JASPER Implementation in NFLD

NCT03205475 | Completed

• 1 other identifier: GovernmentNL
• Study Type: interventional
• Target: 27
• Locations: 1 country
• Sites: 1

Brief Summary

This study will focus on examining the supports required to enable community Senior JASPER Trainers to support the training and development of junior interventionists throughout the province of Newfoundland and Labrador, Canada. The study will examine the training and supports delivered by Senior Trainers to help junior interventionists provide a targeted social communication intervention (JASPER: Joint Attention, Symbolic Play, Engagement, and Regulation) with children with autism spectrum disorder (ASD). Children's engagement, play, and social communication outcomes will be examined as well as the influence of junior interventionists' intervention implementation on children's outcomes. Further, the study will examine the supports required to help junior interventionists who demonstrate slower gains in implementation fidelity after the first three months of standard support. Interventionists who are slow to gain implementation fidelity will be randomized to either (a) enhanced feedback plus peer support or (b) enhanced feedback plus intensive refresher course.

Conditions

Autism Spectrum Disorder

Keywords

Training; Intervention; Social Communication; Play

Outcome Measures

Primary Outcomes (1)

• Change in JASPER Strategy Implementation Fidelity

  Quantitative ratings of the interventionists' quality and accurate use of JASPER intervention strategies.

  Entry, 1 month, 4 months, and 7 month exit

Secondary Outcomes (2)

• Change in Children's Joint Engagement

  Entry for cohort two (month 2), half way (month 4), and exit (month 7)

• Change in Children's Play Skills and Social Communication Skills

  Entry for cohort two (month 2), half way (month 4), and exit (month 7)

Study Arms (6)

A. Above Fidelity Phase 1 and Above Fidelity Phase 2

ACTIVE COMPARATOR

Alternating coaching and streamed or video feedback each week through phase 1, moves to video feedback only for phase 2.

Behavioral: Alternate Coaching and Video Feedback Phase 1; Behavioral: Video Feedback Only Phase 2

B. Below Fidelity Phase 1 and Above Fidelity Phase 2

ACTIVE COMPARATOR

Receive weekly coaching in phase 1, move to video feedback only in phase 2

Behavioral: Weekly Coaching in Phase 1; Behavioral: Video Feedback Only Phase 2

C. Above Fidelity Phase 1, Below in Phase 2- Add Refresher

ACTIVE COMPARATOR

Alternating coaching and streamed or video feedback each week through phase 1. In phase 2, the interventionist is still working toward 90% fidelity and is randomly assigned (50/50) to one of two different types of support from the Senior Trainer. The interventionist will receive a one week intensive in person refresher and then continue with weekly coaching and video feedback from the Senior Trainer (Enhanced Feedback plus intensive refresher course) for the final 12 weeks.

Behavioral: Alternate Coaching and Video Feedback Phase 1; Behavioral: Weekly Coaching plus Intensive Refresher Course Phase 2

D. Above Fidelity Phase 1, Below in Phase 2- Add Peer

ACTIVE COMPARATOR

Alternating coaching and streamed or video feedback each week through phase 1. In phase 2, the interventionist is still working toward 90% fidelity and is randomly assigned (50/50) to one of two different types of support from the Senior Trainer. The interventionist will receive weekly coaching and video feedback from the Senior Trainer plus a weekly session paired with a local interventionist at fidelity (Enhanced Feedback plus peer support).

Behavioral: Alternate Coaching and Video Feedback Phase 1; Behavioral: Weekly Coaching plus Peer Coaching Phase 2

E. Below Fidelity Phase 1, Below in Phase 2- Add Refresher

ACTIVE COMPARATOR

Receive weekly coaching in phase 1. In phase 2, the interventionist is still working toward 90% fidelity and is randomly assigned (50/50) to one of two different types of support from the Senior Trainer. The interventionist will receive a one week intensive in person refresher and then continue with weekly coaching and video feedback from the Senior Trainer (Enhanced Feedback plus intensive refresher course) for the final 12 weeks.

