- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04992169
Clinicianless Training in Autism Treatment: An Adaptive Online Parent Education Program
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Despite scientific advances in treatment for autism spectrum disorder (ASD), most families across the United States do not have access to high quality autism services, let alone the best autism treatment models available. There are a number of reasons for this concerning reality, including the limited number of trained autism clinicians around the country, the rising cost of services, geographic distance from autism service providers, and difficulties in being able to effectively and efficiently train a large number of people in the latest treatment models.
This proposed project focuses on the Department of Defense Autism Research Program - Clinical Translational Research Award Area of Interests focused on Dissemination/Implementation of Clinically Validated Interventions and Behavioral Therapies for ASD Core Symptoms. These areas focus on effective strategies for taking what works (in this case, highly effective autism treatments shown to improve social communication and motivation in children with autism) and spreading or distributing these treatments so that they can benefit a much larger portion of the population. This is important, because a highly effective treatment is of little use if only people in a few areas can benefit from its effect, while the rest of the nation continues to use outdated, less effective strategies.
To accomplish the goal of distributing a highly effective intervention to the general public, this proposed study will take advantage of the wide-spread use of smartphones nationwide. This study proposes to develop and evaluate smartphone apps as a way to train parents of young children with ASD in an autism treatment model known as Pivotal Response Treatment (PRT). Families will be recruited nationwide to participate in this trial.
Pivotal Response Treatment is a well-known, scientifically supported treatment that focuses on using child motivation, play-based lessons, and parent involvement to target the language skills and social engagement of children with ASD. The core smartphone app will offer eight interactive lessons in PRT, consisting of video examples, slides, and brief quizzes. After each lesson, parents will be asked to record a brief video of themselves using PRT with their child, which is submitted within the app to the research team so that they can monitor their mastery of the strategies over time. The investigators will also ask parents to complete autism-related and developmental surveys before and after participation so that the research team can monitor how their child is improving.
Ultimately, the objective of this trial is to develop and test smartphone apps to deliver a highly effective autism intervention to families nationwide. The use of this technology will ensure that families can access gold standard autism treatment regardless of their geographic location, work schedules, or financial background. If successful, the investigators plan to conduct an even larger nationwide study and ultimately make the app available in smartphone app stores so that families everywhere can train themselves in this treatment approach.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Emily Ferguson
- Phone Number: 8058932049
- Email: eferguson@ucsb.edu
Study Locations
-
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California
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Santa Barbara, California, United States, 93106-9490
- University of California, Santa Barbara
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Clinical diagnosis of autism spectrum disorder
- Parent endorsements of significant language delay
- Between the ages of 1.0 and 4.5 years (12 and 54 months)
- Parents willing to complete intake and follow-up assessments, complete the eight weekly PRT lessons, record and submit parent-child PRT videos, and review these videos on a weekly basis.
- Access to an internet connection and an iOS smartphone or tablet that can supports the app and records video.
Exclusion Criteria:
- Significant medical conditions, seizures, and mental health concerns
- Non-English speaking
- Prior parent training in PRT or similar Naturalistic Developmental Behavioral Intervention
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Smartphone App with Video Self-Scoring Functionality
In this condition, after parents video-record their delivery of the intervention, they watch their video and are taught to score their own performance/fidelity through question prompts built into the app.
When they are finished, the app will offer feedback and follow-up lessons based on the PRT strategies they have not demonstrated consistently.
|
Parents are trained in Pivotal Response Treatment, Pivotal Response Treatment is a well-known, scientifically supported treatment that focuses on using child motivation, play-based lessons, and parent involvement to target the language skills and social engagement of children with autism.
The core smartphone app will offer eight interactive lessons in PRT, consisting of video examples, slides, and brief quizzes.
|
Experimental: Smartphone App without Video Self-Scoring Functionality
In this condition, after parents video-record their delivery of the intervention, they watch their own video but do not score their performance.
|
Parents are trained in Pivotal Response Treatment, Pivotal Response Treatment is a well-known, scientifically supported treatment that focuses on using child motivation, play-based lessons, and parent involvement to target the language skills and social engagement of children with autism.
The core smartphone app will offer eight interactive lessons in PRT, consisting of video examples, slides, and brief quizzes.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from Baseline in Parent Fidelity of Implementation of Pivotal Response Treatment (PRT) during Behaviorally Coded Parent-Child Intervention Videos at 8 weeks, 16 weeks
Time Frame: Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
|
Parent participants will record and submit a five-minute video of themselves using the PRT intervention strategies with their child using the clinical trial's smartphone app.
Trained research assistants will behaviorally score each video using computer-based behavioral coding software (Noldus Observer XT) on a trial-by-trial basis for the presence or absence of each PRT intervention component, which include the use of: child choice, child attention, clear opportunities, contingent reinforcement, reinforcement of child response attempts, a balance of maintenance and acquisition tasks, and task variation.
Total uses of these components will be divided by total uses + absences of these components to yield a percentage.
The mean percentage of all components will be used as the primary outcome, with a range of 0% to 100% use of the PRT components.
|
Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from Baseline in Frequency of Child Vocalizations/Word Use during Behaviorally Coded Parent-Child Intervention Videos at 8 weeks, 16 weeks.
