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ASD Parent Trainer: Online Coaching for Parents of Children With Autism

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02469870
Acronym
APT
Enrollment
156
Registered
2015-06-12
Start date
2016-08-31
Completion date
2017-10-30
Last updated
2020-02-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Autism Disorder

Keywords

Parents of children who have autism, video-conferencing, Applied Behavior Analysis, Acceptance Commitment Training, optimism training, Positive Behavior Support

Brief summary

The evaluation of the program efficacy will be conducted via a randomized control study with 136 parents of children aged 3-8 who have autism. Investigators will test whether, compared to a content comparison group (CC), administration of the APT program over a 3-week intervention period (a) improves child behaviors, (b) increases perceived quality of life, (c) decreases parental stress, (d) increases positive parenting practices, and (e) increases parent knowledge of evidence-based support practices.

Detailed description

Participants. The sample will consist of parents who have at least one child diagnosed with autism (aged 3 to 8) and have access to the Internet. From investigators experience in the Phase I and similar studies, an attrition rate of less than 30% is expected. 180 parents (90 per condition) will ensure that the final sample will be no fewer than 136, with 68 in each condition. Participation will be open to two-parent and single-parent families; only one parent per family will be invited to participate in data collection. No parental age, gender, or race exclusions will apply. Procedure. All research will be conducted online. IRIS Ed has extensive experience conducting online studies, and has developed successful recruitment, retention, and assessment procedures. Screening, consent, and data collection will be conducted using Qualtrics (see Human Subjects). Google+ Hangouts will be used to conduct the interactive APT training. The CC training materials will be hosted on irisEd.com. Additional training materials will be hosted on YouTube and SoundCloud. Participants will be recruited nationally using approaches and resources that have yielded results in past online interventions. The APT study will adhere to the following procedures: potential participants will be directed to the recruitment website on Qualtrics and will be screened for eligibility on the following inclusion criteria: (a) have a child aged 3-8 diagnosed with autism and living with the parent, (b) have access to email and an Internet connection, and (c) have access to a computer or other mobile device with a camera and a microphone. Eligible participants will be given a brief explanation of the study and participation requirements, and will be asked to complete an online informed consent (see Human Subjects). Participants will then complete the pretest measures (see Table 3). Upon pretest completion, parents will be randomly assigned to either the APT intervention condition or a content comparison (CC) group. Content Comparison (CC). Parents assigned to the CC will be given access to a self-paced online training program covering the same content as APT. The CC group will receive an online program that delivers antecedent-behavior-consequence (ABC) multimedia instruction that is targeted to parents. For this purpose, investigators and the curriculum designer will adapt a program developed by IRIS entitled Teaching Routines to Children Who Have ASD, A Parent's Guide to the ABC Method. The ABC Method demonstrated in a pre-posttest design that web-based instruction in applied behavioral analytical (ABA) strategies, such as ABC, was effective in helping parents teach children basic self-help skills, and allowed parents to apply this method to a range of skills. The original ABC Method program consisted of nine multimedia lessons (modeling videos, animated sequences, interactive exercises, downloadable summaries) designed to help parents understand and use the antecedent-behavior-consequence concept derived from ABA. Each lesson contained a 3 to 5 minute video that uses simple language, realistic live action, and animation to illustrate a concept and to model how parents can apply the concept as they teach a routine. Each lesson also contained an interactive exercise and printed summary to guide parents through the steps of creating a teaching plan tailored to the needs of their children. To ensure that the CC group receives a dosage equivalent to that of the APT Intervention group, the original program will be reformatted so that it is delivered in 3 rather than 9 lessons. This will require re-editing the original materials, creating new introductions to the three lessons, and making corresponding changes in how the program is delivered by our online Learning Management System. Investigators will also ensure that the reformatted program possesses equivalent validity with the original program. Investigators and the development team will achieve this by enlisting a small test group of parents in an iterative process of review and refinement as the program is reformatted. Parents in the CC will have 3 weeks in which to access the program. Web metrics will allow investigators to track adherence to program fidelity. Treatment. Parents in the APT group will be presented with the dates and times of available training groups and asked to select their preference. They will then receive an access code for logging on to the APT web hub to view the training materials. Participants will also be given access to the videoconferencing workshops, and will test to ensure they can access the site and that their camera and microphone are operating. IRIS Ed technical staff will be available to assist with any difficulties. Each week, for three weeks participants in the APT condition will meet with their training group and the APT Parent Educator for 120 minutes of instruction, discussion, and problem solving. They will also complete assigned homework, including watching online video trainings.

