None listed
Conditions
Brief summary
This study aims to investigate whether a short period of coaching sessions, delivered in person with a clinician or via videocall, helps families of young children who have recently become aware that there may be a risk of autism spectrum disorder. We hypothesise that families need support and guidance in this period, and that these needs are not currently being met by health or disability services. is the researchers' hope that findings from this study will help families in limbo, waiting for diagnostic assessments and unsure what to do or how to help their child in the meantime. This may assist to minimise wasteful waiting periods in a child's early years, when intervention can be of great benefit to children, families and communities.
Interventions
A feasibility study will be conducted using recommended constructs and associated measures, and reported using CONSORT guidance. Participants will be randomised to one of three trial arms. One will include a coaching intervention that aims to address functional goals, Occupational Performance Coaching (OPC), delivered via four face to face sessions (Arm B), within four months of a child aged 1 to 7 years being referred to one of two Victorian services for an autism assessment. A second arm will
A feasibility study will be conducted using recommended constructs and associated measures, and reported using CONSORT guidance. Participants will be randomised to one of three trial arms. One will include a coaching intervention that aims to address functional goals, Occupational Performance Coaching (OPC), delivered via four face to face sessions (Arm B), within four months of a child aged 1 to 7 years being referred to one of two Victorian services for an autism assessment. A second arm will provide coaching delivered over 4 sessions using video conference modalities (Arm C), and the third arm will be usual care (Arm A). Occupational Performance Coaching (OPC) is an occupation-based intervention developed to address the functional support needs of children and families (Graham, 2009). It has been built upon several theoretical foundations including occupation-centred and family-centred practice, as well as ecological models of child health and well-being. The approach involves supporting families to generate goals relating to themselves, their child’s functioning or the functioning of their family as a whole. The therapist then, through a series of interactive, semi-structured interview sessions, provides an opportunity for reflection, sharing of information, and the development of attainable actions for forthcoming review. Performance analysis, strategy generation and resource identification take place collaboratively, and actions are reviewed in subsequent sessions until goals are reached, or alternative strategies for goal attainment are identified. To date, this intervention has not been trialled specifically with families of children waiting for autism diagnostic assessment, nor have modes of treatment delivery been compared within the same study. This coaching will occur in the same way in both treatment arms, with only the mode of intervention as the point of difference. Families in the intervention arms (B and C) will receive coaching sessions between 2 and 6 weeks apart, for approximately 45 minutes each session. This will be in addition to usual care. Arm C will rely on freely-available videoconference software such as Zoom(C) or Skype(C) to connect with participants at agreed times. Participants without current access to existing software will be supported by a member of the research team to safely download a preferred programme onto their chosen device, from a list of options made available to them, at no cost to either party. The research team and consenting participants will use existing access to computers and/or smartphones to undertake these sessions. Preliminary efficacy measures, such as goal attainment across the three intervention arms, will be completed. Coaching will be delivered by a clinician researcher with over 15 years of early intervention expertise, who is trained in the application of OPC. Fidelity will be assessed for 30% of the intervention sessions, double coded by the clinician researcher and the author of OPC, via completion of a published OPC fidelity tool.
Sponsors
Ms Charmaine Bernie
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
1 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants for this study are defined as a pair or group consisting of a young child, and one or two primary caregivers. The usual care and coaching interventions will be delivered to primary carers of children between 1 and 7 years of age referred to one of two centres in Melbourne with a query of autism spectrum disorder. Families may be recruited to the study within 4 months of receipt of their referral, and only following an independent clinical decision confirming service eligibility.
Exclusion criteria
• Respondents whom are not currently the primary carer of the child referred to the assessment service • Children with an existing diagnosis of autism spectrum disorder, or whom have been assessed for the disorder within the last 12 months. • Primary carers who are accessing goal-directed coaching support services at the time of recruitment, and such services are sufficiently meeting their family goals and priorities • Primary carers with known current mental health diagnoses currently under active treatment, supported by relevant health professional/s • Primary carers of children with known developmental or medical diagnoses, whom have already accessed a multidisciplinary team (MDT) diagnostic assessment at a relevant paediatric health care service.
Outcome results
None listed