Early Intervention and Training The Community – A Conversation with Dr. Connie Kasari

If you look up the most influential autism researchers, Dr. Connie Kasari Ph.D., Professor of Human Development and Psychology at UCLA is on that list. A founding member of the Center for Autism Research and Treatment at UCLA, Dr. Kasari aims to develop new and evidence-based intervention strategies for children with ASD that can be used in various communities. She has targeted communities that have been underrepresented in research to make sure everyone has equal access to treatments and other services.

The Real Spectrum: How did you become passionate about autism research and treatment?

Dr. Kasari: Oh goodness, it was a long time ago. I got my masters degree and then I was a teacher for around two years with babies. One of those babies was a little girl with autism but I didn’t know it back then. It was in the early 1980s. I didn’t know much about autism at the time; now, I could say that she probably had an autism diagnosis. Then, I went to grad school and I worked with children with autism. I learned a lot and I think when you start working with the kids and their families, you gain such a fascination learning about them. I’ve heard hundreds of stories of families and kids with autism and that’s really been such a motivation for me since I started in grad school.

At what age is it critical to begin early intervention strategies?

Dr. Connie Kasari, PhD

It really depends on the child. As we’ve learned more about autism, the age for beginning therapy and intervention has become more apparent. You want to begin the minute you realize certain characteristics. If you have anxiety and you begin having anxious thoughts at age 8, you will want to start therapy or treating that anxiety at age 8. If you are a child with autism and you get diagnosed as a toddler, that is when you want to start.

What led you to develop your intervention approach, JASPER (Joint Attention, Symbolic Play, Engagement, and Regulation) to help with social communication?

At the time, I was working with really young kids when they were first being diagnosed. We thought that the main struggles with autism lay in language, like the children just weren’t talking. So, we went back to see what develops before neurotypical kids learn words which are gestures, imitation, and engagement with other people. The kids with autism showed differences so the question is if we could teach those things and will it make a difference in their skills. We created this program, since there weren’t many other strategies like this at the time, to focus on the early skills and how the child’s language and social communication could improve. We started in 1998 and today, we often blend JASPER with other interventions depending on the child.

Why is autism so misdiagnosed when conducting neuropsychological evaluations?

It really depends on the skill and sophistication of the professionals. If a child is diagnosed with ADHD, it probably was because that doctor knew more about ADHD rather than autism. Honestly, sometimes it has to do with the parents. Many times the parents don’t want to hear that their child has autism and so the doctor just provides less worry to the parents if the child appears capable in certain areas. Not a lot of people believe in sensory processing disorder but many doctors see that rather than autism. It is a problem that people can get a series of diagnoses that may not be correct but the more important thing is that you are treating the symptoms and the needs of the child without a label.

I recently met with Dr Kevin Pelphrey at UVA. A lot of his research focuses around ASD in boys and girls. What have you learned about the sex-based differences in ASD?

It’s definitely unclear why there are less girls that are diagnosed and if it’s due to their ability to manage or fit in better. It could honestly be a bias towards boys or truly a sex-difference. I don’t know that there is. We’ve observed girls in schools. We’ve looked at their play behaviors and how they socialize. Boys are much more obvious in their behaviors in the school setting than girls are. I think in the future with research, we need to focus on the diagnosis and then intervention of girls.

In a recent presentation I watched, you mentioned that there are 14,000 children in the LA Unified School District with an ASD diagnosis. How can you make an impact with so many children and so little resources and manpower?

Each of those 14,000 children have different needs. When it comes to schools, we have to do a better job of training generalized education teachers to include all kids. I am a college professor so I try to raise awareness and proficiency of teachers. You can’t make a difference for everyone. I also have another project with adolescents and young adults and we are teaching them another intervention called self-determination; it’s a learning model of instruction (SDLMI). It helps students set goals and helps to promote stronger motivation to achieve those goals.

What is some of the more specific research that you are currently working on in your lab?

Right now, we are really concerned with traditionally marginalized minoritized populations and trying to put out interventions in different community settings. We partner with communities and formulate interventions that we roll out in the community. Our goal is to get them sustained in school systems or a regional health center where people can have access to them. People can have access to more skilled professionals who are trained better. We are also working on projects with babies and toddlers. We have babies starting at 12 months who are starting to show signs of autism. We often see signs of joint tension; they don’t have gestural use and can’t connect to other people or sometimes toys. We don’t diagnose them at 12 months but we will say that they are at risk. In the lab, we also look at brain structure and how certain abnormalities seen in autism develop.

What are you most optimistic about when it comes to autism research?

I think we are learning a lot. I’m hoping that we will get more personalized with our interventions to target each individual person instead of just giving out labels. I am optimistic that we can have these conversations to make a difference in the field.

What do you have to say for girls in STEM?

The world is much more caring and supportive of women in STEM. We need women in STEM. We need to change the conversation. So, do it! You got this!

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