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RecruitingNCT06105736RTUpdated Dec 24, 2025

Regulating Together in Tuberous Sclerosis Complex

An interventional study of Behavioral Intervention in a small group platform in TSC and Behavioral Symptoms, sponsored by Children's Hospital Medical Center, Cincinnati. Recruiting at 2 sites in United States. Open to participants aged 8 Years to 17 Years. Per ClinicalTrials.gov, last updated 2025-12-24.

Sponsored by Children's Hospital Medical Center, Cincinnati · Not applicable, Interventional, and Diagnostic

From the registry’s dates

  • Started Dec 2023; still recruiting 2 years 10 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
105
Allocation
Non-randomized
Ages
8 Years to 17 Years
Sex
All
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Study summary

The purpose of this study is to use a program called Regulating Together (RT), a remote, non-pharmacologic intervention to treat symptoms of emotion dysregulation in children and adolescents with Tuberous Sclerosis Complex (TSC) and TSC-Associated Neuropsychiatric Disorder (TAND).

Read the detailed description

This is a non-pharmacological intervention that will utilize small group-based therapy with participants, followed by a separate caregiver session. The clinical trial will consist of four phases; 1) single in person screening/baseline visit; 2) RT control phase which is a 5-week observational period (Week 1-5); 3) RT intensive phase which is a remote group treatment intervention twice per week over 5 weeks (Week 6-10); 4) RT individualization phase, which is an individualized consultation with the participant and caregiver (Week 11); and 5) the RT generalization phase which is a 10 week follow up period consisting of utilizing the learned skills at home. At the end of the 10-week generalization phase, a semi-structured interview for thematic analysis will occur at the end of the study to capture facilitators and barriers to the intervention (Week 12-22).

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Conditions studied

  • TSC
  • Behavioral Symptoms

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03

In context

Behavioral Symptoms

135 studies on the registry are indexed under Behavioral Symptoms; 18 are open to participants now.

This study's planned enrollment of 105 is above the median of 93 across 114 interventional studies indexed under Behavioral Symptoms.

Browse Behavioral Symptoms studies →

Lead sponsor

Children's Hospital Medical Center, Cincinnati is the lead sponsor of 673 studies on the registry; 130 are open to participants now.

Of its 57 completed or terminated interventional studies of FDA-regulated products, 31 (54%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
8 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Children ages 8-17 years inclusive with a documented clinical and/or genetic diagnosis of TSC and exhibiting symptoms of behavioral dysregulation (identified on the TAND Checklist having temper tantrums, aggressive outbursts, self-injury, and/or impulsivity) are eligible for inclusion.

Additional inclusion/eligibility criteria include:

  • Participants and their caregivers have access to a computer, phone, or tablet with video capability and stable internet connection. If lack of a device or internet service is the sole barrier to eligibility/participation, interested individuals will be connected to a TSC Clinic social worker to link them to existing government and charity programs specifically addressing this disparity in underserved communities and households in need (e.g., the Affordable Connectivity Program).
  • Participants must also be willing to participate in treatment sessions and have minimal levels of functional verbal communication (child and their caregiver must be fluent in English
  • Child must have a minimum IQ>65 on the WASI-II at the screening/baseline visit).

Exclusion criteria

Exclusion Criteria:

  • Participants be on a stable medication regimen at least 4 weeks prior to enrollment
  • Do not have a plan to start a new psychosocial intervention (e.g., individual psychotherapy, family psychotherapy, group psychotherapy or social skills training) or behavior medication within 30 days prior to enrollment or at any point during the study. ----Participants with significant disruptive, aggressive, self-injurious or sexually inappropriate behaviors deemed potentially dangerous or overly disruptive to the group dynamic/session, having significant co-occurring neuropsychiatric illness warranting other treatment approaches as determined by study clinician (e.g., substance use disorders, psychotic disorders, schizophrenia), or having significant sensory impairment that would limit participation in intervention curriculum/materials (e.g., blindness or uncorrected hearing loss) also will be excluded.
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Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
105 participants (estimated)

Study arms

  • Experimental
    Parents

    In this 22-week almost completely remote study, following a 5-week control phase, parents will receive intensive treatment twice per week for 5 weeks followed by a one-time, 1-on-1 counseling session with an RT psychologist (week 11). Then, parents will use skill practice and application in the home environment for 10 weeks. Following this, a final interview is conducted (week 22).

    Behavioral: Behavioral Intervention in a small group platform

  • Experimental
    Children

    In this 22-week almost completely remote study, following a 5-week control phase, children will receive intensive group treatment, twice a week for 5 weeks delivered remotely. During the children's sessions, they will use child structured videos, the PlayPosit curriculum and learning rewards. The following assessments will be completed by the parents, regarding their children, at each phase; EDI, ABC-2, FS, BRIEF-2, CRS, PSI-4SF and CGI-I. Following the completion of group treatment, there will be a one-time, 1-on-1 counseling session with an RT psychologist.

