From the National Institute on Aging, National Institutes of Health. We

From the National Institute on Aging, National Institutes of Health. We are indebted to the Catholic nuns, priests, and lay brothers who participated in the Rush Religious Orders Study, the University of Kentucky RADC clinical cohort and to all ADC center participants that provided clinical and pathological data to the various studies discussed in this review.
HHS Public AccessAuthor manuscriptJ Consult Clin Psychol. Author manuscript; available in PMC 2016 June 01.Published in final edited form as: J Consult Clin Psychol. 2015 June ; 83(3): 554?63. doi:10.1037/a0039080.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptRandomized comparative efficacy study of parent-mediated interventions for toddlers with autismConnie Kasari, PhD, Human Development and Psychology, UCLA; [email protected] Amanda Gulsrud, PhD, Child Psychiatry, UCLA; AGulsrud@Pyrvinium embonate web mednet.ucla.edu Tanya Paparella, PhD, Child Psychiatry, UCLA; [email protected] Gerhard Hellemann, PhD, and Psychiatry Biostatistics, UCLA; [email protected] Kathleen Berry, MA Human Development Psychology, UCLA; [email protected]–This study compared effects of two parent-mediated interventions on joint engagement outcomes as augmentations of an early intervention program for toddlers with autism spectrum disorder (ASD). Method–Participants included 86 toddlers (range 22 ?36 months) with ASD and their primary caregiver. Caregiver-child dyads were randomized to receive ten weeks of hands-on parent training in a naturalistic, developmental behavioral intervention (Joint Attention, Symbolic Play, Engagement and Regulation–JASPER) or a parent-only psychoeducational intervention (PEI). Dose was controlled in terms of researcher-parent contact and early intervention services received by the child. Results–Results yielded significant effects of the HIV-1 integrase inhibitor 2 solubility JASPER intervention on the primary outcome of joint engagement. The treatment effect was large (Cohen’s f2=.69).and maintained over the sixmonth follow-up. JASPER effects were also found on secondary outcomes of play diversity, highest play level achieved, and generalization to the child’s classroom for child-initiated joint engagement. The PEI intervention was found to be effective in reducing parenting stress associated with child characteristics. All secondary effects were generally small to moderate. Conclusions–These data highlight the benefit of a brief, targeted, parent-mediated intervention on child outcomes. Future studies may consider the combination of JASPER and PEI treatments for optimal parent and child outcomes. Trial registry # NCT00999778. Keywords autism toddlers; early intervention; parent training; JASPER; parenting stressCorresponding author: Connie Kasari, 68-268 Semel Institute, UCLA, Los Angeles, CA 90024, 310-825-8342.Kasari et al.PageYoung children with autism spectrum disorder (ASD) display significant impairments in early social communication skills. These include the initiation of joint attention gestures (e.g., showing toys to others, pointing to share, and coordinated eye gaze between objects and people) and the ability to jointly engage in social interactions with others (Adamson, Bakeman, Deckner, 2004; Kasari, Freeman, Paparella, 2006; Sigman, Mundy, Sherman, Ungerer, 1986). These impairments uniquely discriminate children with ASD from children with other developmental delays and typical children of similar mental age (Mundy, Sigman, Ungerer, Sherman, 1987.From the National Institute on Aging, National Institutes of Health. We are indebted to the Catholic nuns, priests, and lay brothers who participated in the Rush Religious Orders Study, the University of Kentucky RADC clinical cohort and to all ADC center participants that provided clinical and pathological data to the various studies discussed in this review.
HHS Public AccessAuthor manuscriptJ Consult Clin Psychol. Author manuscript; available in PMC 2016 June 01.Published in final edited form as: J Consult Clin Psychol. 2015 June ; 83(3): 554?63. doi:10.1037/a0039080.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptRandomized comparative efficacy study of parent-mediated interventions for toddlers with autismConnie Kasari, PhD, Human Development and Psychology, UCLA; [email protected] Amanda Gulsrud, PhD, Child Psychiatry, UCLA; [email protected] Tanya Paparella, PhD, Child Psychiatry, UCLA; [email protected] Gerhard Hellemann, PhD, and Psychiatry Biostatistics, UCLA; [email protected] Kathleen Berry, MA Human Development Psychology, UCLA; [email protected]–This study compared effects of two parent-mediated interventions on joint engagement outcomes as augmentations of an early intervention program for toddlers with autism spectrum disorder (ASD). Method–Participants included 86 toddlers (range 22 ?36 months) with ASD and their primary caregiver. Caregiver-child dyads were randomized to receive ten weeks of hands-on parent training in a naturalistic, developmental behavioral intervention (Joint Attention, Symbolic Play, Engagement and Regulation–JASPER) or a parent-only psychoeducational intervention (PEI). Dose was controlled in terms of researcher-parent contact and early intervention services received by the child. Results–Results yielded significant effects of the JASPER intervention on the primary outcome of joint engagement. The treatment effect was large (Cohen’s f2=.69).and maintained over the sixmonth follow-up. JASPER effects were also found on secondary outcomes of play diversity, highest play level achieved, and generalization to the child’s classroom for child-initiated joint engagement. The PEI intervention was found to be effective in reducing parenting stress associated with child characteristics. All secondary effects were generally small to moderate. Conclusions–These data highlight the benefit of a brief, targeted, parent-mediated intervention on child outcomes. Future studies may consider the combination of JASPER and PEI treatments for optimal parent and child outcomes. Trial registry # NCT00999778. Keywords autism toddlers; early intervention; parent training; JASPER; parenting stressCorresponding author: Connie Kasari, 68-268 Semel Institute, UCLA, Los Angeles, CA 90024, 310-825-8342.Kasari et al.PageYoung children with autism spectrum disorder (ASD) display significant impairments in early social communication skills. These include the initiation of joint attention gestures (e.g., showing toys to others, pointing to share, and coordinated eye gaze between objects and people) and the ability to jointly engage in social interactions with others (Adamson, Bakeman, Deckner, 2004; Kasari, Freeman, Paparella, 2006; Sigman, Mundy, Sherman, Ungerer, 1986). These impairments uniquely discriminate children with ASD from children with other developmental delays and typical children of similar mental age (Mundy, Sigman, Ungerer, Sherman, 1987.