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Oxytocin and Social Cognitive Skills Groups (ION-ASD)

Primary Purpose

Autism Spectrum Disorder

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oxytocin
Social Cognitive Skills Training
Facilitated Play Therapy
Sponsored by
Rush University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Autism Spectrum Disorder focused on measuring Autism Spectrum Disorder, Oxytocin, Social Skills, Social cognitive skills, Cognitive Behavioral Intervention, Combination treatment, Syntocinon, NETT (Nonverbal communication, Emotion recognition, Theory of mind Training), emotion recognition, theory of mind

Eligibility Criteria

8 Years - 11 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Male or female outpatients, 8-11 years of age inclusive
  2. Meet Diagnostic and Statistical Manual of Mental Disorders, 5th Edition for Autism Spectrum Disorder. DSM-V criteria will be established by a clinician with expertise with individuals with ASD. Best estimate Diagnosis will be reached using DSM-V criteria, the Autism Diagnostic Observation Schedule (ADOS-2) and the Autism Diagnostic Interview (ADI-R), or Autism Screening Interview.
  3. Mean score of 9 or less on mentalizing items of Strange Stories Test (Highest possible score = 12, items 21-25, 27).
  4. Have a Clinician's Global Impression-Severity (CGI-S) score ≥ 4 (moderately ill) at Baseline.
  5. Verbal and performance scale IQ ≥ 80 (both subtests of the WISC-V ≥ 70).
  6. If already receiving stable concomitant medications, have continuous participation during the preceding 30 days prior to Screening, and not electively initiate new or modify ongoing medications for the duration of the study. For serotonergic agents, 6 months on a stable dose is required.
  7. If already receiving stable non-pharmacologic educational, behavioral, and/or dietary interventions, have continuous participation during the preceding 3 months prior to Screening, and not electively initiate new or modify ongoing interventions for the duration of the study.
  8. Have normal physical examination and laboratory test results at Screening. If abnormal, the finding(s) must be deemed not clinically significant by the Treating Clinician.
  9. Ability to speak and understand English sufficiently to allow for the completion of all study assessments.
  10. Ability to obtain written assent from the participant as well as written informed consent from their parent(s)/legal guardian.

Exclusion Criteria

  1. Patients born prior to 35 weeks gestational age.
  2. Patients with a primary psychiatric diagnosis other than ASD.
  3. Patients with a medical history of neurological disease, including, but not limited to, epilepsy/seizure disorder (except simple febrile seizures), movement disorder, tuberous sclerosis, fragile X, and any other known genetic syndromes, or known abnormal brain MRI/structural lesion.
  4. Pregnant female patients, sexually active female patients on hormonal birth control and sexually active females who do not use at least two types of non-hormonal birth control.
  5. Patients with evidence or history of malignancy or any significant hematological, endocrine, cardiovascular (including any rhythm disorder), respiratory, renal, hepatic, or gastrointestinal disease.
  6. Patients with one or more of the following: hemophilia (bleeding problems, recent nose and brain injuries), abnormal blood pressure (hypotension or hypertension), drug abuse, immunity disorder or severe depression.
  7. Patients who are currently taking OXT or have taken IN-OXT in the past with no response.
  8. Patients who have an Aberrant Behavior Checklist (ABC) Irritability subscale score > 19 at screening
  9. Patients with sensitivity to OXT or any components of its formulation.
  10. Patients unable to tolerate venipuncture procedures for blood sampling.
  11. Patients in foster care for whom the state is defined as a legal guardian.
  12. If they have an arrhythmia present on ECG, that upon consultation with a cardiologist, is deemed to be clinically significant.
  13. Patients with any of the following clinical lab results

    1. ALT/AST levels of ≥ 5 times the upper limit of normal, or if clinical jaundice occurs
    2. Sodium levels of > 152 mmol/L or < 128 mmol/L
    3. Potassium levels of > 6 mmol/L in a non-hemolyzed sample
    4. Glucose levels of > 11 mmol/L or < 2.8 mmol/L
    5. Hemoglobin levels of < 100 g/L
    6. BUN levels of > 100 mmol/L
    7. Creatinine levels of > 100 µmol/L
    8. Osmolality levels of > 330 mmol/kg

Sites / Locations

  • Rush University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

ION-ASD

Facilitated Play

Arm Description

ION-ASD integrates targeted dosing of intranasal oxytocin and social cognitive skills group training curriculum, Seaver-NETT (Nonverbal communication, Emotion recognition, Theory of mind Training).

