The Effectiveness of an Attention-based Intervention for School Aged Autistic Children With Anger Regulating Problems

NCT05221515 | Completed

• 1 other identifier: BOBpaper2021
• Study Type: interventional
• Target: 51
• Locations: 1 country
• Sites: 2

Brief Summary

Children on the autism spectrum often show aggressive behavior. Treatment can train children to be more aware of their emotions. Investigators studied the effectiveness of an attention-based intervention tailored on aggressive behavior problems and the use of anger coping strategies of school aged autistic children with anger regulation problems.

Conditions

Autism Spectrum Disorder

Keywords

Autism spectrum disorder; Anger; Randomized controlled trial

Outcome Measures

Primary Outcomes (8)

• Aggressive behavior problems: Arguing, Temper tantrums, Destroying things and Physical violence

  Questionnaire Social Behavior (QSB) measuring behavioral and emotion regulation problems typical for autistic children.

  At week 0, before the intervention group received treatment

• Aggressive behavior problems: Arguing, Temper tantrums, Destroying things and Physical violence

  Questionnaire Social Behavior (QSB) measuring behavioral and emotion regulation problems typical for autistic children.

  9 weeks later after treatment

• Aggressive behavior problems: aggression as reported by parent

  The aggression sub scale from the Child Behavior Checklist (CBCL). Minimum value: 0, maximum value: 36. A higher score means more aggression.

  At week 0, before the intervention group received treatment

• Aggressive behavior problems: aggression as reported by parent

  The aggression sub scale from the Child Behavior Checklist (CBCL). Minimum value: 0, maximum value: 36. A higher score means more aggression.

  9 weeks later after treatment

• Aggressive behavior problems: aggression as reported by teacher

  The aggression sub scale from the Teacher Rating Form (TRF). Minimum value: 0, maximum value: 36. A higher score means more aggression.

  At week 0, before the intervention group received treatment

• Aggressive behavior problems: aggression as reported by teacher

  The aggression sub scale from the Teacher Rating Form (TRF). Minimum value: 0, maximum value: 36. A higher score means more aggression.

  9 weeks later after treatment

• Anger coping strategies

  The Behavioral Anger Response Questionnaire for children (BARQ-C)

  At week 0, before the intervention group received treatment

• Anger coping strategies

  The Behavioral Anger Response Questionnaire for children (BARQ-C)

  9 weeks later after treatment

Secondary Outcomes (8)

• Quality of life of the child

  At week 0, before the intervention group received treatment

• Quality of life of the child

  9 weeks later after treatment

• Social impairment due to autism symptoms

  At week 0, before the intervention group received treatment

• Social impairment due to autism symptoms

  9 weeks later after treatment

• Parental stress

  At week 0, before the intervention group received treatment

Study Arms (2)

Intervention condition

EXPERIMENTAL

Participants received both parent training and child-focussed treatment

Behavioral: Anger can go!; Behavioral: Parent psycho-education

Control condition

ACTIVE COMPARATOR

Participants received only parent training

Behavioral: Parent psycho-education

Interventions

Anger can go! BEHAVIORAL

The intervention "Anger Can Go!" was designed to treat anger regulation problems in autistic children aged 8 to 13 years old. The intervention consists of nine sessions of 60 minutes and is divided in four phases. Phase 1: psycho-education, affect-education and measuring anger with an anger-thermometer. This is a self-report scale presented as the drawing of a thermometer, that allows the child to indicate his level of anger, as linked to specific bodily and behavioral representations on a scale from 0 to 3. Phase 2: making a functional behavior assessment (FBA) and taking a time-out at a low anger-level (between 1 and 2 on the scale 0 to 3) to prevent aggressive outbursts. Phase 3: taking a time-out at a low anger-level (between 1 and 2 on the scale 0 to 3) to prevent aggressive outbursts, shifting attention away from aversive stimuli, to cope with the stress of the anger provoking situation. Phase 4: creating solutions to cope with an anger provoking situation.

