Task-Based Grounding Program

A Pilot Randomized Control Trial of the Task-Based Grounding Program

The purpose of this study is to improve the availability of brief interventions to help children with defiant, aggressive and disruptive behaviors by creating a brief scalable intervention for parents delivered via telehealth. As phase 1 study, we are conducting a 2-arm pilot feasibility RCT in order the intervention, measures, and procedures to be used in a larger efficacy trial. The first arm will include a 3-session behavioral therapy treatment we call Task-Based Grounding and the second arm will be an enhanced treatment as usual comparison group.

Study Overview

• Status: Completed
• Conditions: Attention Deficit Hyperactivity Disorder; Aggressive; Defiant Disorder, Oppositional
• Intervention / Treatment: Behavioral: Task-Based Grounding; Behavioral: Connected Care (Enhanced Treatment as usual)

Detailed Description

The investigators have developed a 3-session psychosocial intervention for parents of children between 9-14 with disruptive behaviors. The intervention uses telehealth visits along with written and online resources to teach them parent management skills. To evaluate the acceptability of this intervention and the feasibility of our methods, the investigators will recruit 20 parent-child dyads to participate in this study. This is a mixed methods pilot feasibility RCT design. The investigators designed this study to test the acceptability of the intervention to parents and test the feasibility of our recruitment, retention, measurement, and delivery mechanisms for both the experimental and comparison conditions. The investigators will use a block randomization method to separate parent-child dyads into either treatment or comparison groups. The treatment condition involves 3 telehealth visits and a set of parenting resources. The enhanced treatment as usual condition will involve contact with a "care navigator" that will assess behavior problems in the child and help the parents find an appropriate referral to care in their community. Both groups will be followed for 10 weeks, provide outcome data, and participate in semi-structured qualitative interviews to accept acceptability.

• Study Type: Interventional
• Enrollment (Actual): 28
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • New Hampshire
    • Lebanon, New Hampshire, United States, 03756
      • Dartmouth Hitchcock Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 9 years and older (ADULT, OLDER_ADULT, CHILD)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participating parent-child dyads must include a child between the ages of 9-14 years old and adult over the age of 18.
• The child must have a Vanderbilt Oppositional Defiant Disorder score >3
• The participating caregiver must be a legal guardian of participating child

Exclusion Criteria (child refers to the primary participant's child)

• Child ever been hospitalized for a psychiatric problem
• Child ever attempted suicide or stated that they had a plan to attempt suicide within the past year.
• Child ever engaged in self-harm behaviors
• Child has significant legal history such as adjudicated of a crime or been in diversion
• Child has ever been diagnosed with: Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Intellectual Disability or Developmental Delay, Speech or Hearing Delay, Autism Spectrum Disorder, Schizophrenia or another psychotic disorder, A substance abuse disorder (or had serious concerns about substance use).
• Parent can communicate in spoken English
• Parent is under the age of 18.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Task-Based Grounding; Participating parents will be provided with three 50-minute Task Based Grounding sessions using a standardized manual over 6 weeks.	Behavioral: Task-Based Grounding; Three 50 minutes sessions with an interventionist that includes 6 non-punitive components of treatment common in Behavioral Parent Trainings: Education on behavior change, positive one-on-one time between parents and their children, differential attending to positive and negative behaviors, effective praise, giving effective instructions, and using a point and reward system to encourage prosocial behaviors. These components are distilled into 5 skill modules and paired with Task-Based Grounding, which involves a brief restriction of privileges and provides children with the opportunity to end the restriction by completing a prosocial task.
SHAM_COMPARATOR: Connected Care (Enhanced treatment as usual); Participating parents will be provided with two sessions and one phone check-in call over 6 weeks. They will work with a "care navigator" to assess their child's needs, find them an appropriate referral for care, and help problem solve barriers to finding a therapist.	Behavioral: Connected Care (Enhanced Treatment as usual); Two sessions with a facilitator. The facilitator does NOT provide any guidance to the parent on managing their child's behavior, but provides empathy and problem solving to help them find a resource that best fits their needs. It is particularly geared towards helping parents connect with Behavioral Parent Trainings to address the needs of children with oppositional, defiant, or aggressive behaviors.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of referred participants	Feasibility of recruitment will be measured by number of participants referred	Through study completion, approximately 5 months.
Number of participants who screen positive	Feasibility of recruitment will be measured by number of participants who screen positive	Through study completion, approximately 5 months.
Change from Baseline Session attendance at visit 3	Feasibility of the participant retention in the program will be measured by session attendance by participants	Session attendance will be taken at Session 1 (week 0) and Session 3 (week 6)
Number of participants enrolled	Feasibility of recruitment will be measured by number of participants enrolled	Through study completion, approximately 5 months.
Number of participants who complete all assessment measures	Feasibility of assessment measures will be measured by number of participants who complete assessment measures	Through study completion, approximately 5 months.
Fidelity of the training provided	as measured by having a trained listener code and score fidelity using a checklist developed specifically for the content of each session. Audio recording of intervention sessions will be used. There are 35 items on the checklist, each worth 1pt. Score will be in terms of percentage, with a minimum score of 0 and a maximum score 100%.	Through study completion, approximately 5 months.
Intervention acceptability as measured by the Treatment Evaluation Inventory Short Form	as measured by Treatment Evaluation Inventory Short Form post intervention which measures intervention acceptance. The established cut off scores for determining if a treatment is acceptable is a score of 27. Min score possible is 0, max score possible is 32. Higher scores indicate greater acceptability.	Follow-up/post intervention (up to 10 weeks)
Intervention Acceptability as measured by the Therapy Attitude Inventory	as measured by the Therapy Attitude Inventory post intervention which measures acceptability of behavioral parent trainings. Min score of 1 is possible, max score of 50 is possible. Higher scores indicate greater acceptability.	Follow-up/post intervention (up to 10 weeks)
Intervention Acceptability as measured by the Participant Experiences Questionnaire	as measured by the Participant Experiences Questionnaire which measures acceptability of each skill module included in the program and is specific to program content. Min score of 0 possible, max score of 36 possible. Higher scores indicate greater acceptability.	Follow-up/post intervention (up to 10 weeks)
Acceptability as measured by qualitative interview	as measured by 30 minute semi-structured qualitative interview with participants conducted by a research assistant trained and supervised by the study PI	Follow-up/post intervention (up to 10 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adherence to the intervention	as measured by daily logs that track both children's aggressive and defiant behaviors and parenting behaviors. A count of each time a parent used a skill from the program will be used to estimate adherence and assess whether they matched the appropriate skills to the reported misbehaviors.	Available for completion every day for 10 weeks

Collaborators and Investigators

• Sponsor: Dartmouth-Hitchcock Medical Center
• Investigators: Principal Investigator: James T Craig, Ph.D., Dartmouth-Hitchcock Medical Center

Study record dates

Study Major Dates

• Study Start (ACTUAL): December 3, 2020
• Primary Completion (ACTUAL): October 1, 2021
• Study Completion (ACTUAL): October 1, 2021

Study Registration Dates

• First Submitted: November 14, 2020
• First Submitted That Met QC Criteria: November 23, 2020
• First Posted (ACTUAL): December 1, 2020

Study Record Updates

• Last Update Posted (ACTUAL): November 8, 2021
• Last Update Submitted That Met QC Criteria: November 5, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Keywords: Oppositional Defiant Disorder; Behavioral Parent Training
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Neurodevelopmental Disorders; Disease; Attention Deficit Disorder with Hyperactivity; Attention Deficit and Disruptive Behavior Disorders
• Other Study ID Numbers: D21019

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No