Telehealth Programs for Autism

(STRW-T Trial)

Recruiting at 1 trial location

Overseen By Carrie Fassler

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Children's Hospital Medical Center, Cincinnati

Disqualifiers: Aggressive behaviors, Mental health issues, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 4 months

192 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate how well two different telehealth programs help teens with autism improve their daily living skills. One program, "Surviving and Thriving in the Real World - Telehealth" (STRW-T), focuses on everyday tasks, while the other emphasizes building social skills. Teens in the last two years of high school or those with delayed graduation, who have a diagnosis of autism and struggle with daily living skills, might be a good fit. The study seeks to determine which program better supports teens in managing daily life activities. As an unphased trial, it offers a unique opportunity for teens to access innovative telehealth programs that could significantly enhance their daily living skills.

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 prior data suggests that these telehealth programs are safe for participants?

Research shows that the Surviving and Thriving in the Real World - Telehealth (STRW-T) program is easy for participants to handle. It has been tested for its effectiveness in helping people with autism improve their daily living skills. So far, studies have not found any serious side effects or safety issues. This makes STRW-T a safe choice for those joining telehealth programs aimed at enhancing daily living skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Telehealth Programs for Autism trial because it explores innovative ways to support individuals with autism remotely. Unlike traditional in-person therapies, these programs—Surviving and Thriving in the Real World - Telehealth (STRW-T) and Program for the Education and Enrichment of Relational Skills - Telehealth (PEERS-T)—are delivered online, making them more accessible to families who might face barriers to attending in-person sessions. This trial aims to determine if these telehealth interventions can be just as effective as conventional methods in enhancing social skills and overall well-being. By potentially expanding access to effective therapies, these programs could revolutionize how support is delivered to those with autism.

What evidence suggests that this trial's telehealth programs could be effective for autism?

Research shows that the Surviving and Thriving in the Real World (STRW-T) program, one of the telehealth programs studied in this trial, can help autistic individuals improve their daily living skills. Studies have found that better daily living skills link to more positive outcomes for adults on the autism spectrum. The STRW-T program focuses on these skills, helping participants manage everyday tasks more effectively. Previous participants demonstrated improvements, indicating that this approach can significantly enhance their daily lives. This program targets empowering autistic individuals to succeed in their environments. Another program studied in this trial is the Program for the Education and Enrichment of Relational Skills - Telehealth (PEERS-T), which serves as an active comparator. ^{1 3 4 5 6}

Who Is on the Research Team?

Amie Duncan, PhD

Principal Investigator

Children's Hospital Medical Center, Cincinnati

Are You a Good Fit for This Trial?

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

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

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

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)

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

• STRW-T

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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 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]

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 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]

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 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]

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]

Telehealth services for individuals with autism spectrum disorder (ASD) have been shown to be as effective as traditional face-to-face services, based on a review of 14 studies involving 284 participants ranging from 19 months to adulthood.

The use of telehealth in ASD interventions not only matches in-person services but also outperforms groups that did not receive telehealth, indicating potential benefits for families and educators, though more research is needed for direct applications with children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telehealth and autism: A systematic search and review of the literature. Sutherland, R., Trembath, D., Roberts, J.[2019]

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 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]

Telehealth can effectively train parents in naturalistic teaching strategies to enhance communication skills in children with autism, as demonstrated in a study with five parent-child dyads.

Parents achieved high fidelity in training and reported positive experiences, while children showed variable improvements in communication and increased positive affect, making this approach a cost-effective alternative to traditional training methods.

NCBI (Pubmed)

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. Ferguson, J., Dounavi, K., Craig, EA.[2022]

Citations

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A Randomized Clinical Trial Targeting Daily Living Skills in ... Better DLS are linked to more positive adult outcomes for autistic individuals. Surviving and Thriving in the Real World (STRW) is the only ...

2. withpower.com withpower.com/trial/telehealth-programs-for-autism-12c14

Telehealth Programs for Autism (STRW-T Trial) The current study seeks to compare outcomes of a telehealth intervention targeting daily living skills (Surviving and Thriving in the Real World ...

3. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06552286/strw-t-intervention-for-autistic-adolescents-in-11th-and-12th-grade

STRW-T Intervention for Autistic Adolescents in 11th and ... The current study seeks to compare outcomes of a telehealth intervention targeting daily living skills (Surviving and Thriving in the Real World - Telehealth, ...

4. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/13/NCT03984513/Prot_SAP_000.pdf

Cover Page NCT03984513 Version 12 12/2/2022 SURVIVING AND THRIVING IN THE REAL WORLD: A DAILY ... trial. J ... Parent expectations mediate outcomes for young adults with autism spectrum disorder.

5. journals.sagepub.com journals.sagepub.com/doi/10.1177/10883576251355188

A Randomized Trial Targeting Daily Living Skills in Autistic ... This study evaluated the efficacy of the Surviving and Thriving in the Real World (STRW) intervention, which targets DLS, compared to an active ...

6. strw.org strw.org/wp-content/uploads/2024/01/RCT_STRW-in-11th-and-12th_2023-1.pdf

A Randomized Clinical Trial Targeting Daily Living Skills in ... Better DLS are linked to more positive adult outcomes for autistic individuals. Surviving and Thriving in the Real World (STRW) is the only known evidence-based ...