Transition to school for children with autism spectrum disorder: A systematic review

Table 1 Summary of studies examining school transition for children with autism spectrum disorder

Author (yr)	Country	Sample	Intervention	Measures	Findings
School readiness
Crane[14] (2010)	United States	91 children with ASD; 1338 children with ASD and other disabilities	Children received special education services	(DECA; LeBuffe and Naglieri, 1999); (LAP-D; Nehring, Nehring, Bruni and Randolph, 1992), Early Learning Accomplishment Profile (ELAP; Glover, Preminger and Sanford, 2002), (SRUSS), ESI-K, DIBELS, SAT-10	Children with ASD (and developmental delay group) showed the slowest gains over time in the language, cognitive and fine motor domains. Children with ASD had significantly lower scores on the initiative, self-control and attachment scales than all groups except the developmental delay group
Klubnik, Murphy, Campbell, Reed and Warner- Metzger[15] (2014)	United States	Exp group: 76 children with ID and ASD, M = 53.60 mo. Comp Group: 47 children with ID, M = 59.25 mo		Standford-Binet Intelligence Scales, Fifth Edition (SB5; Roid, 2003), Childhood Autism Rating Scale, Second Edition (CARS-2; Schopler, Van Bourgondien, Wellman, and Love, 2010), Vineland Adaptive Behaviour Scale, Bracken Basic Concept Scale- Third Edition: Receptive (Bracken, 2006)	Receptive understanding of self-/social awareness concepts was significantly lower for the ASD/ID group. ASD/ID group had significantly higher school readiness scores than the ID group. The ASD/ID group’s the School Readiness Composite was greater than their Self/Social-Awareness subtest
Matthews[16] (2014)	United States	Exp: 63 children with a parent-reported diagnosis of ASD, M = 5.16 yr (4-6 yr). Comp Group: 33 TD children, M = 5.35 yr (4-6 yr)		Background information; History of child care; Friendship quality; School readiness - parent report of social-emotional and self-help school readiness; Theory of Mind (ToM Developmental Scale (Wellman et al, 20016; Wellman and Liu, 2004); Appearance-reality (Wellman and Liu, 2004); Second-order false belief (Targer-Flusberg and Sullivan, 1994); School readiness - Cognitive/motor (Cognitive: Concept tasks; Cognitive: Language tasks; Motor tasks); Verbal ability [Peabody Picture Vocabulary Test-III (Dunn and Dunn, 1997)]	Children with ASD, experiencing centre-based care was not associated with cognitive/motor school readiness, social-emotional school readiness, or level of self-help school readiness. Children with ASD who demonstrated more advanced ToM performance had higher cognitive/motor school readiness and levels of self-help school readiness. Both groups, children with more positive friendship quality had higher levels of social-emotional school readiness and self-help school readiness
Waddington and Reed[17] (2009) (Study 2)	United Kingdom	Exp group (PIRKS): 12 children with ASD, Baseline, M = 6.7 yr (4.3-10.5 yr), Comp Group (Treatment as usual (TAU)): 15 children with ASD, Baseline, M = 9.1 yr (5.2-15.0 yr)	PIRKS prepare children for inclusion in a mainstream kindergarten; based on ABA; 5 skill areas: Academic literacy, communication, listening, speaking, social self-management, school self-sufficiency, community, physical/motor. Individualised. Teaching takes place 1:1 or small groups	Gilliam Autism Rating Scale (GARS; Gilliam, 1995), Vineland Adaptive Behavior Scale, Mainstreaming Social Skills Questionnaire (MSSQ: Salend and Lutz, 1984), Strengths and Difficulties Questionnaire (SDQ: Goodman, 1987)	Children who had experienced PIRKS prior to attending mainstream schools demonstrated improvements in communication, socialisation, and daily living skills (not compared with comparison group just significant improvements within group) with these skills continuing at mainstream school
Parents’/teachers’ views/experiences of school transition process
Beamish, Bryer and Klieve[18] (2014)	Australia	91 intervention and advisory (specialised preschool) teachers		Transition practices online survey: 36 practices items identified from review of literature (including Forest et al, 2004). Themes: Child visit, Parent information, Teacher sharing, Placement identification, Decision support, Sending teacher, Support identification, Evaluation administrator, Visit support, Peer preparation	All 36 practices highly endorsed
