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Trial registered on ANZCTR
Registration number
ACTRN12617001472369
Ethics application status
Approved
Date submitted
13/10/2017
Date registered
18/10/2017
Date last updated
21/01/2020
Date data sharing statement initially provided
23/09/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
An Integrated Family Intervention for Child Conduct Problems: How a parenting intervention for childhood behavioural problems influences and is influenced by epigenetic variation in children aged 3 to 8 years.
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Scientific title
Assessing the impact of an Integrated Family Intervention for Child Conduct Problems on child behaviour outcomes, family adjustment and epigenetics in children aged 3 to 8 years.
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Secondary ID [1]
293125
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National Health and Medical Research Council (funding body) grant number: APP1123072
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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:
Child behavioural and emotional disorders
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Condition category
Condition code
Mental Health
304402
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention: The Integrated Family Intervention for Child Conduct Problems (Dadds & Hawes, 2006)
Program description and procedure: The program consists of 10 x 1 hour treatment sessions focusing on managing child aggression, non-compliance and disruptive behaviour. Parents are empowered to strengthen and develop strategies that encourage positive child behaviour by giving attachment rich positive reinforcement and rewards, and discourage challenging behaviour through the provision of consistent, attachment and emotionally neutral behaviour management strategies. The program also includes modules that address parental mental health, marital adjustment and family communication, and, additional modules to address specific concerns such as management of anxiety and worry, emotion regulation and school consultation.
Mode: The intervention is delivered face-to-face in an individual family format (not group).
Location: The program is delivered at the Child Behaviour Research Clinic.
The program is delivered by clinical psychologists, psychologists and provisionally registered psychologists under the supervision of senior clinicians.
Materials/resources: The program is delivered as per the therapist manual for The Integrated Family Intervention for Child Conduct Problems (Dadds & Hawes, 2006)
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Intervention code [1]
299372
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Behaviour
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Intervention code [2]
299373
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Treatment: Other
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Comparator / control treatment
Non-randomised control wait-list for a sub-sample of participants. The duration of the wait-list control sub-sample is approximately 3 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Child adjustment and levels of disruptive behaviour (and symptom severity of other psychological problems) measured using the Diagnostic Interview Schedule for Children, Adolescents and Parents (DISCAP) for DSM-V based on (the DISCAP; Holland & Dadds, 1997).
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Assessment method [1]
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Timepoint [1]
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1. Preliminary Assessment - 3 months prior to commencing treatment (for a sub-sample of participants) 2. Pre-treatment assessment 3. Immediate post treatment assessment (e.g., within a week of completing treatment) 4. Three month follow up assessment
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Primary outcome [2]
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Behavioural and emotional adjustment as measured by the Total Difficulties score on the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997).
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Assessment method [2]
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Timepoint [2]
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1. Preliminary Assessment - 3 months prior to commencing treatment (for a sub-sample of participants) 2. Pre-treatment assessment 3. Immediate post treatment assessment (e.g., within a week of completing treatment) 4. Three month follow up assessment
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Primary outcome [3]
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Family functioning assessed using the Total Score for The Parenting and Family Adjustment Scales (PAFAS: Sanders, Morawska, Haslam, Filus, Fletcher) a brief parent-report measure for use in assessment of parenting skills and family relationships.
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Assessment method [3]
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Timepoint [3]
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1. Pre-treatment assessment
2. Immediate post treatment assessment (e.g., within a week of completing treatment)
3. Three month follow up assessment
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Secondary outcome [1]
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Secondary Outcome 1: Epigenetic change following treatment as assessed through
exploratory analyses of methylation levels on the following genes involved in neurodevelopment: Oxycontin receptor, DRD4, SERT1B, and cortisol receptor.
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Assessment method [1]
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Timepoint [1]
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1. Preliminary Assessment - 3 months prior to commencing treatment (for a sub-sample of participants) 2. Pre-treatment assessment 3. Immediate post treatment assessment (e.g., within a week of completing treatment) 4. Three month follow up assessment
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Secondary outcome [2]
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Parent adjustment assessed using the Parent Problem Checklist (Dadds & Powell, 1991) a brief questionnaire measuring parental adjustment and inter-parental conflict over child rearing issues.
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Assessment method [2]
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Timepoint [2]
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1. Pre-treatment assessment
2. Immediate post treatment assessment (e.g., within a week of completing treatment)
3. Three month follow up assessment
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Secondary outcome [3]
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Parent feelings towards the child assessed using the Parent Feelings Questionnaire (Deater-Deckard, 1996).
