1977). The daily report card: A simplified and flexible

package for classroom behavior management. Psychology in the Schools, 14(2), 191-195.

doi: 10.1002/1520-6807(197704)14:2<191::AID-PITS2310140213>3.0.CO;2-J

Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the

influence of implementation on program outcomes and the factors affecting

implementation. American journal of community psychology, 41(3-4), 327. doi:

10.1007/s10464-008-9165-0

Estes, A., Rivera, V., Bryan, M., Cali, P., & Dawson, G. (2011). Discrepancies between

academic achievement and intellectual ability in higher-functioning school-aged children

with autism spectrum disorder. Journal of autism and developmental disorders, 41(8),

1044-1052. doi: 10.1007/s10803-010-1127-3

Fabes, R. A., Martin, C. L., & Hanish, L. D. (2009). Children's behaviors and interactions with

peers. In Rubin, K. H., Bukowski, W. M., and Laursen, B. (Eds). Handbook of peer

interactions, relationships, and groups. (pp. 45-62). New York, NY: Guilford Press.
DRC WITH HFASD 49

Fabiano, G. A., Vujnovic, R. K., Pelham, W. E., Waschbusch, D. A., Massetti, G. M., Pariseau,

M. E., ... & Greiner, A. R. (2010). Enhancing the effectiveness of special education

programming for children with attention deficit hyperactivity disorder using a daily

report card. School Psychology Review, 39(2), 219-239. Retrieved from

http://naspjournals.org/loi/spsr

Fuchs, D., & Fuchs, L. S. (2006). Introduction to Response to Intervention: What, why, and how

valid is it?. Reading Research Quarterly, 41, 93-99. doi:10.1598/RRQ.41.1.4

Fuchs, L. S., & Fuchs, D. (2007). A model for implementing responsiveness to intervention.

Teaching Exceptional Children, 39, 13-20. doi: 10.1177/004005990703900503

Gage, N. A., & Lewis, T. J. (2012). Hierarchical linear modeling meta-analysis of single-subject

design research. The Journal of Special Education, 48(1), 3-16. doi:

10.1177/0022466912443894

Ganz, M. L. (2007). The lifetime distribution of the incremental societal costs of

autism. Archives of pediatrics & adolescent medicine, 161(4), 343-349. doi:

10.1001/archpedi.161.4.343

Goldstein, A. P., McGinnis, E., Sprafkin, R. P., Gershaw, N. J., & Klein, P. (1997).

Skillstreaming the adolescent: New strategies and perspectives for teaching prosocial

skills (Rev. ed.). Champaign, IL: Research Press.

Gottman, J., Gonso, J., & Rasmussen, B. (1975). Social interaction, social competence, and

friendship in children. Child development, 46 (3), 709-718. doi: 10.2307/1128569

DRC WITH HFASD 50

Gresham, F. M., Hunter, K. K., Corwin, E. P., & Fischer, A. J. (2013). Screening, assessment,

treatment, and outcome evaluation of behavioral difficulties in an RTI model.

Exceptionality, 21, 19-33. doi:10.1080/09362835.2013.750115

Gresham, F. M., McIntyre, L. L., Olson-Tinker, H., Dolstra, L., McLaughlin, V., & Van, M.

(2004). Relevance of functional behavioral assessment research for school-based

interventions and positive behavioral support.Research in Developmental

Disabilities, 25(1), 19-37. doi: 10.1016/j.ridd.2003.04.003

Heward, W. L. (2003). Ten faulty notions about teaching and learning that hinder the

effectiveness of special education. The journal of special education, 36(4), 186-205. doi:

10.1177/002246690303600401

Hintze, J. M., & Matthews, W. J. (2004). The generalizability of systematic direct observations

across time and setting: A preliminary investigation of the psychometrics of behavioral

observation. School Psychology Review,33(2), 258-270. Retrieved from

http://search.proquest.com/openview/c083a02e9d8689733911024a02c1265a/1?pq-

origsite=gscholar

Holtmann, M., Bölte, S., & Poustka, F. (2005). Letters to the editor: ADHD, Aspergers

syndrome, and high-functioning autism. Journal of the American Academy of Child &

Adolescent Psychiatry, 44(11), 1101. doi: 10.1097/01.chi.0000177322.57931.2a

Horner, R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The use of

single-subject research to identify evidence-based practice in special

education. Exceptional children, 71(2), 165-179. doi: 10.1177/001440290507100203

DRC WITH HFASD 51

Horner, R. H., Sugai, G., Smolkowski, K., Eber, L., Nakasato, J., Todd, A. W., & Esperanza, J.

