Caregiver Training for Autism Spectrum Disorder

Overseen By Arlene Fleischhauer

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Western University, Canada

Disqualifiers: Over 48 months, No internet, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 10

Duration: 13 weeks

72 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a program called More Than Words, designed to help parents support their autistic child's social communication skills. A speech-language pathologist delivers the program online to assess its effectiveness in a virtual setting. The trial will compare families who participate in the program to those who have not yet participated to determine what works best. Families with children under 4 years old who have social communication delays and can attend online sessions might be a good fit. As an unphased trial, this study offers families the opportunity to contribute to innovative research that could enhance support for autistic children.

Will I have to stop taking my current medications?

The trial protocol does not specify whether participants need to stop taking their current medications.

What prior data suggests that the More Than Words® program is safe and effective for families?

Research has shown that the More Than Words® program is generally safe for participants. In previous studies, no serious side effects were reported among the children or parents involved. Families, including parents and their children with autism spectrum disorders, have typically found the program manageable. The program focuses on improving social communication skills through parent-led activities, which do not carry the same risks as medication-based treatments. This makes the program a low-risk choice for families considering participation. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Hanen Centre's More Than Words® program because it offers a unique approach for caregivers of children with Autism Spectrum Disorder (ASD). Unlike traditional therapies that primarily involve direct interaction between therapists and children, this program empowers parents by providing them with strategies to enhance their child's social communication skills. Delivered through virtual group sessions and personalized video feedback, it allows for flexible learning and active parental involvement. This method fosters a supportive environment where parents can learn to effectively engage with their children in everyday situations, potentially leading to more meaningful and lasting improvements in communication.

What evidence suggests that the More Than Words program is effective for social communication development in autistic children?

Research has shown that the More Than Words® program can improve social communication skills in autistic children. In this trial, participants in the Virtual MTW Treatment Group will receive the program, which includes group training and individual feedback sessions. One study found that children whose parents participated in the program made noticeable progress compared to those who received standard care. Parents learned ways to support their child's communication, leading to better interactions. Another study found improvements in both language and social communication skills. The program's success stems from teaching parents how to help their children communicate better. ^{2 5 6 7 8}

Are You a Good Fit for This Trial?

This trial is for parents of children with Autism Spectrum Disorder or those who could benefit from social communication support. It's designed to help them use the More Than Words program, which is delivered by speech-language pathologists and can be accessed virtually.

Inclusion Criteria

The child has delays in social communication and play skills according to the clinical assessment of the child's community SLP

The parent (or other primary caregiver) has a smart phone, tablet, or computer with webcam and internet access to attend the virtual MTW sessions and complete study measures

My child is younger than 4 years old.

Exclusion Criteria

Failure to meet the inclusion criteria outlined above.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

1 visit (virtual)

Pre-Program Consultation

SLP conducts an informal assessment of the child's communication and records a video of the parent-child interaction

1 week

1 visit (virtual)

Treatment

Parents participate in the 13-week virtual MTW program, including group training and individual video feedback sessions

13 weeks

8 group sessions, 3 individual sessions (virtual)

Follow-up

Participants are monitored for changes in communication skills and parent self-efficacy after the program

13-15 weeks

Data collection via surveys and video submissions

What Are the Treatments Tested in This Trial?

Interventions

• The Hanen Centre's More Than Words® program

Trial Overview The study tests the updated More Than Words program, focusing on its effectiveness when delivered online. It compares outcomes between families using the program and those not yet receiving it, aiming to refine methods for a larger future study.

How Is the Trial Designed?

Group I: Virtual MTW Treatment Group (TG) Experimental Treatment 1 Intervention

The TG will receive the MTW program which consists of (a) an orientation session, (b) a pre-program consultation appointment, (c) eight 2½ hour group training sessions (8-10 parents/group), and (d) three individual video feedback sessions. At the orientation session, the SLP provides an overview of the program, and provides the parent with two assessment forms to complete (i.e., parent report measures of their child's social communication and communicative participation). At the pre-program consultation, the SLP conducts an informal assessment of the child's communication and records a video of the parent-child interaction. Parents and SLPs co-develop communication goals based on the child's social communication needs and ability. During group training sessions, parents learn support strategies to target goals (e.g., joining a child's idea in play, rather than directing the play; using gestures and animated facial expressions to get the child's attention).

Group II: Waitlist Control Group (WCG) Active Control 1 Intervention

The WCG will be in a waiting period for three months, after which they will receive the Hanen More Than Words® program. However, they can still access other services in their community to support their child during their waiting period.

Who Is Running the Clinical Trial?

Western University, Canada

Lead Sponsor

Trials

270

Recruited

62,500+

The Hanen Centre, Toronto

Collaborator

Published Research Related to This Trial

A study involving 1,089 ABA providers revealed that the number of professional training experiences significantly influences how extensively these providers use parent training strategies for children with autism spectrum disorder (ASD).