Intervention condition

Parent psycho-education BEHAVIORAL

Three psycho-educational parent group sessions (take place before the children's sessions in intervention group). Parents meet with other parents and a therapist to learn about the nature of their Expressed Emotion (EE) and how it relates to the child's aggressive behavior.

Control condition; Intervention condition

Eligibility Criteria

• Age: 8 Years - 13 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Primary diagnosis of autism spectrum disorder
• age 8 - 13
• seeking treatment for aggressive behaviour problems

You may not qualify if:

• psychotropic medication still being set

Sponsors & Collaborators

• VU University of Amsterdam: lead

Study Sites (2)

De Bascule

Amsterdam, North Holland, Netherlands

Location

Wei43

Amsterdam, Netherlands

Location

Related Publications (35)

• Carr, E. G., & Horner, R. H. (2007). The expanding vision of positive behavior support: Research perspectives on happiness, helpfulness, hopefulness. Journal of positive behavior interventions, 9(1), 3-14.

  BACKGROUND

• Chalfant AM, Rapee R, Carroll L. Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial. J Autism Dev Disord. 2007 Nov;37(10):1842-57. doi: 10.1007/s10803-006-0318-4. Epub 2006 Dec 15.

  PMID: 17171539 BACKGROUND

• Fung LK, Mahajan R, Nozzolillo A, Bernal P, Krasner A, Jo B, Coury D, Whitaker A, Veenstra-Vanderweele J, Hardan AY. Pharmacologic Treatment of Severe Irritability and Problem Behaviors in Autism: A Systematic Review and Meta-analysis. Pediatrics. 2016 Feb;137 Suppl 2:S124-35. doi: 10.1542/peds.2015-2851K.

  PMID: 26908468 BACKGROUND

• Goel R, Hong JS, Findling RL, Ji NY. An update on pharmacotherapy of autism spectrum disorder in children and adolescents. Int Rev Psychiatry. 2018 Feb;30(1):78-95. doi: 10.1080/09540261.2018.1458706. Epub 2018 Apr 25.

  PMID: 29693461 BACKGROUND

• Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological inquiry, 26(1), 1-26.

  BACKGROUND

• Hartmann K, Urbano MR, Raffaele CT, Kreiser NL, Williams TV, Qualls LR, Elkins DE. Outcomes of an emotion regulation intervention group in young adults with autism spectrum disorder. Bull Menninger Clin. 2019 Summer;83(3):259-277. doi: 10.1521/bumc.2019.83.3.259.

  PMID: 31502871 BACKGROUND

• Ibrahim K, Kalvin C, Marsh CL, Anzano A, Gorynova L, Cimino K, Sukhodolsky DG. Anger Rumination is Associated with Restricted and Repetitive Behaviors in Children with Autism Spectrum Disorder. J Autism Dev Disord. 2019 Sep;49(9):3656-3668. doi: 10.1007/s10803-019-04085-y.

  PMID: 31144231 BACKGROUND

• Kanne SM, Mazurek MO. Aggression in children and adolescents with ASD: prevalence and risk factors. J Autism Dev Disord. 2011 Jul;41(7):926-37. doi: 10.1007/s10803-010-1118-4.

  PMID: 20960041 BACKGROUND

• Linehan, M. (2014). DBT? Skills training manual. Guilford Publications.

  BACKGROUND

• Luiselli, J. K. (Ed.). (2014). Children and youth with autism spectrum disorder (ASD): recent advances and innovations in assessment, education, and intervention.

  BACKGROUND

• Mascha, K., & Boucher, J. (2006). Preliminary investigation of a qualitative method of examining siblings' experiences of living with a child with ASD. The British Journal of Development Disabilities, 52(102), 19-28.

  BACKGROUND

• McStay RL, Dissanayake C, Scheeren A, Koot HM, Begeer S. Parenting stress and autism: the role of age, autism severity, quality of life and problem behaviour of children and adolescents with autism. Autism. 2014 Jul;18(5):502-10. doi: 10.1177/1362361313485163. Epub 2013 Oct 8.

