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

Trial Summary

What is the purpose of this trial?

This trial is testing JASPER, a play-based therapy, on young children with autism who have limited verbal skills. The therapy uses guided play to help these children improve their social and communication abilities. JASPER (Joint Attention, Symbolic Play, Engagement, and Regulation) is a naturalistic developmental behavioral intervention that has been found effective for promoting social communication in young children with autism.

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 data supports the effectiveness of the JASPER treatment for autism?

Research shows that the JASPER treatment, which focuses on joint attention and symbolic play, helps improve language skills and play diversity in young children with autism. Children receiving JASPER showed greater expressive language gains and more diverse play behaviors compared to those in control groups. ^{1 2 3 4 5}

Is the JASPER intervention safe for humans?

The available research on JASPER intervention for children with autism does not report any safety concerns, suggesting it is generally safe for use in humans. ^{3 4 6 7 8}

How is the JASPER treatment different from other treatments for autism?

JASPER is unique because it focuses on improving joint attention (shared focus on an object or event), symbolic play (using objects to represent something else), engagement, and regulation in natural settings, which are critical developmental areas often overlooked in other autism treatments. It has shown promising results in enhancing play diversity, language skills, and social interactions in young children with autism. ^{3 4 7 9 10}

Eligibility Criteria

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 is between 18 months and 5 years old.

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.

My child is either younger than 18 months or older than 5 years.

Timeline

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)

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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 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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

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

2. United States pubmed.ncbi.nlm.nih.gov

Brief report: longitudinal improvements in the quality of joint attention in preschool children with autism. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Preschool based JASPER intervention in minimally verbal children with autism: pilot RCT. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Language outcome in autism: randomized comparison of joint attention and play interventions. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Symbolic play in autism: a review. [2019]

6. China pubmed.ncbi.nlm.nih.gov

[Clinical efficacy of interactive group sandplay versus individual sandplay in the treatment of preschool children with autism spectrum disorder]. [2020]

7. England pubmed.ncbi.nlm.nih.gov

The effects of JASPER intervention for children with autism spectrum disorder: A systematic review. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Effectivity of Play-Based Interventions in Children with Autism Spectrum Disorder and Their Parents: A Systematic Review. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. [2007]

10. United States pubmed.ncbi.nlm.nih.gov

Developmental Play Skills as Outcomes of Early Intervention. [2023]