Attachment Disorders, Fetal Alcohol Spectrum Disorder
Conditions
Keywords
Fetal Alcohol Spectrum Disorder, FASD
Brief summary
Study Summary: This study is being conducted in order to rigorously evaluate the real-world effectiveness of a publicly-funded, home-based, attachment-focused intervention Circle of Security (COS) Family Intervention Model (Marvin) in improving caregiving and child outcomes in families who have children with Fetal Alcohol Spectrum Disorder (FASD) or who are at-risk for FASD, as delivered under routine practice conditions. Hypothesis: At post-test (after 36 sessions and 3-month follow-up), compared to a wait-list control group receiving standard services, the treatment group receiving COS will show greater improvement in caregiver behaviour, as well as child emotional and behavioural outcomes.
Detailed description
See Arms and Intervention
Interventions
COS is a community based, visually supported, individualized attachment protocol appropriate for use with preschoolers and children and their parents/caregivers. It is based on attachment theory of John Bowlby and Mary Ainsworth and integrates neuroscientific principles of emotional regulation and attachment. The protocol contains both educational and therapeutic components. The goals of the intervention include increasing caregiver sensitivity and appropriate responsiveness to their child through increasing their capacity to recognize and understand their child's cues, and increasing caregiver self-reflection on their own caregiving behaviour.
Sponsors
Study design
Eligibility
Inclusion criteria
* Two criteria must be present for a family (caregiver-child dyad) to be included in the COS component of the FASD Outreach Program and its evaluation: * the child was exposed to alcohol prenatally and has been clinically evaluated using the Canadian FASD diagnostic guidelines as having Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (PFAS), Alcohol Related Neurodevelopmental Disorder (ARND), or is considered at risk for FASD based on their confirmed history of prenatal alcohol exposure and clinical multidisciplinary assessment; and * evidence of disrupted caregiver behaviours or problems in the caregiver-child interaction as identified through a screening process consisting of clinical judgment and the SBSH procedure.
Exclusion criteria
* children from foster families who have experienced more than 2 placements in the last six months, * children who have an Autism diagnosis, * children with a developmental quotient less than 50, * children with sensory impairments (hearing or sight impaired), and * children who are already involved in New Directions' 'Self Regulation Therapy Project'. Children who have parents who are clinically depressed, whose parents have substance abuse or domestic violence issues, or whose parents display a narcissistic devaluation personality trait based on initial clinical evaluation, will also be excluded from study eligibility.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Attachment Classification | Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup) | Attachment classified using Ainsworth's Strange Situation protocol: Secure, Anxious-Insecure, Anxious-Avoidant, Avoidant, Disorganized. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Parenting Scale (TPS) | Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup) | A self-report measure of dysfunctional parenting practices including laxness, over-reactivity, and verbosity. The scale has good internal consistency and test-restest reliability and scores are consistent with other measures of dysfunctional discipline and child misbehaviour. Each subscale score, ranges from 1 to 7; for each subscale (Laxness, Overreactivity, Verbosity) lower values indicate a lower degree of self-perceived ineffective parenting behaviors and higher values indicate a greater degree of self perceived ineffective parenting behaviours. The total score is calculated from a combination of each subscale and also ranges from 1 to 7, reflecting the degree of ineffective parenting behaviours across all categories with lower values indicate a lower degree of self-perceived ineffective parenting behaviors and higher values indicate a greater degree of self perceived ineffective parenting behaviours. |
| The Parenting Stress Index (PSI) | Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup) | A parent-report questionnaire of parental stress reflecting parent-child interaction style and difficult child behaviour. There are two main domain scores, a Child Domain Score and Parent Domain Score from which a Total Stress Score is calculated. Child and Parent Domain raw scores combine to form a Total Stress raw score. Higher scores for each item indicate a higher degree of negative attributes in the given scale while lower scores indicate lower relationship stress and a greater sense of enjoyment in the relationship. Items include: Defensive Responding (DR) Score range 7-35 Parental Distress (PD) Score range 12-60 Parent-Child Dysfunctional Interaction (PCDI) Score range 12-60 Difficult Child (DC) Score range 12-60 PSI Total Stress Score range 36-180 |
