Playing At Preschool: Engineering Playtime to Address Core Deficits

Background: Playing in preschool is often what children do best.  However, for children with ASD play takes on special challenges as children are often rigid and impoverished in their play skills.  While a number of studies have taught play skills to children with ASD, these have often been carried out in 1:1 adult child therapy sessions, and may be less transportable to public preschool programs where teachers typically work with children in dyads or triads of children.  To ensure that evidence based interventions are implemented and sustained in public preschools, alternative models are needed.

Objectives: To determine if a modified efficacious therapeutic approach (JASPER, Kasari et al, 2010) adjusted for small group instruction has a) sustainability and implementation by teachers in low resourced public preschool programs, b) teachers better able to identify targets of treatment and implement JASPER will have children who make greater change in play skills. 

Methods: In collaboration with administration staff in a large school district, a preschool deployment model is currently being executed in all six specialized autism preschool programs in the district.  Each program has two classes, an AM and PM class of 6-8 children each (n= 57).  All preschools contain 80-100% of children on free and reduced lunch, and 91% ethnic minority.  A randomized wait list control design is underway.  Teachers (2 at each site) have been trained to assess all of their children with a modified brief play assessment that yields intervention targets of specific play skills.  Targets chosen by teachers are validated against research assessments (by research team). Teachers in immediate treatment group are taught JASPER modified for group sessions in a coaching and consultation model with fidelity of implementation checks weekly.  Teacher fidelity, match in intervention targets, and child change on play will be compared at end of 8 week treatment phase, and 4 week follow up phase to teachers who have learned to assess children in their classrooms but not taught the treatment.

Results: Thus far, all teachers have been taught the assessment, assessed their children and chosen treatment targets. Intervention consultation and coaching is underway for the immediate treatment groups.  All data will be completed by February and children reassessed.

Conclusions: The results of this study will provide evidence of whether teachers who are more actively involved in the development, and execution of the intervention (and assessment process) will have children who perform better on outcome measures.