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Trial registered on ANZCTR
Registration number
ACTRN12614001221640
Ethics application status
Approved
Date submitted
31/10/2014
Date registered
19/11/2014
Date last updated
29/01/2019
Date data sharing statement initially provided
29/01/2019
Date results provided
29/01/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Parent-mediated cognitive behavioural therapy for young children with high-functioning autism spectrum disorder and anxiety: a randomized control trial.
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Scientific title
Parent-mediated cognitive behavioural therapy for young children with high-functioning autism spectrum disorder and anxiety: a randomized control trial.
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Secondary ID [1]
285299
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Asperger's Syndrome/High Functioning Autism
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Anxiety
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Condition category
Condition code
Mental Health
293268
293268
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0
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Autistic spectrum disorders
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Mental Health
293816
293816
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0
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Group based cognitive behavioural therapy. Parents attend 10 x 1.5 hours sessions (over 13 weeks) administered by two provisional psychologists. Groups sizes range from 3 to 7 parents.
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Intervention code [1]
290207
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Behaviour
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
Wait-list control is offered the treatment after 10 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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Anxiety as measured by scores on the Child Behaviour Checklist.
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Assessment method [1]
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Timepoint [1]
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Baseline and at 14 weeks and 26 weeks after intervention commencement. This change was made prior to any enrollments.
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Secondary outcome [1]
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Internalizing and externalizing behaviours as measured by the Child Behaviour Checklist.
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Assessment method [1]
310372
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Timepoint [1]
310372
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Baseline and 14 weeks and 26 weeks after intervention commencement.
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Secondary outcome [2]
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Child emotional awareness as measured by an adapted versions of the Emotional Awareness Questionnare
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Assessment method [2]
310373
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Timepoint [2]
310373
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Baseline and 14 weeks and 26 weeks after intervention commencement.
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Secondary outcome [3]
310374
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parent depression, anxiety and stress as measured by the Depression, Anxiety and Stress Scale 21
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Assessment method [3]
310374
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Timepoint [3]
310374
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Baseline and 14 weeks and 26 weeks after intervention commencement.
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Secondary outcome [4]
310375
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parenting stress as measured by the Parenting Stress Index-Short Form
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Assessment method [4]
310375
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Timepoint [4]
310375
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Baseline and 14 weeks and 26 weeks after intervention commencement.
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Secondary outcome [5]
310376
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parenting competence as measured by the Parenting Sense of Competence Scale
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Assessment method [5]
310376
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Timepoint [5]
310376
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Baseline and 14 weeks and 26 weeks after intervention commencement.
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Eligibility
Key inclusion criteria
To be included in the study children must have a diagnosis of 1) Asperger's Syndrome or 2) Autism Spectrum Disorder, requiring support for deficits in social communication and requiring support for restricted, repetitive behaviors, without accompanying intellectual impairment or 3) High Functioning Autism (autism without accompanying intellectual impairment) from a pediatrician or psychologist. Children must also meet the criteria for Asperger's Syndrome/High Functioning Autism according to the Checklist of Autism Spectrum Disorders and have elevated scores on the Preschool Anxiety Scale.
No inclusion criteria applied to parents.
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Minimum age
48
Months
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Maximum age
83
Months
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Children who are currently receiving psychological treatment for anxiety will be excluded from the study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomization. Participants were randomly allocated to either treatment condition(TX) or the waitlist control (WLC)via a computer generated, block randomization list.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Previous treatment studies examining the efficacy of modified CBT in treating older children with High Functioning Autism/ Asperger’s Syndrome and anxiety have found large effect sizes for the effect of treatment on anxiety (e.g. Storch et al. 2013). Previous studies on interventions that focus on emotional management in children with ASD have found small to medium effect sizes for the effect of treatment on parent’s mental health and wellbeing (e.g. Scarpa &Reyes, 2011; Whittingham, Sofronoff, Sheffield, & Sanders, 2008). Given that this study is primarily concerned with child outcomes, a large effect size was used to calculate the minimum sample size for the study. As past research has demonstrated the direction of the effect of CBT on anxiety, a one tail analysis was used to calculate sample size. Additionally, as per the convention in clinical psychology an alpha level of .05 was used to calculate sample size. According to the ClinTools Software for Windows (Devilly, 2007) a minimum sample size of 40 participants was needed to produce an effect size of 0.80 with a power of 0.80 (a = 0.05, 1 tailed) for a between groups designed.