(2009). A randomized, wait-list controlled effectiveness trial assessing school-wide

positive behavior support in elementary schools. Journal of Positive Behavior

Interventions, 11(3), 133-144. doi: 10.1177/1098300709332067

Howlin, P. (2000). Outcome in adult life for more able individuals with autism or Asperger

syndrome. Autism, 4(1), 63-83. doi: 10.1177/1362361300004001005

Hughes, C., Russell, J., & Robbins, T. W. (1994). Evidence for executive dysfunction in

autism. Neuropsychologia, 32(4), 477-492. doi: 10.1016/0028-3932(94)90092-2

Hume, K., Loftin, R., & Lantz, J. (2009). Increasing independence in autism spectrum disorders:

A review of three focused interventions. Journal of autism and developmental

disorders, 39(9), 1329-1338. doi: 10.1007/s10803-009-0751-2

Jurbergs, N., Palcic, J., & Kelley, M. L. (2007). School-home notes with and without response

cost: Increasing attention and academic performance in low-income children with

attention-deficit/hyperactivity disorder. School Psychology Quarterly, 22(3), 358. doi:

10.1037/1045-3830.22.3.358

Kaat, A. J., & Lecavalier, L. (2014). Group-based social skills treatment: A methodological

review. Research in Autism Spectrum Disorders, 8(1), 15–24. doi:

10.1016/j.rasd.2013.10.007

Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-250.

Retrieved from http://neurodiversity.com/library_kanner_1943.pdf

DRC WITH HFASD 52

Keen, D., & Ward, S. (2004). Autistic spectrum disorder: A child population

profile. Autism, 8(1), 39-48. doi: 10.1177/1362361304040637

Kelley, M. L. (1990). School-home notes: Promoting children's classroom success. New York:

Guilford Press.

Kelly, M. B. (1977). A review of the observational data‐collection and reliability procedures

reported in the Journal of Applied Behavior Analysis.Journal of Applied Behavior

Analysis, 10(1), 97-101. doi: 10.1901/jaba.1977.10-97

Kim, S.H., Paul, R., Tager-Flusberg, H., Lord, C. (2014). Language and Communication in

Autism. In Volkmar, F.R., Rogers, S. J., Paul, R., & Pelphrey, K. A. (Eds.), Handbook of

Autism and Pervasive Developmental Disorders (pp. 230-262). Hoboken, NJ: John Wiley

and Sons, Inc.

Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F. R., & Lord, C. (2007).

Social and communication abilities and disabilities in higher functioning individuals with

autism spectrum disorders: The Vineland and the ADOS. Journal of autism and

developmental disorders, 37(4), 748-759. doi: 10.1007/s10803-006-0229-4

Knapp, M., & Buescher, A. (2014). Economic Aspects of Autism. In Volkmar, F.R., Rogers, S.

J., Paul, R., & Pelphrey, K. A. (Eds.), Handbook of Autism and Pervasive Developmental

Disorders (pp. 1089-1106). Hoboken, NJ: John Wiley and Sons, Inc.

Kogan, M. D., Blumberg, S. J., Schieve, L. A., Boyle, C. A., Perrin, J. M., Ghandour, R. M., ...

& van Dyck, P. C. (2009). Prevalence of parent-reported diagnosis of autism spectrum

disorder among children in the US, 2007.Pediatrics, 124(5), 1395-1403. Retrieved from

http://pediatrics.aappublications.org/content/124/5/1395
DRC WITH HFASD 53

Kratochwill, T. R., Hitchcock, J. H., Horner, R. H., Levin, J. R., Odom, S. L., Rindskopf, D. M.,

& Shadish, W. R. (2013). Single-case intervention research design standards. Remedial

and Special Education, 34(1), 26-38. doi: 10.1177/0741932512452794

Lai, M. C., Lombardo, M. V., Chakrabarti, B., & Baron-Cohen, S. (2013). Subgrouping the

Autism “Spectrum": Reflections on DSM-5. PLoS Biol, 11(4), e10015004. doi:

10.1371/journal.pbio.1001544

Lecavalier, L. (2006). Behavioral and emotional problems in young people with pervasive

developmental disorders: Relative prevalence, effect of subject characteristics, and

empirical classification. Journal of Autism and Developmental Disorders, 36, 1101–

1114. doi: 10.1007/s10803-006-0147-5

Lerner, M. D., & Mikami, A. Y. (2012). A preliminary randomized controlled trial of two social

skills interventions for youth with high-functioning autism spectrum disorders. Focus on

Autism and Other Developmental Disabilities, 27(3), 147-157. doi:

10.1177/1088357612450613

Loe, I. M., & Feldman, H. M. (2007). Academic and educational outcomes of children with

