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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05673096
Other study ID # DAN-PACT
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date March 13, 2023
Est. completion date August 2025

Study information

Verified date May 2023
Source University of Southern Denmark
Contact Niels Bilenberg, Professor
Phone +4599448683
Email Niels.Bilenberg@rsyd.dk
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Paediatric Autism Communication Therapy (PACT) is a naturalistic developmental behavioural interventions to reduce autism symptoms. The aim of this trial is to assess the beneficial and harmful effects of PACT in 2-6 year-old children with a recent diagnosis of autism spectrum disorder.


Description:

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting approximately 2% of children and young people worldwide. ASD is considered a lifelong disorder and interventions significantly reducing the core autistic symptoms have been sparse. Paediatric Autism Communication Therapy (PACT) is among the first naturalistic developmental behavioural interventions to show promising results for reduction in autism symptoms. The aim of this trial is to assess the beneficial and harmful effects of PACT in 2-6 year-old children with a recent diagnosis of ASD. This trial is an investigator-initiated, independently funded, pragmatic, national, parallel group, superiority, randomised clinical trial comparing PACT combined with management as usual to management as usual alone.


Recruitment information / eligibility

Status Recruiting
Enrollment 280
Est. completion date August 2025
Est. primary completion date August 2025
Accepts healthy volunteers No
Gender All
Age group 2 Years to 6 Years
Eligibility Inclusion Criteria: - Children aged 2 through 6 years (both inclusive) - A diagnosis of ASD meeting the criteria for International Classification of Diseases; Tenth Edition (ICD-10): Diagnose codes: DF84.0, DF84.1, DF84.5, DF84.8 - An Autism Diagnostic Observation Schedule, 2nd Edition Calibrated Severity Score (ADOS-2 CSS) = 4 - The ASD diagnosis must be verified by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Autism Spectrum Disorder Checklist - The ASD diagnosis must be the primary developmental disorder (comorbid conditions allowed) and conferred at a clinical conference - Parents must have sufficient Danish (or English) language skills to communicate with the therapist - Signed informed consent by parents or holders of legal guardianship Exclusion Criteria: - Children having a sibling already included in the trial - Hearing and visual impairment in child or parent - Parent not available for regular sessions with the therapist, evaluated at the consent meeting

Study Design


Related Conditions & MeSH terms


Intervention

Behavioral:
PACT
Paediatric Autism Communication Therapy
MAU
Management as usual

Locations

Country Name City State
Denmark Child and Adolescent Mental Health Center, Aabenraa, Region of Southern Denmark Aabenraa
Denmark Child and Adolescent Mental Health Center, Aalborg, North Denmark Region Aalborg
Denmark Child and Adolescent Psychiatric Dept., Skejby, Aarhus University Hospital Aarhus
Denmark Child and Adolescent Mental Health Center, Capital Region of Denmark Hellerup
Denmark Child and Adolescent Mental Health Center, Odense, Region of Southern Denmark Odense
Denmark Department of Child and Adolescent Psychiatry, Copenhagen University Hospital Roskilde

Sponsors (8)

Lead Sponsor Collaborator
University of Southern Denmark Central Denmark Region, Copenhagen Trial Unit, Center for Clinical Intervention Research, Danish Autism Centre, North Denmark Regional Hospital, Region Capital Denmark, Region of Southern Denmark, Region Zealand

