Adaptive Interventions for Minimally Verbal Children With ASD in the Community (AIM-ASD)
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ClinicalTrials.gov Identifier: NCT01751698 |
Recruitment Status :
Completed
First Posted : December 18, 2012
Last Update Posted : October 11, 2018
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Condition or disease | Intervention/treatment | Phase |
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Autism | Behavioral: JASP-EMT Behavioral: DTT | Not Applicable |
Interventions:
- CORE-DTT is based on behavioral learning theory in which communication and related skills are taught through systematic direct instruction. The goal of CORE-DTT is to help children be successful in learning communication skills by breaking these skills down into small steps, providing systematic direct instruction on each step, and reinforcing children (e.g., with praise or access to preferred items) for demonstrating skills. Imitation and attention skills are a main focus early in intervention. DTT is the most common evidence-based approach for teaching children with ASD, and is often considered the closest to a 'standard of practice' for the field. The participants in the proposed study will have had at least 1 year of previous intervention, likely in an ABA program with DTT as a main strategy. While many children will have been exposed to DTT prior to entering this trial, it is important to insure that children (a) receive quality DTT, and (b) have exposure to CORE elements related to language learning, specifically joint attention and requesting gestures, in order to make the comparison with JASP-EMT.
- JASP-EMT is a developmentally anchored behavioral intervention that assumes that communication develops from social interactions in which specific social engagement strategies, symbolic representations, and early communication forms are modeled and naturally reinforced by adult partner responses to the child. The goal of JASP-EMT is to increase (a) joint engagement, (b) initiating joint attention gestures, (c) social play involving objects and persons, and (d) verbal and nonverbal communication by facilitating meaningful social interactions. The social interaction foundation of JASP-EMT is critical. Modeling and expansions of communicative behaviors and play are used strategically within meaningful social interactions with therapists and caregivers. For minimally verbal children with autism, meaningful social interaction is essential for establishing the platform on which language input and development will be built.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 192 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Adaptive Interventions for Minimally Verbal Children With ASD in the Community |
Actual Study Start Date : | January 2013 |
Actual Primary Completion Date : | June 2017 |
Actual Study Completion Date : | December 2017 |
Arm | Intervention/treatment |
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Active Comparator: JASP-EMT
JASP-EMT (Joint Attention, Symbolic Play and Enhanced Milieu Teaching) focuses on creating a context for joint engagement within naturally occurring child-led play routines. There is evidence of the effects of these interventions with children with ASD, and pilot data showing effects with minimally verbal children.
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Behavioral: JASP-EMT
JASP-EMT is a developmentally anchored behavioral intervention that assumes that communication develops from social interactions in which specific social engagement strategies, symbolic representations, and early communication forms are modeled and naturally reinforced by adult partner responses to the child. The goal of JASP-EMT is to increase (a) joint engagement, (b) initiating joint attention gestures, (c) social play involving objects and persons, and (d) verbal and nonverbal communication by facilitating meaningful social interactions. The social interaction foundation of JASP-EMT is critical. Modeling and expansions of communicative behaviors and play are used strategically within meaningful social interactions with therapists and caregivers. |
Active Comparator: DTT
CORE-DTT (discrete trial training for core features of ASD) emphasizes didactic adult-led instruction and is considered the current evidenced-based 'standard of care' for children with autism (NRC, 2001).
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Behavioral: DTT
CORE-DTT is based on behavioral learning theory in which communication and related skills are taught through systematic direct instruction. The goal of CORE-DTT is to help children be successful in learning communication skills by breaking these skills down into small steps, providing systematic direct instruction on each step, and reinforcing children (e.g., with praise or access to preferred items) for demonstrating skills. Imitation and attention skills are a main focus early in intervention. DTT is the most common evidence-based approach for teaching children with ASD, and is often considered the closest to a 'standard of practice' for the field. |
- Primary Outcome 1: Language Sample [ Time Frame: Follow-Up; 8 months on average ]To determine which intervention for minimally verbal children (JASP-EMT vs. CORE-DTT) produces greater increases in socially communicative spontaneous utterances (SCU; primary outcome).
- Secondary Aim 1: Joint Engagement [ Time Frame: Follow-Up; 8 months on average ]To determine which intervention for minimally verbal children (JASP-EMT vs. CORE-DTT) produces greater increases in symbol-infused joint engagement.
- Secondary Outcome 2: Number of Unique Words (Vocabulary) [ Time Frame: Follow-Up; 8 months on average ]To determine which intervention for minimally verbal children (JASP-EMT vs. CORE-DTT) produces greater increases in number of unique words.
- Secondary Outcome 3: Object Play [ Time Frame: Follow-Up; 8 months on average ]To determine which intervention for minimally verbal children (JASP-EMT vs. CORE-DTT) produces greater increases in object play level.
- Parent Training [ Time Frame: Follow-Up; 8 months on average ]To determine whether adding a parent training component provides additional benefit among participants who demonstrate a positive early response to either JASP-EMT or CORE-DTT.
- Treatment Effects [ Time Frame: Follow-Up; 8 months on average ]To compare and contrast four pre-specified adaptive interventions in terms of primary and secondary outcomes.
- Moderators [ Time Frame: Follow-Up; 8 months on average ]To determine whether (a) baseline repetitive behavior, (b) baseline object interest, and (c) parent expectations for the specific intervention moderate intervention outcomes.

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Ages Eligible for Study: | 54 Months to 96 Months (Child) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Clinical diagnosis of autism
- At least 4 years, 6 months old, and not older than 8 years, 0 months
- Displays less than 20 spontaneous, unique, and socially communicative words during screening assessments
- At least 18 months developmental age
- Currently in school
Exclusion Criteria:
- Diagnosis of syndrome or degenerative disorder
- Poorly controlled seizures

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01751698
United States, California | |
University of California, Los Angeles | |
Los Angeles, California, United States, 90024 | |
United States, New York | |
University of Rochester | |
Rochester, New York, United States, 14642 | |
Weill Cornell Medical College | |
White Plains, New York, United States, 10605 | |
United States, Tennessee | |
Vanderbilt University | |
Nashville, Tennessee, United States, 37203 |
Principal Investigator: | Connie Kasari, PhD | University of California, Los Angeles | |
Principal Investigator: | Ann Kaiser, PhD | Vanderbilt University | |
Principal Investigator: | Tristram Smith, PhD | University of Rochester | |
Principal Investigator: | Catherine Lord, PhD | Weill Medical College of Cornell University |
Responsible Party: | Connie Kasari, Ph.D., Principal Investigator, University of California, Los Angeles |
ClinicalTrials.gov Identifier: | NCT01751698 |
Other Study ID Numbers: |
R01HD073975 ( U.S. NIH Grant/Contract ) R01HD073975 ( U.S. NIH Grant/Contract ) |
First Posted: | December 18, 2012 Key Record Dates |
Last Update Posted: | October 11, 2018 |
Last Verified: | October 2018 |
Autism Minimally Verbal School Age |