DTT + JASPER for Autism
Recruiting in Palo Alto (17 mi)
+2 other locations
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of California, Los Angeles
Disqualifiers: Sensory impairments, Genetic syndromes, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
This trial aims to improve language skills in preschool children with autism using a structured teaching and social interaction-based learning program. The program is adjusted based on each child's progress. The goal is to help these children develop better communication skills and avoid being minimally verbal by age 6.
Do I need to stop my current medications for the trial?
The trial requires that participants have stable medication for the past 6 months, so you should not change your current medications if you want to participate.
What data supports the effectiveness of the DTT + JASPER treatment for autism?
Research shows that JASPER, which is part of the DTT + JASPER treatment, helps improve play diversity and social interactions in children with autism. Additionally, Discrete Trial Training (DTT) has been effective in teaching language and play skills, suggesting that combining these approaches could be beneficial for children with autism.12345
Is the DTT + JASPER treatment safe for humans?
How is the DTT + JASPER treatment for autism different from other treatments?
The DTT + JASPER treatment is unique because it combines Discrete Trial Training (DTT), which is a structured teaching method, with JASPER, which focuses on improving joint attention and symbolic play skills. This combination targets specific developmental areas that are often delayed in children with autism, such as social interaction and play, which are not always the primary focus of other treatments.24689
Eligibility Criteria
The PRISM study is for preschoolers aged 36-59 months with Autism Spectrum Disorder who speak less than 20 functional words. They must have had over 3 months of early intervention, stable medication for the past half year, and a nonverbal mental age above one year. Children with sensory/motor impairments or genetic syndromes like Down Syndrome are not eligible.Inclusion Criteria
My child has been diagnosed with autism.
I am between 3 and 5 years old.
You have certain changes in your genes that can be treated with medication.
See 3 more
Exclusion Criteria
I likely haven't been exposed to AAC.
I do not have sensory, motor impairments, or known genetic syndromes.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Stage 1 Treatment
Participants receive either JASPER or DTT intervention for 10 weeks, 2 hours per week
10 weeks
2 visits per week (in-person)
Stage 2 Treatment
Early responders continue with the same intervention; slow responders are re-randomized to either intensify the current intervention or switch to Combined & Enhanced Treatment (CET)
10 weeks
2-4 visits per week (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment, with assessments at 10 weeks post-treatment and at age 6
Long-term
Treatment Details
Interventions
- DTT (Behavioral Intervention)
- JASPER (Behavioral Intervention)
Trial OverviewThis trial tests an adaptive two-stage language development approach over 20 weeks for minimally verbal children with ASD in community settings. It aims to personalize treatment by choosing between DTT (Discrete Trial Training), JASPER, and CET interventions based on each child's needs.
Participant Groups
2Treatment groups
Active Control
Group I: JASPERActive Control1 Intervention
Child will spend 2 hours per week (2 days, 1 hour per day) for the first 10 weeks doing JASPER. If the child is an early responder, he/she will remain in the same course for the following 10 weeks.
If child is a slow responder, he/she will be randomized for either combined \& enhanced treatment (CET) for 2 hours a week (2 days, 1 hour per day) or Intensified JASPER for 4 hours a week (4 days, 1 hour per day).
Group II: DTTActive Control1 Intervention
Child will spend 2 hours per week (2 days, 1 hour per day) for the first 10 weeks doing DTT. If the child is an early responder, he/she will remain in the same course for the following 10 weeks.
If child is a slow responder, he/she will be randomized for either combined \& enhanced treatment (CET) for 2 hours a week (2 days, 1 hour per day) or Intensified DTT for 4 hours a week (4 days, 1 hour per day).
DTT is already approved in United States for the following indications:
🇺🇸 Approved in United States as Discrete Trial Training for:
- Autism Spectrum Disorder
- Developmental Delays
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of OregonEugene, OR
UCLALos Angeles, CA
University of RochesterRochester, NY
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Who Is Running the Clinical Trial?
University of California, Los AngelesLead Sponsor
References
Varied treatment response in young children with autism: A relative comparison of structured and naturalistic behavioral approaches. [2021]Heterogeneity of treatment response is common in children with autism spectrum disorder. Thus, many providers vary the intervention used based on child characteristics and learning domain. An improved understanding of how to match treatments to different children and domain areas may enhance efforts to individualize treatment and improve treatment response. This study evaluated the relative efficacy of discrete trial training and pivotal response training for teaching young children at risk for autism spectrum disorder receptive and expressive language, play, and imitation skills. Using a single-subject adapted alternating treatments design, children received both the treatments for 12 weeks. Data were collected during treatment and at 3-month follow-up. All participants acquired target skills in both treatments and demonstrated some generalization, maintenance, and spontaneous skill use. Pivotal response training and discrete trial training were each more effective for some children and domains. The results suggest that early rates of learning may be predictive of longer-term treatment response and useful in informing treatment decisions.
Teaching symbolic play skills to children with autism using pivotal response training. [2019]Used Pivotal Response Training (PRT) to teach 7 children with autism to engage in symbolic play behaviors. Symbolic play, complexity of play behavior, and creativity of play were assessed. In addition, generalization measures were obtained across settings, toys, and play partners. Interaction with the play partners and comparison with typical controls were also examined. Results indicated that children with autism rarely exhibited symbolic play before training or after a control condition. After specific symbolic play training using PRT, all of the children learned to perform complex and creative symbolic play actions at levels similar to that of language-matched typical controls. In most cases the children generalized their play to new toys, environments, and play partners and continued to engage in symbolic play behavior after a 3-month follow-up period. In addition, interaction skills improved after training. Treatment implications for these findings are discussed.