Denkyirah and MAgbeke[2] (2010)	United States	Exp group: 306 preschool teachers. Comp group: 82 preschool teachers from Ghana		Survey developed from Forest et al, 2004. Themes: Timing for planning and preparation; Sharing information with family; Discussing placement with family; Helping families fin school and community resources; Preparing and receiving school and teachers; Relationships between sending and receiving schools; Assistive technology; Home visit; Parent taring	All themes endorsed by teachers in both countries
Fontil and Petrakos[4] (2015)	United States	Parents of 10 children (aged 53.8-87.4 mo) with or suspected of having ASD		Interview questions adapted from Kindergarten Transition Parent Interview - Preschool (Pianta and Kraft-Sayre, 2003). Themes: child’s experiences at school, their peer contact, their activities at home, and parents’ personal activities with the school. Measure of Processes of Care (MPOC-20; King, King and Rosenbaum, 2004)	Empathy, Caring, and Understanding: Relationships with preschool teachers more positive than with kindergarten teachers. Knowledge and Expertise: More sharing of information with parents at preschool than school. Less educational opportunities and resources at school than preschool
Quintero and McIntyre[1] (2011)	United States	Exp group: Parents and teachers of 19 children with ASD (M = 58.84 mo). Comp group: Parents and teachers of 76 children with Developmental Difficulties, M = 58.66 mo		Time 1 - end of preschool; Parents: Family Experiences and Involvement in Transition (FEIT; McIntyre et al, 2007); Preschool teachers: Teachers’ Perceptions on Transition (TPOT), Open Ended Questions in TPOT. Time 2 - kindergarten entry; Parents: Family Experiences and Involvement in Transition (FEIT; McIntyre et al, 2007)	Teachers’ Perceptions on Transition: Teachers significantly more likely to report higher concerns (some, many, or very many concerns) for children with ASD than children with DD. Teachers endorsed visiting students’ assigned kindergarten classroom more for children in the ASD group than the DD group. Parent Involvement: Parents of DD group reported participating in a transition planning meeting significantly more than parents in the ASD group. Parents of DD group reported to have received written communication regarding the transition from the kindergarten program significantly more than parents in the ASD group
Protective and risk factors in first year of school
Charman et al[19] (2004)	United Kingdom	Cohort 1: 73 children with ASD, Cohort 2: 52 children with ASD; Baseline both cohorts M = 56.6 mo		Vineland Adaptive Behavior Scales-Screen Version (VABS-S; Sparrows, 2000), Social Communication Questionnaire (SQC; Berument et al, 1999), Autism Treatment Evaluation Checklist (ATEC; Rimland and Edelson, 1999)	Group made more rapid development progress in the 11 mo in school than they had preschool. Pattern of change on the ATEC was mixed. On the social, language and communication subscale the scores did significantly reduce over time. The best developmental progress was made by children with better communication skills at the outset
Esienhower, Blacher and Bush[12] (2015)	United States	166 children with ASD (M = 5 yr 8 mo, 4-7 yr) and one parent per child		Demographics, ADOS, abbreviated WPPSI-II, Student-Teacher Relationship Scale (STRS; Pianta, 2001), Caregiver-Teacher Report Form and Teacher Report Form (CTRF and TRF; Achebach and Rescoria, 2000, 2001)	High externalising behaviour predicted poor STR and was not moderate by cognitive abilities.
Jahromi, Bryce and Swanson[20] (2013)	United States	Exp group: 20 children with HFASD, M = 58.95 mo. Comp group: 20 typically developing children, M = 50.20 mo		Measures: Preschool Language Scale 4 (PLS-4; Zimmerman, Steiner, and Pond, 2002), Differential Abilities Scale II (DAS-II; Elliot, 2007), Autism Diagnostic Interview-Revised (ADI-R; Lord et al, 1994), Social Communication Questionnaire (SCQ; Rutter et al, 2003), Emotion Regulation Checklist (ER Checklist; Shields and Cicchetti, 1997), Day/Night Task (Gerstadt, Hong, and Diamond, 1994), Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P; Gioia, Isquith, Guy, and Kenworthy, 2000), Parent–child joint engagement states and child-initiated joint engagement (Bakeman and Adamson, 1984), Child Behavior Questionnaire–Short Form (CBQ-SF; Putnam and Rothbart, 2006; Rothbart, Ahadi, Hershey, and Fisher, 2001), School Liking and Avoidance Questionnaire (Ladd et al, 2000), parent-report version of the Teacher Rating Scale of School Adjustment (Buhs and Ladd, 2001), Child Behavior Scale (CBS; Ladd and Profilet, 1996)	Children with HFA were rated significantly lower in emotion regulation and effortful control than their typically developing peers. Behavioural engagement: children with HFA had significantly less cooperative and independent participation. Emotional engagement: Executive function emerged as the significant predictor of emotional school engagement. For children with HFA, effortful control promoted greater prosocial behaviour with peers