| The Depression Anxiety Stress Scale (DASS) | Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup) | A self-report measure of depression, anxiety, and stress. The scales of the DASS show high internal consistency and produce meaningful discriminations in different settings, and are appropriate for measuring the emotional states of caregivers over time. The score for each item ranges from 0 to 3, where 0 indicates did not apply to me at all and 3 indicates applied to me very much, or most of the time. The individual items are combined using a scoring template into measures of Depression (D), Anxiety (A), and Stress (S). Depression is scored out of 28 where 0-9 is normal and 10-28 reflect mild, moderate, and severe degrees of depression. Anxiety is scored out of 20 where 0-7 is normal and 8-20 reflect mild, moderate, and severe degrees of anxiety. Stress is scored out of 34 where 0-14 is normal and 15-34 reflect mild, moderate, and severe degrees of stress. |
| The Strengths and Difficulties Questionnaire SDQ | Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup) | The Emotional Symptoms (SDQ-ES), Conduct Problems (SDQ-CP), Hyperactivity (SDQ-HA), Peer Problems (SDQ-PP), and Prosocial (SDQ-PS) Scales each range from 0-10 Higher values in (ES, CP, HA, and PP) indicate a greater degree of abnormal behavior; low values indicate more normative behavior. For the PS scale, higher values indicate greater strengths in prosocial behaviour and lower values indicate more difficulties with prosocial behavior. A Total Difficulties Score ranges from 0 to 40 with higher scores reflecting higher levels of behavioral difficulty. The Total Impact Supplement Score (Total IS) ranges from 0 to 10 with higher values indicating greater behavioral difficulty and social impairment. |
Countries
Canada
Participant flow
Recruitment details
The population studied were families with preschool children with FASD or PAE who were referred to the provincial FASD Outreach program or the FASD Family Support, Education and Counselling Program, a program of New Directions,between January 2011 - December 2013. The age range of children in the FASD Outreach Program is between 2 to 5 years old.
Participants by arm
| Arm | Count |
|---|---|
| Receives COS Intervention Circle of Security (COS) Family Intervention (B. Marvin model) is a community based, visually supported, individualized attachment protocol appropriate for use with preschoolers and children and their parents/caregivers. The goals of the intervention include increasing caregiver sensitivity and appropriate responsiveness to their child through increasing their capacity to recognize and understand their child's cues, and increasing caregiver self-reflection on their own caregiving behaviour. The protocol itself involves a series of activities and repeated videotaped interactions between the child and their caregiver which are reviewed by the therapist who has established themselves with the caregiver as a secure base from which the attachment relationship may be explored.
Circle of Security (COS): COS is a community based, visually supported, individualized attachment protocol appropriate for use with preschoolers and children and their parents/caregivers. It is based on attachment | 8 |
| Control Group-Regular FASD Services Regular FASD Services include general information on Fetal Alcohol Spectrum Disorder (FASD) with general behavioural management strategies and parental supports. | 4 |
| Total | 12 |
Baseline characteristics
| Characteristic | Total | Receives COS Intervention | Control Group-Regular FASD Services |
|---|---|---|---|
| Age, Continuous | 4.1 years | 4.1 years | NA years |
| Age, Customized Greater than 5 years old | 0 Participants | 0 Participants | 0 Participants |
| Age, Customized Less than or equal to 5 years old | 12 Participants | 8 Participants | 4 Participants |
| Region of Enrollment Canada | 12 participants | 8 participants | 4 participants |
| Sex: Female, Male Female | 2 Participants | 1 Participants | 1 Participants |
| Sex: Female, Male Male | 10 Participants | 7 Participants | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Attachment Classification
Attachment classified using Ainsworth's Strange Situation protocol: Secure, Anxious-Insecure, Anxious-Avoidant, Avoidant, Disorganized.