Interventions

BEHAVIORALAutism Parent Trainer (APT)

Experimental condition

BEHAVIORALTeaching Routines (Control)

Content comparison group.

Sponsors

IRIS Media Inc
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* Parents of children aged 3-8 who have autism

Exclusion criteria

* none

Design outcomes

Primary

MeasureTime frameDescription
Child Behavior Measured by Strengths and Difficulties Questionnaire (Goodman, 1997)Pre (0 weeks), Post (3 weeks)Examining change over time points (T2-T1) This 25-item parent-report version of a behavioral screening questionnaire has been used with children aged 3 to 16 years of age. It assesses both positive and negative behaviors in the following domains: conduct problems, inattention-hyperactivity, emotional symptoms, peer problems, and pro-social behavior. The SDQ-P has demonstrated acceptable psychometric properties and is available in Spanish (Goodman, 2001).Total range of scores is from 0 to 50. The prosocial items are reverse scored for the total scale so that on the total scale higher scores indicate worse behaviors.
Family Quality of Life as Measured by Family Quality of Life Survey (Summers et al., 2005)Pre (0 weeks), Post (3 weeks)Examining change over time points (T2-T1) Quality of Life was measured using the Family Quality of Life survey (FQOL; Summers et al., 2005), which is a 25-item measure of the quality of life for a family raising a child with intellectual or developmental disabilities. The outcomes measured are: quality of life in the domains of parenting, emotional well-being, physical/material well-being, and disability-related supports using a 5-point scale with responses ranging from (1) very dissatisfied to (5) very satisfied. The average score on the total scale was used in the analysis. The range is from 1 to 5 with higher scores indicating more positive outcomes.
Parenting Scale (Arnold, O'Leary, Wolff, & Aker, 1993)Pre (0 weeks), Post (3 weeks),Examining change over time points (T2-T1) Parenting Practices will be assessed using the Parenting Scale (PS; Arnold, O'Leary, Wolff, & Aker, 1993) a 30-item, 7 point Likert-like scale with three subscales (laxness, over-reactivity, and hostility). The scale has internal consistency for the total scale and subscales (α = .78 and - .83 respectively) and has been evaluated for factor structure and validity (Rhoades & O'Leary, 2007). The average score on the total scale was used in the analysis with a range of 1 to 7 with lower scores indicating more positive outcomes.
Scales of Independent Behavior-Revised (SIB-R; Bruininks, Woodcock, Weatherman, & Hill, 1996)Pre (0 weeks), Post (3 weeks)Examining change over time points (T2-T1) The SBI-R is a 40-item, 7-point scale that measures 14 areas of adaptive behaviors and 8 areas of maladaptive behaviors. We used the total adaptive scale with a total range of 0 to 120 with higher scores indicating better outcomes.

Secondary

MeasureTime frameDescription
Knowledge About Applied Behavior Analysis and Acceptance Commitment Training Measured by QuestionnairePre (0 weeks), Post (3 weeks)Examining change over time points (T2-T1) 20 multiple choice knowledge items were developed during the project and were used to determine the extent to which participants understood basic program content, e.g., techniques parents can use to help their child master self-care routines. These included questions about the principles of behavior support (gathering information, evaluating possible reinforcers, etc.), definitions of behavioral concepts (tantrums, reinforcement, antecedent), and application of these concepts. The total score ranged from 0 to 20 with higher scores indicating better outcomes.
Consumer Satisfaction QuestionnaireFollow up (6 weeks)A 16-item scale was developed to evaluate parents' views of the feasibility, usability, and personal relevance of the program. It asked about the information taught in the program, the trainers, the website, and the other materials. The average score on these 19 items was evaluated and ranged from 1 to 6 with higher scores indicating more positive outcomes.

Countries

United States

Participant flow

Participants by arm

ArmCount
Autism Parent Trainer (APT)
Autism Parent Trainer (APT) Experimental Condition. Practiced Routines was a facilitated program. It was organized into four modules that included a total of seven videos ranging from 3-13 minutes each. The topics overlapped with those in the TR program, but included more explicit information on function-based strategies, as well as mindfulness practice. Participants were assigned six fillable forms, and provided supplemental data collection tools. Additional resources focused on mindfulness and PBS within family routines. Eighteen brief guided audio meditations were available to participants via the Practiced MindTM mobile application. The meditations focused on bringing the parents' awareness to both internal and external experiences and helping them act intentionally.
77
Teaching Routines (Control)
Teaching Routines was entirely self-directed. The program included eight modules with videos for each ranging 3 - 5 minutes in duration. The topics were antecedent-behavior-consequence method, creating task analyses, antecedent-based strategies, communication, reinforcement, teaching methods, and overcoming obstacles. Participants were assigned six activities using fillable forms and provided additional resources including examples, a glossary of terms, and a list of websites. No feedback was given to the parents apart from the automated completion responses. The participants were given access to the TR LMS for the duration of the study, but post and follow-up assessments were completed at 6 and 10 weeks (i.e., same as the PR condition).
79
Total156

Baseline characteristics

CharacteristicAutism Parent Trainer (APT)Teaching Routines (Control)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
77 Participants79 Participants156 Participants
Age, Continuous37.4 years
STANDARD_DEVIATION 5.9
36.1 years
STANDARD_DEVIATION 5.5
36.7 years
STANDARD_DEVIATION 5.7
Ethnicity (NIH/OMB)
Hispanic or Latino
8 Participants13 Participants21 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
67 Participants62 Participants129 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
2 Participants4 Participants6 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
2 Participants1 Participants3 Participants
Race (NIH/OMB)
Black or African American
13 Participants5 Participants18 Participants
Race (NIH/OMB)
More than one race
3 Participants5 Participants8 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants2 Participants5 Participants
Race (NIH/OMB)
White
56 Participants66 Participants122 Participants
Region of Enrollment
United States
77 participants79 participants156 participants
Sex: Female, Male
Female
75 Participants77 Participants152 Participants
Sex: Female, Male
Male
2 Participants2 Participants4 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 770 / 79
other
Total, other adverse events
0 / 770 / 79
serious
Total, serious adverse events
0 / 770 / 79

Outcome results

Primary

Child Behavior Measured by Strengths and Difficulties Questionnaire (Goodman, 1997)

Examining change over time points (T2-T1) This 25-item parent-report version of a behavioral screening questionnaire has been used with children aged 3 to 16 years of age. It assesses both positive and negative behaviors in the following domains: conduct problems, inattention-hyperactivity, emotional symptoms, peer problems, and pro-social behavior. The SDQ-P has demonstrated acceptable psychometric properties and is available in Spanish (Goodman, 2001).Total range of scores is from 0 to 50. The prosocial items are reverse scored for the total scale so that on the total scale higher scores indicate worse behaviors.

Time frame: Pre (0 weeks), Post (3 weeks)

ArmMeasureValue (MEAN)Dispersion
Autism Parent Trainer (APT)Child Behavior Measured by Strengths and Difficulties Questionnaire (Goodman, 1997)19.27 total score on a scaleStandard Deviation 5.2
Teaching Routines (Control)Child Behavior Measured by Strengths and Difficulties Questionnaire (Goodman, 1997)21.00 total score on a scaleStandard Deviation 5.2
Comparison: To address hypotheses predicting differential change in outcome measures between condition over time we used analysis of covariance (ANCOVA) models that allow for examination of cross-sectional effects and mean adjusted outcomes. The ANCOVA models (adjusted for baseline scores) were used for analyses of change in the outcome measures at posttest.p-value: 0.598ANCOVA
Primary

Family Quality of Life as Measured by Family Quality of Life Survey (Summers et al., 2005)

Examining change over time points (T2-T1) Quality of Life was measured using the Family Quality of Life survey (FQOL; Summers et al., 2005), which is a 25-item measure of the quality of life for a family raising a child with intellectual or developmental disabilities. The outcomes measured are: quality of life in the domains of parenting, emotional well-being, physical/material well-being, and disability-related supports using a 5-point scale with responses ranging from (1) very dissatisfied to (5) very satisfied. The average score on the total scale was used in the analysis. The range is from 1 to 5 with higher scores indicating more positive outcomes.

Time frame: Pre (0 weeks), Post (3 weeks)

ArmMeasureValue (MEAN)Dispersion
Autism Parent Trainer (APT)Family Quality of Life as Measured by Family Quality of Life Survey (Summers et al., 2005)3.99 average score on a scaleStandard Deviation 0.5
Teaching Routines (Control)Family Quality of Life as Measured by Family Quality of Life Survey (Summers et al., 2005)3.86 average score on a scaleStandard Deviation 0.6
Comparison: . To address hypotheses predicting differential change in outcome measures between condition over time we used analysis of covariance (ANCOVA) models that allow for examination of cross-sectional effects and mean adjusted outcomes. The ANCOVA models (adjusted for baseline scores) were used for analyses of change in the outcome measures at posttest.p-value: 0.81ANCOVA
Primary

Parenting Scale (Arnold, O'Leary, Wolff, & Aker, 1993)

Examining change over time points (T2-T1) Parenting Practices will be assessed using the Parenting Scale (PS; Arnold, O'Leary, Wolff, & Aker, 1993) a 30-item, 7 point Likert-like scale with three subscales (laxness, over-reactivity, and hostility). The scale has internal consistency for the total scale and subscales (α = .78 and - .83 respectively) and has been evaluated for factor structure and validity (Rhoades & O'Leary, 2007). The average score on the total scale was used in the analysis with a range of 1 to 7 with lower scores indicating more positive outcomes.

Time frame: Pre (0 weeks), Post (3 weeks),

ArmMeasureValue (MEAN)Dispersion
Autism Parent Trainer (APT)Parenting Scale (Arnold, O'Leary, Wolff, & Aker, 1993)3.7 average score on a scaleStandard Deviation 0.6
Teaching Routines (Control)Parenting Scale (Arnold, O'Leary, Wolff, & Aker, 1993)3.72 average score on a scaleStandard Deviation 0.3
Comparison: . To address hypotheses predicting differential change in outcome measures between condition over time we used analysis of covariance (ANCOVA) models that allow for examination of cross-sectional effects and mean adjusted outcomes. The ANCOVA models (adjusted for baseline scores) were used for analyses of change in the outcome measures at posttest.p-value: 0.404ANCOVA
Primary

Scales of Independent Behavior-Revised (SIB-R; Bruininks, Woodcock, Weatherman, & Hill, 1996)

Examining change over time points (T2-T1) The SBI-R is a 40-item, 7-point scale that measures 14 areas of adaptive behaviors and 8 areas of maladaptive behaviors. We used the total adaptive scale with a total range of 0 to 120 with higher scores indicating better outcomes.

Time frame: Pre (0 weeks), Post (3 weeks)

ArmMeasureValue (MEAN)Dispersion
Autism Parent Trainer (APT)Scales of Independent Behavior-Revised (SIB-R; Bruininks, Woodcock, Weatherman, & Hill, 1996)65.56 total score on a scaleStandard Deviation 15.4
Teaching Routines (Control)Scales of Independent Behavior-Revised (SIB-R; Bruininks, Woodcock, Weatherman, & Hill, 1996)63.87 total score on a scaleStandard Deviation 16.2
Comparison: . To address hypotheses predicting differential change in outcome measures between condition over time we used analysis of covariance (ANCOVA) models that allow for examination of cross-sectional effects and mean adjusted outcomes. The ANCOVA models (adjusted for baseline scores) were used for analyses of change in the outcome measures at posttest.p-value: 0.246ANCOVA
Secondary

Consumer Satisfaction Questionnaire

A 16-item scale was developed to evaluate parents' views of the feasibility, usability, and personal relevance of the program. It asked about the information taught in the program, the trainers, the website, and the other materials. The average score on these 19 items was evaluated and ranged from 1 to 6 with higher scores indicating more positive outcomes.

Time frame: Follow up (6 weeks)

ArmMeasureValue (MEAN)Dispersion
Autism Parent Trainer (APT)Consumer Satisfaction Questionnaire5.50 average score on a scaleStandard Deviation 0.67
Teaching Routines (Control)Consumer Satisfaction Questionnaire5.24 average score on a scaleStandard Deviation 0.88
Comparison: Two-sample t-testp-value: 0.045t-test, 2 sided
Secondary

Knowledge About Applied Behavior Analysis and Acceptance Commitment Training Measured by Questionnaire

Examining change over time points (T2-T1) 20 multiple choice knowledge items were developed during the project and were used to determine the extent to which participants understood basic program content, e.g., techniques parents can use to help their child master self-care routines. These included questions about the principles of behavior support (gathering information, evaluating possible reinforcers, etc.), definitions of behavioral concepts (tantrums, reinforcement, antecedent), and application of these concepts. The total score ranged from 0 to 20 with higher scores indicating better outcomes.

Time frame: Pre (0 weeks), Post (3 weeks)

ArmMeasureValue (MEAN)Dispersion
Autism Parent Trainer (APT)Knowledge About Applied Behavior Analysis and Acceptance Commitment Training Measured by Questionnaire14.52 total correct answersStandard Deviation 2.7
Teaching Routines (Control)Knowledge About Applied Behavior Analysis and Acceptance Commitment Training Measured by Questionnaire13.37 total correct answersStandard Deviation 2.4
Comparison: . To address hypotheses predicting differential change in outcome measures between condition over time we used analysis of covariance (ANCOVA) models that allow for examination of cross-sectional effects and mean adjusted outcomes. The ANCOVA models (adjusted for baseline scores) were used for analyses of change in the outcome measures at posttest.p-value: 0.007ANCOVA

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026