Developmental and Augmented Intervention for Facilitating Expressive Language

Both treatments will be manualized and a novel research design method called Sequential
Multiple Assignment Randomized Trial (SMART) will be applied. SMART design will allow the
interventionists to adjust the course of treatment based on whether the children respond to
the treatment. More specifically, there will be two stages of intervention and during Stage
1, 90 nonverbal (e.g. those who have less than 5 spoken words) children with ASD between 5
and 8 years of age will be randomly assigned to either the JAE-EMT or JAE-AAC group. After
receiving the assigned Stage 1 treatment for 12 weeks, all participants will be assessed to
see if they responded to the Stage 1 treatment. If the children do respond to Stage 1
treatment, they will continue with that same treatment for another 12 weeks in Stage 2. A
different treatment sequence will be used for those who do not respond to Stage 1 treatment
where these non-responders will be re-assigned to 1 of 3 alternative intervention
conditions. For example, those who do not respond to JAE-AAC will have the intensity of that
same JAE-AAC treatment increased. Those who do not respond to the other, JAE-EMT treatment
will be randomly assigned to either a more intense JAE-EMT condition, or the original
JAE-AAC implemented in Stage 1. At the end of Stage 2, another follow-up assessment of
cognitive, language, and social communication skills will be administered. Furthermore,
several children who enter the study in the early stages will be tested again, 3 months
after the Stage 2 follow up (not all children will be able to be tested at 9 months within
the 3 year grant period).