Title: Pilot trial of a new parent group intervention to manage repetitive behaviours in young children with ASD
Funder: Department of Health (England)

Abstract: Background Repetitive behaviours (RBs) such as repetitive motor mannerisms, non-functional routines, preoccupation with restricted interests, resistance to change, are a core feature of autism spectrum disorder (ASD)[1]. These RBs can cause significant social impairment and distress for the individual and their family, interfere with learning and decrease the likelihood of positive interaction and acquisition of new skills[2]. There is no parent group based intervention targeting RBs for young children with ASD[3]. Most early ASD parent groups focus on social communication skills. Our ASD research group using NIHR FSF 2009 funding has successfully developed, with parents, a new parent based group intervention that focuses on identification, understanding and management of RBs in young children. Aims We will assess, through an external pilot trial, the feasibility of a future randomised controlled trial of our parent group intervention to manage RBs. This study will inform the design of an adequately powered multi-site RCT. The intervention is designed to increase parental understanding of RBs in ASD. Parents are supported to identify a ‘target’ behaviour and to develop behaviour management strategies that might be useful for their child’s target and other RBs. Our development study (n=5) found that the group is highly valued by parents, and that target behaviours improved (3 to a marked extent).The pilot RCT will help determine further the acceptability of the intervention, issues of recruitment, randomisation and retention, and variability in the proposed outcomes. Plan of Investigation We plan to recruit 36 parents of young children with ASD to join a trial of a new 8 session parent group intervention. 18 parents will be randomised to intervention (with other services as usual), and 18 to control (services as usual) with the offer of group intervention after 6 months. A range of outcome measures will be assessed, including external rating of vignettes of ‘target’ behaviours; blind researcher-coded video ratings of child RBs and parent management strategies in parent-child interaction; parent rated RB questionnaires; parental self efficacy and confidence in using intervention strategies taught during the group; teacher ratings of child RBs; and independent researcher ratings of the child’s overall functioning. Potential Impact The potential impact of a parent group intervention targeting RBs is substantial. Successful intervention to manage RBs will reduce the deleterious consequences of a restricted range of activities, facilitate the child’s ability to engage with their environment and increase opportunities for social interaction and learning[3]. Our parent group intervention will potentially extend the range of appropriate available interventions around the time of early diagnosis. This pilot trial will provide the basis for a fully powered multi-centre RCT to be submitted for NIHR Health Technology Assessment funding. Investigation of the acceptability of this intervention for parents and professionals and the suitability of proposed outcome measures will ensure best use of therapeutic resources.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MENTAL HEALTH