Project Activities
A randomized controlled trial will be used to determine the efficacy of J-EMT. Approximately 120 children, age 24–36 months, with ASD and their parents will participate in this research project. Children will be randomly assigned to the treatment or business-as-usual control condition, and they will participate in their services (intervention or typical community services) for 6 months. Primary data-collection points include before, immediately after, and 6 months after the intervention period. Data will be analyzed to examine the impact of J-EMT on measures of children's social communication, language, and related skills, as well as potential moderators of the impact.
Structured Abstract
Setting
The study will take place in the homes of toddlers with ASD in metropolitan areas of Tennessee and Illinois.
Sample
Approximately 120 toddlers, age 24-36 months, diagnosed with ASD and their parents will participate in this study, as well as the therapists delivering the intervention.
Intervention
The J-EMT blends two evidence-based interventions, Enhanced Milieu Teaching (EMT) and Joint Attention, Symbolic Play and Regulation (JASPER). EMT is a naturalistic language intervention designed to teach spoken language in the context of every day interactions with parents and teachers. JASPER is designed to teach the social foundations of communication in the context of social play. The combined J-EMT intervention is implemented by both parents and therapists as an integrated intervention package for children with ASD. The intervention will be implemented as 48 1-hour sessions with toddlers over a 6-month period and includes teaching parents to implement J-EMT in daily activities at home.
Research design and methods
Using a randomized controlled trial, children will be assigned to the treatment or business-as-usual control condition. Approximately 40 toddlers with ASD and their parents will participate in the study annually for each of the 3 years of data collection. Children in both groups will receive services (J-EMT or their usual community services) for 6 months. Data on services received and parent use of intervention strategies will be assessed for both groups. There will be three primary assessment points for most of the child outcome data—pre-intervention, post-intervention, and 6 months after the intervention ends. Social communication and expressive language will be assessed monthly. Data will be analyzed to examine the immediate and longer-term efficacy of J-EMT on children's language, communication, symbolic play, symbol-infused joint attention, parents' use of language support strategies, and growth in children's language skills over time. The researchers will also explore whether child characteristics and fidelity of parental strategy use moderates child outcomes.
Control condition
The control condition consists of toddlers with ASD receiving typical community and early intervention services. Use of services will be documented. Parents will also receive reports of their children's communication progress and assistance in advocating for community services.
Key measures
Children will be screened for participating using the Autism Diagnostic Observation Schedule — Second Edition (ADOS-2) and Autism Diagnostic Interview-Revised (ADI-R). Communication and language outcome measures include the following: children's social communication in observed language samples; expressive language using language samples, parent report, Preschool Language Scale-Fifth Edition (PLS-5), and MacArther-Bates Communicative Development Inventories; home communication using Language Environment Analysis (LENA); and receptive language using the PLS-5. Additional outcome measures include the Structured Play Assessment (symbolic play), Early Social Communication Scales (joint attention), and coding of observational parent-child interactions for joint engagement. The team will also collect data on moderators, including parent use of language support strategies, services received, family characteristics, and additional child skills (mental age, imitation skills, and expressive vocabulary).
Data analytic strategy
To examine the impact of the intervention on most of the outcomes, the research team will use linear ordinary least squares regression. To examine growth in social communication and expressive language over time, as well as the impact of moderators, multi-level growth modeling will be used.
People and institutions involved
IES program contact(s)
Products and publications
Products: The products of this project include understanding the efficacy of J-EMT on the social communication outcomes for toddlers with ASD and their parents, as well as peer-reviewed publications and presentations.
Book chapter
Kaiser, A. P., Hampton, L. and Roberts, M. Y. (2016). Parents as Partners in Effective Communication Intervention. Communication Interventions for Children with Severe Disabilities. Brookes Publishing Co. Retrieved from http://products.brookespublishing.com/Communication-Interventions-for-Individuals-with-Severe-Disabilities-P948.aspx.
Book chapter, edition specified
Kaiser, A. P. and Hampton, L. H. (2016). Enhanced Milieu Teaching.
Journal article, monograph, or newsletter
Hampton, L. H., and Kaiser, A. P. (2016). Intervention Effects on Spoken-Language Outcomes for Children with Autism: A Systematic Review and Meta-Analysis. Journal of Intellectual Disability Research, 60(5): 444-463. doi:10.1111/jir.12283 Full text
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Supplemental information
Co-Principal Investigator: Megan Roberts (Northwestern University)
Questions about this project?
To answer additional questions about this project or provide feedback, please contact the program officer.
