Stepped-care Telehealth for Young Children With ASD
Examining a Stepped-care Telehealth Program for Parents of Young Children With Autism: a Proof of Concept Trial
1 other identifier
interventional
20
1 country
1
Brief Summary
This proof-of-concept study addresses the gap in the access to care literature by examining a stepped-care version of a telehealth naturalistic developmental behavioral intervention (NDBI), Online RIT. Online RIT is an interactive website introducing Reciprocal Imitation Training (RIT), an NDBI focused on enhancing social imitation. RIT uses a naturalistic behavioral approach to teach object and gesture imitation to young children with ASD within a play-based context. The efficacy of RIT has been demonstrated through a small randomized control trial, several single-subject design studies, as well as in independent replications. Prior research also suggests that parents can be taught to effectively use RIT with their children in person, and two single-subject design studies detail the development and feasibility testing of Online RIT plus therapist assistance. These preliminary data suggest Online RIT may serve as an ideal platform for examining the potential of individualized telehealth delivery formats, such as stepped-care. Therefore, the goal of this study was to compare a stepped-care format of Online RIT to a waitlist control condition to determine initial feasibility and effectiveness of this innovative intervention and service delivery model.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for not_applicable
Started Jan 2016
1 active site
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
January 10, 2016
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 30, 2017
CompletedStudy Completion
Last participant's last visit for all outcomes
August 30, 2017
CompletedFirst Submitted
Initial submission to the registry
June 26, 2020
CompletedFirst Posted
Study publicly available on registry
July 10, 2020
CompletedJuly 10, 2020
July 1, 2020
1.6 years
June 26, 2020
July 7, 2020
Conditions
Outcome Measures
Primary Outcomes (3)
Change from Baseline RIT Parent Fidelity Form (RIT-PFF) Score at 15 weeks
Trained observers scored the parent-child interactions for parent fidelity of the RIT intervention techniques.
Baseline and 15 weeks
Change from Baseline Unstructured Imitation Assessment (UIA) Score at 15 weeks
The UIA was used to measure child social imitation. It is a standardized assessment that evaluates spontaneous imitation of actions with objects and gestures during play.
Baseline and 15 weeks
Change from Baseline Early Intervention Parenting Self-Efficacy Scale (EIPSES) Score at 15 weeks
The EIPSES is a 20-item parent questionnaire designed to measure parenting efficacy within the context of early intervention.
Baseline and 15 weeks
Secondary Outcomes (2)
Change from Baseline Social Communication Checklist (SCC) Score at 15 weeks
Baseline and 15 weeks
Change from Baseline Beach Center Family Quality of Life Scale (FQOL) Score at 15 weeks
Baseline and 15 weeks
Study Arms (2)
Stepped-Care Online Reciprocal Imitation Training (Online RIT)
EXPERIMENTALParticipants completed four telehealth modules over a period of 5 weeks (\~1 per week, 1 week to practice). Two variables were selected as tailoring variables for this stepped-care model. Fidelity (RIT-PFF) and self-efficacy (EIPSES) at 5 weeks were used to determine which participants were in need of a "step up" in care, in the form of remote parent coaching. Parents who demonstrated ≥80% on the RIT-PFF, and who reported gains on the EIPSES continued to have access to Online RIT and practiced on their own for the next 5 weeks, but did not receive any remote coaching. Parents who demonstrated \<80% fidelity on the RIT-PFF and/or who didn't report increases in the EIPSES were directed into coaching. Coaching involved videoconferences once per week (wks. 6-10) with a parent coach (PI), and followed the occupational performance coaching model. Sessions included review of successes and challenges, parent practice with feedback, problem solving, and planning.
Wait List Control
NO INTERVENTIONParticipants provided with information about available community resources after randomization. These participants were given the opportunity to engage in the stepped-care format of Online RIT after the post-intervention data collection time point; however their data was included exclusively in control group analyses.
Interventions
Online RIT presents RIT techniques in four sequential learning modules: (1) Setting Up For Success (2) Imitating your Child (3) Describing Play (4) Teaching Object Imitation. Each learning module includes an instructional video, quiz, interactive exercises, and at-home planning and reflection. The website also includes a video library, Frequently Asked Questions, downloadable visual aids, links to relevant external resources, and a customizable "dashboard" that allows users to track their individualized goals and the amount of time they have spent working on their goals (e.g., practice log).
Eligibility Criteria
You may qualify if:
- Have a diagnosis of ASD or significant concerns of ASD
- Parent reported imitation deficits
You may not qualify if:
- Children of parents who are non-English speaking
- Actively participating in other parent training programs
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Rush University Medical Center
Chicago, Illinois, 60657, United States
Related Publications (1)
Wainer AL, Arnold ZE, Leonczyk C, Valluripalli Soorya L. Examining a stepped-care telehealth program for parents of young children with autism: a proof-of-concept trial. Mol Autism. 2021 May 8;12(1):32. doi: 10.1186/s13229-021-00443-9.
PMID: 33964979DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
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
- Research Director, AARTS Center
Study Record Dates
First Submitted
June 26, 2020
First Posted
July 10, 2020
Study Start
January 10, 2016
Primary Completion
August 30, 2017
Study Completion
August 30, 2017
Last Updated
July 10, 2020
Record last verified: 2020-07