An interventional study of Technology-Enhanced Parent Training and Technology-Enhanced Tutor Training in Autism Spectrum Disorders, sponsored by University of Nebraska. Status unknown at 1 site in United States. Open to participants aged 18 Months to 48 Months. Per ClinicalTrials.gov, last updated 2018-02-07.
Sponsored by University of Nebraska · Not applicable, Interventional, and Treatment
The purpose of this study is to determine the extent to which technology may be used to provide (a) state-of-the-art assessment and intervention for children diagnosed with autism and (b) parent and tutor training for those who care for these children.
Children with autism often have problems with social interaction, language, and repetitive behavior (e.g., hand flapping and body rocking). Without early and intensive treatments, the long-term outcomes for children with autism are not very good; therefore, it is very important that effective treatments are started as soon as possible. Research has shown that Early Intensive Behavioral Interventions (EIBI) is an effective treatment for autism. Although EIBI is effective, most children with autism in military families do not receive EIBI because there are few professionals and paraprofessionals that are appropriately trained to do this, especially in the remote areas where military families tend to serve. The investigators want to show that web-based technologies (e.g., web-cams and internet-protocol cameras) can be used so that professionals in one place can treat children with autism anywhere in the world. The investigators also expect that providing these services will help children with autism improve their language, social, and academic skills. The investigators expect that the gains made by the children will help relieve many daily stressors and worries that families with children with autism have.
Children with autism who lack adaptive skills require constant help and supervision from parents. Thus, the improvements in the child's functioning will allow the child to become more independent and decrease parent stress associated with the need to constantly watch and help the child. Because EIBI services produce lasting improvements long after the intervention has ended, this project will provide both short-term and long-term benefits to the children who participate in the study, which will provide lasting relief to these dedicated military families.
In the long-term, this project may really change the way in which all (military and non-military) children and families get effective services that they cannot get now. Also, the results may help other professionals and researchers in psychology and medicine. That is, the results should be helpful to any kind of service that uses parent training and paraprofessionals. Most importantly, these services will improve the overall functioning of the children with autism and decrease the overall stress on these families as they continue to serve our country.
Specific Aim: Technology-enhanced parent training. The investigators will assess whether E-Learning using the latest web-based instructional technologies provides an efficient and effective mechanism for training military parents of children with autism, regardless of their geographic location, to implement effective behavior management and teaching strategies with high procedural integrity (90% accuracy).
Specific Aim: Technology-enhanced ABA tutor training. The investigators will show that E-Learning using the latest web-based instructional technologies provides an efficient and effective mechanism for training adults to become ABA tutors who implement EIBI procedures with high procedural integrity (90% accuracy) in areas of the world where such services would otherwise be unavailable.
Specific Aim: Technology-enhanced EIBI services. The investigators will demonstrate that technology-enhanced telehealth provides remote access to efficient and effective EIBI services to military families affected by autism.
Specific Aim: Reducing stress in military families affected by autism. The investigators will show that the provision of efficient and effective EIBI services using technology-enhanced telehealth will reduce family stress among military families affected by autism.
1,344 studies on the registry are indexed under Autistic Disorder; 334 are open to participants now.
This study's enrollment of 66 is above the median of 45 across 1,044 interventional studies indexed under Autistic Disorder.
Browse Autistic Disorder studies →University of Nebraska is the lead sponsor of 473 studies on the registry; 66 are open to participants now.
Of its 75 completed or terminated interventional studies of FDA-regulated products, 46 (61%) have results posted.
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Inclusion Criteria:
Inclusion criteria for children with autism. a. Upon completion of the diagnostic assessment, children who meet the following inclusion criteria will be considered for participation. The inclusion criteria are:
Inclusion criteria for behavioral technicians.
The participants for Experiment 2 will be young adults who are interested in being trained (at no cost) to provide ABA services to children with autism. Inclusion criteria for participation in this study are:
Exclusion Criteria:
Exclusion criteria for children with autism
a. Upon completion of the diagnostic assessment, children who meet the following exclusion criteria will be thanked for their participation, discharged from the project, and referred for services by other service providers. The exclusion criteria are:
Exclusion criteria for parents of children with autism.
a. Active duty military personnel who are unavailable due to deployment during this project will not participate, but will be offered parent training after their deployment is completed even if their data are not included in this project.
