Communication Intervention: JASPER

Finding what works in a parent-led communication intervention for young children with autism.

As more and more children are diagnosed with Autism Spectrum Disorder (ASD), it is important that early interventionists and clinicians have therapy techniques that have been tested and proven to work with families of children with ASD.  However, one question we don’t often ask is why particular interventions work well and which specific components of these interventions lead to positive child outcomes. In a recent scientific study by Gulsrud, Hellemann, Shire, and Kasari (2015), the authors investigated a play-based therapy called JASPER and examined which specific strategies in this intervention are most related to children’s improvements in social communication.

What is JASPER?

JASPER stands for “Joint Attention, Symbolic Play, Engagement, and Regulation,” which highlights the components this therapy. JASPER is unique in that it focuses on parents and therapists following the child’s lead, uses strategies that are natural and based in families’ everyday routines, targets the foundations of social communications, and includes both parents and teachers (http://researchautism.net). The primary goal of JASPER is to improve what therapists call “joint engagement,” which refers to times when an adult and a child both focus on the same thing while doing an activity together, such as playing with toys. When parents and children focus on the same things during play, it creates more opportunities for communication and allows the adult to enter the child’s world by focusing on what most interests the child; the adult can also then imitate the child’s actions and reinforce how fun play can be (Gulsrud et al., 2015, p. 6).

JASPER uses four core components in its approach to increase joint engagement for young children: environmental arrangement, mirrored pacing, prompting, and communication.

• Environmental Arrangement refers to how the parent can choose which toys and materials to use during playtime with their child, as well as how to choose new toys in order to keep their child interested in playtime. It also refers to how the parent can physically sit and arrange toys and objects so that they are at the child’s eye level (Gulsrud et al., 2015).

• Mirrored Pacing refers to how the parent can follow their child’s lead and “mirror” the child’s interests by imitating the way their child is playing with toys and objects. By doing this, parents can help their child learn to take turns and strengthen their child’s ability to have social interactions with other adults and children (Gulrud et al., 2015). In JASPER, parents are taught which actions to imitate and when to imitate them in order to best develop joint engagement with their child.

• Prompting consists of different prompting techniques that are based on the child’s current language abilities. Parents can use these techniques to help improve engagement and how their child uses communication and language. For example, if the child points to a toy they want to play with, the parent could respond by prompting them to say the toy’s name (i.e. “say doll”) and then handing them the doll.

• Communication refers specifically to how parents can imitate the language their child uses, and then expand it by adding new words (Gulsrud et al., 2015). For example, if the child says “car,” the parent can expand this by saying, “drive the car.” This technique builds on the child’s existing language, while also teaching them new words.

What works?

In Gulsrud’s study, 86 toddlers with ASD and their parents participated in the study. Parents were either taught to implement the JASPER intervention or received a parent education and parental stress reduction intervention. After 10 weeks of intervention training, the parents in the JASPER intervention significantly increased their use of all four JASPER strategies compared to the comparison group. The researchers then looked at the four components of JASPER individually to see which ones impacted children’s joint engagement skills the most. Results showed that mirrored pacing and environmental arrangement significantly improved joint engagement in children (Gulsrud et al., 2015). Furthermore, mirrored pacing was identified as the “active ingredient” in the JASPER intervention, as it was found to be the most important factor in improving children’s joint engagement (Gulsrud et al., 2015).

This finding does not mean that other components of JASPER are not important for improving child outcomes; it rather tells us that mirrored pacing is directly related to improvements in joint engagement, while other strategies like prompting and communication may help improve other child skills, like “increasing child responding to adult requests” (Gelrud et al., 2015, p. 6). Ultimately, JASPER is a successful intervention for young children with autism and this study helps to uncover which specific strategies in the intervention are related to joint engagement.

Why does this matter?

The research done by these authors is essential for the field of early intervention and particularly for clinicians working with young children with autism. It is important that clinicians are using therapies and strategies that have been proven to show positive results. However, when using complex interventions like JASPER that integrate many strategies and techniques, it is also essential that we understand which parts of these interventions are most important for child improvement. This knowledge allows clinicians and parents to adapt interventions to meet the specific needs of young children with autism.

Citations

Gulrud, A. C., Hellemann, G., Shire, S. and Kasari, C. (2015). Isolating active ingredients in a parent-mediated social communication intervention for toddlers with autism spectrum disorder. Journal of Child Psychology and Psychiatry.

Research Autism (2015). Joint Attention Symbolic Play Engagement and Regulation. Retrieved from: http://researchautism.net/glossary/2244/joint-attention-symbolic-play-engagement-and-regulation