  PMID: 24104515 BACKGROUND

• Mazurek, M. O., Kanne, S. M., & Wodka, E. L. (2013). Physical aggression in children and adolescents with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(3), 455-465.

  BACKGROUND

• Patel S, Day TN, Jones N, Mazefsky CA. Association between anger rumination and autism symptom severity, depression symptoms, aggression, and general dysregulation in adolescents with autism spectrum disorder. Autism. 2017 Feb;21(2):181-189. doi: 10.1177/1362361316633566. Epub 2016 Jul 9.

  PMID: 27095831 BACKGROUND

• Hill AP, Zuckerman KE, Hagen AD, Kriz DJ, Duvall SW, van Santen J, Nigg J, Fair D, Fombonne E. Aggressive Behavior Problems in Children with Autism Spectrum Disorders: Prevalence and Correlates in a Large Clinical Sample. Res Autism Spectr Disord. 2014 Sep 1;8(9):1121-1133. doi: 10.1016/j.rasd.2014.05.006.

  PMID: 25221619 BACKGROUND

• Reese RM, Richman DM, Belmont JM, Morse P. Functional characteristics of disruptive behavior in developmentally disabled children with and without autism. J Autism Dev Disord. 2005 Aug;35(4):419-28. doi: 10.1007/s10803-005-5032-0.

  PMID: 16134028 BACKGROUND

• Samson AC, Phillips JM, Parker KJ, Shah S, Gross JJ, Hardan AY. Emotion dysregulation and the core features of autism spectrum disorder. J Autism Dev Disord. 2014 Jul;44(7):1766-72. doi: 10.1007/s10803-013-2022-5.

  PMID: 24362795 BACKGROUND

• Samson AC, Wells WM, Phillips JM, Hardan AY, Gross JJ. Emotion regulation in autism spectrum disorder: evidence from parent interviews and children's daily diaries. J Child Psychol Psychiatry. 2015 Aug;56(8):903-13. doi: 10.1111/jcpp.12370. Epub 2014 Dec 1.

  PMID: 25442191 BACKGROUND

• Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2013). Mindfulness-based cognitive therapy for depression. Guilford Publications.

  BACKGROUND

• Sofronoff K, Attwood T, Hinton S, Levin I. A randomized controlled trial of a cognitive behavioural intervention for anger management in children diagnosed with Asperger syndrome. J Autism Dev Disord. 2007 Aug;37(7):1203-14. doi: 10.1007/s10803-006-0262-3.

  PMID: 17082978 BACKGROUND

• Wong C, Odom SL, Hume KA, Cox AW, Fettig A, Kucharczyk S, Brock ME, Plavnick JB, Fleury VP, Schultz TR. Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review. J Autism Dev Disord. 2015 Jul;45(7):1951-66. doi: 10.1007/s10803-014-2351-z.

  PMID: 25578338 BACKGROUND

• White SW, Ollendick T, Scahill L, Oswald D, Albano AM. Preliminary efficacy of a cognitive-behavioral treatment program for anxious youth with autism spectrum disorders. J Autism Dev Disord. 2009 Dec;39(12):1652-62. doi: 10.1007/s10803-009-0801-9. Epub 2009 Jun 30.

  PMID: 19568924 BACKGROUND

• White SW, Albano AM, Johnson CR, Kasari C, Ollendick T, Klin A, Oswald D, Scahill L. Development of a cognitive-behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism. Clin Child Fam Psychol Rev. 2010 Mar;13(1):77-90. doi: 10.1007/s10567-009-0062-3.

  PMID: 20091348 BACKGROUND

• Wood JJ, Drahota A, Sze K, Har K, Chiu A, Langer DA. Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. J Child Psychol Psychiatry. 2009 Mar;50(3):224-34. doi: 10.1111/j.1469-7610.2008.01948.x.

  PMID: 19309326 BACKGROUND

• Bos MGN, Diamantopoulou S, Stockmann L, Begeer S, Rieffe C. Emotion Control Predicts Internalizing and Externalizing Behavior Problems in Boys With and Without an Autism Spectrum Disorder. J Autism Dev Disord. 2018 Aug;48(8):2727-2739. doi: 10.1007/s10803-018-3519-8.

