A Pilot Feasibility Randomized Trial of the RUBI in Educational Settings Intervention With Paraeducators Supporting Autistic Students in Public Elementary Schools.

The sample was small and underpowered, limiting the ability to detect differences between groups. The primary outcome relied on paraeducator ratings, who were not blinded to their assigned intervention, creating a high risk of reporting bias. Recruitment occurred largely during the COVID-19 pandemic, which impacted school staffing and student attendance, potentially affecting baseline behavior and intervention delivery. Students included had mild-to-moderate externalizing behaviors, some with low baseline scores, which may have created a floor effect that masked potential improvements. The intervention targeted only the paraeducator, not the broader school team or classroom environment, which may have limited the generalization of behavioral changes.

Dr. Bearss, an author, receives royalties from Oxford University Press and served as a consultant for Attend|Behavior. No other specific funding sources for the trial design or execution were detailed in the provided text.

Do not conclude that RUBIES is ineffective because the primary behavioral outcomes were null. The trial was underpowered, unblinded, and relied on self-reported outcomes from participants who received the training, which makes it difficult to detect true differences in student behavior. The significant increase in paraeducator confidence suggests potential value that the behavioral measures did not capture.