Time Frame: Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
|
Parent participants will record and submit a five-minute video of themselves using the PRT intervention strategies with their child using the clinical trial's smartphone app.
Trained research assistants will behaviorally score each video using computer-based behavioral coding software (Noldus Observer XT) on a continuous basis for the total frequency of child vocalizations and word use (both prompted and unprompted/spontaneous).
The minimum number of vocalizations/words is 0 (no vocalizations or spoken words) and there is technically no maximum (although this is limited by the 5-minute duration of the video probe).
|
Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
|
Change from Baseline in Percentage of Child Positive Affect during Behaviorally Coded Parent-Child Intervention Videos at 8 weeks, 16 weeks.
Time Frame: Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
|
Parent participants will record and submit a five-minute video of themselves using the PRT intervention strategies with their child using the clinical trial's smartphone app.
Trained research assistants will behaviorally score each video using computer-based behavioral coding software (Noldus Observer XT) on a continuous basis for the total duration of child positive affect (i.e.
directed positive facial expressions - observable smiling and laughter).
The minimum percentage is 0% (no positive affect) and the maximum is 100% (constant presence of positive affect).
|
Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
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Change from Baseline in MacArthur-Bates Communicative Development Inventory (CDI), Level I Short Form (Total Score) at 16 weeks
Time Frame: Baseline, 16 weeks (follow-up)
|
The MacArthur-Bates CDI (Fenson et al., 2000) is a caregiver-reported measure of child expressive vocabulary use.
Parents will complete a digital version of the CDI to obtain information on reported word usage and understanding.
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Baseline, 16 weeks (follow-up)
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Change from Baseline in Vineland Adaptive Behavior Scales, Third Edition (Standard Score on Communication Domain) at 16 weeks
Time Frame: Baseline, 16 weeks (follow-up)
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The Vineland-III (Sparrow et al., 2016) is a caregiver-completed measure of adaptive functioning in children.
Parents will complete a digital version of the Communication Domain of the Vineland-III Parent/Caregiver Rating Form.
Item responses are converted to Standard Scores with a mean of 100 and a Standard Deviation of 15.
|
Baseline, 16 weeks (follow-up)
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Change from Baseline in Vineland Adaptive Behavior Scales, Third Edition (Standard Score on Socialization Domain) at 16 weeks
Time Frame: Baseline, 16 weeks (follow-up)
|
The Vineland-III (Sparrow et al., 2016) is a caregiver-completed measure of adaptive functioning in children.
Parents will complete a digital version of the Socialization Domain of the Vineland-III Parent/Caregiver Rating Form.
Item responses are converted to Standard Scores with a mean of 100 and a Standard Deviation of 15.
|
Baseline, 16 weeks (follow-up)
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Change from Baseline in Social Responsiveness Scale, Second Edition (SRS-2; Total T-Score) at 16 weeks
Time Frame: Baseline, 16 weeks (follow-up)
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The SRS-2 (Constantino & Gruber, 2007) is a caregiver-completed measure of a child's autism symptom severity.
Parents will complete a digital version of the Toddler SRS-2.
Item responses are converted to a SRS-2 T-score with a mean of 50 and a Standard Deviation of 10.
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Baseline, 16 weeks (follow-up)
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from Baseline in Percentage of Child Eye Contact during Behaviorally Coded Parent-Child Intervention Videos at 8 weeks, 16 weeks.
Time Frame: Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
|
Parent participants will record and submit a five-minute video of themselves using the PRT intervention strategies with their child using the clinical trial's smartphone app.
Trained research assistants will behaviorally score each video using computer-based behavioral coding software (Noldus Observer XT) on a continuous basis for the total frequency and duration of child eye contact (i.e.
child gazing in the direction of the caregiver's head).
The minimum percentage is 0% (no eye contact) and the maximum is 100% (constant eye contact).
|
Baseline, 8 weeks (intervention completion), 16 weeks (follow-up)
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Scale of Treatment Perceptions (Total Score)
Time Frame: 8 weeks
|
The Scale of Treatment Perceptions (STP; Berger, et al., 2016) assesses parents' satisfaction with intervention using the mean of survey items with 1-7 Likert rating scale, with higher scores indicating higher levels of satisfaction (better outcome).
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8 weeks
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Parent Adherence to Treatment and Competence Measure
Time Frame: 8 weeks
|
The PATC is a six-item self-report adherence-to-treatment and competence measure (PATC; Kasari et al., 2010) will be administered to parents once they complete the app program.
The measure consists of four items concerning adherence to treatment protocol: (1) made time to carry out the learned strategies, (2) found it complex to carry out the learned strategies, (3) thought it natural to carry out the learned strategies, and (4) made an effort to carry out the learned strategies.
The PATC also includes two items concerning parental competence: (1) was confident carrying out the learned strategies, and (2) was comfortable carrying out the learned strategies.
All items consist of a series of ratings on a 1-5 Likert rating scale, with higher scores indicating a better outcome.
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8 weeks
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Collaborators and Investigators
Investigators
- Principal Investigator: Ty Vernon, University of California, Santa Barbara
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 24-21-0034
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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