Behavioral: Weekly Coaching in Phase 1; Behavioral: Weekly Coaching plus Intensive Refresher Course Phase 2

F. Below Fidelity Phase 1, Below in Phase 2- Add Peer

ACTIVE COMPARATOR

Receive weekly coaching in phase 1. In phase 2, the interventionist is still working toward 90% fidelity and is randomly assigned (50/50) to one of two different types of support from the Senior Trainer. The interventionist will receive weekly coaching and video feedback from the Senior Trainer plus a weekly session paired with a local interventionist at fidelity (Enhanced Feedback plus peer support).

Behavioral: Weekly Coaching in Phase 1; Behavioral: Weekly Coaching plus Peer Coaching Phase 2

Interventions

Alternate Coaching and Video Feedback Phase 1 BEHAVIORAL

Alternates each week between live/tele-health coaching (coaching) or Video review and call (feedback)

A. Above Fidelity Phase 1 and Above Fidelity Phase 2; C. Above Fidelity Phase 1, Below in Phase 2- Add Refresher; D. Above Fidelity Phase 1, Below in Phase 2- Add Peer

Weekly Coaching in Phase 1 BEHAVIORAL

Weekly coaching (live or telehealth)

B. Below Fidelity Phase 1 and Above Fidelity Phase 2; E. Below Fidelity Phase 1, Below in Phase 2- Add Refresher; F. Below Fidelity Phase 1, Below in Phase 2- Add Peer

Weekly Coaching plus Intensive Refresher Course Phase 2 BEHAVIORAL

Continue weekly coaching with senior trainer and add one week intensive refresher course

C. Above Fidelity Phase 1, Below in Phase 2- Add Refresher; E. Below Fidelity Phase 1, Below in Phase 2- Add Refresher

Weekly Coaching plus Peer Coaching Phase 2 BEHAVIORAL

Continue weekly coaching with senior trainer and add weekly peer coaching from another interventionist in the region who is at high fidelity

D. Above Fidelity Phase 1, Below in Phase 2- Add Peer; F. Below Fidelity Phase 1, Below in Phase 2- Add Peer

Video Feedback Only Phase 2 BEHAVIORAL

Receive video feedback and calls only

A. Above Fidelity Phase 1 and Above Fidelity Phase 2; B. Below Fidelity Phase 1 and Above Fidelity Phase 2

Eligibility Criteria

• Age: 24 Months - 97 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Children: Must be 2.0-8.11 years of age; must meet the scoring benchmark for "autism" or "autism spectrum disorder" on the ADOS-2; has not previously received JASPER intervention in the province
• Interventionists: Work as an interventionist for the Government of Newfoundland and Labrador; minimum educational requirement is a Bachelor's Degree or Master's Degree in Psychology or a related field
• Senior JASPER Trainers: - Have been trained previously in JASPER; Work as a Senior Trainer for the Government of Newfoundland and Labrador; Minimum educational requirement is a Master's degree in a related field (e.g., Speech and Language Pathology, Occupational Therapy, Developmental Psychology).

You may not qualify if:

• Children: Child is below 2.0 years of age or above 8.11 years of age; Child does not meet the benchmark for autism or autism spectrum disorder on the ADOS-2; Child has received JASPER intervention prior to this study
• Interventionists: Not employees of the Government of Newfoundland and Labrador; does not hold a Bachelor's degree in a related field
• Senior Trainers: No prior JASPER training; Not employees of the Government of Newfoundland and Labrador; does not hold a Master's Degree in a related field

Sponsors & Collaborators

• Government of Newfoundland and Labrador: lead

Study Sites (1)

Department of Health and Community Services, Government of Newfoundland and Labrador

St. John's, Newfoundland and Labrador, A1B 3X9, Canada

Location

MeSH Terms

Conditions

Autism Spectrum Disorder; Communication

Interventions

Clinical Trials, Phase I as Topic

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Clinical Trials as Topic; Clinical Studies as Topic; Epidemiologic Study Characteristics; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Connie Kasari, PhD

  University of California, Los Angeles

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: JASPER (Joint Attention, Symbolic Play, Engagement, and Regulation) is a play based targeted social communication intervention. Sessions will be delivered one on one by an interventionist in training with a child age 2.0-8.11 years who has autism.

Study Record Dates

• First Submitted: June 27, 2017
• First Posted: July 2, 2017
• Study Start: May 1, 2018
• Primary Completion: December 31, 2018
• Study Completion: December 30, 2023
• Last Updated: September 25, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)