ADHD. Journal Of Pediatric Psychology,32(6), 643-654. doi:10.1093/jpepsy/jsl054

Lopata, C., Thomeer, M. L., Volker, M. A., Lee, G. K., Smith, T. H., Smith, R. A., ... & Toomey,

J. A. (2012). Feasibility and initial efficacy of a comprehensive school‐based intervention

for high‐functioning autism spectrum disorders. Psychology in the Schools, 49(10), 963-

974. doi: 10.1002/pits.21649

Lopata, C., Thomeer, M. L., Volker, M. A., & Nida, R. E. (2006). Effectiveness of a cognitive-

behavioral treatment on the social behaviors of children with Asperger disorder. Focus on
DRC WITH HFASD 54

Autism and Other Developmental Disabilities, 21, 237–244. doi:

10.1177/10883576060210040501

Lopata, C., Thomeer, M. L., Volker, M. A., Nida, R. E., & Lee, G. K. (2008). Effectiveness of a

manualized summer social treatment program for high-functioning children with autism

spectrum disorders. Journal of Autism and Developmental Disorders, 38(5), 890–904.

doi: 10.1007/s10803-007-0460-7

Ma, H. H. (2006). An alternative method for quantitative synthesis of single-subject researches

percentage of data points exceeding the median. Behavior modification, 30(5), 598-617.

doi: 10.1177/0145445504272974

Macintosh, K., & Dissanayake, C. (2006). Social skills and problem behaviours in school aged

children with high-functioning autism and Asperger's Disorder. Journal of Autism and

Developmental Disorders, 36(8), 1065-1076. doi:10.1007/s10803-006-0139-5

Maglione, M. A., Gans, D., Das, L., Timbie, J., & Kasari, C. (2012). Nonmedical interventions

for children with ASD: Recommended guidelines and further research needs. Pediatrics,

130(Supplement 2), S169-S178. doi: 10.1542/peds.2012-0900O

Manolov, R., Jamieson, M., Evans, J., & Sierra, V. (2016). A discussion of alternatives for

establishing empirical benchmarks for interpreting single-case effect sizes. Psicológica,

37(2), 209-234. doi:

Marquis, J.G., Horner, R.H., Carr, E.G., Turnbull, A.P., Thompson, M., Behrens, G.A, &

Doolah, A. (2000). A meta-analysis of positive behavior support. In R. Gersten, E.P.

Schiller, & B.J. Vaughn (Eds.), Contemporary special education research: Syntheses of
DRC WITH HFASD 55

the knowledge base on critical instructional issues (pp. 137-178). Mahwah, NJ:

Lawrence Erlbaum.

McCain, A. P., & Kelley, M. L. (1993). Managing the classroom behavior of an ADHD

preschooler: The efficacy of a school-home note intervention. Child & Family Behavior

Therapy, 15(3), 33-44. doi: 10.1300/J019v15n03_03

McGinnis, E. (2011). Skillstreaming the Elementary School Child: A Guide for Teaching

Prosocial Skills, 3rd Edition. Champaign, IL: Research Press

McGinnis, E., & Goldstein, A. P. (1997). Skillstreaming the elementary school child: New

strategies and perspectives for teaching prosocial skills (Rev. ed.). Champaign, IL:

Research Press.

McKenzie, H. S., Clark, M., Wolf, M. M., Kothera, R., & Benson, C. (1968). Behavior

modification of children with learning disabilities using grades as tokens and allowances

as back up reinforcers. Exceptional Children, 34(10), 745-752. Retrieved from

http://psycnet.apa.org/psycinfo/1969-11835-001

Meany‐Daboul, M. G., Roscoe, E. M., Bourret, J. C., & Ahearn, W. H. (2007). A comparison of

momentary time sampling and partial‐interval recording for evaluating functional

relations. Journal of applied behavior analysis, 40(3), 501-514. doi:

10.1901/jaba.2007.40-501

Mrug, S., & Hodgens, J. B. (2008). Behavioral summer treatment program improves social and

behavioral functioning of four children with Asperger's disorder. Clinical Case Studies,

7(3), 171-190. doi: 10.1177/1534650107306293

DRC WITH HFASD 56

MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies

for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56(12), 1073.

doi: 10.1001/archpsyc.56.12.1073

National Center on Response to Intervention. (2010). Essential components of RTI – A closer

look at response to intervention. Washington, DC: U.S. Department of Education, Office

of Special Education Programs, National Center on Response to Intervention.

Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based

practices in interventions for children and youth with autism spectrum disorders.

