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Trial registered on ANZCTR
Registration number
ACTRN12620000164998
Ethics application status
Approved
Date submitted
22/11/2019
Date registered
17/02/2020
Date last updated
17/02/2020
Date data sharing statement initially provided
17/02/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Coaching Whilst Waiting: Feasibility of Occupational Performance Coaching and service navigation support to address child and family goals whilst waiting for autism assessment
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Scientific title
Coaching Whilst Waiting: Feasibility of Occupational Performance Coaching and service navigation support to address child and family goals whilst waiting for autism assessment
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Secondary ID [1]
299886
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None
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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:
developmental delay
315305
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autism spectrum disorder
315306
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Condition category
Condition code
Mental Health
313607
313607
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0
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Autistic spectrum disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A feasibility study will be conducted using recommended constructs and associated measures, and reported using CONSORT guidance. Participants will be randomised to one of three trial arms. One will include a coaching intervention that aims to address functional goals, Occupational Performance Coaching (OPC), delivered via four face to face sessions (Arm B), within four months of a child aged 1 to 7 years being referred to one of two Victorian services for an autism assessment. A second arm will provide coaching delivered over 4 sessions using video conference modalities (Arm C), and the third arm will be usual care (Arm A).
Occupational Performance Coaching (OPC) is an occupation-based intervention developed to address the functional support needs of children and families (Graham, 2009). It has been built upon several theoretical foundations including occupation-centred and family-centred practice, as well as ecological models of child health and well-being. The approach involves supporting families to generate goals relating to themselves, their child’s functioning or the functioning of their family as a whole. The therapist then, through a series of interactive, semi-structured interview sessions, provides an opportunity for reflection, sharing of information, and the development of attainable actions for forthcoming review. Performance analysis, strategy generation and resource identification take place collaboratively, and actions are reviewed in subsequent sessions until goals are reached, or alternative strategies for goal attainment are identified. To date, this intervention has not been trialled specifically with families of children waiting for autism diagnostic assessment, nor have modes of treatment delivery been compared within the same study. This coaching will occur in the same way in both treatment arms, with only the mode of intervention as the point of difference. Families in the intervention arms (B and C) will receive coaching sessions between 2 and 6 weeks apart, for approximately 45 minutes each session. This will be in addition to usual care.
Arm C will rely on freely-available videoconference software such as Zoom(C) or Skype(C) to connect with participants at agreed times. Participants without current access to existing software will be supported by a member of the research team to safely download a preferred programme onto their chosen device, from a list of options made available to them, at no cost to either party. The research team and consenting participants will use existing access to computers and/or smartphones to undertake these sessions.
Preliminary efficacy measures, such as goal attainment across the three intervention arms, will be completed. Coaching will be delivered by a clinician researcher with over 15 years of early intervention expertise, who is trained in the application of OPC. Fidelity will be assessed for 30% of the intervention sessions, double coded by the clinician researcher and the author of OPC, via completion of a published OPC fidelity tool.
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Intervention code [1]
316156
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Treatment: Other
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Comparator / control treatment
Usual care for children and families waiting for autism spectrum disorder assessment will form the comparison group. Usual care can consist of community services that the child is accessing, including but not limited to child-focused developmental therapies. Usual care also includes telephone access, 2 days per week, to a clinical coordinator that can provide service access support by way of service navigation recommendations.
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Control group
Active
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Outcomes
Primary outcome [1]
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A composite primary outcome of recommended feasibility options will be adopted. This will be based on Bowen et al's feasibility constructs, and include the following:
- Recruitment Rate
- Completion Rate (families involved in coaching arms). Complete participants will be those who participated in all four coaching sessions and completed 80% of outcome measures post intervention, if allocated to arms B and C.
- Acceptability via a specifically-designed quantitative and qualitative questionnaire, and two standardised measures; one which explores family-centredness of care received (The Measure of Processes of Care (King et al 1996)) and one which ascertains performance and satisfaction ratings around goal attainment (measured by Canadian Occupational Performance Measure (Law et al 1990)).
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Assessment method [1]
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Timepoint [1]
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Recruitment rate - at closure of study's recruitment phase
All other measures: At the conclusion of the final participant's review session (T1): 4-6 months post baseline measure completion.
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Secondary outcome [1]
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Parent-health related measures including:
- Parenting Stress Index (Abidin et al 2012)
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Assessment method [1]
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Timepoint [1]
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Families in all study arms will attend a baseline (T0) and follow up session (T1); 60 minutes in duration each, approximately 4-6 months apart.
