Parents Resources for Decreasing the Incidence of Change Triggered Temper Outbursts
Condition: Child Behavior
Study type: Interventional
Phase: Phase 1

Summary: 
      'PREDICTORS' (Parents Resources for Decreasing the Incidence of Change Triggered Temper
      Outbursts) aims to evaluate web-based training packages for caregivers of children who show
      frequent temper outbursts following changes to their routines and plans. The training
      packages will teach caregivers how to apply strategies that aim to reduce the number of
      temper outbursts that the children show following changes, as well as making any outbursts
      they do show less severe (less functionally impairing).
    

Detailed description: 
      The aims of PREDICTORS are: 1. To refine the tools to implement and evaluate a
      resource-efficient caregiver training program for signalling changes to children with
      intellectual disabilities or autism spectrum disorders. 2. To pilot the program to test the
      feasibility of taking it forward into a clinical trial. 3. To conduct a process and economic
      evaluation of the pilot intervention to provide further data on its suitability for a
      clinical trial.

      Parents/caregivers of children aged 7-16 years old who frequently show temper outbursts when
      things change in their routines or plans will keep a web-based diary accessed via smart phone
      or other device on their child's temper outbursts for a 6 month period (baseline). After 6
      months of keeping this diary, parents/caregivers will then access web-based training for
      approximately 1 month which will include sessions to study once or twice per week as well as
      exercises to practice in between sessions.

      After the training is complete parents will be asked to implement the strategies they have
      learnt in the 6 months that follow. In addition researchers from the university will
      telephone parents/ caregivers to ask some questions about their child's temper outbursts and
      on the effects this behaviour has on daily life. Parents will be interviewed at three points
      during the study (before baseline, after baseline, before intervention and after intervention
      phases). Interviews will focus on gathering information of their child's behaviour.

      Focus groups with relevant experienced professionals and parents (not participating in the
      main part of the study) will guide the training resource development and development and
      content of the behaviour diary used by parents during the study.
    

Intervention name(s): Visual Scheduling; signalling change
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Caregivers will present a visual schedule with pictorial representations of activities/events expected to occur each day will be presented to children at set times of day (tailored for individual's schedules). Ultimately caregivers will aim to ensure that activities occur as per the schedule as far as possible - thus decreasing the child's level of exposure to unexpected changes in routines or plans.; Caregivers will present a distinct visual-verbal cue card whenever they become aware that a change to the child's routine or plan is about to occur. Thus, the intervention uses a stimulus control approach so that the child learns that presentation of the cue reliably predicts the subsequent occurrence of a change to routine/plan, and the change is therefore more predictable and easier for the child to deal with.
Other intervention name(s): antecedent manipulation; cuing change
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: change triggered temper outbursts; parent training; autism; intellectual disability; Prader-Willi syndrome; Fragile X syndrome; web-based training; Down syndrome