Preventing school failure: Alternative education for children and youth, 54(4), 275-282.

doi: 10.1080/10459881003785506

O'Leary, K. D., Pelham, W. E., Rosenbaum, A., & Price, G. H. (1976). Behavioral treatment of

hyperkinetic children. An experimental evaluation of its usefulness. Clinical

Pediatrics, 15(6), 510-515. doi: 10.1177/000992287601500603

Owens, J. S., Holdaway, A. S., Zoromski, A. K., Evans, S. W., Himawan, L. K., Girio-Herrera,

E., & Murphy, C. E. (2012). Incremental benefits of a daily report card intervention over

time for youth with disruptive behavior. Behavior Therapy, 43(4), 848-861. doi:

10.1016/j.beth.2012.02.002

Ozonoff, S. (1997). Components of executive dysfunction in autism and other disorders. In J.

Russell (Ed.), Autism as an Executive Disorder (179-211). New York, NY: Oxford

University Press.

Parker, R. I., & Vannest, K. J. (2009). An improved effect size for single-case research: Nonoverlap of all

pairs. Behavior Therapy, 40, 357-367. doi: 10.1016/j.beth.2008.10.006

DRC WITH HFASD 57

Parker, R.I., Vannest, K.J., & Davis, J.L. (2011). Effect Size in Single-Case Research: A Review

of Nine Nonoverlap Techniques. Behavior Modification, 20(10), 1-20. doi:

10.1177/0145445511399147

Parker, R.I., Vannest, K.J., Davis, J.L., Sauber, S.B. (2010). Combining non-overlap and trend

for single case research: Tau-U. Behavior Therapy. 42, 284–299. doi:

10.1016/j.beth.2010.08.006.

Pelham, W. E., & Bender, M. E. (1982). Peer relationships in hyperactive children: Description

and treatment. Advances in Learning & Behavioral Disabilities, 1, 365-436. doi: 1983-

06085-001

Powell, J. (1984). On the misrepresentation of behavioral realities by a widely practiced direct

observation procedure: Partial interval (one-zero) sampling. Behavioral Assessment, 6

(3), 209-219. Retrieved from http://psycnet.apa.org/psycinfo/1985-11091-001

Presmanes Hill, A., Zuckerman, K.E., Fombonne, E. (2014). Epidemiology of Autism Spectrum

Disorders. In Volkmar, F.R., Rogers, S. J., Paul, R., & Pelphrey, K. A. (Eds.), Handbook

of Autism and Pervasive Developmental Disorders (pp. 57-96). Hoboken, NJ: John Wiley

and Sons, Inc.

Pyle, K., Fabiano, G. (in press). A Meta-Analysis of Single-Subject Design Studies Utilizing the

Daily Report Card Intervention for Students with ADHD. Exceptional Children.

Rao, P. A., Beidel, D. C., & Murray, M. J. (2008). Social skills interventions for children with

Asperger’s syndrome or high-functioning autism: A review and recommendations.

Journal of autism and developmental disorders, 38(2), 353-361. doi: 10.1007/s10803-

007-0402-4
DRC WITH HFASD 58

Rathvon, N. (2008). Effective school interventions: Evidence-based strategies for improving

student outcomes. New York, NY: Guilford Press.

Reichow, B., Steiner, A. M., & Volkmar, F. (2012). Social skills groups for people aged 6 to 21

with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, (7)

http://dx.doi.org/10.1002/14651858.CD008511.pub2

Riley-Tillman, T. C., & Burns, M. K. (2009). Single case design for measuring response to

educational intervention. New York: Guilford.

Riley-Tillman, T. C., Chafouleas, S. M., Sassu, K. A., Chanese, J. A., & Glazer, A. D. (2008).

Examining the agreement of direct behavior ratings and systematic direct observation

data for on-task and disruptive behavior.Journal of Positive Behavior

Interventions, 10(2), 136-143. doi: 10.1177/1098300707312542

Russell, J., Jarrold, C., & Hood, B. (1999). Two intact executive capacities in children with

autism: Implications for the core executive dysfunctions in the disorder. Journal of

Autism and Developmental Disorders, 29(2), 103-112. doi: 10.1023/A:1023084425406

Rutter, M., Bailey, A., & Lord, C. (2003). The social communication questionnaire: Manual.

Western Psychological Services.

Safran, J. S., & Safran, S. P. (2001). School-based consultation for Asperger syndrome. Journal

Of Educational & Psychological Consultation, 12(4), 385-395.

doi:10.1207/S1532768XJEPC1204_05

Scruggs, T. E., & Mastropieri, M. A. (2001). How to summarize single-participant research:

Ideas and applications. Exceptionality, 9(4), 227-244. doi: 10.1207/S15327035EX0904_5

DRC WITH HFASD 59

Simmons, E., Lanter, E., & Lyons, M. C. (2014). Supporting Mainstream Educational Success.

