Document text
Principal Investigator: Brian Antonio Boyd
Organization: UNIVERSITY OF KANSAS LAWRENCE
Fiscal Year: 2024
Award: $473,017
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
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.
Terms: <0-11 years old><ASD><Active Follow-up><Acute><After Care><After-Treatment><Aftercare><Anxiety><Autism><Autistic Disorder><Behavior><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral><Behavioral Conditioning Therapy><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><CV-19><Care Givers><Caregivers><Caring><Categories><Cell Phone><Cellular Phone><Cellular Telephone><Child><Child Behavior><Child Youth><Children (0-21)><Clinical Treatment><Conditioning Therapy><Coronavirus Infectious Disease 2019><Cues><Distal><Early Infantile Autism><Education><Educational aspects><Educational process of instructing><Effectiveness><Environment><Ethnic Origin><Ethnicity><Family><Feeling><Functional impairment><Goals><Infantile Autism><Intervention><Intervention Strategies><Intervention Studies><Kanner's Syndrome><Knowledge><Learning><Link><Marital Status><Mediating><Mobile Phones><Modeling><Outcome><Parenting Education><Parents><Persons><Pilot Projects><Play><Probability><Race><Races><Randomized, Controlled Trials><Reporting><Research><Rewards><Role><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sample Size><Secure><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Stress><Survey Instrument><Surveys><Symptoms><Teaching><Technology><Therapeutic><Time><Translational Research><Translational Science><Videoconferencing><active followup><alleviate symptom><ameliorating symptom><anxiety symptoms><anxious symptom><autism attributes><autism indicator><autism spectral disorder><autism spectrum disorder><autism spectrum disorder features><autism spectrum disorder indicator><autism spectrum disorder symptoms><autism symptomology><autism symptoms><autism-like symptoms><autism-related attributes><autistic children><autistic features><autistic spectrum disorder><autistic symptoms><autistic traits><autistic-like symptoms><behavior intervention><behavior study><behavioral intervention><behavioral study><child services><children on the autism spectrum><children with ASD><children with autism><children with autism spectrum disorder><co-morbid><co-morbidity><communication behavior><comorbidity><comparator group><comparison group><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus infectious disease-19><decrease symptom><delivered remotely><design><designing><effective therapy><effective treatment><experience><falls><feelings><fewer symptoms><flexibility><flexible><follow up><follow-up><followed up><followup><iPhone><implementation intervention><improved><interest><intervention research><interventional research><interventional strategy><interventional study><interventions research><kids><lower income families><neglect><neurobehavioral><novel><pandemic><pandemic disease><parent><pediatric services><personalized health intervention><personalized intervention><pilot study><pilot test><post treatment><precision interventions><psychiatric co-morbidity><psychiatric comorbidity><racial><racial background><racial origin><randomized control trial><reduce symptoms><relieves symptoms><remote delivery><remote intervention><repetitive behavior><response to therapy><response to treatment><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><smart phone><smartphone><social communication><social role><symptom alleviation><symptom reduction><symptom relief><technology intervention><technology-based interventions><technology-enabled interventions><technology-focused interventions><telehealth><therapeutic response><therapy response><translation research><translational investigation><treatment effect><treatment research><treatment response><treatment responsiveness><trial comparing><trial regimen><trial treatment><uptake><video conferencing><youngster>