Parent implemented treatment for repetitive behaviors in children with ASD: Using a novel telehealth approach to increase service access

家长对自闭症谱系障碍儿童的重复行为进行治疗：使用新颖的远程医疗方法来增加服务的可及性

• 批准号: 10610955
• 负责人: Brian Antonio Boyd
• 金额: $ 49.51万
• 依托单位: UNIVERSITY OF KANSAS LAWRENCE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-10 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10610955
• 关键词: Acute; Aftercare; Anxiety; Behavior; Behavior Therapy; Behavioral; COVID-19; COVID-19 pandemic; Caregivers; Caring; Categories; Cellular Phone; Child; Child Behavior; Clinical Treatment; Cues; Distal; Education; Educational process of instructing; Effectiveness; Environment; Ethnic Origin; Family; Feeling; Goals; Intervention; Intervention Studies; Knowledge; Learning; Link; Marital Status; Mediating; Modeling; Outcome; Parenting Education; Parents; Persons; Pilot Projects; Play; Probability; Race; Randomized, Controlled Trials; Reporting; Research; Rewards; Role; Sample Size; Secure; Services; Stress; Surveys; Symptoms; Technology; Therapeutic; Time; Translational Research; Videoconferencing; anxiety symptoms; autism spectrum disorder; autistic children; behavioral study; child services; communication behavior; comorbidity; comparison group; design; effective therapy; experience; falls; flexibility; follow-up; functional disability; implementation intervention; improved; interest; lower income families; neglect; neurobehavioral; novel; pandemic disease; personalized intervention; pilot test; psychiatric comorbidity; reduce symptoms; remote delivery; remote intervention; repetitive behavior; skills; social communication; telehealth; treatment effect; treatment research; treatment response; trial comparing; uptake

PROJECT SUMMARY Families are facing significant challenges during the COVID-19 pandemic, especially those caring for a child with autism spectrum disorder (ASD). A recent SPARK survey1 (N = 8,000) found that approximately 95% of parents reported increases in their child’s challenging behaviors as a result of COVID-19, and the restricted, repetitive behaviors and interests (RRBI) of children likely fall within this category. Since only 35% of parents who took the SPARK survey indicated their child is receiving therapy services remotely, the COVID-19 pandemic will likely exacerbate this core symptom of ASD. RRBIs are often the target for clinical treatment, as they can significantly interfere with learning, and are associated with long-term functional impairment, and psychiatric comorbidities (e.g., anxiety). Given children with ASD are currently out of routine and experiencing a severe reduction in therapeutic and educational services, the RRBIs and comorbidities of children are likely magnified at this time. Yet, there are no effective therapies to treat the full range of repetitive, inflexible behaviors found in ASD, and there have been no large-scale studies of behavioral interventions specifically developed to target this core symptom domain. This has resulted in a significant treatment gap between the number of effective behavioral therapies used to target atypical social-communication behaviors in autism when compared to those designed to treat repetitive behaviors. Thus, our team developed and pilot-tested the Family-Implemented Treatment for Behavioral Inflexibility (FITBI), derived from neurobehavioral models of reward and learning. The overall goal of FITBI is to teach parents how to identify high probability cues in the environment that can elicit RRBI symptoms and teach their child to inhibit repetitive behaviors and instead replace them with flexible and more functional behaviors. Since our initial pilot studies, the need for technology-based interventions has certainly increased. While the effectiveness of telehealth interventions for children with ASD is emerging, early research suggests interventions delivered via telehealth for children with ASD may be just as effective as in-person interventions. Yet, we currently have no understanding of the effectiveness of RRBI interventions delivered remotely. Therefore, the overall goal of this project is to conduct a parallel group randomized controlled trial (RCT) comparing remote delivery of FITBI (12-week intervention + 3 booster sessions over 6 months) to remote delivery of a parent education only (PE) control condition in a final sample size of 100 (3-9 years) children with ASD and high rates of ritualistic repetitive behaviors. We will use TORSH, a comprehensive secure online platform that enhances therapist-parent coaching via telehealth. Further, an important objective of this proposal is to examine child and parent factors associated with treatment response and uptake in order to advance translational research and knowledge on personalized intervention approaches.

项目总结