Time frame: Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup)
Population: Number of participants analyzed Receives COS Intervention Pretest= 8; Post-test=3; Follow-up=4 Control Group Pretest=4; Post-test=1; Follow-up=1
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Receives COS Intervention | Attachment Classification | Disordered (post test) | 2 participants |
| Receives COS Intervention | Attachment Classification | Avoidant (followup) | 0 participants |
| Receives COS Intervention | Attachment Classification | Anxious-Insecure (post test) | 0 participants |
| Receives COS Intervention | Attachment Classification | Disordered (followup) | 3 participants |
| Receives COS Intervention | Attachment Classification | Secure (followup) | 1 participants |
| Receives COS Intervention | Attachment Classification | Secure (pretest) | 0 participants |
| Receives COS Intervention | Attachment Classification | Avoidant (post test) | 0 participants |
| Receives COS Intervention | Attachment Classification | Anxious-Insecure (pretest) | 0 participants |
| Receives COS Intervention | Attachment Classification | Anxioius-Insecure (followup) | 0 participants |
| Receives COS Intervention | Attachment Classification | Anxious-Avoidant (pretest) | 0 participants |
| Receives COS Intervention | Attachment Classification | Anxious-Avoidant (post test) | 0 participants |
| Receives COS Intervention | Attachment Classification | Avoidant (pretest) | 3 participants |
| Receives COS Intervention | Attachment Classification | Anxious-Avoidant (followup) | 0 participants |
| Receives COS Intervention | Attachment Classification | Disordered (pretest) | 5 participants |
| Receives COS Intervention | Attachment Classification | Secure (post test) | 1 participants |
| Control Group-Regular FASD Services | Attachment Classification | Disordered (pretest) | 4 participants |
| Control Group-Regular FASD Services | Attachment Classification | Secure (post test) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Anxious-Insecure (post test) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Anxious-Avoidant (post test) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Avoidant (post test) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Disordered (post test) | 1 participants |
| Control Group-Regular FASD Services | Attachment Classification | Secure (followup) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Anxioius-Insecure (followup) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Anxious-Avoidant (followup) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Avoidant (followup) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Disordered (followup) | 1 participants |
| Control Group-Regular FASD Services | Attachment Classification | Secure (pretest) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Anxious-Insecure (pretest) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Anxious-Avoidant (pretest) | 0 participants |
| Control Group-Regular FASD Services | Attachment Classification | Avoidant (pretest) | 0 participants |
The Depression Anxiety Stress Scale (DASS)
A self-report measure of depression, anxiety, and stress. The scales of the DASS show high internal consistency and produce meaningful discriminations in different settings, and are appropriate for measuring the emotional states of caregivers over time. The score for each item ranges from 0 to 3, where 0 indicates did not apply to me at all and 3 indicates applied to me very much, or most of the time. The individual items are combined using a scoring template into measures of Depression (D), Anxiety (A), and Stress (S). Depression is scored out of 28 where 0-9 is normal and 10-28 reflect mild, moderate, and severe degrees of depression. Anxiety is scored out of 20 where 0-7 is normal and 8-20 reflect mild, moderate, and severe degrees of anxiety. Stress is scored out of 34 where 0-14 is normal and 15-34 reflect mild, moderate, and severe degrees of stress.
Time frame: Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup)
Population: Receives COS Intervention Pretest= 8; Post-test=6; Follow-up=5 Control Group Pretest=4; Post-test=2; Follow-up=2
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-D (post test) | 3.33 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-A (followup) | 4 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-A (pretest) | 4.13 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-S (pretest) | 7.63 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-D (followup) | 5.2 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-S (post test) | 6.17 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-A (post test) | 4.5 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-S (followup) | 9 units on a scale |
| Receives COS Intervention | The Depression Anxiety Stress Scale (DASS) | DASS-D (pretest) | 2.63 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-S (followup) | 2 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-D (pretest) | 1 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-D (post test) | 0 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-D (followup) | 0 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-A (pretest) | 0.5 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-A (post test) | 0 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-A (followup) | 0 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-S (pretest) | 3 units on a scale |
| Control Group-Regular FASD Services | The Depression Anxiety Stress Scale (DASS) | DASS-S (post test) | 4.5 units on a scale |
The Parenting Scale (TPS)
A self-report measure of dysfunctional parenting practices including laxness, over-reactivity, and verbosity. The scale has good internal consistency and test-restest reliability and scores are consistent with other measures of dysfunctional discipline and child misbehaviour. Each subscale score, ranges from 1 to 7; for each subscale (Laxness, Overreactivity, Verbosity) lower values indicate a lower degree of self-perceived ineffective parenting behaviors and higher values indicate a greater degree of self perceived ineffective parenting behaviours. The total score is calculated from a combination of each subscale and also ranges from 1 to 7, reflecting the degree of ineffective parenting behaviours across all categories with lower values indicate a lower degree of self-perceived ineffective parenting behaviors and higher values indicate a greater degree of self perceived ineffective parenting behaviours.
