Chatbot-based Assistant to Improve Problem-solving Skills in Parents of Children With ASD

The goal of this study is to evaluate how a Chatbot-based assistant can improve problem-solving skills and coping strategies in parents of children with Autism Spectrum Disorder (ASD).

Study Overview

• Status: Recruiting
• Conditions: Autism Spectrum Disorder
• Intervention / Treatment: Behavioral: Chatbot-base problem-solving skills training(PSST)

Detailed Description

A report by the World Health Organization reveals that Autism Spectrum Disorder (ASD), which is among the most prevalent and significant developmental disorders affecting children, is diagnosed in roughly one out of every 100 children around the world. This condition can cause a range of disabilities and changes in how a child communicates and interacts socially. Parenting a child with ASD is a continuous and demanding journey, often marked by heightened stress and mental health challenges for the caregivers. These parents must navigate an array of daily pressures, such as limited influence over their child's behaviors, concerns about the child's cognitive progress and their acquisition of adaptive skills, as well as the relentless requirements of caregiving and time management. They also grapple with worries regarding their bond with their child and the looming uncertainties about the child's long-term prospects. As children with ASD grow, their evolving needs can introduce new complexities. In comparison to parents of neurotypical children, those raising children with ASD encounter a significantly greater number of stress-inducing factors. The problem-solving ability is a key factor in helping parents cope with these stressors, improve their mental health, and have a positive impact on their child and other family members. There is a pressing need to find widely accepted interventions that can improve problem-solving skills and reduce distress in parents of children with ASD.

Problem-Solving Skills Training (PSST) focuses on developing practical problem-solving abilities to enhance coping mechanisms and reduce psychological distress. Although PSST has demonstrated remarkable success in various populations, its application specifically for parents of children with ASD remains understudied. Given the unique challenges faced by ASD caregivers, there is a pressing need to investigate how PSST might be adapted and implemented to support this specific population's mental health and problem-solving capabilities.

Considering the convenience, low cost and popularity of Chatbot, Chatbot-based PSST (C-PSST) will be administered in this study. A pilot study will be proposed to evaluate the effectiveness of C-PSST. A total of 20 caregivers of children will be recruited to receive the C-PSST and usual service. Through this proposed project, we shall determine (i) whether the C-PSST is acceptable and feasible for parents of children with ASD, (ii) whether it can improve problem-solving abilities and well-being, reduce depressive symptoms, and improve the quality of life in caregivers of children with ASD.

The findings will provide evidence for C-PSST in Chinese caregivers, inform evidence-based practice to provide mental health support to caregivers of children with ASD, and provide essential guidance for practitioners (such as nurses and social workers), and policymakers to improve the quality of life in families of children with ASD.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Wendy Zhang; Phone Number: 39702945; Email: wwzhang@hkmu.edu.hk

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Recruiting
    • Hong Kong Metropolitan University
    • Contact: Wendy Zhang, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

The inclusion criteria are parents:

(i) providing long-term care for children with a diagnosis of ASD from a qualified clinician according to the Diagnostic and Statistics Manual of Mental Disorders - Fifth Edition (DSM-5), confirmed through the provision of written documentation by parents, (ii) who identified as the primary caregiver of the children with ASD, (iii) who are older than 18 years old, and (iv) who have the ability to communicate in and read Chinese.

Exclusion Criteria are parents:

(i) who attended other parent training programs at the same time, (ii) who declined to complete the three scheduled assessments, and (iii) who had a diagnosis of severe psychiatric disorders (such as schizophrenia and severe bipolar disorder) or cognitive impairment.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Chatbot group; Use a specialized Chatbot designed to provide real-time guidance and support for ASD-related parenting challenges

Behavioral: Chatbot-base problem-solving skills training(PSST); The intervention incorporates eight sessions: Session 1 involves rapport building, understanding relevant personal and medical history, and introducing the Chatbot-based program and worksheet; Session 2 focuses on maintaining brightness and optimism when faced with a specific obstacle; Sessions 3-7 involve the continued application of problem-solving skills training(PSST) to identify problems and the promotion of problem-solving strategies and skills in vivo, including (a) identifying the problem, (b) determining the options, (c) evaluating and choosing the best option, (d) acting according to the best option, and (e) seeing if it works; and Session 8 involves a review of PSST principles and termination.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of the C-PSST	Feasibility will be assessed by 2 items modified from the Feasibility of Intervention Measure, and the semi-structured interview will be conducted immediately after the intervention. Barriers and facilitators to participant adherence and retention will be discussed to collect feedback. These 2 items will ask participants to evaluate that the Chatbot is implementable and easy to use via a 5-point Likert scale from completely disagree (1) to completely agree (5). The score range is 2 to 10 and higher scores indicate greater feasibility.	After the intervention immediately
Acceptability of the C-PSST	Acceptability will be assessed through the following items: (i) the usage and repeated usage of the Chatbot by the participants in the trial indicated by logged user statistics; (ii) the number of times of login-errors and other login-problems. The higher usage and lower times of login-errors indicate greater acceptability	After the intervention immediately

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depressive symptoms	Depressive symptoms will be measured by the Patient Health Questionnaire-9 (PHQ-9), which evaluates the frequency of occurrence of main depressive symptoms over the past 2 weeks via a 4-point Likert scale from not at all (0) to nearly every day (3). The total score is from 0 to 27 and the higher scores indicate more severe depressive symptoms.	Baseline and after the intervention immediately
Problem-solving skills	Problem-solving skills will be measured by the Social Problem-Solving Inventory, Revised (SPSI-R)which is a widely recognized and validated scale with 52 items. A higher total score suggests a higher level of problem-solving skills.	Baseline and after the intervention immediately
Stress	Stress will be assessed by a 10-item Perceived Stress Scale (PSS-10) with a 5-point Likert scale from never (0) to very often (4). The total score is from 0 to 40 and a higher score reflects a higher level of perceived stress.	Baseline and after the intervention immediately
Health Related Quality of life	Quality of life will be measured by the Chinese version of Short Form-12(SF-12), including 12 sub-scales. The sub-scale score can be represented as T-scores(mean =50, standard deviation =10) and a higher score indicating better QoL.	Baseline and after the intervention immediately
Well-being	Well-being will be measured by the World Health Organization-5 Well-being Index to evaluate vitality (being active and waking up fresh and rested), being interested in things, and having a pleasant attitude. Each item is scored using a 6-point Likert scale from at no time (0) to all of the time (5). The total score ranges from 0 to 25, with higher scores suggesting better self-perceived well-being.	Baseline and after the intervention immediately

Collaborators and Investigators

• Sponsor: Hong Kong Metropolitan University

Study record dates

Study Major Dates

• Study Start (Actual): December 12, 2024
• Primary Completion (Estimated): March 31, 2025
• Study Completion (Estimated): May 31, 2025

Study Registration Dates

• First Submitted: December 4, 2024
• First Submitted That Met QC Criteria: December 4, 2024
• First Posted (Actual): December 9, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 12, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Neurodevelopmental Disorders; Child Development Disorders, Pervasive; Autism Spectrum Disorder
• Other Study ID Numbers: 202415

Drug and device information, study documents

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