In Volkmar, F.R., Rogers, S. J., Paul, R., & Pelphrey, K. A. (Eds.), Handbook of Autism

and Pervasive Developmental Disorders (pp. 838-857). Hoboken, NJ: John Wiley and

Sons, Inc.

Smith, S. W. (1990). Comparison of individualized education programs (IEPs) of students with

behavioral disorders and learning disabilities. The Journal of Special Education, 24(1),

85-100. doi: 10.1177/002246699002400107

Spiel, C. F., Evans, S. W., & Langberg, J. M. (2014). Evaluating the content of Individualized

Education Programs and 504 Plans of young adolescents with attention

deficit/hyperactivity disorder. School Psychology Quarterly,29(4), 452-468. doi:

10.1037/spq0000101

Szatmari, P., Bartolucci, G., Bremner, R., Bond, S., & Rich, S. (1989). A follow-up study of

high-functioning autistic children. Journal of autism and developmental disorders, 19(2),

213-225. doi: 10.1007/BF02211842

Tarbox, R. S., Ghezzi, P. M., & Wilson, G. (2006). The effects of token reinforcement on

attending in a young child with autism. Behavioral Interventions, 21(3), 155-164. doi:

10.1002/bin.213

Tonge, B. J., Brereton, A. V., Gray, K. M., & Einfeld, S. L. (1999). Behavioural and emotional

disturbance in high-functioning autism and Asperger syndrome. Autism, 3, 117–130. doi:

10.1177/1362361399003002003

Trice, A. D., Parker, F. C., Furrow, F., & Iwata, M. M. (1983). An analysis of home

contingencies to improve school behavior with disruptive adolescents. Education and

DRC WITH HFASD 60

Treatment of Children, 6(4), 389-399. Retrieved from

http://www.jstor.org/stable/42898800

Tsatsanis, K.D., & Powell, K. (2014). Neuropsychological Characteristics of Autism Spectrum

Disorders. In Volkmar, F.R., Rogers, S. J., Paul, R., & Pelphrey, K. A. (Eds.), Handbook

of Autism and Pervasive Developmental Disorders (pp. 302-331). Hoboken, NJ: John

Wiley and Sons, Inc.

U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office

of Special Education Programs. (2008). Identifying and treating Attention-Deficit

Hyperactivity Disorder: A resource for school and home. Washington, D.C.: Author.

VanDerHeyden, A. M., Witt, J. C., & Gilbertson, D. (2007). A multi-year evaluation of the

effects of a response to intervention (RTI) model on identification of children for special

education. Journal of School Psychology, 45(2), 225-256. doi: 10.1016/j.jsp.2006.11.004

Vannest, K. J., Davis, J. L., Davis, C. R., Mason, B. A., & Burke, M. D. (2010). Effective

intervention for behavior with a daily behavior report card: A meta-analysis. School

Psychology Review, 39(4), 654-672. Retrieved from

http://www.nasponline.org/publications

Voeltz, L. M., Kishi, G., & Brennan, J. (1981). The social interaction observation system (SIOS).

Honolulu: University of Hawaii.

Volkmar, F.R., Reichow, B., Westphal, A., & Mandell, D. S. (2014). Autism and the Autism

Spectrum: Diagnostic Concepts. In Volkmar, F.R., Rogers, S. J., Paul, R., & Pelphrey, K.

A. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp. 3-28).

Hoboken, NJ: John Wiley and Sons, Inc.

DRC WITH HFASD 61

Volpe, R. J., & Fabiano, G. A. (2013). Daily behavior report cards: An evidence-based system of

assessment and intervention. New York: Guilford Press.

Vujnovic, R. K., Holdaway, A. S., Owens, J.S., Fabiano, G.A. (2014). Response to Intervention

for Youth with Attention-Deficit/ Hyperactivity Disorder: Incorporating an Evidence-

Based Intervention within a Multi-Tiered Framework. In M.D. Weist et al. (Eds),

Handbook of School Mental Health: Research, Training, Practice, and Policy (pp. 399-

411). New York: Springer.

What Works Clearinghouse. (2016). What Works Clearinghouse: Procedures and Standards

Handbook Version 3.0. Downloaded from

http://ies.ed.gov/ncee/wwc/pdf/reference_resources/wwc_procedures_v3_0_standards_ha

ndbook.pdf

Witwer, A. N., & Lecavalier, L. (2008). Examining the validity of autism spectrum disorder

subtypes. Journal of autism and developmental disorders,38(9), 1611-1624. doi:

10.1007/s10803-008-0541-2

Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., ... & Schultz, T. R.

