Teacher-implemented joint attention intervention: Pilot randomized controlled study for preschoolers with autism

Background:  The vast majority of children with an autism spectrum disorder (ASD) attend public preschools at some point in their childhood. Currently, most preschool practices are not evidence-based and almost none target the core deficits of ASD. Joint attention is a core deficit of autism spectrum disorders that has been linked to the emergence of several critical skills in children who are typically developing or who have an autism spectrum disorder. Several studies suggest it is possible to improve the joint attention of children with autism. Unfortunately, at this time, few intervention studies exist for improving the joint attention skills of children with autism in the preschool context where they spend the most time and none are implemented by preschool teachers during naturally occurring preschool activities.

Objectives:  This study investigated whether preschool teachers could reach fidelity on a validated intervention (the Joint Attention and Symbolic Play/Engagement and Regulation intervention-JASP/ER) that targeted the instruction of joint attention to preschoolers with autism during ongoing classroom activities. In addition, the study focused on which of the 11 specific JASP/ER strategies teachers/paraprofessionals reached fidelity with. 

Methods:  Sixteen dyads (preschoolers with ASD and the public school teacher or paraprofessional who worked in the child’s classroom) were randomly assigned to the six-week JASP/ER intervention or a control group.

Results:  At the end of the intervention, JASP/ER teachers/paraprofessionals used more JASP/ER strategies than the control teachers/paraprofessionals. JASP/ER teachers/paraprofessionals reached fidelity with six JASP/ER strategies.  

Conclusions:  Findings suggest that teachers/paraprofessionals could implement a validated treatment in a public preschool context.