Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT05106166 |
| Other study ID # |
2020/126 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
April 1, 2020 |
| Est. completion date |
June 5, 2021 |
Study information
| Verified date |
November 2021 |
| Source |
Hacettepe University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
In order to support the development of preschool children, joint attention training with
activities incorporated in their natural routines can support the achievement of occupational
therapy goals. This study explores the adjunctive benefit of a joint attention-based
occupational therapy program offered in addition to the usual special education program
(USEP) compared to USEP alone.
The present study was designed as a randomized controlled study, including pre-post testing.
The Social Communication Questionnaire (SCQ), Autism Behaviour Checklist (ABC), and A
Motor-Free Visual Perception Test 4 (MVPT-4) were implemented to measure the participants'
conditions before and after the intervention.
Description:
Twenty children, ten in each group, were included in the study. The study inclusion criteria
were being between the ages of 4 and 6, diagnosed with ASD, and consenting to participate in
the study. The study did not include children who had a co-morbid condition other than ASD
and had no previous education or training. Between 1 April and 25 June 2020, a total of 28
children were interviewed for this study, and 3 children were excluded because they did not
meet the inclusion criteria. 13 children were randomly assigned to the study group and 12
children to the control group. 3 individuals from the study group were excluded because of
time, transportation or other reasons, and 2 children from the control group were excluded
because they did not complete the assessments. As a result, a total of 20 children with ASD,
10 of whom were working and 10 were control, formed the sample group of the study. Informed
consent was obtained after the scope and purpose of the study were explained in detail to the
participants and primary family caregivers.
A social communication questionnaire (SCQ), autistic behavior checklist (ABC), and motor-free
visual perception test-4 (MVPT-4) were administered to the children before and after the
intervention, and the results were compared.
The SCQ was developed to evaluate the social communication of individuals with autism. The
total score can be between 0-and 39 for children who can speak. The SCQ which comprises three
sub-dimensions: reciprocal social interaction, language and communication, and repetitive and
stereotyped patterns has the validity and reliability in Turkish.
The ABC is among the scales used for screening and evaluating education in autism in many
countries. The ABC consists of five sub-dimensions: sensory, relating, body or object use,
language, and social and self-help. The total score is between 0-159.
MVPT-4 is an instrument that presents a fast, reliable, and valid evaluation of children and
adults' general and visual perceptual abilities. MVPT-4 consists of 45 items that are
organized and grouped to provide a smooth implementation process. The items consist of black
and white drawings and patterns developed to present answer options, making the
implementation easy in a multiple-choice form. Motor skills are not necessary to get a
response, which makes this test useful, especially for people with motor disabilities.
All children included in the study attend a usual special education program (USEP) 2 sessions
per week in a rehabilitation center. The USEP studied was including gross motor skills,
communication skills, preschool preparation skills, and self-care skills. The control group
of the study consisted of children attending the USEP. Children in the study group received
an occupational therapy intervention based on joint attention in addition to the USEP they
continued. As an intervention in the study group, the sessions were conducted three days a
week for a total of 12 weeks. The initial assessments were administered to children in both
groups. At the end of the 12 weeks, the evaluations were repeated in both groups.
The acquisition frame of reference, which proposes to shape the behaviors that contribute to
skill acquisition, and the developmental frame of reference, which emphasizes the continuous
change and emergence of skills with age, guided the occupational therapy intervention.
Therefore, all activities were designed according to the chronological and developmental ages
of the children. During the joint attention-based intervention sessions, holistic
occupational therapy approaches for the child's sensory, physical, social, language and
communication deficits were discussed.
The steps followed are:
1. Each parent was interviewed about the child's preferences. The toy types preferred by a
child and the toys that a child might react negatively to were identified. The
intervention specialist selected a total of 15 toys for paired stimulus preference
assessments. Five of these toys were stuffed animals and figures. Five comprised
multi-part activities, and the other five consisted of toys activated by light,
movement, and/or sound. Each group of toys was used according to the child's interests
and habits in three stages: creating a response to a joint attention offer, initiating
joint attention, and reinforcing a joint attention response.
2. During the joint attention-based occupational therapy intervention, researchers paid
attention to maintaining eye contact and following the child's lead. Activities were
conducted at the desk and on the floor. A game pattern was created using the selected
toys; the pattern was planned and implemented as activities for an average of 20
minutes.
3. In the sessions, (a) fine motor activities such as handicrafts, finger games; (b) gross
motor activities such as obstacle course, music, dance; (c) visual-motor activities such
as drawing, cutting, and assembly were used. Initiating and responding to joint
attention during these activities was the focus of the intervention. With the training,
the aim was to generalize behavioral skills and transfer them to the context of social
play.
4. It is stated that compatible environmental arrangements that will provide visual cues
are important when structuring environmental activities because children with autism
respond to the use of visual input. For this reason, environmental arrangements were
made with visual stimuli that could attract a child's attention.