(2015). Evidence-based practices for children, youth, and young adults with autism

spectrum disorder: A comprehensive review. Journal of Autism and Developmental

Disorders, 45(7), 1951-1966. doi: 10.1007/s10803-014-2351-z

Wymbs, B. T., Robb, J. A., Chronis, A. M., Massetti, G. M., Fabiano, G. A., Arnold, F. W., ... &

Hoffman, M. T. (2005). Long-term, multimodal treatment of a child with asperger's

syndrome and comorbid disruptive behavior problems: A case illustration. Cognitive and

Behavioral Practice, 12(3), 338-350. doi: 10.1016/S1077-7229(05)80056-2

 Running head: DRC WITH HFASD 62

Table 1
Participant Demographics and Relevant Assessment Scores
Age Gender Race Grade Class Type SCQ WISC-IV CASL CASL
Score FSIQ/SB-5 Receptive/PLS- Expressive/PLS-
FSIQ 5 Auditory 5 Expressive
Comprehension Communication
Adam 6 Male White 1 Integrated, co- 16 112 139 118
taught

Patrick 6 Male White 1 General 24 112 109 110

Education

Louie 11 Male White 5 8:1:1 27 97 85 79

Henry 10 Male White 5 General 28 112 117 101

Education

Note. SCQ = Social Communication Questionnaire. A score of 15 or greater on the SCQ suggests the presence of characteristics typical of children with autism.
WISC-IV = Weschler Intelligence Scale for Children, 4 th Edition. FSIQ = Full-scale Intelligence Quotient. SB-5 = Stanford Binet, 5th Edition. PLS-5 = Preschool
Language Scales, 5th Edition. An FSIQ above 80 indicates a higher-functioning student with autism. CASL = Comprehensive Assessment of Spoken Language.
The CASL scores were also used to determine if the student was high-functioning. A score of 85 or higher on either the receptive or expressive domain of the
CASL was indicative of a high-functioning student with autism.
 Running head: DRC WITH HFASD 63

Table 2
Effect Sizes for Each Case and Observation Target

Academic Engagement Social Engagement Disruptive Behavior

Effect Size (90% CI) p-value Effect Size (90% CI) p-value Effect Size (90% CI) p-value

Adam
SMD 2.03 -0.09 -0.78
Tau/Tau-U 1.00 (0.50, 1.00) 0.00 -0.14 (-0.63, 0.36) 0.65 -0.47 (-0.97, 0.03) 0.12
Patrick
SMD 0.64 0.52 -0.89
Tau/Tau-U 0.54 (0.00, 1.00) 0.10 0.00 (-0.54, 0.54) 1.00 -0.64 (-1.00, -0.10) 0.04
Louie
SMD 0.96 -0.62 -0.81
Tau/Tau-U 0.68 (0.14, 1.00) 0.04 -0.38 (-0.92, 0.16) 0.24 -0.42 (-0.96, 0.12) 0.20
Henry
SMD 0.99 -0.65 -0.35
Tau/Tau-U 0.52 (-0.02, 1.00) 0.11 -0.30 (-0.84, 0.24) 0.36 -0.12 (-0.66, 0.42) 0.71
Aggregate
SMD 1.19 -0.07 -0.57
Tau/Tau-U 0.69 (0.38, 1.00) 0.00 -0.20 (-0.52, 0.11) 0.21 -0.41 (-0.73, -0.10) 0.01
Note. SMD = Standard Mean Difference. Tau-U effect sizes were calculated when there was a need to correct for significant baseline trend. Tau-U effect
sizes are bolded in the table to distinguish them from Tau effect sizes. Aggregate effect sizes were calculated by pooling means and standard deviations for
each target across participants, and creating a weighted aggregate effect size using the online Tau calculator software (Vannest, Parker, & Gonen, 2011).
 DRC WITH HFASD 64

Table 3
Effect Sizes for Patrick’s Home DRC
Following Directions Actively Involved Safe Hands
Effect Size (90% CI) p-value Effect Size (90% CI) p-value Effect Size (90% CI) p-value

Patrick - Home
SMD 2.29 2.74 1.83
Tau/Tau-U -1.03 (-1.00, -0.52) 0.00 -0.93 (-1.00, -0.42) 0.00 -0.94 (-1.00, -0.44) 0.00
Note. SMD = Standard Mean Difference. Tau-U effect sizes were calculated when there was a need to correct for significant baseline trend. Tau-U effect
sizes are bolded in the table to distinguish them from Tau effect sizes.
Running head: DRC WITH HFASD 65

Figure 1. Multiple baseline figure demonstrating the changes from the baseline
(BL) to intervention (DRC) phase for the academic engagement target.
DRC WITH HFASD 66

Figure 2. Multiple baseline figure demonstrating the changes from the baseline
(BL) to intervention (DRC) phase for the disruptive behavior target.
DRC WITH HFASD 67

Figure 3. Multiple baseline figure demonstrating the changes from the baseline
(BL) to intervention (DRC) phase for the social engagement target.
DRC WITH HFASD 68

Figure 4. Graphed DBR scores for Patrick’s home DRC demonstrating the changes from the
baseline (BL) to intervention (DRC) phase for the “Follows Directions” target. Higher scores
= more reminders, which is less desirable.