The investigators will demonstrate that web-based instructional technologies provides an efficient and effective mechanism for training military parents of children with autism, regardless of their geographic location, to implement effective behavior management and teaching strategies with high procedural integrity (90% accuracy).
Behavioral: Technology-Enhanced Parent Training
The investigators will demonstrate that web-based instructional technologies provides an efficient and effective mechanism for training tutors to implement early intervention services that are commonly used with children diagnosed with autism with high procedural integrity (above 80%).
Behavioral: Technology-Enhanced Tutor Training
The investigators will demonstrate that technology-enhanced service delivery will provide remote access to efficient and effective EIBI services to military families affected by autism.
Behavioral: Technology-enhanced Early Intensive Behavioral Intervention
Tutors and families will be assigned to treatment and control groups using the process of minimization, which has been recommended for small clinical trials because it minimizes differences between the groups on relevant covariables while guarding against bias in ways comparable to simple randomization. The control group will not receive intervention services.
Behavioral: No-Intervention
The training for the parents of children with autism assigned to the EIBI group will begin with completion of a structured parent-training program for 6 weeks that includes 16 to 18 sessions (three, 90-minute sessions per week). When a new topic is introduced, the initial training will include viewing a Power Point presentation, with embedded video and audio, that explains, in laymen's terms, the basic principles and processes related to the topic. The second part of the training involves a parent recruiting an adult friend, who will play the role of a child with autism. The adult playing the child with autism will wear a Bluetooth earpiece connected to a computer, which in turn will be connected to a UNMC expert. The expert will guide the actions of the adult playing the role of the child such that this confederate "child" will exhibit a variety of target behaviors relevant to the target skill, which will provide an opportunity for immediate feedback.
The training for the tutors to work with children diagnosed with autism, who were assigned to the EIBI group, will complete a 40-hour structured training program for 4 to 8 weeks that includes approximately 32 sessions. When a new topic is introduced, the initial training will include viewing a PowerPoint presentation, with embedded video and audio, that explains, in laymen's terms, the basic principles and processes related to the topic. The second part of the training involves a tutor recruiting an adult friend, who will play the role of a child with autism. The adult playing the child with autism will wear a Bluetooth earpiece connected to a computer, which in turn will be connected to a UNMC expert. The expert will guide the actions of the adult playing the role of the child such that this confederate "child" will exhibit a variety of target behaviors relevant to the target skill, which will provide an opportunity for immediate feedback.
After training, the ABA tutor and parents will assist in the implementation of early intervention services that will be tailored to the particular needs of the family's child. These programs could include conducting a paired-stimulus preference assessment, using a natural language program to increase spoken communication, and using matching-to-sample methods to teach categorization skills. We will record and review at least an hour of the ABA tutor's and parents' interactions with the child per week during unstructured and structured teaching situations. The purpose of these observations is to determine whether the parents are implementing the teaching strategies or behavior-management programs as designed (i.e., treatment integrity measures). If the ABA tutor or parent implements a program with less than 80% accuracy across two consecutive observations, an additional scripted role-play will be conducted as a booster session for the targeted skills.
The ABA tutors, parents/caregivers, and children will be randomly assigned to a wait-list control group.
Intelligent Quotient: Differential Abilities Scales, Second Edition
The investigators will use the Differential Abilities Scales, Second Edition (DAS-2; Elliott, 2007) as the primary dependent measure because it is particularly useful for measuring the cognitive abilities of young children; it covers a large age range (ages 2-6 to 17-11); it is well standardized; it has strong internal consistency and test-retest reliability (.90 to .95); and it correlates well with other measures of intelligence (M r = .76).
Time frame: Time-to-Event Outcome Measure: Prior to and following intervention services (approximately 8 months)
Parent Training: Behavioral Implementation Skills for Play Activities
Almost all studies focusing on training parents and/or staff to implement behavior-analytic procedures include dependent measures that assess the extent to which parents display the following behaviors before and after training: (a) correct and incorrect instructions, (b) correct and incorrect prompts, (c) correct and incorrect consequences for appropriate behavior, and (d) correct and incorrect consequences for problem behavior. These basic measures can be adapted to measure procedural integrity.
Time frame: Time-to-Event Outcome Measure: Prior to and following parent-training curriculum (6 to 8 weeks)
Tutor Training: Behavioral Implementation of Work Activities
Same dependent measure as described for the parent-training curriculum.
Time frame: Time-to-Event Outcome Measure: Prior to and following tutor-training curriculum (9 to 12 weeks)
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