A series of preliminary analyses will be conducted to ensure there are no significant differences between treatment and waitlist condition on demographic variables and outcome measures prior to treatment. Chi-square analysis will be conducted to test for significant differences between groups for child gender, child country of birth, mother educational level, father educational level and household income. Univariate analysis of variance (ANOVA) will be used to test for significant differences between groups for child age, mother age, father age and number of siblings. In relation to children’s functioning at pre-treatment ANOVA will be used to test for significant differences between groups on the Preschool Anxiety Scale, Child Behaviour Checklist, Emotional Awareness Questionnaire, Depression, Anxiety and Stress Scale, and Parenting Sense of Competence Scale and Parenting Stress Index.
In order to evaluate effects from pre-post treatment, a series of repeated measures, between groups, 2 (Condition: Treatment, Waitlist Control) x 2 (Time: Pre, Post) ANOVA’s will be conducted for each of the dependent variables separately. Effect sizes for the Condition x Time interaction will be calculated using Hedge’s g and will be based upon the changes scores for each condition’s mean form pre- to post-treatment. Reliable and clinical change will also be computed to evaluate the meaningfulness of change within each condition.
In order to assess for maintenance effects at 3-month follow-up, a series of repeated measures ANOVAS (pre, post, follow-up) will be conducted with the treatment participants only, as the waitlist group cease to be part of the study after post-assessment. The significance of multiple follow up tests will be determined by using Bonferroni adjustments and partial eta squared will be computed to estimate effect size.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
3/06/2014
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Actual
13/05/2014
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Date of last participant enrolment
Anticipated
1/06/2015
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Actual
16/03/2015
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Date of last data collection
Anticipated
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Actual
14/09/2015
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Sample size
Target
40
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Accrual to date
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Final
31
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment postcode(s) [1]
8684
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4122 - Mount Gravatt
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Griffith University
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Address [1]
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Griffith University
176 Messines Ridge Road
Mt Gravatt
Queensland
4122
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Caroline Donovan
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Address
Griffith University
School of Psychology
Mt Gravatt Campus
Messines Ridge Road
Mt Gravatt QLD 4122
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Griffith University Human Research Ethics Committee
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Ethics committee address [1]
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Office for Research Gold Coast Campus Room 4.25, The Learning Commons Building (G11) Griffith University Parklands Drive, Southport QLD 4215
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291644
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Approval date [1]
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04/12/2013
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Ethics approval number [1]
291644
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PSY/E4/13/HREC
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Summary
Brief summary
We are investigating the use of a parent-based Cognitive Behavioural Therapy (CBT) program for treating anxiety difficulties in children aged four to six with Asperger’s Syndrome/High Functioning Autism. Parent-based CBT programs offer an alternative to traditional child-based CBT programs which may be too intellectually demanding for children under the age of seven. Moreover, parent-based CBT programs have be found to effective in treating anxiety in young neuro-typical children and older children with Autism Spectrum Disorders. The design is between groups, repeated measures RCT in which parents will be assigned to one of two conditions: treatment or waitlist control. It is hypothesized that from pre- to post- treatment children of parents in the CBT group, compared to children of parents in the waitlist control group, will demonstrate a significantly greater improvement in emotional awareness and a significantly greater reduction in anxiety. Additionally, it is hypothesized that from pre- to post- treatment, parents in the CBT group, compared to parents in the waitlist group, will demonstrate a greater reduction in parenting stress and parenting distress as well as a greater improvement in parental self-efficacy and parental satisfaction. Finally, it is hypothesized that pre- to post- treatment improvement for children and parents in the CBT group will be maintained or improved upon at 3-month follow up.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Caroline Donovan
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Address
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Griffith University
School of Psychology
Mt Gravatt Campus
Messines Ridge Road
Mt Gravatt QLD 4122
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Country
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Australia
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Phone
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+61 07 3735 3401
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
51283
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Julia Cook
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Address
51283
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Griffith University
School of Psychology
Mt Gravatt Campus
Messines Ridge Road
Mt Gravatt QLD 4122
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Country
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Australia
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Phone
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+61 07 3735 3326
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Fax
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Email
51283
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[email protected]
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Contact person for scientific queries
Name
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Julia Cook
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Address
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Griffith University
School of Psychology
Mt Gravatt Campus
Messines Ridge Road
Mt Gravatt QLD 4122
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Country
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Australia
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Phone
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+61 07 3735 3326
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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