Autism Spectrum Disorder, Autistic Disorder
Conditions
Keywords
Autism Spectrum Disorder, Autism
Brief summary
This study aims to implement and test a specific brief Applied Behavior Analysis model for assessing and responding to severe challenging behavior during acute medical and behavioral hospitalization for children with ASD. The investigators will evaluate the impact of this program by conducting a randomized trial across both medical and psychiatric hospital settings.
Interventions
BEHAVIORALBrief Analogue Functional Analysis
The Brief AFA seeks to identify the function of the challenging behavior by creating controlled test conditions in which specific responses are provided for challenging behavior (e.g., attention, escape from task demands, access to tangible - including variants of each as needed), as well as a control condition in which continual access to attention and preferred items is provided. It consists of a 30-90-minute abbreviated analysis comprised of a single exposure to 2-5-minute test and control conditions, along with replication of applicable test conditions and a treatment probe, which provides evidence of challenging behavior function faster than other methods.
OTHERNo Brief AFA
These participants will receive typical standard of care procedures while hospitalized, but will not receive the additional behavioral intervention
Sponsors
Vanderbilt University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* documented diagnosis of an ASD based on clinical DSM-5 diagnostic criteria assessed by attending psychiatrist * the presence of a significant challenging behaviors (e.g., aggression, property destruction, self-injury, elopement) * admission to the VPH or medical floors * individual and caregiver agreement to participate and ability to provide informed consent (and assent).
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Aberrant Behavior Checklist | Change from Baseline ABC at Hospital Discharge (an expected average of 42 days) and 3-Months Post-Discharge | The ABC is a well-validated measure designed to assess for the presence of clinically significant challenging behavior in the areas of irritability and agitation, lethargy and social withdrawal, stereotypic behavior, hyperactivity and noncompliance, and inappropriate speech. |
| Decrease in Length of Hospitalization | Participants will be followed from admission to discharge, an expected average of 42 days | Reduction in the days hospitalized past medical clearance). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Global Impression Scales of Severity | Baseline and Day of Patient's Discharge (an expected average of 42 days from admission) | Attending physician's impressions of participant's clinical impairment and improvement. |
| Blinded Observational Ratings | Participants will be followed for duration of hospital stay, an expected average of 42 days | Blinded coding of the challenging behaviors targeted in the treatment arm |
| Physician/Nurse/Family Perception of Care | Day of Patient's Discharge (an expected average of 42 days from admission) | The primary medical attending, lead discharge nurse staff member, and the child's primary parent will also be asked at discharge to provide both quantitative and qualitative ratings of challenges and successes during hospitalization. Caregivers will be contacted to complete a simple interview/questionnaire 3- months post-hospitalization regarding changes in the patient's medication, medical conditions, residential/classroom placement, emergency room visits or psychiatric hospitalizations since the discharge date, as well as ratings of successes implementing components of the behavioral strategies plan utilized during the hospitalization (if applicable). |
Countries
United States
Outcome results
None listed