The active comparison condition is a facilitated play therapy group.

Outcomes

Primary Outcome Measures

Change from Baseline in Social Behavior Composite
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Children's Communication Checklist (CCC) and the Griffith Empathy Scale.
Change from Baseline in Social Behavior Composite
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Children's Communication Checklist (CCC) and the Griffith Empathy Scale.
Change from Baseline in Social Behavior Composite
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Children's Communication Checklist (CCC) and the Griffith Empathy Scale.
Change from Baseline in Social Cognition Composite
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Reading Mind in the Eyes Test (RMET) and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2)
Change from Baseline in Social Cognition Composite
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Reading Mind in the Eyes Test (RMET) and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2)
Change from Baseline in Social Cognition Composite
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Reading Mind in the Eyes Test (RMET) and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2)

Secondary Outcome Measures

Change from Baseline in Global Functioning
Global Functioning will be assessed using the Clinical Global Impressions-Improvement Scale. The CGI-I employs a seven point (1 = very much improved to 7 = very much worse) to determine the patient's improvement in response to treatment.
Change from Baseline in Global Functioning
Global Functioning will be assessed using the Clinical Global Impressions-Improvement Scale. The CGI-I employs a seven point (1 = very much improved to 7 = very much worse) to determine the patient's improvement in response to treatment.
Change from Baseline in Global Functioning
Global Functioning will be assessed using the Clinical Global Impressions-Improvement Scale. The CGI-I employs a seven point (1 = very much improved to 7 = very much worse) to determine the patient's improvement in response to treatment.
Change from Baseline in Social Functioning
Social Functioning will be assessed using the Social Responsiveness Scale
Change from Baseline in Social Functioning
Social Functioning will be assessed using the Social Responsiveness Scale
Change from Baseline in Social Functioning
Social Functioning will be assessed using the Social Responsiveness Scale
Change from Baseline in Quality of Life
Quality of Life will be assessed using the Caregiver Strain Questionnaire
Change from Baseline in Quality of Life
Quality of Life will be assessed using the Caregiver Strain Questionnaire
Change from Baseline in Quality of Life
Quality of Life will be assessed using the Caregiver Strain Questionnaire

Full Information

First Posted
September 9, 2016
Last Updated
October 16, 2023
Sponsor
Rush University Medical Center
Collaborators
University of Illinois at Chicago, University of Chicago, Northwestern University, Eotvos Lorand University
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1. Study Identification

Unique Protocol Identification Number
NCT02918864
Brief Title
Oxytocin and Social Cognitive Skills Groups
Acronym
ION-ASD
Official Title
Integrated Oxytocin and Nonverbal, Emotion Recognition, and Theory of Mind Training for Children With Autism Spectrum Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
June 15, 2016 (Actual)
Primary Completion Date
September 2021 (Actual)
Study Completion Date
September 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Rush University Medical Center
Collaborators
University of Illinois at Chicago, University of Chicago, Northwestern University, Eotvos Lorand University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the feasibility, safety, and preliminary efficacy of integrating targeted dosing of intranasal oxytocin with a social cognitive skills group therapy for school-aged children with autism spectrum disorder (ASD).
Detailed Description
The study is a proof-of-concept, combination intervention designed to address individual treatment targets presumed to influence social learning in school-aged children with autism spectrum disorder (ASD). This proposal builds upon prior research on an empirically supported social cognitive skills training curriculum, NETT (Nonverbal communication, Emotion recognition, and Theory of mind Training). NETT is a cognitive-behavioral intervention (CBI) for nonverbal communication, emotion recognition, and theory of mind deficits in youth with ASD. In this two-phase, 3 year, single-blind, contact controlled study, school-aged children with ASD (n=60) will be randomized into a 12-session, parallel group design of Integrated Oxytocin and NETT (ION) or a control social group condition (facilitated play). The study aims to evaluate the safety, tolerability, and efficacy of integrating the neuropeptide, oxytocin (OT), with the social cognitive curriculum, as well as to identify targets of change and pre-treatment factors predictive of response to ION-ASD. Maintenance of treatment effects will also be assessed 1 month and 3 months post-treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autism Spectrum Disorder
Keywords
Autism Spectrum Disorder, Oxytocin, Social Skills, Social cognitive skills, Cognitive Behavioral Intervention, Combination treatment, Syntocinon, NETT (Nonverbal communication, Emotion recognition, Theory of mind Training), emotion recognition, theory of mind