Time frame: Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup)
Population: Number of Participants Analyzed Receives COS Intervention Pretest= 8; Post-test=6; Follow-up=5 Control Group Pretest=4; Post-test=2; Follow-up=2
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Verbosity (follow up) | 3.11 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Total (pretest) | 4.08 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Laxness (followup) | 2.47 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Overreactivity (pretest) | 2.39 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Laxness (post test) | 2.97 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Overreactivity (post test) | 2.18 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Overreactivity (follow up) | 2.46 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Total (post test) | 2.97 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Verbosity (pretest) | 3.54 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Verbosity (post test) | 3.56 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Total (followup) | 2.67 units on a scale |
| Receives COS Intervention | The Parenting Scale (TPS) | TPS Laxness (pretest) | 3.22 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Verbosity (follow up) | 3.36 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Laxness (followup) | 2.46 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Overreactivity (post test) | 2.53 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Total (pretest) | 2.3 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Total (post test) | 3.27 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Laxness (pretest) | 2.22 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Laxness (post test) | 3.14 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Overreactivity (pretest) | 1.65 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Overreactivity (follow up) | 1.85 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Verbosity (pretest) | 2.80 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Verbosity (post test) | 3.52 units on a scale |
| Control Group-Regular FASD Services | The Parenting Scale (TPS) | TPS Total (followup) | 2.6 units on a scale |
The Parenting Stress Index (PSI)
A parent-report questionnaire of parental stress reflecting parent-child interaction style and difficult child behaviour. There are two main domain scores, a Child Domain Score and Parent Domain Score from which a Total Stress Score is calculated. Child and Parent Domain raw scores combine to form a Total Stress raw score. Higher scores for each item indicate a higher degree of negative attributes in the given scale while lower scores indicate lower relationship stress and a greater sense of enjoyment in the relationship. Items include: Defensive Responding (DR) Score range 7-35 Parental Distress (PD) Score range 12-60 Parent-Child Dysfunctional Interaction (PCDI) Score range 12-60 Difficult Child (DC) Score range 12-60 PSI Total Stress Score range 36-180
Time frame: Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup)
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Receives COS Intervention | The Parenting Stress Index (PSI) | PD (post test) n=6, n=1 | 27 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PCDI (followup) n=5, n=2 | 27.8 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | DR (post test) n=6, 1 | 15.66 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | DC (pretest) n=8, n=4 | 35.75 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PD (followup) n=5, n=2 | 33.4 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | DC (post test) n=6, n=1 | 33.66 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PD (pretest) n=8, n=4 | 42.75 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | DC (followup) n=5, n=2 | 35.4 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PCDI (pretest) n=8, n=4 | 37.5 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PSI total Stress (pretest) n=8, n=4 | 116 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | DR (followup) n=5, n=2 | 19 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PSI total Stress (post test) n=6, n=1 | 86.33 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PCDI (post test) n=6, n=1 | 25.66 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | PSI total Stress (followup) n=5, n=2 | 96.6 units on a scale |
| Receives COS Intervention | The Parenting Stress Index (PSI) | DR (pretest) n=8, n=4 | 25.13 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PSI total Stress (followup) n=5, n=2 | 96.5 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | DR (pretest) n=8, n=4 | 14.25 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | DR (post test) n=6, 1 | 16 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | DR (followup) n=5, n=2 | 18 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PD (pretest) n=8, n=4 | 24 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PD (post test) n=6, n=1 | 29 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PD (followup) n=5, n=2 | 30.5 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PCDI (pretest) n=8, n=4 | 24.5 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PCDI (post test) n=6, n=1 | 31 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PCDI (followup) n=5, n=2 | 24 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | DC (pretest) n=8, n=4 | 40.75 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | DC (post test) n=6, n=1 | 56 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | DC (followup) n=5, n=2 | 42 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PSI total Stress (pretest) n=8, n=4 | 89.25 units on a scale |
