Spoken language outcomes in limited language preschoolers with autism and global developmental delay: RCT of early intervention approaches.
Connie Kasari, Stephanie Shire, Wendy Shih and 3 others
PMID 37070270WHAT IT FOUND
Both Discrete Trial Teaching and JASPER significantly improved spoken language in preschoolers with autism and severe delays.
Neither approach was superior for the primary outcome, though DTT showed slight advantages in word diversity and play level at follow-up.
Key findings
01Children in both intervention groups improved significantly in expressive language from baseline to exit and follow-up, with no difference in improvement between the DTT and JASPER groups.
02By the end of the intervention, 27.3% of children demonstrated phrase speech, up from zero at baseline, with no significant difference between intervention groups.
03While overall language gains were similar, children receiving DTT gained 1.5 more unique words than those in JASPER at exit, and showed greater improvements in play level at follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not include a control group receiving only their usual community care, so it is unclear how much of the improvement was due to the specific research intervention versus the additional hours of therapy provided. The primary measure (Reynell) had significant floor effects, requiring analysis of raw scores rather than standardized age equivalents. The sample size was smaller than planned (164 randomized vs. 192 planned) due to recruitment difficulties. All children were already receiving substantial intervention hours (12–25 per week) in their community preschools, which may limit the generalizability to children with less existing support.
Declared interests
The study was supported by the National Institute of Mental Health (NIMH). No other conflicts of interest are reported.
The easy way to misread this
Do not conclude that DTT and JASPER are equally effective for all outcomes. While they produced similar gains in overall expressive language, DTT showed superior results in word diversity and play level at follow-up, and JASPER was better for joint attention in children with baseline sharing skills. Choosing an intervention based solely on the primary language outcome may miss these specific benefits.