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
83 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ION-ASD
Arm Type
Experimental
Arm Description
ION-ASD integrates targeted dosing of intranasal oxytocin and social cognitive skills group training curriculum, Seaver-NETT (Nonverbal communication, Emotion recognition, Theory of mind Training).
Arm Title
Facilitated Play
Arm Type
Active Comparator
Arm Description
The active comparison condition is a facilitated play therapy group.
Intervention Type
Drug
Intervention Name(s)
Oxytocin
Intervention Description
This is an integrated pharmacological-behavioral intervention targeting social cognitive skills for school-aged children with ASD. Four doses of intranasal oxytocin (24 IUs/dose) will be delivered each week before weekly homework and group therapy sessions.
Intervention Type
Behavioral
Intervention Name(s)
Social Cognitive Skills Training
Intervention Description
Social cognitive skills training utilize cognitive behavioral strategies such as problem identification, affective education, performance feedback, and weekly homework activities to target impairments in nonverbal synchrony, emotional expression, and interpretation of intent. The NETT curriculum is manualized and anchored in CBI strategies, such as problem identification, affective education, performance feedback, and weekly homework activities. Parent education sessions run concurrently with child groups to help facilitate generalization.
Intervention Type
Behavioral
Intervention Name(s)
Facilitated Play Therapy
Intervention Description
The facilitated play therapy group is a manualized treatment designed to tailor play to the interests and abilities of group members. Therapists use general therapeutics strategies such as reflective functioning statements to foster communication with therapists as well as between peers. Standard educational practices for children with ASD such as visual supports, schedules, and short-directed statements are also used. The concurrent parent group is supportive in nature.
Primary Outcome Measure Information:
Title
Change from Baseline in Social Behavior Composite
Description
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Children's Communication Checklist (CCC) and the Griffith Empathy Scale.
Time Frame
Week 12 (Endpoint)
Title
Change from Baseline in Social Behavior Composite
Description
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Children's Communication Checklist (CCC) and the Griffith Empathy Scale.
Time Frame
Week 16 (follow-up)
Title
Change from Baseline in Social Behavior Composite
Description
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Children's Communication Checklist (CCC) and the Griffith Empathy Scale.
Time Frame
Week 24 (follow-up)
Title
Change from Baseline in Social Cognition Composite
Description
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Reading Mind in the Eyes Test (RMET) and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2)
Time Frame
Week 12 (Endpoint)
Title
Change from Baseline in Social Cognition Composite
Description
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Reading Mind in the Eyes Test (RMET) and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2)
Time Frame
Week 16 (follow-up)
Title
Change from Baseline in Social Cognition Composite
Description
This domain will be measured by a composite score developed through a factor analysis of the following caregiver report measures: Reading Mind in the Eyes Test (RMET) and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA2)
Time Frame
Week 24 (follow-up)
Secondary Outcome Measure Information:
Title
Change from Baseline in Global Functioning
Description
Global Functioning will be assessed using the Clinical Global Impressions-Improvement Scale. The CGI-I employs a seven point (1 = very much improved to 7 = very much worse) to determine the patient's improvement in response to treatment.
Time Frame
Week 12 (Endpoint)
Title
Change from Baseline in Global Functioning
Description
Global Functioning will be assessed using the Clinical Global Impressions-Improvement Scale. The CGI-I employs a seven point (1 = very much improved to 7 = very much worse) to determine the patient's improvement in response to treatment.
Time Frame
Week 16 (follow-up)
Title
Change from Baseline in Global Functioning
Description
Global Functioning will be assessed using the Clinical Global Impressions-Improvement Scale. The CGI-I employs a seven point (1 = very much improved to 7 = very much worse) to determine the patient's improvement in response to treatment.
Time Frame
Week 24 (follow-up)
Title
Change from Baseline in Social Functioning
Description
Social Functioning will be assessed using the Social Responsiveness Scale
Time Frame
Week 12 (Endpoint)
Title
Change from Baseline in Social Functioning
Description
Social Functioning will be assessed using the Social Responsiveness Scale
Time Frame
Week 16 (follow-up)
Title
Change from Baseline in Social Functioning
