Developmental and Augmented Intervention for Facilitating Expressive Language

NCT01013545 | Completed

• 2 other identifiers: G09-04-013-015666
• Study Type: interventional
• Target: 96
• Locations: 1 country
• Sites: 3

Brief Summary

This study will contrast two experimental treatment conditions by testing whether joint attention/joint engagement intervention using spoken communication (JAE-EMT) results in better outcomes than joint attention/joint engagement intervention that is instead supplemented with an individualized AAC system (JAE-AAC). Thus, the skills of joint attention/joint engagement (JAE) remain foundational to developing expressive language but the difference in the two treatments will be between whether the JAE is administered through the more traditional spoken means (EMT) or through an augmentative and alternative communication device (AAC).

Conditions

Joint Engagement + Enhanced Milieu Training; Joint Engagement + Enhanced Milieu Training+Augmentative Communication (AAC)

Keywords

joint engagement; augmentative communication (AAC); enhanced milieu training; autism spectrum disorder; language

Outcome Measures

Primary Outcomes (1)

• Number of words used spontaneously during language sample

  Change in spontaneous language from beginning of treatment, to the mid-point.

  3 months

Secondary Outcomes (1)

• Number of words used spontaneously during language sample

  6 months

Study Arms (2)

JAE-EMT

EXPERIMENTAL

The interventionist will coach the caregiver and child while they engage in play routines established through collaboration between caregiver and interventionist. This intervention condition uses spoken language as the mode of communication. Individual, single word targets will be selected based on the child's level of language production and specific interests. The targets are systematically modeled in response to child actions and attention during play. A sequence of milieu teaching prompts will also be used to elicit targets from the child when use of the target language is functional for the child.

Behavioral: JAE Intervention

JAE-AAC

EXPERIMENTAL

The interventionist will coach the caregiver and child while they engage in play routines established through collaboration between caregiver and interventionist. The mode of communication introduced in this intervention condition is a developmentally chosen augmentative communication device. These devices are provided with a set of individually selected visual-graphic symbols and a relevant lexicon. The use of the device is taught within natural communicative exchanges within play routines and daily activities.

Behavioral: JAE Intervention

Interventions

JAE Intervention BEHAVIORAL

The overall goal in each session will be for the caregiver-child dyad to be in a state of supported or coordinated joint engagement. In this state the child is aware of the other's activity, and may actively coordinate their attention between an object/toy and the caregiver. The interventionist will coach the caregiver and child while they engage in play routines established through collaboration between caregiver and interventionist.

JAE-AAC; JAE-EMT

Eligibility Criteria

• Age: 5 Years - 8 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Diagnosis of autism from a licensed psychologist or board certified developmental pediatrician, or child and adolescent psychiatrist, confirmed by Module 1 of the Autism Diagnostic Observation Schedule (Lord et al., 2001)
• Chronological age between 5 and 8 years
• Classified as nonverbal with fewer than 20 spontaneous expressive words as determined by parent report, language sample, and standardized tests.
• Demonstrated slow or no progress in expressive language acquisition despite at least 2 years of early intervention

You may not qualify if:

• Major medical conditions other than autism, specifically: a) motor disabilities such as cerebral palsy or tuberous sclerosis, b) sensory disabilities such as blindness or deafness, and c) genetic disorders such as Fragile X or Down syndrome.
• Nonverbal mental age \< 24 months, based on a nonverbal score from the Leiter-R (Roid \& Miller, 1997).

Sponsors & Collaborators

• Autism Speaks: lead
• Hugo W. Moser Research Institute at Kennedy Krieger, Inc.: collaborator
• Vanderbilt University: collaborator
• University of California, Los Angeles: collaborator

Study Sites (3)

University of California, Los Angeles

Los Angeles, California, 90095, United States

Location

Kennedy Krieger Institute

Baltimore, Maryland, 21211, United States

Location

Vanderbilt University

Nashville, Tennessee, 37203, United States

Location

Related Publications (12)

• Kasari C. Assessing change in early intervention programs for children with autism. J Autism Dev Disord. 2002 Oct;32(5):447-61. doi: 10.1023/a:1020546006971.