Figure 5. Graphed DBR scores for Patrick’s home DRC demonstrating the changes from the
baseline (BL) to intervention (DRC) phase for the “Actively Involved” target. Higher scores
= more reminders, which is less desirable.
DRC WITH HFASD 69

Figure 6. Graphed DBR scores for Patrick’s home DRC demonstrating the changes from the
baseline (BL) to intervention (DRC) phase for the “Safe Hands” target. Higher scores = more
reminders, which is less desirable.
 DRC WITH HFASD 70

Appendix A

Adam Daily Report Card Date: _____________

My reward last night was: __________________________________________________________.

I finished my morning routine (putting away bookbag, getting YES N/A NO

out folder and homework, signing up for lunch & snack) by myself.

Actively Involved Uses Social Skills Comments

(No more than 2 reminders to be
actively involved in the class activity –
TIME this includes finishing seatwork,
listening to the teacher, following adult
directions, or completing a center
activity)
(At least 2 instances per period.
Social skills include Having a
Conversation, Asking for Help,
Listening, Using Self-Control,
and Contributing to a
Discussion)

7:30-7:50 YES N/A NO YES N/A NO

7:50-8:15 YES N/A NO YES N/A NO
8:15-8:45 YES N/A NO YES N/A NO
8:45-9:15 YES N/A NO YES N/A NO
9:15-9:40 YES N/A NO YES N/A NO
9:40-10:00 YES N/A NO YES N/A NO
10:00-10:20 YES N/A NO YES N/A NO
10:20-10:45 YES N/A NO YES N/A NO
10:45-11:05 YES N/A NO YES N/A NO
Lunch YES N/A NO
11:45-12:15 YES N/A NO YES N/A NO
12:15-12:55 YES N/A NO YES N/A NO
1:00-1:20 YES N/A NO YES N/A NO
1:20-1:30 YES N/A NO YES N/A NO

I finished my afternoon routine (chair up, homework & waterbottle in bookbag) by myself.
YES N/A NO

I went to the bathroom at least once by myself today. YES N/A NO

TOTAL # OF YESES: ________out of ________ chances % = ______

REWARD EARNED? : ________YES ________ NO
Comments: ______________________________________________________________________________
 DRC WITH HFASD 71

Patrick Daily Report Card Date: _____________

My reward last night was: __________________________________________________________.

I completed the morning routine (coat off and hung up the right way,
unpack folder, clip in for lunch, go to the bathroom) by myself.

Morning Afternoon
GOAL
Eye Contact
(No more than 2 reminders to make appropriate
eye contact)

Follows Classroom Rules

(No more than 2 reminders to: follow
directions, use materials (including hands)
correctly, and stay quiet in the hallway)
Asks for Help or Asks a Question
(At least 1 instance of asking for help or
asking a question, as needed, especially
when he is done completing his work)

If needed, I tied my own shoes today.

Patrick needs at least 6 Smiley Faces to earn his reward.

REWARD EARNED? : ________YES ________ NO

Comments: _______________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
DRC WITH HFASD 72

Patrick - HOME Daily Report Card Date: _____________

Following Directions
(Cross off a circle each time you remind Patrick to
follow directions. If all 4 circles get crossed off, this is a “No”) YES N/A NO

Paying Attention
(Cross off a circle each time you remind Patrick to
pay attention or be actively involved. If all four circles are YES N/A NO
crossed off, this is a “No”)

Using Hands Safely

(Cross off a circle each time you remind Patrick to
use his hands safely. If all four circles are YES N/A NO
crossed off, this is a “No”)

0-1 Yes = No Reward

2-3 Yes = Reward Earned
DRC WITH HFASD 73

Louie Daily Report Card Date: _____________

My reward last night was: __________________________________________________________.

