Telehealth Programs for Autism

(STRW-T Trial)

Recruiting at 1 trial location

Overseen By Carrie Fassler

Age: < 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Children's Hospital Medical Center, Cincinnati

Disqualifiers: Aggressive behaviors, Mental health issues, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

The current study seeks to compare outcomes of a telehealth intervention targeting daily living skills (Surviving and Thriving in the Real World - Telehealth, or STRW-T) intervention to a control group telehealth intervention targeting social skills (Program for the Education and Enrichment of Relational Skills- Telehealth, or PEERS-T). The key endpoint will be change in daily living skills on primary and secondary outcome measures at the end of treatment.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment STRW-T, Surviving and Thriving in the Real World - Telehealth, for autism?

Research shows that telehealth interventions can effectively increase motivation and engagement in autistic adolescents and young adults, and similar programs have been rated as feasible and useful by both practitioners and participants. Additionally, telehealth has been successfully used to train parents in evidence-based interventions, leading to improvements in child social communication. ^{1 2 3 4 5}

Is telehealth generally safe for individuals with autism?

The research indicates that telehealth is generally considered safe and user-friendly for individuals with autism, with high satisfaction rates reported by caregivers and participants. ^{4 6 7 8 9}

What makes the STRW-T treatment unique for autism?

STRW-T is unique because it is the only evidence-based telehealth program specifically designed to help autistic adolescents without intellectual disabilities develop daily living skills, which are crucial for a successful transition to adulthood. ^{10 11 12 13 14}

Research Team

Amie Duncan, PhD

Principal Investigator

Children's Hospital Medical Center, Cincinnati

Eligibility Criteria

This trial is for autistic adolescents in 11th and 12th grade who are looking to improve their daily living skills. Participants should be able to engage in telehealth sessions. Specific eligibility criteria were not provided, so interested individuals should contact the study organizers for more details.

Inclusion Criteria

I am in my last 2 years of high school or delaying graduation.

Diagnosis of ASD based on clinical judgement and/or meeting the cut-off score on the Autism Diagnostic Observation Schedule, 2nd Edition

Full scale IQ of 70 or above as measured by the Wechsler Abbreviated Scale of Intelligence, 2nd Edition

Exclusion Criteria

I have severe mental health issues or aggressive behaviors that need specialized treatment.

If the adolescent has already completed the social skills group (PEERS), either at Cincinnati Children's or in another setting, unless it has been a significant amount of time since they did the PEERS group (2-3 years, or up to the discretion of the PI)

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the STRW-T or PEERS-T telehealth intervention targeting daily living or social skills

4 months

Weekly virtual sessions

Follow-up

Participants are monitored for sustained improvements in daily living skills

6 months

Periodic virtual assessments

Post-high school follow-up

Participants' outcomes in college, employment, and Quality of Life are assessed

6 months post-high school graduation

Treatment Details

Interventions

• STRW-T (Behavioral Intervention)

Trial Overview The study compares two telehealth interventions: STRW-T focuses on enhancing daily living skills, while PEERS-T concentrates on social skills development. The main goal is to see which intervention better improves daily living abilities as measured by various tools at treatment's end.

Participant Groups

Group I: Surviving and Thriving in the Real World - Telehealth (STRW-T) Experimental Treatment 1 Intervention

randomized to STRW-T intervention

Group II: Program for the Education and Enrichment of Relational Skills - Telehealth (PEERS-T) Active Control 1 Intervention

randomized to PEERS-T intervention

Who Is Running the Clinical Trial?

Children's Hospital Medical Center, Cincinnati

Lead Sponsor

Trials

844

Recruited

6,566,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

University of North Carolina, Chapel Hill

Collaborator

Trials

1,588

Recruited

4,364,000+

Findings from Research

Remote interventions like the SPAN program can significantly enhance motivation and engagement in autistic adolescents and young adults during intervention processes.