    Behavioral: Behavioral Intervention in a small group platform

Interventions

  • BehavioralBehavioral Intervention in a small group platform

    RT is small-group-based, intensive behavioral intervention session delivered twice weekly over a secure remote platform for 60-minutes over 5 weeks. Each session is led by a psychologist trained and certified in RT. Caregiver groups meet at the same frequency and duration but at different times. Each session has a specific focus for teaching participants to identify emotions and incorporation of cognitive behavioral therapy (CBT) and mindfulness skills that are reinforced through repeated practice. Each session will include a review, relaxation, new material didactic, activities to reinforce material, mindfulness, and homework.

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What researchers measure

Primary outcomes

  1. Prevalence of ED in TSC Cohort

    Prevalence of emotion dysregulation is highly prevalent in TSC patients who exhibit problematic behaviors. The EDI-R score at the screening study visit will determine the EDI-R and determine the presence or absence of emotion dysregulation in the cohort.

    Time frame: Baseline

  2. Change in EDI-R Score from Control Phase to RT Intensive and RT Generalization Phases Combined

    EDI-R score will be compared from pre-treatment (control phase) to post-treatment (RT Intensive Phase and RT Generalization Phases combined). EDI-R is a caregiver administered, emotion dysregulation inventory with construct, range, and directionality that includes questions that the rater is asked to answer based on behaviors that are observed to cause problems. These questions include, but are not limited to, creating a dangerous situation, interference with daily activities, increasing the stress of those around the individual, and hurting relationships. There are 13 questions on the EDI-R; they are rated at, not at all, mild, moderate, severe, and very severe.

    Time frame: Intensive Phase (Week 6-10) and Generalization Phase (Week 12-22)

  3. Change in CP-CTI score from pre-treatment to post-treatment

    The primary endpoint will be CP-CTI responses from caregivers upon completion of RT Generalization Phase using a thematic analysis. This will identify obstacles to treatment access. Scores will be compared pre-treatment to post-treatment. CP-CTI is a staff administered, caregiver perspective clinical trial interview. This will occur through a telephone call from the study team to the caregiver.

    Time frame: Administered after completion of RT (Week 22)

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Study locations

1 of 2 sites recruiting
  • University of North Carolina Chapel Hill-Carolina Institute for Developmental Disabilities
    Carrboro, North Carolina 27510, United States
    Completed

    Not enrolling at this site.

  • Cincinnati Children's Hospital Medical Center (CCHMC)
    Cincinnati, Ohio 45229, United States
    Recruiting
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References and documents

Publications

  • Shaffer RC, Schmitt LM, Reisinger DL, Coffman M, Horn P, Goodwin MS, Mazefsky C, Randall S, Erickson C. Regulating Together: Emotion Dysregulation Group Treatment for ASD Youth and Their Caregivers. J Autism Dev Disord. 2023 May;53(5):1942-1962. doi: 10.1007/s10803-022-05461-x. Epub 2022 Feb 9. PubMed 35141815 ↗
  • Shaffer RC, Wink LK, Ruberg J, Pittenger A, Adams R, Sorter M, Manning P, Erickson CA. Emotion Regulation Intensive Outpatient Programming: Development, Feasibility, and Acceptability. J Autism Dev Disord. 2019 Feb;49(2):495-508. doi: 10.1007/s10803-018-3727-2. PubMed 30143951 ↗

Individual participant data

Plan to share: Yes — Deidentified individual data that supports the results will be shared beginning 9 to 36 months following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.

Supporting information: Statistical analysis plan

Time frame: Beginning 9 and continuing for 36 months following publication

Access criteria: Investigator has approved IRB, IEC, or REB and an executed data use/sharing agreement with UNC.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Dec 2023 (actual). Primary completion is estimated for Dec 2026, 36 months after the start.

Of 68 non-industry interventional studies with no phase under Behavioral Symptoms, half reached primary completion within 27 months of starting (the median), counting those still running; a quarter within 16 and three quarters within 55. This study's planned 36 months is above that.

Counting every sponsor, half of 68 studies reached it within 27 months; a quarter within 16 and three quarters within 55.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 23, 2023
First posted
Oct 30, 2023
StartActual
Dec 20, 2023
Primary completionEst.
Dec 20, 2026
CompletionEst.
Dec 20, 2026
Last update
Dec 24, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Dec 24, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06105736
Collaborators
United States Department of Defense, University of Rochester
Responsible party
Jamie Capal (Pediatric Neurologist-Professor, Children's Hospital Medical Center, Cincinnati) — Principal investigator
First posted
Oct 30, 2023
Start date
Dec 20, 2023
Primary completion
Dec 20, 2026 (estimated)
Completion
Dec 20, 2026 (estimated)
Last update
Dec 24, 2025

Study contacts

Jamie Capal, MD
Contact
jamie.capal@cidd.unc.edu
(919) 966-9343
Jamie Capal, MD
principal investigator · University of North Carollina at Chapel Hill

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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