  PMID: 29512017 RESULT

• Dempsey AG, Llorens A, Brewton C, Mulchandani S, Goin-Kochel RP. Emotional and behavioral adjustment in typically developing siblings of children with autism spectrum disorders. J Autism Dev Disord. 2012 Jul;42(7):1393-402. doi: 10.1007/s10803-011-1368-9.

  PMID: 21984214 RESULT

• Fernandez-Alcantara M, Garcia-Caro MP, Perez-Marfil MN, Hueso-Montoro C, Laynez-Rubio C, Cruz-Quintana F. Feelings of loss and grief in parents of children diagnosed with autism spectrum disorder (ASD). Res Dev Disabil. 2016 Aug;55:312-21. doi: 10.1016/j.ridd.2016.05.007. Epub 2016 May 25.

  PMID: 27235768 RESULT

• Mazefsky CA, Kao J, Oswald DP. Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Res Autism Spectr Disord. 2011 Jan;5(1):164-174. doi: 10.1016/j.rasd.2010.03.006.

  PMID: 24013401 RESULT

• Ridderinkhof A, de Bruin EI, Blom R, Bogels SM. Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements. Mindfulness (N Y). 2018;9(3):773-791. doi: 10.1007/s12671-017-0815-x. Epub 2017 Oct 6.

  PMID: 29875881 RESULT

• Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. S., Singh, A. N., Singh, J., & Singh, A. D. (2011). A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Research in Autism Spectrum Disorders, 5(3), 1153-1158.

  RESULT

• Seymour M, Wood C, Giallo R, Jellett R. Fatigue, stress and coping in mothers of children with an autism spectrum disorder. J Autism Dev Disord. 2013 Jul;43(7):1547-54. doi: 10.1007/s10803-012-1701-y.

  PMID: 23124359 RESULT

• Shivers CM, Jackson JB, McGregor CM. Functioning Among Typically Developing Siblings of Individuals with Autism Spectrum Disorder: A Meta-Analysis. Clin Child Fam Psychol Rev. 2019 Jun;22(2):172-196. doi: 10.1007/s10567-018-0269-2.

  PMID: 30178117 RESULT

• Spek AA, van Ham NC, Nyklicek I. Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Res Dev Disabil. 2013 Jan;34(1):246-53. doi: 10.1016/j.ridd.2012.08.009. Epub 2012 Sep 8.

  PMID: 22964266 RESULT

• Tanksale R, Sofronoff K, Sheffield J, Gilmour J. Evaluating the effects of a yoga-based program integrated with third-wave cognitive behavioral therapy components on self-regulation in children on the autism spectrum: A pilot randomized controlled trial. Autism. 2021 May;25(4):995-1008. doi: 10.1177/1362361320974841. Epub 2020 Nov 25.

  PMID: 33238718 RESULT

• Zaidman-Zait A, Mirenda P, Duku E, Vaillancourt T, Smith IM, Szatmari P, Bryson S, Fombonne E, Volden J, Waddell C, Zwaigenbaum L, Georgiades S, Bennett T, Elsabaggh M, Thompson A. Impact of personal and social resources on parenting stress in mothers of children with autism spectrum disorder. Autism. 2017 Feb;21(2):155-166. doi: 10.1177/1362361316633033. Epub 2016 Jul 9.

  PMID: 27091948 RESULT

MeSH Terms

Conditions

Autism Spectrum Disorder

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Frits Boer, PhD

  Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

  STUDY CHAIR

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: Professor

Study Record Dates

• First Submitted: November 23, 2021
• First Posted: February 3, 2022
• Study Start: January 1, 2011
• Primary Completion: October 30, 2018
• Study Completion: October 30, 2018
• Last Updated: February 3, 2022

Record last verified: 2022-02

Data Sharing

• IPD Sharing: Will not share

Locations

NL (2)