JASPER Implementation in NFLD

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-05-01

Study Completion Date

2023-12-30

Brief Summary

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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.

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Detailed Description

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The proposed study is an adaptive intervention trial that will focus on tailoring supports for new JASPER interventionists. Coaching and training supports will be provided by Local Senior JASPER Trainers will support the development of new interventionists. Based on the interventionist's individual response to the coaching/training supports, a change in support may be provided at a priori time points including end of month 1 (training case) if at least 70% fidelity is not reached, and at end of month 4 (midpoint of first child cohort), at least 90% fidelity is not reached.

Conditions

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Autism Spectrum Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

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.

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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A. Above Fidelity Phase 1 and Above Fidelity Phase 2

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

Group Type ACTIVE_COMPARATOR

Alternate Coaching and Video Feedback Phase 1

Intervention Type BEHAVIORAL

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

Video Feedback Only Phase 2

Intervention Type BEHAVIORAL

Receive video feedback and calls only

B. Below Fidelity Phase 1 and Above Fidelity Phase 2

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

Group Type ACTIVE_COMPARATOR

Weekly Coaching in Phase 1

Intervention Type BEHAVIORAL

Weekly coaching (live or telehealth)

Video Feedback Only Phase 2

Intervention Type BEHAVIORAL

Receive video feedback and calls only

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

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.

Group Type ACTIVE_COMPARATOR

Alternate Coaching and Video Feedback Phase 1

Intervention Type BEHAVIORAL

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

Weekly Coaching plus Intensive Refresher Course Phase 2

Intervention Type BEHAVIORAL

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

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

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).

Group Type ACTIVE_COMPARATOR

Alternate Coaching and Video Feedback Phase 1

Intervention Type BEHAVIORAL

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

Weekly Coaching plus Peer Coaching Phase 2

Intervention Type BEHAVIORAL

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

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

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.

Group Type ACTIVE_COMPARATOR

Weekly Coaching in Phase 1

Intervention Type BEHAVIORAL

Weekly coaching (live or telehealth)

Weekly Coaching plus Intensive Refresher Course Phase 2

Intervention Type BEHAVIORAL

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

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

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).

Group Type ACTIVE_COMPARATOR

Weekly Coaching in Phase 1

Intervention Type BEHAVIORAL

Weekly coaching (live or telehealth)

Weekly Coaching plus Peer Coaching Phase 2

Intervention Type BEHAVIORAL

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

Interventions

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Alternate Coaching and Video Feedback Phase 1

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

Intervention Type BEHAVIORAL

Weekly Coaching in Phase 1

Weekly coaching (live or telehealth)

Intervention Type BEHAVIORAL

Weekly Coaching plus Intensive Refresher Course Phase 2

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

Intervention Type BEHAVIORAL

Weekly Coaching plus Peer Coaching Phase 2

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

Intervention Type BEHAVIORAL

Video Feedback Only Phase 2

Receive video feedback and calls only

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 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).

Exclusion Criteria

* 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

Minimum Eligible Age

24 Months

Maximum Eligible Age

97 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes