Down Syndrome
Conditions
Keywords
Parent Coaching, Parent Education, Social Communication, Play Skills, Behavioral regulation, Development, Emotional regulation
Brief summary
In this study, investigators will study the impact of a 1:1 caregiver coaching intervention using the JASPER (Joint Attention, Symbolic Play, Engagement, Regulation) behavioral therapy curriculum compared to a psychoeducational curriculum that will be provided to caregivers for self-directed learning. Investigators want to determine the impact of both interventions on the child's development and behavior, and caregiver implementation of strategies.
Detailed description
Down syndrome (DS), the most common genetic cause of intellectual disability, can be associated with a wide range of developmental needs. Behavioral challenges are common, and can impact learning, overall achievement, relationships, inclusion in schools, and community integration. The goal of this study is to determine whether JASPER (Joint Attention Symbolic Play Engagement and Regulation) can improve caregiver implementation of behavioral strategies, caregiver self-efficacy and confidence, and child development. Participants will be randomized to receive either the JASPER intervention or a caregiver psychoeducational group. Participants in the JASPER intervention will receive 10 weekly virtual educational sessions utilizing JASPER therapy modules through 1:1 parent-child coaching sessions. Caregivers in the comparison group will receive 10 weekly modules containing a psychoeducational curriculum. The outcome measures will assess caregiver responsiveness, child joint engagement with caregiver, caregiver self-efficacy, and child behavior, language, and adaptive skills.
Interventions
BEHAVIORALJASPER
JASPER is a therapist and caregiver-mediated intervention that (1) targets the foundations of social communication, (2) uses naturalistic behavioral strategies to increase the rate and complexity of social communication and (3) includes caregivers as implementers of the intervention to promote generalization across settings and to ensure maintenance. This intervention is individualized and centered around two key developmental domains critical for social communication function: joint engagement and joint attention.
BEHAVIORALPsychoeducational Curriculum
The psychoeducational modules will include written information about child development, communication and social interaction skills, behavioral principles for managing challenging behavior and strategies for teaching new skills. No direct caregiver-child mediated coaching will be provided. The material provided will be similar to what a pediatrician or developmental specialist may review as a part of routine care.
Sponsors
Boston Children's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
36 Months to 90 Months
Healthy volunteers
No
Inclusion criteria
* Confirmed diagnosis of Trisomy 21 * Age 3-7 years * Able to walk independently * English speaking * Caregiver able to complete either 1:1 virtual coaching sessions or psychoeducational behavioral curriculum
Exclusion criteria
* Mosaic Down syndrome * Significant and uncorrected hearing and/or vision problems
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Joint engagement and joint attention skills | 20 weeks | Joint engagement and joint attention skills will be coded from Caregiver-Child Interaction (CCX) video recordings. The 15-minute CCX videos measure the amount of time that caregiver and child engage during a play session. The frequency of the child's engagement states will be coded using an Engagement State Coding Scheme to measure proportion of video during which child is maintaining Joint Engagement (shared engagement in a play routine). |
| Social communication skills | 20 weeks | Social communication skills will be coded from Caregiver-Child Interaction (CCX) video recordings. The 15-minute CCX videos measure the amount of time that caregiver and child engage during a play session. A Social Communication Coding Scheme will measure the child's social communication skills. This coding scheme includes various social communication items and Yes or No codes to measure social communication skill development over time. Increasing answers of Yes indicate growth in social communication skills. |
| Caregiver use of behavioral strategies | 20 weeks | The frequency with which caregivers use behavioral strategies will be collected from a weekly caregiver Behavioral Strategy Log. |
| Language, socialization, play, problem behavior, and adaptive skills | 20 weeks | Language, socialization, play, problem behavior, and adaptive skills measured by a parent interview about development using the Vineland Adaptive Behavior Scales (VABS-III). Behavior frequency is measured on a range of 0=Never to 1=Sometimes to 2=Usually. |
| Socialization and play skills | 20 weeks | Socialization and play skill development measured by the Play Assessment Questionnaire. The Play Assessment Questionnaire includes Yes or No items about play skills, symbolic play types and routines, and play level. This caregiver questionnaire measures play skill development over time. Increasing answers of Yes indicate growth in play skills. |
Countries
United States
Outcome results
None listed