  PMID: 12463519 BACKGROUND

• Kasari C, Paparella T, Freeman S, Jahromi LB. Language outcome in autism: randomized comparison of joint attention and play interventions. J Consult Clin Psychol. 2008 Feb;76(1):125-37. doi: 10.1037/0022-006X.76.1.125.

  PMID: 18229990 BACKGROUND

• Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. J Child Psychol Psychiatry. 2006 Jun;47(6):611-20. doi: 10.1111/j.1469-7610.2005.01567.x.

  PMID: 16712638 BACKGROUND

• Millar DC, Light JC, Schlosser RW. The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. J Speech Lang Hear Res. 2006 Apr;49(2):248-64. doi: 10.1044/1092-4388(2006/021).

  PMID: 16671842 BACKGROUND

• Kaiser AP, Trent JA. Communication intervention for young children with disabilities: Naturalistic approaches to promoting development. In S Odom, R Horner, M Snell & J Blacher (Eds), Handbook of Developmental Disabilities. New York: Guilford Press, 2007.

  BACKGROUND

• Kaiser AP, Hancock TB, Nietfeld, JP. The effects of parent-implemented enhanced milieu teaching on the social communication of children who have autism. Journal of Early Educaiton and Development [Special Issue] 4: 423-446, 2000.

  BACKGROUND

• Landa R. Early communication development and intervention for children with autism. Ment Retard Dev Disabil Res Rev. 2007;13(1):16-25. doi: 10.1002/mrdd.20134.

  PMID: 17326115 BACKGROUND

• Hancock TB, Kaiser, AP. Enhanced Milieu Teaching. In R. McCauley & M. Fey (Eds.) Treatment of language disorders in children. Baltimore: Paul H. Brookes. 2006.

  BACKGROUND

• Shire SY, Goods K, Shih W, Distefano C, Kaiser A, Wright C, Mathy P, Landa R, Kasari C. Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal. J Autism Dev Disord. 2015 Jun;45(6):1712-24. doi: 10.1007/s10803-014-2329-x.

  PMID: 25475363 RESULT

• Kasari C, Patterson S. Interventions addressing social impairment in autism. Curr Psychiatry Rep. 2012 Dec;14(6):713-25. doi: 10.1007/s11920-012-0317-4.

  PMID: 23055002 RESULT

• Almirall D, DiStefano C, Chang YC, Shire S, Kaiser A, Lu X, Nahum-Shani I, Landa R, Mathy P, Kasari C. Longitudinal Effects of Adaptive Interventions With a Speech-Generating Device in Minimally Verbal Children With ASD. J Clin Child Adolesc Psychol. 2016 Jul-Aug;45(4):442-56. doi: 10.1080/15374416.2016.1138407. Epub 2016 Mar 8.

  PMID: 26954267 DERIVED

• Kasari C, Kaiser A, Goods K, Nietfeld J, Mathy P, Landa R, Murphy S, Almirall D. Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial. J Am Acad Child Adolesc Psychiatry. 2014 Jun;53(6):635-46. doi: 10.1016/j.jaac.2014.01.019. Epub 2014 Mar 12.

  PMID: 24839882 DERIVED

MeSH Terms

Conditions

Autism Spectrum Disorder; Language

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders; Communication; Behavior

Study Officials

• Connie Kasari, Ph.D.

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Professor, Ph.D.

Study Record Dates

• First Submitted: November 12, 2009
• First Posted: November 13, 2009
• Study Start: July 1, 2009
• Primary Completion: July 1, 2012
• Study Completion: December 1, 2012
• Last Updated: June 11, 2024

Record last verified: 2024-06

Locations

US (3)