Prino, Pasta, Giovanna, Gastaldi and Longobardi[23] (2016)	Italy	Exp group: 14 children with ASD, M = 85.75 mo; 18 children with Down Syndrome, M = 85.75 mo, teacher or teaching assistant per child (n = 32). Comp group: 128 TD children (classmates), M = 78.54 mo1		Student-Teacher Relationship Scale (STRS; Pianta, 2001)	No difference between teachers' perceptions of children with Down Syndrome and their TD classmates. Teachers' reported significantly higher conflict scores and significantly lower closeness scores for children with ASD than their TD peers
Sparapani etal[21] (2016)	United States	196 children with ASD, M = 6.36 yr		ADOS, Standford-Binet Intelligence Scale - 5th Ed (SB-5; Roid, 2003), Peabody Picture Vocabulary Test - 4th Ed (PPVT-4; Dunn and Dunn, 2007), Expressive One Word Vocabulary Picture Test - 4th Ed (EOWVPT-4; Brownwell, 2000), Social Skills Rating system (SSRS; Gresham and Elliott, 1990), Teacher Report Form (TRF; Achenbach and Rescorla, 2001), 60-min classroom observations. Five themes: Emotional Regulation, Classroom Participation, Social Connectedness, Initiating Communication, and Flexibility	No difference between children in general education and special education classes. Students spent less than 50% of time in a well-regulated state, productively and independently participating in classroom activities. Students only responded to half of verbal bids for interaction, infrequently directed communication, and rarely used generative language
Grindle et al[10] (2012)	United Kingdom, 4-5 yr	Exp group (ABA): 11 children with ASD, baseline: Age range 43 to 68 mo (M = 58.2 mo). Comp group [Education as usual (EAU)]: 18 children with ASD baseline: Age range 54 to 72 mo (M = 63.89 mo)	School-based comprehensive behavioural intervention features: (1) Parents generalize skills at home; (2) One-to-one intervention at desks in a shared classroom; (3) Education for a maximum of 6 h per day for 38 wk of year; (4) Matched school timetable; (5) Generalise skills to mainstream classes; and (6) based on the United Kingdom National Curriculum	IQ: Standford-Binet Intelligence Scale -Fourth Edition or Leiter International Performance Scale-Revised; Vineland Adaptive Behavior Scale-Survey Form (VABS); ABLLS/ABLLS-R assesses skills such as effective social and communicative functioning, imitation, and cooperation	Positive changes were observed for the majority of children enrolled in the ABA class - moderate to large-sized effects found for standardized test outcomes after 1 yr of intervention. Outcomes for ABA class were positive compared with the treatment as usual
Kamps et al[11] (2015)	United States	Exp group (Peer Networks Intervention): 56 children with ASD, baseline: Age M = 5.8 yr. Comp group (EAU): 39 children with ASD baseline: Age M = 5.8 yr	Peer network intervention: peer training and direct instruction. Five skills: (1) Requests and shares; (2) Comments about one’s own play; (3) Comments about others’ play; (4) Niceties, e.g., please, thank-you; and (5) play organizers, e.g., to give ideas about setting up games and rules	Dependent measures from direct observations consisted Clinical Evaluation of Language Fundamentals-4, Core Language Scores (CELF-4; Semel et al 2003); the Vineland Adaptive Behaviour Scale Teacher Report-Communication subtest (VABS; Sparrow et al 2006); and teacher ratings of classroom social behaviours [The Teacher Impression Scale (TIS); Odom and McConnell, 1997]	Peer intervention group improved more in initiations to peers during non-treatment social probes and during generalization probes in natural settings than the comparison group participants. Standard scores for language performance and communication (teacher report), and teachers ratings of peer network participants social communication behaviours greater for peer intervention group than for comparison group children
Locke et al[26] (2014)	United States	192 children with ASD, M = 6.1 yr (5-8 yr), grades Kindergarten to second	Strategies for Teaching based on Autism Research (STAR), which incorporates discrete trial training (DDT, Smith 2001, from ABA), pivotal response training (PRT; Koegel et al, 1989) and functional routines	ADOS, Differential Ability Scales-Second Edition (DAS-II; Elliott, 2009), Adaptive Behavior Assessment System-Second Ed (ABAS-ii; Harrison and Oakland, 2003), Pervasive Developmental Disorder Behavior Inventory (PDDBI; Cohen and Sudhalter, 2005)-Teacher Form	Modest increases in global cognitive ability scores. Negligible changes in social functioning
