KneuroKnits: Participation and Anxiety in People With Neurological Conditions Participating in a Knitting Group
Condition: Autism Spectrum Disorder; Neurodevelopmental Disorders; Acquired Brain Injury; Physical Disability
MeSH terms: Brain Injuries; Autism Spectrum Disorder; Neurodevelopmental Disorders
Study type: Interventional

Summary: 
      The reported social benefits of knitting combined with the urgent need for social and
      activity-based programs in the disability community suggest that a knitting intervention may
      fill a substantial gap in available programs. Knitting may also be well suited to autistic
      strengths, combining sensory aspects (colourful sights, soft touch, rhythmic sounds), visual
      patterning, and repetitive actions. Surprisingly, no knitting programs for ASD or other
      conditions are reported in the literature. It is proposed that a knitting group can provide
      social and skill-building opportunities, improving real-world social outcomes for youth with
      ASD, and resulting in KneuroKnits, a program designed specifically to serve this need. The
      program will be designed and run by a collaborative team of clinicians, researchers, knitting
      experts, and a self-advocate with ASD. This program will enhance evidence supporting programs
      providing contexts for the dual goals of meaningful social interaction for young people with
      neurodevelopmental disorders, physical disabilities, and acquired brain injuries and building
      a real world creative skill that can facilitate social interaction within and beyond the
      program. This study will evaluate participants' experiences of the program as well as their
      levels of anxiety at various points during the program.
    

Detailed description: 
      This study has two sets of aims. The first are related to social and environmental
      experiences, and the second are related to anxiety experiences.

      Aim 1: Social and environmental experiences

        1. To qualitatively observe and understand the social and skill-building experiences of a
           knitting group for people with neurodevelopmental disorders, physical disabilities, and
           acquired brain injuries from the perspectives of participants, their parents, and
           program facilitators;

        2. To explore whether a professionally facilitated knitting group is perceived to be a
           beneficial and/or enjoyable environment for people with neurodevelopmental disorders,
           physical disabilities, and acquired brain injuries to socialize with peers;

        3. To explore whether a professionally facilitated knitting group is perceived as an
           appropriate and/or desired learning or skill building environment for people with
           neurodevelopmental disorders, physical disabilities, and acquired brain injuries; and

        4. To collect data that will drive the creation of a manualized KneuroKnits program and
           funding for future quantitative outcome measurements of program success.

      Aim 2: Anxiety

      a. To evaluate the impact of a knitting instructional program on self report of anxiety in
      individuals with neurodevelopmental disorders, physical disabilities, and/or acquired brain
      injuries.

      Program design:

      The KneuroKnits program will be based upon current knitting education practices and leading
      practices in facilitation of social participation for youth with neurodevelopmental
      disorders, physical disabilities, and acquired brain injuries. The program will consist of 4
      weekly sessions in which participants will learn knitting fundamentals and have opportunities
      to socialize over a shared occupation. The 4 weekly sessions of the KneuroKnits curriculum
      will include related knitting and social skills themes of the week. Each session will begin
      with a structured lesson on the knitting topic of the day, and will then continue into
      knitting practice and social interaction. Participants will be encouraged to practice their
      new skills (knitting and social) between sessions, and will be allowed to keep all materials
      that they use or create. The project involves two pilot runs of the program in a pre-post
      study design.

      Research Design:

      The research includes both qualitative and quantitative components, all of which align with
      the structure of the KneuroKnits program described above. The project has two complementary
      foci that will be evaluated separately: (1) social and skill based experiences of program
      participation, and (2) the impact of program participation on anxiety related responses.

        1. Social and skill based experiences of program participation:

           Primarily using qualitative design driven by an interpretive phenomenological
           methodology, this study will explore program experiences using observation and
           interviews with participants and stakeholders. The research team will also evaluate the
           program environment (activity setting) using a validated measure (SEAS).

        2. The impact of program participation on anxiety related responses:

      This study will employ a pre-post design. Anxiety will be measured at 2 time points for all
      participants (baseline, week 4) using self report (the anxiety subscale of the Symptom
      Checklist 90 [SCL-90] and the State-Trait Anxiety Inventory [STAI] will be collected when the
      participant attends the relevant KneuroKnits session. If the participant misses that
      particular session, they will be asked to come in to Holland Bloorview at their earliest
      convenient time to complete the measures.

      The program will be administered at two different sites to increase access to a broad
      population. In October-November 2018, the 4-week program will be conducted at the Ontario
      Science Centre site, and in November-December 2018, the program will be conducted at the
      Holland Bloorview site.
    

Intervention name(s): KneuroKnits
Intervention type(s): Other
Intervention description(s): The KneuroKnits program will be based upon current knitting education practices and leading practices in facilitation of social participation for individuals with neurodevelopmental disorders, physical disabilities, and acquired brain injuries. The program will consist of 4 weekly sessions in which participants will learn knitting fundamentals and have opportunities to socialize over a shared occupation. The 4 weekly sessions of the KneuroKnits curriculum will include related knitting and social skills themes of the week. Each session will begin with a structured lesson on the knitting topic of the day, and will then continue into knitting practice and social interaction. Participants will be encouraged to practice their new skills (knitting and social) between sessions, and will be allowed to keep all materials that they use or create.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment