MedPath

Stepped-care Telehealth for Young Children With ASD

Not Applicable
Completed
Conditions
Autism Spectrum Disorder
Interventions
Behavioral: Online RIT
Registration Number
NCT04467073
Lead Sponsor
Rush University Medical Center
Brief Summary

This proof-of-concept study addresses the gap in the access to care literature by examining a stepped-care version of a telehealth naturalistic developmental behavioral intervention (NDBI), Online RIT. Online RIT is an interactive website introducing Reciprocal Imitation Training (RIT), an NDBI focused on enhancing social imitation. RIT uses a naturalistic behavioral approach to teach object and gesture imitation to young children with ASD within a play-based context. The efficacy of RIT has been demonstrated through a small randomized control trial, several single-subject design studies, as well as in independent replications. Prior research also suggests that parents can be taught to effectively use RIT with their children in person, and two single-subject design studies detail the development and feasibility testing of Online RIT plus therapist assistance. These preliminary data suggest Online RIT may serve as an ideal platform for examining the potential of individualized telehealth delivery formats, such as stepped-care. Therefore, the goal of this study was to compare a stepped-care format of Online RIT to a waitlist control condition to determine initial feasibility and effectiveness of this innovative intervention and service delivery model.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Have a diagnosis of ASD or significant concerns of ASD
  • Parent reported imitation deficits
Exclusion Criteria
  • Children of parents who are non-English speaking
  • Actively participating in other parent training programs

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Stepped-Care Online Reciprocal Imitation Training (Online RIT)Online RITParticipants completed four telehealth modules over a period of 5 weeks (\~1 per week, 1 week to practice). Two variables were selected as tailoring variables for this stepped-care model. Fidelity (RIT-PFF) and self-efficacy (EIPSES) at 5 weeks were used to determine which participants were in need of a "step up" in care, in the form of remote parent coaching. Parents who demonstrated ≥80% on the RIT-PFF, and who reported gains on the EIPSES continued to have access to Online RIT and practiced on their own for the next 5 weeks, but did not receive any remote coaching. Parents who demonstrated \<80% fidelity on the RIT-PFF and/or who didn't report increases in the EIPSES were directed into coaching. Coaching involved videoconferences once per week (wks. 6-10) with a parent coach (PI), and followed the occupational performance coaching model. Sessions included review of successes and challenges, parent practice with feedback, problem solving, and planning.
Primary Outcome Measures
NameTimeMethod
Change from Baseline RIT Parent Fidelity Form (RIT-PFF) Score at 15 weeksBaseline and 15 weeks

Trained observers scored the parent-child interactions for parent fidelity of the RIT intervention techniques.

Change from Baseline Unstructured Imitation Assessment (UIA) Score at 15 weeksBaseline and 15 weeks

The UIA was used to measure child social imitation. It is a standardized assessment that evaluates spontaneous imitation of actions with objects and gestures during play.

Change from Baseline Early Intervention Parenting Self-Efficacy Scale (EIPSES) Score at 15 weeksBaseline and 15 weeks

The EIPSES is a 20-item parent questionnaire designed to measure parenting efficacy within the context of early intervention.

Secondary Outcome Measures
NameTimeMethod
Change from Baseline Social Communication Checklist (SCC) Score at 15 weeksBaseline and 15 weeks

The SCC is a 47-item checklist completed by parents to indicate if a child uses a specific social communication skill.

Change from Baseline Beach Center Family Quality of Life Scale (FQOL) Score at 15 weeksBaseline and 15 weeks

The FQOL Scale is a 25-item self-report measure designed to assess family interaction, parenting, emotional well-being, physical/maternal well-being, and disability-related supports.

Trial Locations

Locations (1)

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

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