Only 15% of providers utilized manualized parent training programs, but those who did were more likely to implement parent training effectively, highlighting the importance of structured resources in enhancing treatment practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of Professional Training Experiences and Manualized Programs in ABA Providers' Use of Parent Training With Children With Autism. Ingersoll, B., Straiton, D., Caquias, NR.[2020]

Caregiver training interventions for children with autism can effectively enhance social interaction, communication, and positive behaviors, and these interventions can be successfully delivered via telehealth, showing similar positive outcomes as in-person training.

Telehealth methods offer advantages such as cost-effectiveness and increased accessibility, making them a promising solution to address the global treatment gap for families of children with autism, although further research is needed to evaluate their effectiveness across diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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

A pilot study involving 38 caregivers of children with autism spectrum disorder (ASD) evaluated a novel 6-session brief behavioral parent training (BPT) that effectively targeted high-frequency challenging behaviors.

Caregivers who participated in the BPT reported higher satisfaction and acceptability compared to those in the active control group, indicating that this intervention is both feasible and well-received.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Preliminary Evaluation of a Brief Behavioral Parent Training for Challenging Behavior in Autism Spectrum Disorder. Rohacek, A., Baxter, EL., Sullivan, WE., et al.[2023]

Out of 1,231 studies evaluated, only 36 included a parent education component aimed at improving expressive verbal communication in nonverbal or minimally verbal children with autism spectrum disorder, highlighting a significant gap in research.

The review found considerable variability in the design and implementation of parent education programs, with unclear descriptions and few studies measuring how well parents implemented the interventions, suggesting a need for more standardized approaches in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent Education in Studies With Nonverbal and Minimally Verbal Participants With Autism Spectrum Disorder: A Systematic Review. Koegel, LK., Bryan, KM., Su, PL., et al.[2021]

A pilot program in Ontario tested two approaches for coaching caregivers of children with autism, showing that both observation followed by coaching and immediate coaching led to significant improvements in children's social engagement, play, and communication skills.

The intervention was effectively delivered by practitioners, achieving an average success rate of 83%, but attendance for follow-up booster sessions was inconsistent, highlighting the need for more research to tailor interventions to diverse caregiver needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring coaching and follow-up supports in community-implemented caregiver-mediated JASPER intervention. Shire, SY., Shih, W., Barriault, T., et al.[2022]

A study involving 13 families showed that parent training in the Naturalistic Developmental Behavioral Intervention, Project ImPACT, is feasible and positively received in community settings.

Parents reported finding value in their involvement in the intervention, perceiving benefits for their children, which highlights the importance of parent engagement in early autism interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent perceptions of an adapted evidence-based practice for toddlers with autism in a community setting. Stahmer, AC., Brookman-Frazee, L., Rieth, SR., et al.[2018]

In a study involving 280 caregivers of children aged 6 to 11 on the autism spectrum, it was found that children received a wide range of interventions, with some receiving up to 79.3 hours per week, highlighting the complexity of treatment environments.

Children with higher autism symptom levels and certain demographic factors received more evidence-based interventions, suggesting that these factors should be considered when designing clinical trials for autism treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patterns of Intervention Utilization Among School-Aged Children with Autism Spectrum Disorder: Findings from a Multi-Site Research Consortium. Sridhar, A., Kuhn, J., Faja, S., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4783130/

A randomized controlled trial of Hanen's 'More Than Words' in ... This randomized controlled trial compared Hanen's 'More than Words' (HMTW), a parent-implemented intervention, to a 'business as usual' control group.

2. hanen.org hanen.org/information-tips/who-we-are-research/more-than-words-research-summary

Research Summary for More Than Words The goal of More Than Words is to empower parents to become the primary facilitator of their child's social communication development, thereby maximizing the ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0021992425000826

Maximizing the use of practice-based clinical data to track ... This paper leverages standard clinical information gathered during More Than Words®- The Hanen Program® for Parents of Autistic Children or Children Who May ...

4. thewatsoninstitute.org thewatsoninstitute.org/wp-content/uploads/2017/10/MTW-professional-research-summary.pdf

More Than Words® However, the outcomes highlight the potential of sensitive measures for detecting important changes in the social skills of this group of children. Page 8. More ...

5. pubs.asha.org pubs.asha.org/doi/10.1044/2022_AJSLP-22-00256

Families' Experiences in the Virtual Hanen More Than ... These results differ from two previous studies that reported improved language and social communication skills for all children whose families participated in ...

6. hanen.org hanen.org/programs/more-than-words

More Than Words® Program for Parents of Autistic Children At a More Than Words Program, you start by learning how to understand your child's communication better and how to identify the things that interest them.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT06847347?term=AREA%5BBasicSearch%5D(AREA%5BConditionSearch%5D(%22Social%20Communication%20Disorder%22))&rank=1

Feasibility Trial of Parent-delivered Social Communication ... More Than Words® (MTW) is a 13-week parent-implemented program designed to enhance communication, play development, and parent-child interaction for children ...

8. researchgate.net researchgate.net/publication/50591879_A_randomized_controlled_trial_of_Hanen's_'More_Than_Words'_in_toddlers_with_autism_symptoms

A randomized controlled trial of Hanen's 'More Than Words' ... Sixty-two children (51 boys and 11 girls; M age = 20 months; SD = 2.6) who met criteria for autism spectrum disorders (ASD) and their parents ...