McKeating[28] (2014)	United States	Exp group: 39 children with ASD, M = 6.21 yr (5-7 yr). Comp Group: 39 children with other disabilities, M = 6.26 yr (5-8 yr) (Footnote: 73 teachers of children in sample)	Children received Itinerant, supplemental or full-time special education services	Inclusive Classroom Profile (ICP; Soukakou, 2010), Autism Evaluation Treatment Checklist (AETC; Rimland and Edelson, 1999), Teacher Perception Survey (TPS)	Children receiving full time special education services made substantially greater progress in sociability and behaviour, but not in communication, sensory or cognitive abilities, than children receiving supplemental and itinerant services. All children, regardless of placement achieved higher sociability scores at post-test. Teacher perceptions of inclusion predicted higher ATEC scores
Pellecchia etal[25] (2016)	United States	152 children with ASD, M = 6.0 yr (5-8 yr), grades Kindergarten to second	Strategies for Teaching based on Autism Research (STAR), which incorporates discrete trial training (DDT, Smith 2001, from ABA), pivotal response training (PRT; Koegel et al, 1989) and functional routines.	ADOS, Differential Ability Scales–Second Edition (DAS-II; Elliott, 2009), Adaptive Behavior Assessment System-Second Ed (ABAS-ii; Harrison and Oakland, 2003), Pervasive Developmental Disorder Behavior Inventory (PDDBI; Cohen and Sudhalter, 2005)-Teacher Form, Child Symptom Inventory-4 (CSI-4; Gdaow and Sprafkin, 2002)	Modest mean change in DAS GCA scores. Several measures of adaptive behaviour; functional academics, health and safety, self-direction, social skills, and the overall adaptive composite predicted changes in DAS scores. Social anxiety symptoms predicted changes in DAS scores. Higher social anxiety symptoms and increase in student age significantly predicted a decrease in DAS scores
Sainato et al[27] (2015)	United States	Exp group (Inclusive kindergarten program): 41 children with ASD, baseline: Age M = 75.7 mo. Comp group (Eclectic intervention): 21 children with ASD, baseline: Age M = 74.1 mo	Experimental group participated in general education classroom taught by trained teachers. Curriculum addressed core deficits of children with ASD using evidence-based strategies and behaviour management	Leiter International Performance Scale-Revised (Leiter-R; Roid, and Miller, 2002); Kaufman Test of Educational Achievement, Second Edition (KTEA-II; Kaufman and Kaufman, 2004); The Test of Language Development (TOLD-P: 3; Newcomer and Hammill, 1997); Vineland Adaptive Behavior Scales-Classroom Edition (Sparrow, Balla, and Cicchetti, 1985)	Experimental group made significant gains in nonverbal intelligence, academic achievement, and language scores compared with comparison group. Comparison group exhibited either no improvement or decreases. Both model and comparison groups demonstrated similar improvement in pre- and post-test outcomes on the Vineland Adaptive Behavior Scales-Classroom Edition (Sparrow et al, 1985)
Whalen etal[24] (2010)	United States	Exp group (preschool and K-1 students): 22 children with ASD, range 3 to 6 yr. Comp group (preschool and K-1 students): 25 children with ASD, range 3 to 6 yr	TeachTown: Basics', a CAI program that includes computer lessons and natural environment activities (Connection Activities) for developmental ages 2-7 yr. The student is taught in a discrete trial format where they receive reinforcement for correct responses. Treatment group used TeachTown: Basics for approximately 20 min a day on school days over three months	Peabody Picture Vocabulary Test, 3rd Edition (PPVT; Dunn and Dunn), Expressive Vocabulary Test (EVT, Williams, 1997), The Brigance Inventory of Early Development (Brigance, 2004), Childhood Autism Rating Scale (CARS), Ongoing Automatic Data Collection (TeachTown: Basics)	Children in the TeachTown: Basics group performed better across all language and cognitive outcome measures than the children in the control group. Additionally, students who used TeachTown: Basics demonstrated significant progress overall in the software and those students who used the program for more time demonstrated larger gains within the software and in outcome measures

¹Footnote: Other research populations examined separately not reported in this systematic review. DECA: Devereux Early Childhood Assessment; LAP-D: Learning Accomplishment Profile-Diagnostic; SRUSS: School Readiness Uniform Screening System; ASD: Autism spectrum disorder.