JASPER Intervention for Autism

(EBJ Trial)

Recruiting at 3 trial locations

Overseen By Consuelo Garcia, BS

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Age under 18 months, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 25

Duration: 10 weeks

90 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate JASPER, a play-based intervention designed to help children with autism improve their communication and social skills. The research will compare two groups: one where parents deliver JASPER with guidance, and another where clinicians work directly with the child. After 10 weeks, researchers will assess which approach is more effective. Children who are minimally verbal, have a confirmed autism diagnosis, and show some emerging phrases are good candidates for this study. Researchers will observe participants to see if their communication improves during the trial. As an unphased trial, this study offers families a unique opportunity to contribute to understanding effective autism interventions.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the JASPER intervention is safe for children with autism?

Research has shown that JASPER, a play-based program, is generally well-received by young children with autism. Studies have found that JASPER is safe when guided by either parents or clinicians.

In one study, children who participated in the JASPER program, whether led by a parent or a clinician, improved their social communication skills. No major negative effects were reported, indicating the program's safety.

JASPER has also been successfully used in various settings to help children with joint engagement and managing emotions. This background demonstrates that JASPER is a dependable choice for children with autism, focusing on enhancing their interaction and communication through guided play.

Overall, existing research supports JASPER as a safe and effective option for children who need these types of interventions. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the JASPER intervention for autism because it emphasizes social communication skills and play development through naturalistic interactions. Unlike traditional autism therapies that often involve structured, therapist-led sessions focusing on behavior modification, JASPER integrates parents as active participants in the therapy process, empowering them to use therapeutic techniques in everyday interactions with their child. This parent-mediated approach is unique because it aims to make therapy more consistent and accessible, potentially leading to more meaningful improvements in a child's social engagement and overall development. Furthermore, the clinician-mediated JASPER sessions offer personalized, one-on-one interactions with therapists, ensuring that each child's specific needs are addressed.

What evidence suggests that JASPER is effective for autism?

Research shows that JASPER, a play-based program, can help improve social skills in children with autism. In this trial, participants will join one of two groups: parent-mediated JASPER or clinician-mediated JASPER. Studies have found that when either parents or clinicians use JASPER, children make significant progress in joint attention, improving their ability to focus on the same thing as someone else. Specifically, parent-led JASPER has enhanced children's joint attention skills, crucial for interacting with others. Clinician-led JASPER has also improved children's social communication skills. Overall, JASPER appears to be an effective way to help children with autism develop key social abilities. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

This trial is for children aged 18 months to 5 years with Autism Spectrum Disorder who are minimally verbal or have emerging phrase speech. They must have a nonverbal mental age of at least 12 months and a confirmed diagnosis of autism.

Inclusion Criteria

My child has a confirmed diagnosis and understands things like a 1-year-old or older.

My child speaks very little or uses only simple phrases.

Exclusion Criteria

Children without a confirmed diagnosis

My child's mental age is under 12 months.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Pre-Intervention Behavioral Testing

Administration of ADOS, MSEL, ESCS, SPA, CCX, and Vineland Adaptive Behavior Scales. ELSA-T and BOSCC sessions for test-retest reliability.

1 week

2 visits (in-person)

Treatment

Participants receive JASPER intervention, either clinician-mediated or parent-mediated, for 10 weeks. Monthly check-ins for responders and non-responders.

10 weeks

20 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment. T3 assessments conducted.

10 weeks

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• JASPER

Trial Overview

The study tests JASPER, a play-based intervention for autism, delivered by either clinicians or parents. It measures the effectiveness using BOSCC and ELSA-T assessments over a period of 20 weeks, with adjustments based on initial response after the first half.

How Is the Trial Designed?

Group I: parent-mediated JASPER Experimental Treatment 1 Intervention

This group will consist of the therapist assisting the parent implement JASPER on the child twice a week.

Group II: clinician-mediated JASPER Experimental Treatment 1 Intervention

This group will consist of the child and therapist having one-on-one, JASPER sessions, twice a week.

JASPER is already approved in United States for the following indications:

Approved in United States as JASPER for:

• Autism Spectrum Disorder (ASD), specifically for improving social communication and play skills in minimally verbal children

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Simons Foundation

Collaborator

Trials

8

Recruited

101,000+

Published Research Related to This Trial

Preschoolers with autism who participated in joint attention and symbolic play interventions showed significant improvements in the quality of joint attention, specifically in shared positive affect and utterances, compared to a control group.

The study highlights the effectiveness of targeted interventions in enhancing joint attention quality in children with autism, suggesting that these approaches can foster better social interactions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief report: longitudinal improvements in the quality of joint attention in preschool children with autism. Lawton, K., Kasari, C.[2021]

Pivotal Response Training (PRT) effectively taught 7 children with autism to engage in symbolic play, resulting in all participants demonstrating complex and creative play behaviors comparable to typical peers.

