Spoken language outcomes in limited language preschoolers with autism and global developmental delay: RCT of early intervention approaches.

This study tested two different ways to help autistic preschoolers with very limited speech learn to communicate better. 164 children got one hour of therapy each day for 6 months at their preschools, then researchers checked their progress again 6 months later. Both therapy types helped - children gained about 6 months of language skills during treatment. Some children did better with one type of therapy depending on their starting abilities, like how well they could point to share interest or understand language.

This RCT compared two early intervention approaches (JASPER and Discrete Trial Training) in 164 minimally verbal autistic preschoolers with global developmental delays. Children received one hour of daily therapy for 6 months in community preschool settings, followed by 6-month follow-up. Both interventions produced significant gains: children averaged 6 months of language development during the 6-month active intervention period, with no overall difference between approaches. However, individual responses varied based on baseline abilities.

Children with higher joint attention initiation or receptive language benefited more from JASPER, while those receiving Discrete Trial Training showed greater progress during the post-intervention follow-up period. The study included predominantly historically excluded populations (low income, minority families).

Results support intensive early intervention for minimally verbal autistic children with global delays. Treatment selection may benefit from considering baseline joint attention and receptive language abilities. Both approaches show promise but may have different timing of optimal effects.

Study duration was relatively short (6 months intervention plus 6 months follow-up). Individual variation in treatment response suggests need for more personalized approaches. Sample size details not provided in abstract limits assessment of statistical power.

Preschool autistic children with significant global developmental delays and very limited language skills are at high risk for remaining minimally verbal at entry into primary school. This study compared two early intervention models for improving social communication and spoken language outcomes in 164 children who received intervention in their community preschool program for 6 months, with a six-month follow-up. The primary outcome measure was a standardized language assessment, and secondary measures focused on social communication. Results indicated children on average made 6 months gain in language development in the active 6 months of intervention with no difference between intervention models.

Children who initiated joint attention more frequently, or who had higher receptive language at baseline made more progress if assigned to receive JASPER, a naturalistic developmental behavioral intervention. Children who received Discrete Trial Training made greater spoken language progress from exit to follow-up. These findings suggest that progress can be made in autistic children who have very little spoken language and who receive targeted early interventions. Individual trajectories vary and depend in part on initial abilities in social communication and receptive language.

Future research might consider methods to systematically personalize approaches to fit child characteristics and family preference. LAY SUMMARY: This study compared two different early intervention approaches for teaching spoken language to minimally verbal, globally delayed autistic preschoolers. Children were given an hour of therapy daily for 6 months and then reassessed 6 months later. The majority of the 164 participants were from historically excluded populations (low income and minority), and therapy was delivered in school community settings by expert clinicians.

Results indicated that the participants made significant progress regardless of intervention approach: 6 months gain in standardized language scores over 6 months, but slower progress during the period after therapy ended. Children who initiated joint attention more frequently, or who had higher language understanding at baseline made more progress if assigned to receive JASPER, a naturalistic developmental behavioral intervention. Children who received Discrete Trial Training made greater language progress during 6-month period after therapy ended. These findings suggest that progress can be made in children with ASD who have very little spoken language and who receive targeted early interventions.