# Personalized, Responsive Intervention Sequences for Minimally Verbal Children with Autism (PRISM)

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2024 · $617,090

## Abstract

PROJECT ABSTRACT
 Many 3-4 year olds with autism spectrum disorder (ASD) who are `preverbal' (30-50%) do not go on
to develop socially related words and phrases by age 5-6 years and are reclassified as `minimally verbal',
never moving past 20 functional, non-echoed words, even with exposure to evidence-based early
interventions. Despite significant research of children older than 5 who are already classified as minimally
verbal, little research has attempted to optimize intervention for limited language preschool children who
may be more likely to develop language with appropriate, targeted, and personalized intervention
approaches. Therefore, a major gap in our knowledge remains on how to place these children with ASD on
a path to becoming verbal by school age, thus reducing the numbers of minimally verbal children. A key
challenge in this population is that one size does not fit all: there is vast heterogeneity in presentation and
response to intervention. To capitalize on this heterogeneity, it will be necessary to use an individually
tailored, sequential approach to intervention whereby treatment is adapted over time based on how the child
responds. The overarching goal of the proposed multi-site project is to maximize language outcomes for
preschoolers at risk for maintaining `minimally verbal' status by developing a two-stage, 20-week “adaptive
intervention” (an intervention that incorporates a replicable sequence of treatment decision rules to guide
clinicians on when and how to alter an intervention). This study addresses key questions in designing an
adaptive intervention, including how best to intervene with children responding slowly to initial intervention,
which of four pre-specified adaptive interventions is best, which moderators are important to designing a
more individually tailored adaptive intervention, and better understanding the mechanism by which the
adaptive interventions may exhibit their effects. Specifically, the primary aim tests the effect of intensifying
stage 1 singular interventions versus changing intervention by systematically combining and enhancing
treatment modules. The stage 1 interventions include a commonly recommended approach based on
applied behavior analysis (discrete trial training) and an evidence-based early intervention that specifically
addresses the social communication impairment in ASD, JASPER (Joint Attention Symbolic Play
Engagement & Regulation). The primary outcome is spontaneous communicative utterances, and
secondary outcomes include joint engagement, receptive language, and presence of word combinations.
Our secondary and exploratory aims include moderator and mediator tests, and longitudinal outcome at age
5-6 years. Child participants include 140 4-year-olds with ASD and limited language (<20 functional words)
across 3 sites (U Oregon, Rochester, and UCLA). This study has the potential to dramatically improve
communication outcomes for children with ASD, and addresses a high priority ne...

## Key facts

- **NIH application ID:** 10565679
- **Project number:** 5R01HD095973-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** CONNIE L. KASARI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $617,090
- **Award type:** 5
- **Project period:** 2019-05-05 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10565679

## Citation

> US National Institutes of Health, RePORTER application 10565679, Personalized, Responsive Intervention Sequences for Minimally Verbal Children with Autism (PRISM) (5R01HD095973-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10565679. Licensed CC0.

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