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Intervention for Toddlers at Risk for Autism Spectrum Disorders (ASD)

9 mars 2021 uppdaterad av: Rebecca Landa, Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

A Comprehensive Approach to Intervention for Toddlers at Risk for ASD

This research is being done to test the effectiveness of an early intervention model for very young children at high risk for autism spectrum disorders (ASD) and their families. If children show improvement in this intervention, the investigators hope that the availability of public services of this type will be increased. Children between 11 months and 21 months old with Autism Spectrum Disorders, or with social and communication delays that indicate high risk for Autism Spectrum Disorders, and their parents may join the study. Treatment must start prior to the second birthday.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

49

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Maryland
      • Baltimore, Maryland, Förenta staterna, 21211
        • Kennedy Krieger Institute

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

11 månader till 1 år (Barn)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Children will be ascertained between 11 months and 21 months of age
  • Must be able to enter the study prior to their second birthday
  • Must then pass an eligibility assessment to determine whether the child meets criteria for ASD and thus qualifies for the study. This assessment will consist of the Baby ADOS and the Mullen Scales of Early Learning. Children must meet criteria for ASD or autism on the ADOS, score more than one standard deviation below the mean on the Receptive or Expressive Language scale of the MSEL, and have a clinical judgment of ASD to be eligible for enrollment into treatment.
  • Parents must agree to participate in the study and commit to having their child participate in the intervention to which they are randomized for 6 months
  • The parent (or other primary caregiver, such as grandparent) in the Parent Enrichment/Training condition must agree to attend the training sessions

Exclusion Criteria:

  • Fail hearing or vision screening (by pediatrician's office, audiologist, or ophthalmologist)
  • Family's first language being other than English (language measures are normed on English speakers, putting non-English speakers at a disadvantage. In addition, the treatment is delivered in English. Children from non-English speaking homes may not make progress, but for reasons other than the efficacy of the intervention.)
  • Head injury (because this may cause some of the symptoms, which may not be due to autism and therefore we would not be able to assess the effects of the intervention on autism)
  • Identified reason for the autism (e.g., fragile X syndrome, Rett syndrome, Tuberous Sclerosis)
  • Inability of the family to attend the playgroup sessions and parent trainings
  • Parents whose hearing or vision is not within normal limits after correction (e.g., hearing aid, glasses)
  • Parents with developmental delays, language or learning impairments, or a psychiatric diagnosis IF the impairment would interfere with parent training (PI will assess on a case by case basis by talking to the parent)
  • Foster children
  • Refusal to allow videotaping of the children's assessments or intervention or to allow videotaped footage to be used for teaching purposes.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Playgroup and Parent Training
  1. One to two-hour individual therapeutic sessions with parent training in the home or clinic, 1x every week over six months;
  2. parent training/enrichment once a week in our clinic for 20 sessions at 1-2 hours;
  3. a playgroup session for 1-2 hours 2x week for 6 months in our clinic and
  4. Community treatment as usual.
Beteende: Playgroup
The playgroup will be conducted at our center and focuses on providing an invigorating learning environment in which emerging skills/knowledge are skillfully brought to a higher level of maturity, integrated with existing abilities, and used functionally. Learning with and through peers, provides the opportunity to address abnormal peer relationships for developmental level. Providing an enriched environment with toys, structured learning, and opportunities for ongoing engagement we offer the children experiences that they would not otherwise have. Parent training sessions will focus on strategies aimed at improving child social engagement and communication. Parent education sessions will focus on topics related to autism, learning styles, interventions, and resources.
Beteende: Parent Training
The 1-2 hour individual therapeutic sessions with parent training in the home or clinic (1x every week over six months) are based on our own program which is in development. This program focuses on teaching parents how to encourage social and communication skills in their toddlers and also provides comprehensive information about development. Sessions will focus on knowledge of autism, current access to services, general knowledge of strategies used to facilitate child development, advocacy, knowledge of how to access services, and coping strategies.
Andra namn:
  • Enrichment Sessions
Beteende: Parent Training
In the once-a-week 1 to 2 hour parent training/enrichment, we will ask parents to target specific play and care routines in which they may stimulate their child's development in the ways identified by the therapist. These stimulation times may be provided by the parents, other family members, friends, volunteers or hired assistants. Parents will be encouraged to have their child in direct skill-enhancing engagement for 1-2 hour per day. The therapist will work with the family to identify times during the day that best lend themselves to accomplishing this goal.
Andra namn:
  • Individual Therapeutic Sessions
Aktiv komparator: Parent Training
  1. Parent enrichment sessions once a week for 20 sessions (for 1-2 hours)
  2. Community treatment as usual.
Beteende: Parent Training
The 1-2 hour individual therapeutic sessions with parent training in the home or clinic (1x every week over six months) are based on our own program which is in development. This program focuses on teaching parents how to encourage social and communication skills in their toddlers and also provides comprehensive information about development. Sessions will focus on knowledge of autism, current access to services, general knowledge of strategies used to facilitate child development, advocacy, knowledge of how to access services, and coping strategies.
Andra namn:
  • Enrichment Sessions
Beteende: Parent Training
In the once-a-week 1 to 2 hour parent training/enrichment, we will ask parents to target specific play and care routines in which they may stimulate their child's development in the ways identified by the therapist. These stimulation times may be provided by the parents, other family members, friends, volunteers or hired assistants. Parents will be encouraged to have their child in direct skill-enhancing engagement for 1-2 hour per day. The therapist will work with the family to identify times during the day that best lend themselves to accomplishing this goal.
Andra namn:
  • Individual Therapeutic Sessions

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Developmental Level
Tidsram: 3 months into treatment, 6 months into treatment, and 6 months after treatment ends
Using the Mullen Scales of Early Learning to assess.
3 months into treatment, 6 months into treatment, and 6 months after treatment ends

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Communication
Tidsram: 3 months after treatment starts
Using Communication and Symbolic Behavior Scales to assess.
3 months after treatment starts
Communication
Tidsram: 6 months into treatment
Using Communication and Symbolic Behavior Scales to assess.
6 months into treatment
Communication
Tidsram: 6 months after treatment ends
Using Communication and Symbolic Behavior Scales to assess.
6 months after treatment ends
Presence and Severity of Autism
Tidsram: 3 months after treatment starts
Using Autism Diagnostic Observation Schedule to assess.
3 months after treatment starts
Presence and Severity of Autism
Tidsram: 6 months into treatment
Using Autism Diagnostic Observation Schedule to assess.
6 months into treatment
Presence and Severity of Autism
Tidsram: 6 months after treatment ends
Using Autism Diagnostic Observation Schedule to assess.
6 months after treatment ends

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

Samarbetspartners

Autism Speaks

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 januari 2008

Primärt slutförande (Faktisk)

1 december 2011

Avslutad studie (Faktisk)

1 december 2011

Studieregistreringsdatum

Först inskickad

21 juli 2010

Först inskickad som uppfyllde QC-kriterierna

10 augusti 2010

Första postat (Uppskatta)

11 augusti 2010

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

10 mars 2021

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

9 mars 2021

Senast verifierad

1 mars 2021

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NA_00006553

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