Coaching Children With Anxiety and Autism Through Telehealth

NCT05588570 | Completed

• 1 other identifier: 00121415
• Study Type: interventional
• Target: 17
• Locations: 1 country
• Sites: 1

Brief Summary

This study will examine a telehealth parenting intervention to reduce anxiety in 20 families of children between 4 and 8 years old with autism and anxiety. Caregivers and children complete 12 telehealth treatment sessions. Caregivers and children will complete pre tests, post tests, and 3 month followup assessments that include observations, heart rate monitoring, and caregiver ratings.

Conditions

Autism; Autism Spectrum Disorder; Anxiety

Outcome Measures

Primary Outcomes (12)

• Change in Child Anxiety Symptoms as assessed by PRAS-ASD

  The Parent Rated Anxiety Scale for ASD (PRAS-ASD) is a 25-item measure. Parents score severity of various anxiety symptoms on a scale of 0-3. The PRAS-ASD yields a total raw score for severity of anxiety and a normed T-score with higher scores indicating higher anxiety severity. The cut-off for clinical significance is a raw score of 44.

  Pre to Post (~14 weeks)

• Change in Child Anxiety Symptoms as assessed by PRAS-ASD

  The Parent Rated Anxiety Scale for ASD (PRAS-ASD) is a 25-item measure. Parents score severity of various anxiety symptoms on a scale of 0-3. The PRAS-ASD yields a total raw score for severity of anxiety and a normed T-score with higher scores indicating higher anxiety severity. The cut-off for clinical significance is a raw score of 44.

  Pre to Follow-up (~26 weeks)

• Change in Parent Accommodation as assessed by FAS-A

  The Family Accommodation Scale-Anxiety (FAS-A) is a 9 item measure. Parents score the amount that they accommodate their child's anxiety on a 0-4 frequency scale. The FAS-A yields a total raw score for accommodations and a normed T-score with higher scores indicating more accommodations.

  Pre to Post (~14 weeks)

• Change in Parent Accommodation as assessed by FAS-A

  The Family Accommodation Scale-Anxiety (FAS-A) is a 9 item measure. Parents score the amount that they accommodate their child's anxiety on a 0-4 frequency scale. The FAS-A yields a total raw score for accommodations and a normed T-score with higher scores indicating more accommodations.

  Pre to Follow-up (~26 weeks)

• Child Heart Rate

  Change in heart rate during structured play interaction from pre to post

  Pre to Post (~14 weeks)

• Parent Heart Rate

  Change in heart rate during structured play interaction from pre to post

  Pre to Post (~14 weeks)

• Child Respiratory Sinus Arrhythmia as assessed by Actiheart software

  Change in respiratory sinus arrhythmia during structured play interaction from pre to post while participant is wearing Actiheart electrodes. After heart activity is collected, Actiheart software is used to analyze Respiratory Sinus Arrhythmia (RSA)

  Pre to Post (~14 weeks)

• Parent Respiratory Sinus Arrhythmia as assessed by Actiheart software

  Change in respiratory sinus arrhythmia during structured play interaction from pre to post while participant is wearing Actiheart electrodes. After heart activity is collected, Actiheart software is used to analyze Respiratory Sinus Arrhythmia (RSA)

  Pre to Post (~14 weeks)

• Parent Anxiety Symptoms as assessed by GAD-7

  The Generalized Anxiety Disorder (GAD-7) is a 7-item screening tool to assess for adult anxiety. Parents score their anxiety symptoms on a 0-3 frequency scale. The GAD-7 yields a total raw score for level of anxiety and a normed T-score with higher scores indicating higher levels of anxiety. The cut-off for clinical significance is a raw score of 8.

  Pre to Post (~14 weeks)

• Parent Anxiety Symptoms as assessed by GAD-7

  The Generalized Anxiety Disorder (GAD-7) is a 7-item screening tool to assess for adult anxiety. Parents score their anxiety symptoms on a 0-3 frequency scale. The GAD-7 yields a total raw score for level of anxiety and a normed T-score with higher scores indicating higher levels of anxiety. The cut-off for clinical significance is a raw score of 8.

  Pre to Follow-up (~26 weeks)

• Change in Parenting Stress as assessed by Parenting Stress Index-Short Form (PSI-SF)

  Parents will complete the PSI-SF, a 36-item measure yielding scores for a Total Stress scale. The PSI-SF is a widely used measure in ASD samples and has been used as an outcome measure in PCIT ASD studies. The PSI-SF yields a total raw score for stress level and a percentile score which describes parent stress relative to all parents assessed during the development and testing of the PSI. Scores above 80 are considered high stress scores.

  Pre to Post (~14 weeks)

• Change in Parenting Stress as assessed by Parenting Stress Index-Short Form (PSI-SF)

  Parents will complete the PSI-SF, a 36-item measure yielding scores for a Total Stress scale. The PSI-SF is a widely used measure in ASD samples and has been used as an outcome measure in PCIT ASD studies. The PSI-SF yields a total raw score for stress level and a percentile score which describes parent stress relative to all parents assessed during the development and testing of the PSI. Scores above 80 are considered high stress scores.

  Pre to Follow (~26 weeks)

Secondary Outcomes (1)

• Caregiver Satisfaction with treatment as assessed by Therapy Attitude Inventory (TAI)

  Pre to Post (~14 weeks)

Study Arms (1)

CAT

EXPERIMENTAL

Participants will receive behavioral treatment for anxiety.

Behavioral: CAT

Interventions

CAT BEHAVIORAL

Treatment includes 12 sessions: 2 caregiver teach sessions, 4 caregiver coach sessions in the child-directed interaction (CDI) phase, and 6 caregiver coach sessions in the DADS (Describe situation, Approach situation, give Direct command for child to join situation, provide Selective attention based on child's performance) phase. Throughout the 12 sessions, caregivers are coached through exposures in which the child is given the opportunity to slowly encounter anxiety-provoking factors. In the first session, caregivers are provided psychoeducation on anxiety and parenting practices and taught PRIDE (praise, reflect, imitate, describe, enjoy) skills, which are aimed at increasing approach behaviors and decreasing avoidant behaviors. In the CDI phase, caregivers are coached live via Bluetooth headset through the PRIDE and active ignoring skills. In the last 5 sessions, caregivers are coached through the DADS protocol while working up the Fear Hierarchy with the child.

CAT

Eligibility Criteria

• Age: 48 Months - 107 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Child participants must:
• Be between 4:0-8:11 years old
• Have clinically significant caregiver-report symptoms of anxiety on the Parent-Rated Anxiety Scale for ASD (PRAS-ASD)
• Have a primary anxiety concern on the Anxiety Disorders Interview Schedule for Autism Spectrum and Developmental Disorders: Parent Version (ADIS/ASA)
• Have an ASD diagnosis made by a qualified diagnostician
• Have a cognitive level of 48 months on the Wechsler Preschool \& Primary Scale of Intelligence-Fourth Edition (WPPSI-IV; ages 2:6-7:7) or the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V; ages 6:0-16:11)
• Caregiver participants must:
• Have access to a computer, tablet, or phone with a camera and Wi-Fi access

You may not qualify if:

• Primary concern other than anxiety as measures on the ADIS/ASA

Sponsors & Collaborators

• Medical University of South Carolina: lead

Study Sites (1)

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

MeSH Terms

Conditions

Autistic Disorder; Autism Spectrum Disorder; Anxiety Disorders

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: June 13, 2022
• First Posted: October 20, 2022
• Study Start: September 23, 2022
• Primary Completion: January 31, 2024
• Study Completion: January 31, 2024
• Last Updated: March 4, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)