Journal of Autism and Developmental Disorders

, Volume 43, Issue 5, pp 1050–1056 | Cite as

Preschool Based JASPER Intervention in Minimally Verbal Children with Autism: Pilot RCT

  • Kelly Stickles GoodsEmail author
  • Eric Ishijima
  • Ya-Chih Chang
  • Connie Kasari
Brief Report


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.


Autism Minimally verbal Intervention 



This study was supported by Organization for Autism Research grant 20072725. We appreciate the support of Elisabeth Laugeson, PhD in the UCLA/HELP Group Alliance, Barbara Firestone, PhD, staff of the Help Group Preschools, and especially the children, parents, and teachers who participated in the study. The study was partially supported by Autism Speaks grant 5666, NIH/NICHD 1 P50-HD-055784, and Department of Health and Human Services UA3MC11055.


  1. Adamson, L. B., & Bakeman, R. (1985). Affect and attention: Infants observed with mothers and peers. Child Development, 56(3), 582–593.CrossRefGoogle Scholar
  2. Anderson, D. K., Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., et al. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 75(4), 594–604.PubMedCrossRefGoogle Scholar
  3. Billstedt, E., Gillberg, I. C., & Gillberg, C. (2007). Autism in adults: Symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. Journal of Child Psychology and. Psychiatry, 48(11), 1102–1110.Google Scholar
  4. Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry, 46(5), 500–513.PubMedCrossRefGoogle Scholar
  5. Dawson, G., Toth, K., Abbott, R., Osterling, J., Munson, J., Estes, A., et al. (2004). Early social attention impairments in autism: Social orienting, joint attention, and attention to distress. Developmental Psychology, 40(2), 271–283.PubMedCrossRefGoogle Scholar
  6. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2009). Randomized, controlled trial of an intervention for toddlers with autism: The early start Denver model. Pediatrics, 125, 17–23.CrossRefGoogle Scholar
  7. Evans, C., Margison, F., & Barkham, M. (1998). The contribution of reliable and clinically significant change methods to evidence-based mental health. Evidence Based Mental Health, 1, 70–72.CrossRefGoogle Scholar
  8. Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19.PubMedCrossRefGoogle Scholar
  9. Kasari, C., Freeman, S., & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47(6), 611–620.PubMedCrossRefGoogle Scholar
  10. Kasari, C., Gulsrud, A., Freeman, S., Paparella, T., & Hellemann, G. (2012). Longitudinal follow-up of children with autism on joint attention and play. Journal of the American Academy of Child and Adolescent Psychiatry, 51(5), 487–495.Google Scholar
  11. Kasari, C., Gulsrud, A., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056.PubMedCrossRefGoogle Scholar
  12. Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008). Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology, 76(1), 125–137.PubMedCrossRefGoogle Scholar
  13. Landa, R. J., Holman, K. C., O’Neill, A. H., & Stuart, E. A. (2011). Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 52(1), 13–21.PubMedCrossRefGoogle Scholar
  14. Lifter, K., Sulzer-Azaroff, B., Anderson, S., & Cowdery, G. E. (1993). Teaching play activities to preschool children with disabilities: The importance of developmental considerations. Journal of Early Intervention, 17, 139–159.CrossRefGoogle Scholar
  15. Lord, C., Risi, S., Lambrecht, L., Cook, E. H, Jr, Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnositc observation schedule-generic: A standard measure of social and communication deficits associated with spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.PubMedCrossRefGoogle Scholar
  16. Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.PubMedCrossRefGoogle Scholar
  17. Mullen, E. (1997). Mullen scales of early learning. Circle Pines, MN: American Guidance Services.Google Scholar
  18. Mundy, P., Delgado, C., Block, J., Venezia, M., Hogan, A., & Seibert, J. (2003). Early Social Communication Scales (ESCS). Coral Gables: University of Miami.Google Scholar
  19. Mundy, P., Hogan, A., & Doelring, P. (1996). A preliminary manual for the abridged Early Social Communication Scales. Coral Gables, FL: University of Miami.Google Scholar
  20. Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20(1), 115–128.PubMedCrossRefGoogle Scholar
  21. Reynell, J. K. (1977). Reynell Developmental Language Scales. Windsor: NFER Publishing Co.Google Scholar
  22. Rutter, M., (1978). Diagnosis and definition of childhood autism. Journal of autism and childhood schizophrenia, 8(2).Google Scholar
  23. Sigman, M., & Ruskin, E. (1999). Continuity and change in the social competence of children with autism, down syndrome, and developmental delays. Monographs of the Society for Research in Child Development, 64(1), 1–114.PubMedCrossRefGoogle Scholar
  24. Smith, T., Groen, A. D., & Wynn, J. W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105(4), 269–285.PubMedCrossRefGoogle Scholar
  25. Ungerer, J., & Sigman, M. (1984). The relation of play and sensorimotor behavior to language in the second year. Child Development, 55(4), 1448–1455.PubMedCrossRefGoogle Scholar
  26. Watt, N., Wetherby, A., & Shumway, S. (2006). Prelinguistic predictors of language outcome at 3 years of age. Journal of Speech, Language, and Hearing Research, 49, 1224–1237.PubMedCrossRefGoogle Scholar
  27. Wong, C. & Kasari, C. (2012). Play and joint attention of children with autism in the preschool special education classroom. Journal of Autism and Developmental Disorders, 1-10. doi  10.1007/s10803-012-1467-2.

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Kelly Stickles Goods
    • 1
    Email author
  • Eric Ishijima
    • 2
  • Ya-Chih Chang
    • 2
  • Connie Kasari
    • 2
  1. 1.Center for Autism Research and Treatment, Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesUSA
  2. 2.Division of Psychological Studies in Education, Center for Autism Research and Treatment, Semel Institute for Neuroscience and Human BehaviorUniversity of CaliforniaLos AngelesUSA

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