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Secondary outcome [2]
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Child functioning measures - completed by primary caregiver as proxy:
- Vineland Adaptive Behaviour Scales (iii) - Caregiver completed form (Sparrow et al 2016)
- Social Responsiveness Scale (SRS) (Constantino et al 2012)
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Assessment method [2]
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Timepoint [2]
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T1: 4 - 6 months post baseline measure completion
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Secondary outcome [3]
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Number of services child and family are accessing for therapeutic support
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Assessment method [3]
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Timepoint [3]
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T1: 4 - 6 months following baseline measure completion
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Eligibility
Key inclusion criteria
Participants for this study are defined as a pair or group consisting of a young child, and one or two primary caregivers. The usual care and coaching interventions will be delivered to primary carers of children between 1 and 7 years of age referred to one of two centres in Melbourne with a query of autism spectrum disorder. Families may be recruited to the study within 4 months of receipt of their referral, and only following an independent clinical decision confirming service eligibility.
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Minimum age
1
Years
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Maximum age
No limit
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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
• Respondents whom are not currently the primary carer of the child referred to the assessment service
• Children with an existing diagnosis of autism spectrum disorder, or whom have been assessed for the disorder within the last 12 months.
• Primary carers who are accessing goal-directed coaching support services at the time of recruitment, and such services are sufficiently meeting their family goals and priorities
• Primary carers with known current mental health diagnoses currently under active treatment, supported by relevant health professional/s
• Primary carers of children with known developmental or medical diagnoses, whom have already accessed a multidisciplinary team (MDT) diagnostic assessment at a relevant paediatric health care service.
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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)
Central randomisation by a computer programme, conducted offsite by an independent member of the research team.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation sequence conducted via a formula in a computer programme.
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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
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Statistical methods / analysis
The study is aiming to recruit 15 to 24 families to the study to allow for 5 to 8 participants randomised to each intervention arm. Based on clinical and research expertise across the team, this number was seen to be sufficient to inform process planning related to a future randomised control trial, and to satisfactorily meet the requirements for obtaining all research aims. With a sample size of 24, we will be able to predict a participation rate of 20% to within a 95% confidence interval of +/- 16%.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
7/03/2019
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Date of last participant enrolment
Anticipated
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Actual
14/10/2019
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Date of last data collection
Anticipated
28/02/2020
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Actual
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Sample size
Target
20
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Accrual to date
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Final
17
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [2]
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Djerriwarrh Health Services - Melton Health - Melton West
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Recruitment postcode(s) [1]
28596
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3052 - Parkville
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Recruitment postcode(s) [2]
28597
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3337 - Melton West
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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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The University of Melbourne
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Address [1]
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50 Flemington Rd
Parkville VIC 3052
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Country [1]
304343
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Australia
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Primary sponsor type
Individual
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Name
Ms Charmaine Bernie
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Address
Department of Paediatrics
The University of Melbourne
50 Flemington Rd
Parkville VIC 3052
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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]
304594
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Royal Children's Hospital Human Resource Ethics Committee
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Ethics committee address [1]
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50 Flemington Rd Parkville VIC 3052
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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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28/06/2018
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Approval date [1]
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01/10/2018
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Ethics approval number [1]
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HREC 38154A
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Summary
Brief summary
This study aims to investigate whether a short period of coaching sessions, delivered in person with a clinician or via videocall, helps families of young children who have recently become aware that there may be a risk of autism spectrum disorder. We hypothesise that families need support and guidance in this period, and that these needs are not currently being met by health or disability services. is the researchers' hope that findings from this study will help families in limbo, waiting for diagnostic assessments and unsure what to do or how to help their child in the meantime. This may assist to minimise wasteful waiting periods in a child's early years, when intervention can be of great benefit to children, families and communities.
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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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Ms Charmaine Bernie
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Address
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Department of Paediatrics
The University of Melbourne
50 Flemington Rd
Parkville VIC 3058
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Country
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Australia
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Phone
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+61 3 9345 6487
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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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Charmaine Bernie
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Address
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Department of Paediatrics
The University of Melbourne
50 Flemington Rd
Parkville VIC 3058
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Country
98231
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Australia
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Phone
98231
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+61 3 9345 6487
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Fax
98231
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Email
98231
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[email protected]
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Contact person for scientific queries
Name
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Charmaine Bernie
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Address
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Department of Paediatrics
The University of Melbourne
50 Flemington Rd
Parkville VIC 3058
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Country
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Australia
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Phone
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+61 3 9345 6487
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Fax
98232
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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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