Feedback from 15 stakeholders helped shape adaptations of SPAN for autistic AYA, leading to the development of a new SPAN-ASD website and intervention manual, with plans for future usability testing and pilot studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social Participation and Navigation: Formative Evaluation of a Remote Intervention for Autistic Adolescents and Young Adults. Lamash, L., Gal, E., Bedell, G.[2023]

The SPAN-ASD intervention, designed for adolescents and young adults with autism, was found to be highly feasible and usable, with practitioners rating its feasibility between 4.30 and 4.68 out of 5.

Both practitioners and autistic participants viewed the SPAN-ASD website and application as good and useful tools for promoting independence and social participation, indicating strong potential for technology-supported interventions in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SPAN Website for Remote Intervention with Autistic Adolescents and Young Adults: Feasibility and Usability. Lamash, L., Gal, E., Yaar, E., et al.[2023]

The ImPACT Online program, which trains parents to use evidence-based interventions for children with autism spectrum disorder via telehealth, showed a 25.8% registration rate among families referred to the program, indicating potential for wider dissemination.

While parents in the open trial reported high satisfaction with the program, they engaged at a lower rate compared to those in controlled trials, suggesting that additional support strategies may be necessary to enhance participation and effectiveness in community settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-Directed Telehealth Parent-Mediated Intervention for Children With Autism Spectrum Disorder: Examination of the Potential Reach and Utilization in Community Settings. Ingersoll, B., Shannon, K., Berger, N., et al.[2018]

Telehealth has been shown to be an effective method for delivering behavior analytic interventions to individuals with autism spectrum disorder (ASD), especially with increased accessibility during the COVID-19 pandemic.

However, the current literature lacks comprehensive details on important factors such as participant skills, implementer training, and the inclusion of older age groups, indicating areas for future research to improve telehealth services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Descriptive Review of Telehealth for Individuals With Autism Spectrum Disorder. Kane, CL., DeBar, RM.[2023]

The SUPER project developed a digital platform aimed at improving collaboration and information sharing among families, health services, and schools for children with autism spectrum disorder (ASD), demonstrating its potential to enhance personalized care.

In a preliminary user test with 30 participants, SUPER received an excellent usability score of 89.2, indicating it is a user-friendly tool that can effectively support communication and collaboration in managing ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Multidisciplinary Telerehabilitation Approach for Supporting Social Interaction in Autism Spectrum Disorder Families: An Italian Digital Platform in Response to COVID-19. Vallefuoco, E., Purpura, G., Gison, G., et al.[2021]

A study involving 530 children aged 3 to 12 with autism spectrum disorder (ASD) revealed that 93% of parents reported challenging behaviors, particularly symptoms related to attention-deficit/hyperactivity disorder, irritability, and anxiety, highlighting the need for targeted interventions.

The quality of life scores for these children were lower than those of the general pediatric population, despite high rates of receiving recommended health services, indicating a gap in effective management of behavioral challenges associated with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Behavior Challenges and Quality of Life in the Autism Learning Health Network. Anixt, JS., Murray, DS., Coury, DL., et al.[2020]

The combination of risperidone and virtual reality (VR) intervention significantly improved social skills and reduced behavioral problems in children with autism compared to a control group, with notable effects observed immediately after the 3-month intervention and at a 3-month follow-up.

While risperidone alone also showed some effectiveness in improving social skills and behavior, the addition of VR enhanced the overall treatment response, suggesting that integrating technology with medication can better prepare children for social interactions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing the Effect of Risperidone, Virtual Reality and Risperidone on Social Skills, and Behavioral Problems in Children with Autism: A Follow-up Randomized Clinical Trial. Soltani Kouhbanani, S., Khosrorad, R., Zarenezhad, S., et al.[2021]

A survey of 640 caregivers at Cincinnati Children's Hospital Medical Center revealed that 92% were satisfied with telehealth appointments for Psychology and Psychiatry services after the COVID-19 pandemic, indicating high acceptance and effectiveness of this approach.