Country where clinical trial is conducted

Denmark, 

Outcome

Type Measure Description Time frame Safety issue
Other Parent-child synchrony and initiative in communication Dyadic Communication Measure for Autism (DCMA) is used to rate parent synchrony and responsiveness to the child, child communicative initiations, responses and communicative functions, and amount of mutual shared attention between parent and child will be measured by the DCMA. DCMA is rated on a 12-minute videotaped parent-child play-session. Raters will be blinded to treatment allocation. At 6 month and end of intervention (12 months)
Other Parent implementation of strategy Caregivers' implementation of PACT strategies will be measured by the Measure of Naturalistic Developmental Behavioral Intervention Strategy Implementation - Caregiver Change (MONSI-CC) rated on a 12-minute videotaped parent-child play-session. Each of 21 items are rated between 1 (strategy was rarely implemented) and 5 (strategies were well-timed) and summed on different subscales. Raters will be blinded to treatment allocation. End of intervention (12 months)
Other Behavioural and emotional problems Child symptoms and problems are measured by the Child Behavior Checklist for ages 1½-5 (CBCL/1½-5). A 99 item questionnaire generating a Total problem Score (range 0-198). Higher score indicating more problems End of intervention (12 months)
Other Family life functioning Participant family life functioning will be measured by the Autism Family Experience Questionnaire (AFEQ). A parent-reported questionnaire with 48 items (range 48-240). High score indication low function. End of intervention (12 months)
Other Social impairment The presence and severity of social impairment will be measured by the Social Responsiveness Scale, 2nd Edition (SRS-2). A parent reported questionnaire with 65 items identifying the presence and severity of social impairment. Each item is scored on a 4 point Likert-scale: 1 ("not true"); 2 ("sometimes true); 3 (often true); and 4 ("almost always true"). Scores are obtained for five Treatment Subscales: Social Awareness; Social Cognition; Social Communication; Social Motivation; and Restricted Interests and Repetitive Behavior. Higher scores indicating more severe impairment. End of intervention (12 months)
Other Parental reflective functioning Parental reflective functioning will be measured by the Parental Reflective Functioning Questionnaire (PRFQ-1) with 18 items all rated on a 7-point scale with (7 if you strongly agree; and 1 if you strongly disagree. The midpoint, if you are neutral or undecided, is 4). High score indicate highly or hyper- reflective End of intervention (12 months)
Other Child attachment Parents' perception of their child's attachment is rated on the Maternal Perception of Child Attachment (MPCA). This parent-report measure consists of 23 items rated on a 5-point rating scale, ranging from frequently (1) to never (5). High scores indicate maternal perceptions of strong child attachment. End of intervention (12 months)
Other Adverse events Adverse events that occur during the study will be measured by the Negative Effects Questionnaire (NEQ). The NEQ questionnaire measures six factors; symptoms, quality, dependency, stigma, hopelessness, and failure. The self-report measure consists of three parts. First, respondents endorse specific items in case they have occurred or not during treatment, yes/no (1/0). Second, the respondents rate how negatively the negative effect was on four-point Likert-scale, ranging from "Not at all" to "Extremely" (0-4). Third, the respondents attribute the negative effect to "The treatment I received" yes/no (1/0). End of intervention (12 months)
Other Serious Adverse Events Serious Adverse Events (SAE) defined as any adverse event (AE) that results in death, is life-threatening, requires hospitalisation or prolongation of existing hospitalisation, or results in persistent or significant disability or incapacity is registered continuously through patient files End of intervention (12 months)
Other Cost-effectiveness The costs of delivering PACT combined with MAU compared to MAU alone will be estimated through cost-effectiveness analyses of intervention deliveries and parents' productivity loss End of intervention (12 months)
Other Parents' perceptions of the intervention Parents' perceptions of the intervention will be explored in a subsample of parents in each intervention group by qualitative interviews End of intervention (12 months)
Other Receptive language Child receptive language as measured by the Mullens Scales of Early Learning (MSEL). The MSEL consists of four cognitive scales: Visual Reception, Fine Motor, Receptive Language, Expressive Language, as well as a Gross Motor Scale, and can be administered to infants and children up to 5 years, 6 months of age. The MSEL receptive language raw scores will be used for the total study population in order to use the same instrument for all children, even when some of them may be older than the validated target group. End of intervention (12 months)
Other Language Child language as measured by the New Reynell Developmental Language Scale (NRDLS). The NRDLS covers a number of important aspects of language acquisition including vocabulary, sentence structure, verb morphology, inference, and grammaticality judgement. NRDLS is developed for children 2-7 years of age. The NRDLS raw scores will be used for the total study population in order to use the same instrument for all children, even when some of them may older than the validated target group at follow-up. End of intervention (12 months)
Primary Autism Symptoms Autism symptoms are measured by Diagnostic Observation schedule, 2nd Edition, Calibrated Severity Score (ADOS-2 CSS). Range 0-10, with 10 indicating the highest symptom severity. End of intervention (12 months)
Secondary Child adaptive functioning Child adaptive functioning, or personal and social skills needed for everyday living will be measured by the Vineland Adaptive Behavior Scales, 3rd Edition (VABS-3), an online questionnaire filled in by parents. Each of four domains, Communication, Daily Living Skills, Socialization and Motor Skills are divided into 3 sub-domains. Each item is scored on a Likert-type format with scores 0 (never), 1(sometimes), and 2 (usually or often). Individual items scores are summed to a raw composite score and converted into a standard scale scores. Higher scores indicate higher functioning. End of intervention (12 months)
Secondary Social interaction of the child Brief Observation of Social Communication Change (BOSCC) is rated on a 12-minute videotaped parent-child play-session. Each of the 15 behavioural items is coded using an empirically based decision tree that captures information regarding the behaviour including frequency and quality. Each item is rated on a 6- point scale from 0 (abnormality is not present) to 5 (abnormality is present and significantly impairs functioning). For measuring change only item 1-12 (range 0-60) are used. At 6 month and end of intervention (12 months)
Secondary Quality of Life (child) Parents' assessment of their child's quality of life with Pediatric Quality of Life Inventory (PEDSQL), a questionnaire including 23 items covering four dimensions of health related quality of life. Each item is rated between 0 and 100. A higher score indicates a higher level of health-related quality of life. The mean item score is used as outcome. End of intervention (12 months)
Secondary Quality of life (parents) Parent quality of life is measured by the questionnaire World Health Organization Quality of Life assessment- BREF (WHOQOL-BREF), including 28 items of quality of life for parents in 4 dimensions: Physiological, emotional, social and context. The item scores range from 1 to 5 with higher scores denoting higher quality of life. As the number of items differs for each subscale, the mean item score is used as outcome. End of intervention (12 months)
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