The children not only generalized their newly learned play skills to different toys and settings but also maintained these behaviors three months after training, indicating lasting benefits and improved interaction skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching symbolic play skills to children with autism using pivotal response training. Stahmer, AC.[2019]

In a study involving 58 preschool children with autism, both joint attention (JA) and symbolic play (SP) interventions led to greater expressive language gains compared to a control group after 5-6 weeks of daily sessions.

Children with the lowest initial language levels showed significantly better language outcomes from the JA intervention compared to the SP and control groups, highlighting the importance of targeting JA skills in early autism treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Language outcome in autism: randomized comparison of joint attention and play interventions. Kasari, C., Paparella, T., Freeman, S., et al.[2022]

A systematic review of 32 randomized controlled trials (RCTs) found that play-based interventions for children with autism spectrum disorder (ASD) generally led to improvements in social interaction, communication, daily functioning, and play behavior, as well as reductions in problem behaviors.

Despite these positive outcomes, 25 out of 32 RCTs were assessed to have a high risk of bias, indicating that the effectiveness of these interventions may vary and future studies should address these biases for more reliable results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectivity of Play-Based Interventions in Children with Autism Spectrum Disorder and Their Parents: A Systematic Review. Dijkstra-de Neijs, L., Tisseur, C., Kluwen, LA., et al.[2023]

In a pilot study involving minimally verbal children with autism aged 3 to 5, the JASPER intervention showed significant improvements in play diversity and engagement compared to a control group receiving standard ABA therapy.

The JASPER treatment, which included just 30 minutes of intervention twice a week, led to increased initiation of gestures and reduced unengaged time in the classroom, highlighting its potential effectiveness in addressing core deficits in autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preschool based JASPER intervention in minimally verbal children with autism: pilot RCT. Goods, KS., Ishijima, E., Chang, YC., et al.[2021]

Research indicates that autistic children show significant impairments in spontaneous symbolic and functional play, suggesting a deficit in these areas.

However, studies that prompted or instructed play suggest that autistic children may have the ability to engage in symbolic play when guided, indicating that their capacity for such play might not be fully expressed spontaneously.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Symbolic play in autism: a review. Jarrold, C., Boucher, J., Smith, P.[2019]

The JASPER intervention, which focuses on joint attention, play skills, and language development, showed significant improvements in these areas for children with autism spectrum disorder compared to those who did not receive the intervention, based on a review of 19 studies.

While parents and educators generally found the JASPER techniques effective, the studies reviewed did not meet all quality indicators, indicating a need for further research to explore the broader impacts of JASPER on children with autism.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of JASPER intervention for children with autism spectrum disorder: A systematic review. Waddington, H., Reynolds, JE., Macaskill, E., et al.[2021]

A study involving 58 children with autism aged 3 to 4 years showed that targeted interventions for joint attention and symbolic play significantly improved relevant behaviors compared to a control group.

Children receiving joint attention training initiated more joint attention behaviors, while those in the symbolic play group demonstrated greater diversity and higher levels of play, indicating the effectiveness of these interventions in enhancing developmental skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. Kasari, C., Freeman, S., Paparella, T.[2007]

The JASPER intervention significantly improved play skills in 109 preschool-age children with autism, enhancing both the diversity and complexity of their play compared to control groups.

Children who showed more joint attention skills at the start of the intervention made even greater improvements in their play skills, highlighting the importance of targeting both play and joint attention in autism interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developmental Play Skills as Outcomes of Early Intervention. Chang, YC., Shire, S., Shih, W., et al.[2023]

A study involving 80 preschool children with autism spectrum disorder (ASD) found that interactive group sandplay significantly improved social withdrawal and overall behavior compared to individual sandplay after three months of treatment.

Both treatment methods were effective, but the interactive group sandplay led to greater improvements in sociability, emotional responses, and reductions in stereotypic behaviors, highlighting its potential as a more beneficial intervention for children with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder]. Wang, YX., Lu, GB., Ge, P., et al.[2020]

Citations

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sciencedirect.com

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Most studies found that children who received JASPER intervention showed significantly greater improvements in at least one outcome.

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SMARTer Approach to Personalizing Intervention for ...

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JASPER

JASPER is a play-based intervention that teaches social communication skills to young children with autism, developed by Dr. Connie Kasari at the University of ...

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NCT03653143 | JASPER Intervention in Down Syndrome

JASPER is a therapist and parent-mediated intervention that (1) targets the foundations of social communication, (2) uses naturalistic behavioral strategies to ...