Despite overall satisfaction, there were significant drops in satisfaction among caregivers of patients in Group Therapy and those with diagnoses classified as 'Other', suggesting areas for improvement in telehealth services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief Report: Telehealth Satisfaction Among Caregivers of Pediatric and Adult Psychology and Psychiatry Patients with Intellectual and Developmental Disability in the Wake of Covid-19. Rosen, V., Blank, E., Lampert, E., et al.[2022]

The STRW program is a 14-session group treatment designed to help adolescents with autism spectrum disorder (ASD) develop essential daily living skills, which are crucial for successful adult independence.

Initial feasibility studies indicate that STRW is effective in promoting these skills, and the program has been adapted to a telehealth format, allowing adolescents to practice in their own homes with therapist support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Iterative Development of a Daily Living Skills Intervention for Adolescents with Autism Without an Intellectual Disability. Duncan, A., Liddle, M., Stark, LJ.[2022]

The Surviving and Thriving in the Real World (STRW) program significantly improved daily living skills (DLS) in autistic adolescents without intellectual disabilities, with notable gains in overall DLS and specific areas like domestic tasks and money management, compared to the PEERS program.

With 64 participants (34 in STRW and 30 in PEERS), the study demonstrated that STRW helps close the gap between the adolescents' chronological age and their DLS, potentially leading to better adult outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Clinical Trial Targeting Daily Living Skills in Autistic Adolescents Without an Intellectual Disability Before the Transition to Adulthood. Duncan, A., Meinzen-Derr, J., Ruble, L., et al.[2023]

The telehealth system established between the Autism Resource Centre of Brittany and Vannes' Hospital has improved diagnostic precision and support for autistic patients and their families, demonstrating effective collaboration despite geographical distances.

Families reported high satisfaction with the telehealth meetings, which facilitated communication between health professionals and provided timely access to specialized care, while also reducing travel costs and environmental impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Telepsychiatry at the service of autism]. Saint-André, S., Neira Zalentein, W., Robin, D., et al.[2011]

References

1. United States pubmed.ncbi.nlm.nih.gov

Social Participation and Navigation: Formative Evaluation of a Remote Intervention for Autistic Adolescents and Young Adults. [2023]

2. Switzerland pubmed.ncbi.nlm.nih.gov

SPAN Website for Remote Intervention with Autistic Adolescents and Young Adults: Feasibility and Usability. [2023]

3. Canada pubmed.ncbi.nlm.nih.gov

Self-Directed Telehealth Parent-Mediated Intervention for Children With Autism Spectrum Disorder: Examination of the Potential Reach and Utilization in Community Settings. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

A Descriptive Review of Telehealth for Individuals With Autism Spectrum Disorder. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

The impact of a telehealth platform on ABA-based parent training targeting social communication in children with autism spectrum disorder. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

A Multidisciplinary Telerehabilitation Approach for Supporting Social Interaction in Autism Spectrum Disorder Families: An Italian Digital Platform in Response to COVID-19. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Improving Behavior Challenges and Quality of Life in the Autism Learning Health Network. [2020]

8. Iran pubmed.ncbi.nlm.nih.gov

Comparing the Effect of Risperidone, Virtual Reality and Risperidone on Social Skills, and Behavioral Problems in Children with Autism: A Follow-up Randomized Clinical Trial. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Brief Report: Telehealth Satisfaction Among Caregivers of Pediatric and Adult Psychology and Psychiatry Patients with Intellectual and Developmental Disability in the Wake of Covid-19. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Iterative Development of a Daily Living Skills Intervention for Adolescents with Autism Without an Intellectual Disability. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

A Randomized Clinical Trial Targeting Daily Living Skills in Autistic Adolescents Without an Intellectual Disability Before the Transition to Adulthood. [2023]

12. France pubmed.ncbi.nlm.nih.gov

[Telepsychiatry at the service of autism]. [2011]

13. Switzerland pubmed.ncbi.nlm.nih.gov

Telehealth-delivered caregiver training for autism: Recent innovations. [2023]

14. England pubmed.ncbi.nlm.nih.gov

Telehealth and autism: A systematic search and review of the literature. [2019]