Description
Social Functioning will be assessed using the Social Responsiveness Scale
Time Frame
Week 24 (follow-up)
Title
Change from Baseline in Quality of Life
Description
Quality of Life will be assessed using the Caregiver Strain Questionnaire
Time Frame
Week 12 (Endpoint)
Title
Change from Baseline in Quality of Life
Description
Quality of Life will be assessed using the Caregiver Strain Questionnaire
Time Frame
Week 16 (follow-up)
Title
Change from Baseline in Quality of Life
Description
Quality of Life will be assessed using the Caregiver Strain Questionnaire
Time Frame
Week 24 (follow-up)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
8 Years
Maximum Age & Unit of Time
11 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Male or female outpatients, 8-11 years of age inclusive Meet Diagnostic and Statistical Manual of Mental Disorders, 5th Edition for Autism Spectrum Disorder. DSM-V criteria will be established by a clinician with expertise with individuals with ASD. Best estimate Diagnosis will be reached using DSM-V criteria, the Autism Diagnostic Observation Schedule (ADOS-2) and the Autism Diagnostic Interview (ADI-R), or Autism Screening Interview. Mean score of 9 or less on mentalizing items of Strange Stories Test (Highest possible score = 12, items 21-25, 27). Have a Clinician's Global Impression-Severity (CGI-S) score ≥ 4 (moderately ill) at Baseline. Verbal and performance scale IQ ≥ 80 (both subtests of the WISC-V ≥ 70). If already receiving stable concomitant medications, have continuous participation during the preceding 30 days prior to Screening, and not electively initiate new or modify ongoing medications for the duration of the study. For serotonergic agents, 6 months on a stable dose is required. If already receiving stable non-pharmacologic educational, behavioral, and/or dietary interventions, have continuous participation during the preceding 3 months prior to Screening, and not electively initiate new or modify ongoing interventions for the duration of the study. Have normal physical examination and laboratory test results at Screening. If abnormal, the finding(s) must be deemed not clinically significant by the Treating Clinician. Ability to speak and understand English sufficiently to allow for the completion of all study assessments. Ability to obtain written assent from the participant as well as written informed consent from their parent(s)/legal guardian. Exclusion Criteria Patients born prior to 35 weeks gestational age. Patients with a primary psychiatric diagnosis other than ASD. Patients with a medical history of neurological disease, including, but not limited to, epilepsy/seizure disorder (except simple febrile seizures), movement disorder, tuberous sclerosis, fragile X, and any other known genetic syndromes, or known abnormal brain MRI/structural lesion. Pregnant female patients, sexually active female patients on hormonal birth control and sexually active females who do not use at least two types of non-hormonal birth control. Patients with evidence or history of malignancy or any significant hematological, endocrine, cardiovascular (including any rhythm disorder), respiratory, renal, hepatic, or gastrointestinal disease. Patients with one or more of the following: hemophilia (bleeding problems, recent nose and brain injuries), abnormal blood pressure (hypotension or hypertension), drug abuse, immunity disorder or severe depression. Patients who are currently taking OXT or have taken IN-OXT in the past with no response. Patients who have an Aberrant Behavior Checklist (ABC) Irritability subscale score > 19 at screening Patients with sensitivity to OXT or any components of its formulation. Patients unable to tolerate venipuncture procedures for blood sampling. Patients in foster care for whom the state is defined as a legal guardian. If they have an arrhythmia present on ECG, that upon consultation with a cardiologist, is deemed to be clinically significant. Patients with any of the following clinical lab results ALT/AST levels of ≥ 5 times the upper limit of normal, or if clinical jaundice occurs Sodium levels of > 152 mmol/L or < 128 mmol/L Potassium levels of > 6 mmol/L in a non-hemolyzed sample Glucose levels of > 11 mmol/L or < 2.8 mmol/L Hemoglobin levels of < 100 g/L BUN levels of > 100 mmol/L Creatinine levels of > 100 µmol/L Osmolality levels of > 330 mmol/kg
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Latha Soorya, PhD, BCBA
Organizational Affiliation
Rush University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Data from this study may be submitted to the National Database for Autism Research (NDAR), a computer system run by the National Institutes of Health that allows researchers studying autism to collect and share information. Data will be shared with study collaborators as well.

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Oxytocin and Social Cognitive Skills Groups

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