| Control Group-Regular FASD Services | The Parenting Stress Index (PSI) | PSI total Stress (post test) n=6, n=1 | 116 units on a scale |
The Strengths and Difficulties Questionnaire SDQ
The Emotional Symptoms (SDQ-ES), Conduct Problems (SDQ-CP), Hyperactivity (SDQ-HA), Peer Problems (SDQ-PP), and Prosocial (SDQ-PS) Scales each range from 0-10 Higher values in (ES, CP, HA, and PP) indicate a greater degree of abnormal behavior; low values indicate more normative behavior. For the PS scale, higher values indicate greater strengths in prosocial behaviour and lower values indicate more difficulties with prosocial behavior. A Total Difficulties Score ranges from 0 to 40 with higher scores reflecting higher levels of behavioral difficulty. The Total Impact Supplement Score (Total IS) ranges from 0 to 10 with higher values indicating greater behavioral difficulty and social impairment.
Time frame: Administered 3 times: at baseline (pretest), 9 months (postest), 12 months (followup)
Population: Please see category specific n values below.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-PS (post test) n=6, n=1 | 6.66 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-HA (followup) n=5, n=2 | 7.8 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-PS (followup) n=5, n=2 | 6.2 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-CP (post test) n=6, n=1 | 3.66 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | Total SDQ (pretest)n=7, n=4 | 18.71 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ- PP (pretest) n=7, n=4 | 3 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | Total SDQ (post test)n=6, n=1 | 18 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | Total SDQ (followup) n=5, n=2 | 19.2 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-HA (pretest)n=6, n=4 | 8.17 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | Total IS (pretest) n=7, n=4 | 4.43 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ- PP (post test)n=6, n=1 | 3.33 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | Total IS (post test) n=6, n=1 | 2.12 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-CP (pretest) n=5, n=4 | 5 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | Total IS (followup)n=5, n=0 | 3.4 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ- PP (followup)n= 5, n=2 | 2.8 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-ES (pretest) n=7, n=4 | 2.86 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-HA (post test) n=6, n=1 | 6.66 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-ES (post test) n=6, n=1 | 4.33 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-PS (pretest) n=7, n=4 | 5.86 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-ES (followup) n=5, n=2 | 3.8 units on a scale |
| Receives COS Intervention | The Strengths and Difficulties Questionnaire SDQ | SDQ-CP (followup) n=5, n=2 | 4.8 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-ES (followup) n=5, n=2 | 3 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-CP (pretest) n=5, n=4 | 4.5 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-CP (post test) n=6, n=1 | 7 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-CP (followup) n=5, n=2 | 4 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-HA (pretest)n=6, n=4 | 8 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-HA (post test) n=6, n=1 | 9 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-HA (followup) n=5, n=2 | 6.5 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ- PP (pretest) n=7, n=4 | 4 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ- PP (post test)n=6, n=1 | 6 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ- PP (followup)n= 5, n=2 | 3 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-PS (pretest) n=7, n=4 | 6 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-PS (post test) n=6, n=1 | 5 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-PS (followup) n=5, n=2 | 7 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | Total SDQ (pretest)n=7, n=4 | 21 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | Total SDQ (followup) n=5, n=2 | 16 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | Total IS (pretest) n=7, n=4 | 5.5 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | Total IS (post test) n=6, n=1 | 10 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | Total IS (followup)n=5, n=0 | NA units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-ES (pretest) n=7, n=4 | 4.5 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | SDQ-ES (post test) n=6, n=1 | 3 units on a scale |
| Control Group-Regular FASD Services | The Strengths and Difficulties Questionnaire SDQ | Total SDQ (post test)n=6, n=1 | 25 units on a scale |