Joint Attention, Symbolic Play and Engagement Regulation (JASPER)
JASPER (Joint Attention Symbolic Play Engagement Regulation) is a treatment approach based on a combination of developmental and behavioral principles developed by Dr. Connie Kasari at the Center for Autism Research and Treatment, at University of California, Los Angeles. This intervention model targets the foundations of social-communication (joint attention, imitation, play), uses naturalistic strategies to increase the rate and complexity of social-communication, and includes parents and teachers as implementers of the intervention to promote generalization across settings and activities and to ensure maintenance over time. Dr. Kasari and her colleagues have tested this approach in a series of target and modularized research studies. In the first randomized controlled trial, 58 preschool children with autism were recruited from an early intervention program based on applied behavior analysis, and were taught joint attention and play skills. This study showed promising evidence that a child-centered treatment focused on early social-communication deficits of joint attention and play could lead to improvements in these core deficits while also increasing the child's use of language (Kasari et al, 2006, 2008, 2012) over a 5 year span. Researchers are continuing to test the use of JASPER with children of various ages (infants to school-aged) and across various settings (clinic, home and schools).
Children with autism show noticeable difficulty coordinating attention with others for the purpose of sharing experience. This coordination of attention, called joint attention, is linked with both concurrent and future language ability in young children with autism. In response to increasing evidence that joint attention improves later language skills, the JASPER treatment was developed to improve core deficits in children with ASD.
The JASPER approach is composed of four main targets:
Joint Attention – The strategies in JASPER promote joint attention skills – coordinating attention between objects and people for purposes of sharing. Examples include looking between people and objects, showing, and pointing to show. While joint attention develops naturally in typical children, those with autism must actively learn these skills. Our studies show that when joint attention skills are modeled and taught directly, children with autism use more joint attention. This leads to increased engagement and learning.
Symbolic Play – A primary target of JASPER is to increase the diversity of children's play skills. Appropriate play acts are modeled, joint attention is facilitated within play routines, and greater diversity in types of play are encouraged. The overall goal is to help the child increase their diversity and flexibility in play and reach higher levels of play. Although reaching levels of symbolic play is an ultimate goal, functional play is also targeted depending on the child's developmental level.
Engagement – JASPER utilizes a number of strategies to improve the child's state of engagement with others during intervention. The goal is to scaffold the child from being unengaged or solely focused on objects to higher states of joint engagement with others, and increase their diversity and flexibility enabling them to reach higher levels of play. Increases in engagement lead to increased opportunities for social communication and learning.
Regulation – This approach stresses the importance of emotion and behavior regulation. A series of strategies are employed to handle self-stimulatory behaviors that interfere with learning, lack of engagement, and disregulation.
The objective for every JASPER session is to increase joint engagement, diversify and expand play skills, and promote nonverbal and verbal communication. First, the child undergoes a series of assessments to measure joint attention, play and engagement so that appropriate targets for intervention can be chosen. Next, the adult (teacher, paraprofessional, therapist, or parent) and child meet with a trained professional for a series of sessions, usually twice per week to learn the JASPER strategies. The adult learns to adjust the environmental arrangement, balance modeling and imitation, and expand on language and play routines as needed to promote joint attention and engagement during play.
Basic JASPER strategies:
- Modeling – joint attention, language, play acts
- Prompting hierarchies for – joint attention, language, play acts
- Imitating – joint attention, language, play acts
- Expanding – joint attention, language, play acts
- Pacing adult language to match the child's language
- Adjusting play routines based on the child's interests
These sessions utilize a naturalistic play setting with a balance of structure and flexibility. There is flexibility in that the adult is continually following the child's lead, playing with toys that appeal to the child, shifting attention as needed, and imitating language and play acts. But there is also structure and support in that the adult must frequently rearrange and adjust the child's environment to promote engagement.
The adult learns to slow the pace of their language to match the child's and to avoid directive language (e.g. commands, demands, and test questions). By commenting (e.g. labeling items), instead of directing, the adult models functional language in a way that promotes spontaneous language from the child.
JASPER has been empirically tested with many children, ranging in age from 12 months to 8 years, with a wide range of developmental abilities. It has application for parents, teachers, paraprofessionals and clinicians. JASPER works well in conjunction with other behavioral-based therapies and can be naturally incorporated into inclusion and special education classrooms and every day activities in the home. The only required materials are developmentally-appropriate toys or activities.
Learn more at www.interactingwithautism.com.