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Assessment method [3]
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Timepoint [3]
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1. Pre-treatment assessment
2. Immediate post treatment assessment (e.g., within a week of completing treatment)
3. Three month follow up assessment
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Eligibility
Key inclusion criteria
Children with conduct problems (DSM-V Oppositional Defiant Disorder and or Conduct Disorder) as assessed using the DISCAP V. We adhere to the National Institute of Mental Health (NIMH) guidelines that research into the externalising disorders is compromised by exclusion of the major and naturally occurring comorbidities, Thus ADHD, affective/anxiety disorders, learning problems, and mild autistic features are allowed if conduct problems are also present and the child is not receiving or is stabilised on psychoactive medication in relation to them at the time of assessment.
Fluency in English
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Minimum age
2
Years
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Maximum age
8
Years
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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
1. Current diagnosis of a psychotic disorder
2. Diagnosis of ASD at a severity level greater than 1
3. Developmental delay (estimated at IQ < 70)
4. Major medical disorder that has significantly interfered with family or school life
5. Family involvement in current legal issues including child custody disputes
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
N/A
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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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
Other
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Other design features
A non-randomised control wait-list arm of the study was added to the study design after enrolment of approximately 150 participants.
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
23/10/2017
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Actual
23/10/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
400
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Accrual to date
179
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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The National Health and Medical Research Council
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Address [1]
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The National Health and Medical Research Council
NHMRC Research Administration Section
GPO Box 1421 Canberra City ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Professor Mark Dadds
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Address
Griffith Taylor Building (A 19)
School of Psychology
The University of Sydney, NSW 2006
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Meryn lechowicz
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Address [1]
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Child Behaviour Research Clinic
Brain and Mind Centre
97 Church Street, Camperdown
Sydney NSW 2050
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Associate Professor David Hawes
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Address [2]
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Clinical Psychology Unit
Mallett Street Campus
The University of Sydney
NSW 2006 Australia
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Country [2]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
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Ethics and Research Integrity Margaret Telfer Building (K07) University of Sydney NSW 2006
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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13/07/2017
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Ethics approval number [1]
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HREC Project ID: 2017/539
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Summary
Brief summary
The REAL Treatment project will investigate the inter-play between evidenced-based interventions that improve the child caregiving context, childhood behavioural outcomes, and, changes in DNA methylation of the major neurodevelopmental genes. 400 Children aged 2 to 8 years and their families will be recruited through the Sydney Child Behaviour Research Clinic over a 4 year period to participate in the REAL Treatment Study: A parenting Intervention for Child Conduct Problems. Families and the research team will form a supportive partnership to assess and monitor a child’s behavioural, emotional and neurodevelopmental progress, as well as parenting progress and family environment over the course of a 6 to 10 week tailored, evidenced-based parenting intervention to address child conduct problems. Assessments will be taken prior to and directly after receipt of the intervention as well as at a three month follow-up review assessment. Assessment will cover areas including: Child adjustment and diagnostic status, caregiver/parent adjustment, family environment, engagement with and dose of intervention received, epigenetic assessment (buccal cell collection for methylation assessment) and neurodevelopmental assessment (examining processes of emotional attention and responsiveness to stimuli). Preliminary assessments will also be conducted with a sub-sample of participants who are expected to be on the wait-list for 3 months or more before commencing treatment. A multi-informant assessment method will be applied throughout the research protocol that includes gathering data from: parents/caregivers; clinical interviews; the use of standardized questionnaire and psychometric assessments; coding of observational data of child and family interaction activities; and, teacher/educator reports and completion of questionnaires. We aim to a) confirm an emerging model of how epigenetic regulation of the major neurodevelopmental systems maps onto individual differences in comorbid symptom profiles before and after intervention; b) to examine how this regulation and mapping predicts individual differences in responsiveness of children to intervention that produces standardised and measurable improvements in the child caregiving environment; c) to examine how early intervention alters epigenetic regulation of the major neurodevelopmental systems and REAL (responsiveness, emotional attention and learning) phenomena, thus modifying risk versus protection for future development.
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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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Prof Mark Dadds
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Address
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Griffith Taylor Building (A 19)
School of Psychology
The University of Sydney, NSW 2006
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Country
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Australia
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Phone
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+61 2 8627 4583
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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
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Meryn Lechowicz
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Address
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Child Behaviour Research Clinic
Brain and Mind Centre
97 Church Street, Camperdown
Sydney NSW 2050
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Country
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Australia
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Phone
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+612 9114 4326
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Mark Dadds
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Address
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Griffith Taylor Building (A 19)
School of Psychology
The University of Sydney, NSW 2006
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Country
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Australia
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Phone
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+61 2 8627 4583
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Fax
78312
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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
No IPD sharing specified
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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
Source
Title
Year of Publication
DOI
Embase
Using Time-out for Child Conduct Problems in the Context of Trauma and Adversity: A Nonrandomized Controlled Trial.
2022
https://dx.doi.org/10.1001/jamanetworkopen.2022.29726
N.B. These documents automatically identified may not have been verified by the study sponsor.
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