NCT02457676

Brief Summary

This study on children with fetal alcohol spectrum disorder (FASD) aims to (i) characterize their self-regulation deficits, a process important for controlling emotions and behavior, (ii) describe brain structure and function underlying self-regulation, and (iii) determine whether training to improve self-regulation abilities changes brain and behavior. Individuals with FASD have a high risk of cognitive and social deficits, which reflect their difficulties in self-regulation and may lead to mental health concerns in adulthood. Importantly, early intervention improves long-term outcome. However the full extent of self-regulation problems in FASDs is unknown and the underlying neuroanatomy has not been fully described. Furthermore, information on how to best treat children with FASDs is lacking. Thus, the investigators propose three studies with a sample of 8-12 year old children, 40 with FASDs and 20 typically developing controls. In Study 1, the participants will be evaluated on cognitive and social self-regulation abilities using clinical and experimental tests. In Study 2, the participants will undergo a 1-hour MRI scanning session to obtain measures of their brain structure and function. In Study 3, FASDs will be randomly assigned to an immediate or delayed treatment group. The immediate group will undergo 12-weeks of therapy with the Alert Program for Self Regulation®. On conclusion of training, all will repeat Studies 1 and 2 and following this retest, the delayed treatment group will undergo training. The investigators will evaluate change in cognitive and social behavior and in brain structure and function by comparing performance and neuroimaging findings before and after the intervention. The investigators expect Alert training to significantly improve behavior and alter brain regions important for self-regulation. The findings will yield important information for improving self-regulation in FASDs and mitigating the development of mental health challenges.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
65

participants targeted

Target at P50-P75 for not_applicable

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2009

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2012

Completed
2.5 years until next milestone

First Submitted

Initial submission to the registry

November 19, 2014

Completed
6 months until next milestone

First Posted

Study publicly available on registry

May 29, 2015

Completed
Last Updated

May 29, 2015

Status Verified

May 1, 2015

Enrollment Period

2.7 years

First QC Date

November 19, 2014

Last Update Submit

May 26, 2015

Conditions

Keywords

Self-Regulation TrainingNeuroimagingResponse InhibitionBehavioral RegulationEmotional Regulation

Outcome Measures

Primary Outcomes (1)

  • Emotion regulation

    Evaluated by parent questionnaires

    14 weeks after initial testing

Secondary Outcomes (6)

  • Inhibitory control: Test of Everyday Attention for Children; NEPSY, BRIEF

    14 weeks after initial testing

  • Social cognition: Saltzman's Social Cognitive Task; NEPSY

    14 weeks after initial testing

  • Behavior: Behavior Rating Inventory of Executive Function; Child Behavior Checklist

    14 weeks after initial testing

  • Brain structure: Voxel-based morphometry

    14 weeks after initial testing

  • Brain structure: Cortical thickness

    14 weeks after initial testing

  • +1 more secondary outcomes

Study Arms (3)

Alert Program for Self-Regulation

EXPERIMENTAL

Participants with FASD who received the Alert Program for Self-Regulation therapy between the two testing periods.

Behavioral: Alert Program for Self-Regulation

FASD Alert Waitlist

NO INTERVENTION

Participants with FASD who did not receive therapy between the two testing periods but were provided intervention on study completion.

Typically Developing Control

NO INTERVENTION

Normally developing controls not exposed to alcohol in utero who were not treated between the two testing periods.

Interventions

Children attend 12 1.5 hour weekly sessions. Alert uses the analogy of a car engine to help children identify their own self-regulatory behavior. Children learn strategies to regulate their own "engine speed" in different situations.

Alert Program for Self-Regulation

Eligibility Criteria

Age8 Years - 12 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17)

You may qualify if:

  • FASD: diagnosis of FAS/pFAS or ARND OR
  • healthy child

You may not qualify if:

  • head injury or other neurological abnormality
  • debilitating or chronic medical condition affecting the nervous system
  • MRI contraindication, such as braces
  • inability to read
  • non-English speaking
  • IQ below 80 (typically developing controls only)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (2)

  • Soh DW, Skocic J, Nash K, Stevens S, Turner GR, Rovet J. Self-regulation therapy increases frontal gray matter in children with fetal alcohol spectrum disorder: evaluation by voxel-based morphometry. Front Hum Neurosci. 2015 Mar 4;9:108. doi: 10.3389/fnhum.2015.00108. eCollection 2015.

  • Nash K, Stevens S, Greenbaum R, Weiner J, Koren G, Rovet J. Improving executive functioning in children with fetal alcohol spectrum disorders. Child Neuropsychol. 2015;21(2):191-209. doi: 10.1080/09297049.2014.889110. Epub 2014 Jul 10.

MeSH Terms

Conditions

Fetal Alcohol Spectrum DisordersEmotional Regulation

Condition Hierarchy (Ancestors)

Fetal DiseasesPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesAlcohol-Induced DisordersAlcohol-Related DisordersSubstance-Related DisordersChemically-Induced DisordersSelf-ControlSocial BehaviorBehavior

Study Officials

  • Joanne Rovet, PhD

    The Hospital for Sick Children

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior Scientist

Study Record Dates

First Submitted

November 19, 2014

First Posted

May 29, 2015

Study Start

October 1, 2009

Primary Completion

June 1, 2012

Last Updated

May 29, 2015

Record last verified: 2015-05