Preschool based JASPER intervention in minimally verbal children with autism: pilot RCT. [2021]In this pilot study, we tested the effects of a novel intervention (JASPER, Joint Attention Symbolic Play Engagement and Regulation) on 3 to 5 year old, minimally verbal children with autism who were attending a non-public preschool. Participants were randomized to a control group (treatment as usual, 30 h of ABA-based therapy per week) or a treatment group (substitution of 30 min of JASPER treatment, twice weekly during their regular program). A baseline of 12 weeks in which no changes were noted in core deficits was followed by 12 weeks of intervention for children randomized to the JASPER treatment. Participants in the treatment group demonstrated greater play diversity on a standardized assessment. Effects also generalized to the classroom, where participants in the treatment group initiated more gestures and spent less time unengaged. These results provide further support that even brief, targeted interventions on joint attention and play can improve core deficits in minimally verbal children with ASD.
Language outcome in autism: randomized comparison of joint attention and play interventions. [2022]This study reports results of a randomized controlled trial aimed at joint attention (JA) and symbolic play (SP) in preschool children with autism, with prediction to language outcome 12 months later. Participants were 58 children (46 boys) with autism between 3 and 4 years of age. Children were randomized to a JA intervention, an SP intervention, or control group. Interventions were conducted 30 min daily for 5-6 weeks. Assessments of JA skills, SP skills, mother-child interactions, and language development were collected at 4 time points: pre- and postintervention and 6 and 12 months postintervention by independent testers. Results indicate that expressive language gains were greater for both treatment groups compared with the control group, and results could not be explained by differences in other interventions in which children participated. For children beginning treatment with the lowest language levels, the JA intervention improved language outcome significantly more than did the SP or control interventions. These findings suggest clinically significant benefits of actively treating JA and SP skills in young children with autism.
GOLIAH: A Gaming Platform for Home-Based Intervention in Autism - Principles and Design. [2020]Children with Autism need intensive intervention and this is challenging in terms of manpower, costs, and time. Advances in Information Communication Technology and computer gaming may help in this respect by creating a nomadically deployable closed-loop intervention system involving the child and active participation of parents and therapists. An automated serious gaming platform enabling intensive intervention in nomadic settings has been developed by mapping two pivotal skills in autism spectrum disorder: Imitation and Joint Attention (JA). Eleven games - seven Imitations and four JA - were derived from the Early Start Denver Model. The games involved application of visual and audio stimuli with multiple difficulty levels and a wide variety of tasks and actions pertaining to the Imitation and JA. The platform runs on mobile devices and allows the therapist to (1) characterize the child's initial difficulties/strengths, ensuring tailored and adapted intervention by choosing appropriate games and (2) investigate and track the temporal evolution of the child's progress through a set of automatically extracted quantitative performance metrics. The platform allows the therapist to change the game or its difficulty levels during the intervention depending on the child's progress. Performance of the platform was assessed in a 3-month open trial with 10 children with autism (Trial ID: NCT02560415, Clinicaltrials.gov). The children and the parents participated in 80% of the sessions both at home (77.5%) and at the hospital (90%). All children went through all the games but, given the diversity of the games and the heterogeneity of children profiles and abilities, for a given game the number of sessions dedicated to the game varied and could be tailored through automatic scoring. Parents (N = 10) highlighted enhancement in the child's concentration, flexibility, and self-esteem in 78, 89, and 44% of the cases, respectively, and 56% observed an enhanced parents-child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial.
GOLIAH (Gaming Open Library for Intervention in Autism at Home): a 6-month single blind matched controlled exploratory study. [2020]To meet the required hours of intensive intervention for treating children with autism spectrum disorder (ASD), we developed an automated serious gaming platform (11 games) to deliver intervention at home (GOLIAH) by mapping the imitation and joint attention (JA) subset of age-adapted stimuli from the Early Start Denver Model (ESDM) intervention. Here, we report the results of a 6-month matched controlled exploratory study.
Using head-mounted eye tracking to examine visual and manual exploration during naturalistic toy play in children with and without autism spectrum disorder. [2021]Multimodal exploration of objects during toy play is important for a child's development and is suggested to be abnormal in children with autism spectrum disorder (ASD) due to either atypical attention or atypical action. However, little is known about how children with ASD coordinate their visual attention and manual actions during toy play. The current study aims to understand if and in what ways children with ASD generate exploratory behaviors to toys in natural, unconstrained contexts by utilizing head-mounted eye tracking to quantify moment-by-moment attention. We found no differences in how 24- to 48-mo children with and without ASD distribute their visual attention, generate manual action, or coordinate their visual and manual behaviors during toy play with a parent. Our findings suggest an intact ability and willingness of children with ASD to explore toys and suggest that context is important when studying child behavior.
Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. [2007]Delays and deficits in joint attention and symbolic play constitute two important developmental problems in young children with autism. These areas of deficit have been well studied in autism but have rarely been the focus of treatment efforts (see Kasari, Freeman, & Paparella, 2001). In this study, we examine the efficacy of targeted interventions of joint attention and symbolic play.
Teaching children with autism to identify and respond appropriately to the preferences of others during play. [2019]We observed three children with autism spectrum disorder during structured play dates in which play partners displayed interest or disinterest in the toys with which they were playing. We then taught subjects to identify play partners' preferences and to make appropriate toy offers using a multiple-exemplar training package consisting of rules, midplay preference questions, prompting, and praise with observed generalization across untrained partners.