Raise Hand Before Uses Materials Uses Social Skills

Speaking Appropriately
(At least 2 instances per
(No more than 2 (No more than 2 period. Social skills include
SUBJECT reminders to raise his reminders to use his Having a Conversation,
hand before speaking materials – books, Asking for Help, Listening,
out in class) pencils, clothing, hands, Using Self-Control, and
and feet – appropriately ) Contributing to a Discussion)

Special YES N/A NO YES N/A NO YES N/A NO

Class Meeting/Morning
YES N/A NO YES N/A NO YES N/A NO
Work

Math/Speech/OT YES N/A NO YES N/A NO YES N/A NO

Spelling/Writing YES N/A NO YES N/A NO YES N/A NO

Read Aloud YES N/A NO YES N/A NO YES N/A NO

Lunch YES N/A NO YES N/A NO YES N/A NO

SSR YES N/A NO YES N/A NO YES N/A NO

SS/TA YES N/A NO YES N/A NO YES N/A NO

ELA YES N/A NO YES N/A NO YES N/A NO

FLEX TIME/Special YES N/A NO YES N/A NO YES N/A NO

TOTAL # OF YESES: ________out of ________ chances % = ______

REWARD EARNED? : ________YES ________ NO

Comments: _______________________________________________________________________
_________________________________________________________________________________
DRC WITH HFASD 74

Henry Daily Report Card Date: _____________

My reward last night was: __________________________________________________________.

Raise Hand Before Speaking Uses Social Skills

(No more than 2 reminders to raise his (At least 2 instances per period. Social
SUBJECT hand before speaking out in class) skills include Having a Conversation,
Asking for Help, Listening, Using Self-
Control, and Contributing to a Discussion)

ELA YES N/A NO YES N/A NO

Math YES N/A NO YES N/A NO

BLOCK YES N/A NO YES N/A NO

Lunch YES N/A NO YES N/A NO

ELA Skills YES N/A NO YES N/A NO

In the hallways,
TOTAL I walked
# OF YESES: quietly and
________out ofused an appropriate
________ chances % voice.
= ______ YES N/A NO

Henry can earn 3 minutes of screen time for every “Yes.”

REWARD EARNED? : ________YES ________ NO

DRC WITH HFASD 75

Appendix B

Conjoint Behavioral Consultation Guide Form

1. What are the key concerns you have for ___________ at school?

2. Where do these behaviors typically occur (or fail to occur)?

3. About how often do you have to remind ___________ about those behaviors?

4. What have you already tried to address these behaviors?

 Running head: DRC WITH HFASD 76

Systematic Direct Observation Form

Observer (Initials) Child Observed (first name)

Co-Observer (Initials)

Time :00 :10 :20 :30 :40 :50 1:00 1:10 1:20 1:30 1:40 1:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 2:00 2:10 2:20 2:30 2:40 2:50 3:00 3:10 3:20 3:30 3:40 3:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 4:00 4:10 4:20 4:30 4:40 4:50 5:00 5:10 5:20 5:30 5:40 5:50
Academically
Engaged
Socially
Engaged
Disruptive
 DRC WITH HFASD 77

Time 6:00 6:10 6:20 6:30 6:40 6:50 7:00 7:10 7:20 7:30 7:40 7:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 8:00 8:10 8:20 8:30 8:40 8:50 9:00 9:10 9:20 9:30 9:40 9:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 10:00 10:10 10:20 10:30 10:40 10:50 11:00 11:10 11:20 11:30 11:40 11:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 12:00 12:10 12:20 12:30 12:40 12:50 13:00 13:10 13:20 13:30 13:40 13:50
Academically
Engaged
Socially
 DRC WITH HFASD 78

Engaged
Disruptive
Time 14:00 14:10 14:20 14:30 14:40 14:50 15:00 15:10 15:20 15:30 15:40 15:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 16:00 16:10 16:20 16:30 16:40 16:50 17:00 17:10 17:20 17:30 17:40 17:50
Academically
Engaged
Socially
Engaged
Disruptive

Time 18:00 18:10 18:20 18:30 18:40 18:50 19:00 19:10 19:20 19:30 19:40 19:50
Academically
Engaged
Socially
Engaged
Disruptive
Running head: DRC WITH HFASD 79

Sample Daily Behavior Rating Form

Running head: DRC WITH HFASD 80

Daily Report Card Fidelity Tracking Form

Date: Subject:
Student: Time:
Facilitator:

Was DRC reviewed at the beginning of the interval (N/A if not the beginning of the day) YES N/A NO

Target 1: Target 2: Target 3: Target 4:

Observer Facilitator Observer Facilitator Observer Facilitator Observer Facilitator

Agree on outcome? Agree on outcome? Agree on outcome? Agree on outcome?

YES N/A NO YES N/A NO YES N/A NO YES N/A NO

Was DRC reviewed at the end of the interval? YES N/A NO

Total Yes: _____________________

Total No: ______________________

Percentage: ____________________
DRC WITH HFASD 81

Appendix C

Sample Social Skills List