Autism Spectrum Disorder Clinical Trial
Official title:
Development and Validation of a Comprehensive Module for Management of Sleep Disorders in Children With Autism Spectrum Disorder Aged 4-10 Years: a Pre and Post Intervention Study
Sleep disorder in autism children is common and it affects the physical, behavior and mental health. There is lack of comprehensive management program/module to treat the sleep disorders in children with ASD. Limited studies evaluating the utility of actigraphy to diagnose sleep disorders in ASD and its validation with PSG are present. Rationale of this study is to develop the comprehensive module and validate it for children with autism spectrum disorders, so as to improve the behavioral outcomes as well. This study also helps to utilize actigraphy as a modality to diagnose sleep disorders in children with autism spectrum disorder as performing PSG in these children is cumbersome and difficult as ASD children tend to have sensory abnormalities.
Status | Not yet recruiting |
Enrollment | 25 |
Est. completion date | June 30, 2025 |
Est. primary completion date | June 30, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 4 Years to 10 Years |
Eligibility | Inclusion Criteria: 1. Children aged 4-10 years with diagnosis of ASD and ICSD based sleep disorder 2. At-least 6 months of behavioral therapy and follow-up at AIIMS Exclusion Criteria: 1. Refractory epilepsy 2. Secondary causes of ASD like Fragile-X Syndrome, Down Syndrome, Tuberous sclerosis 3. ASD with metabolic disorders |
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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All India Institute of Medical Sciences, New Delhi |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Development of comprehensive module for management of sleep disorders in autism spectrum disorders | The comprehensive module will be developed for management of sleep disorders. The proposed components in the module are Behavioral intervention like modifying stimulus by change in location of sleep onset,Giving schedule activities which interfere with sleep before bedtime,Using a bedtime pass which allows children to make a predetermined number of requests for parental attention while in bed,Giving sleep items,Delaying the bedtime,Sleep hygiene by providing suitable environment for child to sleep, providing proper bedtime routine , sleep wake schedules,Providing rewards as positive reinforcement.Pharmacological intervention to treat them accordingly as per standard protocol available,The components of the module will be decided based on Delphi method. Experts opinion will be taken and comprehensive module will be developed accordingly. | 3 months from onset of study | |
Primary | To validate the above module in children of ASD with sleep disorders by measuring change in Children's Sleep Habits Questionnaire(CSHQ) score pre and post intervention. | The CSHQ is a parent-rated questionnaire comprised of 45 items; 33 scored questions, and 7 additional items intended to provide other relevant information pertaining to sleep behavior (e.g., nocturnal body pains) Each scored question is rated on a 3-point scale as occurring "usually" (i.e., 5-7 times within the past week), "sometimes" (i.e., 2-4 times within the past week), or "rarely" (i.e., never or 1 time within the past week).
A number of items on the questionnaire are reverse-scored, so that higher scores consistently indicate problem behaviors. Ratings are combined to form eight subscales: Bedtime Resistance, Sleep Onset Delay, Sleep Duration, Sleep Anxiety, Night Wakings, Parasomnias, Sleep Disordered Breathing, and Daytime Sleepiness. A Total Sleep Disturbances score is calculated as the sum of all CSHQ scored questions, and can range from 33 to 99. |
From baseline to 6 months | |
Primary | To validate the above module in children of ASD with sleep disorders by comparing sleep efficiency | Change in sleep efficiency (%) as measured by PSG and actigraphy pre and post intervention. | From baseline to 6 months | |
Primary | To validate the above module in children of ASD with sleep disorders by comparing change in sleep onset latency | Change in sleep onset latency(time duration)as measured by PSG and actigraphy pre and post intervention. | From baseline to 6 months | |
Secondary | To evaluate the agreement of actigraphy with polysomnography in sleep efficiency for evaluation of sleep disorders in children with autism spectrum disorder | Agreement between PSG and actigraphy in sleep efficiency (%) using Intraclass Correlation Coefficient and Lin's Concordance Correlation Coefficient Agreement between PSG and actigraphy in sleep efficiency (%) and sleep onset latency(duration) using Intraclass Correlation Coefficient and Lin's Concordance Correlation Coefficient | 6 months | |
Secondary | Change in autism severity using ATEC (Autism treatment evaluation checklist) score | Change in scores of ATEC (Autism treatment evaluation checklist) pre and post intervention ATEC is comprised of four subscales: (1) Speech/Language/Communication, (2) Sociability, (3) Sensory/Cognitive Awareness, and (4) Health/Physical/Behavior. These four subscales are used to calculate a total score that ranges from 0 to 179. A lower score indicates less severe symptoms of (Autism Spectrum Disorder)ASD and a higher score correlates with more severe symptoms of ASD. | 6 months | |
Secondary | To evaluate the agreement of actigraphy with polysomnography in determining sleep onset latency duration for evaluation of sleep disorders in children with autism spectrum disorder | Agreement between PSG and actigraphy in sleep onset latency (duration )using Intraclass Correlation Coefficient and Lin's Concordance Correlation Coefficient | 6 months | |
Secondary | Change in autism severity using CBCL (child behavior checklist) behavioral scales. | Change in scores of CBCL (child behavior checklist) pre and post intervention. CBCL is used for determining the behavioral comorbidities. The CBCL assesses behavior in 11 domains and there are two sets of questionnaires, one for 1.5 to 5 years of age and another for 6 to 18 years of age which is separate for boys and girls.The T- score of less than 65 is normal,65-70 is borderline t score, more than 70 is clinical range. | 6 months | |
Secondary | Change in autism severity using CARS-2(childhood autism rating scale -2). | Change in CARS-2(childhood autism rating scale -2) score pre and post intervention.
CARS is done to estimate the severity of autism. It is different for high functioning children (IQ >80, age >6 years with fluent speech) , with scores of 15-27.5 being minimal ; 28-33.5 mild to moderate; and more than 34 is severe. For other children (age <6 years, without fluent speech) score of 15-29.5; 15-27.5(age for 13+,IQ<80) is minimal, 30-36.5 (age <6 years, without fluent speech) ;28-34.5(age for 13+,IQ<80) is mild to moderate and and (age <6 years, without fluent speech) score of 37 and higher , score of 35 and higher (age for 13+,IQ<80) shows severe symptoms of Autism Spectrum Disorder.The CARS is a 15-item scale used to grade the severity of autism in 14 behavioral domains. |
6 months | |
Secondary | Change in autism severity using Development Profile 3 (DP3) | Change in Development Profile 3 (DP3) score pre and post intervention. The DP3 assesses DQ/IQ in 5 domains (Physical behavior, Adaptive Behavior, Cognition, Social Emotional and Communication) by parental reporting as well as direct observation. | 6 months | |
Secondary | Change in autism severity using sensory profile. | Change in sensory profile score pre and post intervention. Sensory profile include Tactile (touch),Gustatory (taste),Olfactory (smell),Visual (sight),Auditory (hearing),Proprioceptive (body awareness),Vestibular (movement/balance).Child will be assesed in the above mentioned components and score will be given accordingly. Maximum score of 190 is given. | 6 months | |
Secondary | Change in autism severity using Autism Behaviour Checklist (ABC) score | Change in Autism Behaviour Checklist (ABC) score pre and post intervention. The ABC is a 57-item behavior rating scale assessing the behaviors and symptoms of autism for children 3 and older. The instrument consists of a list of 57 questions divided into five categories: (1) sensory, (2) relating, (3) body and object use, (4) language, and (5) social and self-help. Each item has a weighted score ranging from 1 to 4. | 6 months |
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