NCT07276750

Brief Summary

Schools serve a large number of autistic children, yet face two critical gaps that stifle the delivery of evidence-based practices: 1) an intervention gap characterized by limited availability of evidence-based practices educators can use to address externalizing behaviors when they occur in the classroom; and 2) an implementation gap consisting of insufficient evidence-based practice fidelity and sustainment over time. To address these gaps, this project proposes a hybrid type 2 effectiveness-implementation trial that simultaneously tests: 1) the clinical effectiveness of an efficient, educator-delivered clinical intervention to reduce autistic children's externalizing behaviors (Research Units in Behavioral Interventions in Educational Settings; RUBIES), and 2) the implementation effectiveness of an organizational implementation strategy designed specifically to enhance sustainment of evidence-based practices in public schools (Helping Educational Leaders Mobilize evidence; HELM). Consistent with the National Institute of Mental Health (NIMH)'s experimental therapeutics approach, the project also examines the mechanisms through which RUBIES impacts clinical outcomes and through which HELM influences implementation outcomes. The proposed study directly responds to high priority research areas of the US Department of Health and Human Services Interagency Autism Coordinating Committee's Strategic Plan for Autism Research, which calls for expanded research on the translation of proven-efficacious interventions into the community, NIMH Strategic Priority 3.3 to test interventions for effectiveness in community practice settings, and NIMH Strategic Priority 4.2 to expedite adoption, sustained implementation, and continuous improvement of evidence-based mental health services. If successful, this study will have substantial public health impact because it will produce an effective intervention for a prevalent problem among a high impact population in schools across the United States of America and will determine how to sustain this (and other) intervention(s) with high fidelity, to the betterment of health.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
373

participants targeted

Target at P75+ for not_applicable

Timeline
53mo left

Started Feb 2026

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress6%
Feb 2026Aug 2030

First Submitted

Initial submission to the registry

November 18, 2025

Completed
23 days until next milestone

First Posted

Study publicly available on registry

December 11, 2025

Completed
2 months until next milestone

Study Start

First participant enrolled

February 1, 2026

Completed
4.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2030

Expected
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2030

Last Updated

December 11, 2025

Status Verified

September 1, 2025

Enrollment Period

4.4 years

First QC Date

November 18, 2025

Last Update Submit

December 10, 2025

Conditions

Keywords

implementationschoolsautismbehavior management

Outcome Measures

Primary Outcomes (3)

  • Reported Externalizing Behavior - SESBI-R

    The Sutter Eyberg Student Behavior Inventory-Revised (SESBI-R) is a teacher-report measure used to assess conduct problems in youth ages 2-16. It contains 38 items where teachers are able to indicate the current frequency of behavior problems (Never to Always) and determine whether or not they find the behaviors to be problematic.

    Baseline to 24 weeks after baseline

  • Reported Externalizing Behavior- EDI

    The Emotion Dysregulation Inventory (EDI) is a questionnaire that assesses emotion regulation and is validated for youth with autism spectrum disorder (ASD). Response options are on a 5-point Likert scale from "not at all" to "very severe" for observed functioning over the past 7 days.

    Baseline to 24 weeks after baseline

  • RUBIES Fidelity

    Educator Homework Completion is rated by the coach after the completion of each module, with evaluation focused on three domains, each evaluated on a 4-point scale: 1) homework data collection , 2) correct implementation, and 3) frequency. Homework Completion is then calculated as the sum of coach ratings across the 3 domains/12 (total possible score). Educator Behavior Support Plan (BSP) Implementation is rated by the Coach after the completion of each module on a scale of 1-8 (1=none of the components of the BSP are implemented; 4=BSP is partially implemented and with some implementation errors; 8=The BSP is implemented consistently and effectively in its entirety). BSP Implementation is calculated as a proportion: sum of coach ratings/12 (total possible score). These measures allow for a calculation of educator weekly as well as total average Homework Completion and BSP implementation across the course of RUBIES

    Baseline to 16 weeks after baseline

Secondary Outcomes (1)

