JASPER Implementation in NFLD

Government of Newfoundland and Labrador

Status: Completed

Conditions: Autism Spectrum Disorder

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

Study type: Interventional

Funder types: Other

Identifiers

NCT03205475

GovernmentNL

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 27 patients

Sex: All

Ages: 24 to 97 months old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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27 participants in 6 patient groups

A. Above Fidelity Phase 1 and Above Fidelity Phase 2

Active Comparator group

Description:

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

Treatment:

Behavioral: Video Feedback Only Phase 2

Behavioral: Alternate Coaching and Video Feedback Phase 1

B. Below Fidelity Phase 1 and Above Fidelity Phase 2

Active Comparator group

Description:

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

Treatment:

Behavioral: Video Feedback Only Phase 2

Behavioral: Weekly Coaching in Phase 1

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

Active Comparator group

Description:

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.

Treatment:

Behavioral: Weekly Coaching plus Intensive Refresher Course Phase 2

Behavioral: Alternate Coaching and Video Feedback Phase 1

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

Active Comparator group

Description:

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).

Treatment:

Behavioral: Weekly Coaching plus Peer Coaching Phase 2

Behavioral: Alternate Coaching and Video Feedback Phase 1

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

Active Comparator group

Description:

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.

Treatment:

Behavioral: Weekly Coaching plus Intensive Refresher Course Phase 2

Behavioral: Weekly Coaching in Phase 1

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

Active Comparator group

Description:

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).

Treatment:

Behavioral: Weekly Coaching plus Peer Coaching Phase 2

Behavioral: Weekly Coaching in Phase 1