Parents as therapists: How much strategy use is enough?

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We talked last month about JASPER-EMT (Joint Attention, Symbolic Play, Engagement and Regulation + Enhanced Milieu Training), a play-based social communication intervention designed to increase language use in minimally verbal children with autism (see previous studies here and here for more). The intervention includes a parent training component, and this study focused specifically on how parents’ use of the intervention strategies (e.g., imitation and modeling, establishing play routines; see Table 2) affected spontaneous commenting by their 5- to 8-year-old children with autism.

The authors found that when parents used JASPER-EMT strategies at least 70% of the time (measured by averaging scores across multiple rating scales), children showed a significant increase in comment use compared to those whose parents used the strategies less often. This is a preliminary finding, but it’s notable that it’s lower than the 80% benchmark often used for clinicians. (Note that half of parents in the study were implementing JASPER-EMT strategies in at least 70% of opportunities when the treatment ended.)

Overall, this study adds to the evidence that parent-implemented programs can increase children’s social communication, and gives us a rough benchmark to shoot for when coaching parents on JASPER-EMT strategy use.  

Shire, S. Y., Shih, W., & Kasari, C. (2018). Brief report: Caregiver strategy implementation—advancing spoken communication in children who are minimally verbal. Journal of Autism and Developmental Disorders, 48, 1228–1234. doi: org/10.1007/s10803-017-3454-0