  • Sustainment

    52 and 76 weeks after baseline

Study Arms (3)

RUBIES + HELM

EXPERIMENTAL
Other: RUBIESOther: HELM

RUBIES

EXPERIMENTAL
Other: RUBIES

Psychoeducation

ACTIVE COMPARATOR
Other: Educator Psychoeducation

Interventions

HELMOTHER

School principals and district-level leaders (e.g., Special Education Director, Special Education Administrator/Liaison, Inclusion Specialist, etc.) will participate in HELM. HELM is a 9-month, data-driven organizational and leadership implementation strategy that entails eight components: 1) Assessment and Feedback, 2) Initial Training, 3) Leadership Development Plan, 4) Individual Coaching; 5) Organizational Strategy Development; 6) Optional Group Coaching; 7) Professional Learning Collaborative; and 8) Graduation.

RUBIES + HELM
RUBIESOTHER

RUBIES is a promising, but unvalidated, educator-delivered intervention that directly engages mechanistic antecedents of externalizing behavior of autistic children and is ready for large-scale testing. RUBIES is an 8-module intervention designed to help educators functionally evaluate and understand behavior as communication and to account for autistic characteristics including rigidities and sensory sensitivities.

RUBIESRUBIES + HELM

Autistic children in schools assigned to the educator psychoeducation condition will receive standard of care school-based interventions at the professional discretion and direction of educators (no research intervention). To support enrollment and provide an active clinical comparator to RUBIES, participating educators in schools randomized to this condition will receive an online, self-paced, 8-module independent studies webinar program broadly focused on supporting autistic children in schools. The program includes: 1) Introduction to Autism, 2) Autism in Schools, 3) Interventions for Supporting Communication, 4) Executive Functioning, 5) Inclusion in Schools, 6) Autism EBPs, 7) Social Functioning in Autism, and 8) Recess Engagement Strategies. Each module is 20-35-minutes and does not discuss behavioral management strategies.

Psychoeducation

Eligibility Criteria

Age5 Years+
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Special or general education teachers, paraeducators, and other staff who provide direct instruction and/or behavioral support to autistic children during the school day (e.g., speech therapist, school psychologist).
  • Autistic children with:
  • a documented autism spectrum disorder diagnosis via school records (i.e., Individualized Education Program; IEP)
  • are enrolled with a participating educator
  • are in grades K-5
  • ages 5-12
  • Sutter Eyberg Student Behavior Inventory-Revised (SESBI-R) total score \>=101
  • EDI sum score of \>=8 at baseline

You may not qualify if:

  • SESBI-R total score \<101 (i.e. T score 51+)
  • EDI sum score \<8

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

UCLA

Los Angeles, California, 90025, United States

RECRUITING

Related Publications (1)

  • Locke J, Williams NJ, Sridhar A, Shih W, Espeland C, Tagavi D, Bearss K. Study protocol for coaching and leadership in autism support settings: a cluster randomized controlled hybrid type 2 effectiveness-implementation trial. Implement Sci. 2026 Mar 28. doi: 10.1186/s13012-026-01497-0. Online ahead of print.

MeSH Terms

Conditions

Autism Spectrum DisorderAutistic Disorder

Condition Hierarchy (Ancestors)

Child Development Disorders, PervasiveNeurodevelopmental DisordersMental Disorders

Central Study Contacts

Jill J Locke, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor in Residence

Study Record Dates

First Submitted

November 18, 2025

First Posted

December 11, 2025

Study Start

February 1, 2026

Primary Completion (Estimated)

June 30, 2030

Study Completion (Estimated)

August 31, 2030

Last Updated

December 11, 2025

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will share

The investigators will make data from our study available for access by the research community via NDAR on a semi-annual basis as set forth in the NDAR policy. Data from descriptive measures will be submitted by July 15 and January 15 or the next business day, annually.

Time Frame
The research community will have access to data when the award ends in 2030.
Access Criteria
Data will be available in NDAR.
More information

Locations