Abstract
BackgroundFetal alcohol spectrum disorder (FASD) is a term used to encompass the full range of neurobehavioral and cognitive dysfunction that may occur as a consequence of prenatal alcohol exposure. There is relatively little research on intervention strategies that specifically target the behavioral problems of children with FASD. Availability and access to services are barriers to timely and effective care for families. The Strongest Families FASD intervention was recently adapted from the Strongest Families “Parenting the Active Child” program to include FASD-specific content delivered via an Internet-based application in conjunction with 11 telephone coaching sessions.ObjectiveOur objectives are to (1) evaluate the effectiveness of Strongest Families FASD in reducing externalizing problems (primary outcome), internalizing problems, and parent distress (secondary outcomes) in children aged between 4 and 12 years diagnosed with FASD when compared to a control group with access to a static resource Web page; (2) evaluate the effectiveness of Strongest Families FASD in improving social competence (secondary outcome) in school-aged children aged between 6 and 12 diagnosed with FASD when compared with an online psychoeducation control; and (3) explore parental satisfaction with the Strongest Families FASD online parenting program.MethodsParents and caregivers (N=200) of children diagnosed with FASD who have significant behavioral challenges, ages 4-12, are being recruited into a 2-arm randomized trial. The trial is designed to evaluate the effectiveness of the Web-based Strongest Families FASD parenting intervention on child behavior and caregiver distress, compared to a control group receiving access to a static resource Web page (ie, a list of FASD-specific websites, readings, videos, and organizations).ResultsThe primary outcome will be externalizing problems measured by the Child Behavior Checklist (CBCL). Secondary outcomes include (1) internalizing problems and (2) social competence, both measured by the CBCL; and (3) parental distress measured by the Depression Anxiety Stress Scale-21. The Client Satisfaction Questionnaire-8 (CSQ-8) and the Satisfaction Survey are completed by the intervention group at the end of session 11. Results will be reported using the standards set out in the Consolidated Standards of Reporting Trials (CONSORT) Statement.ConclusionsIt is hypothesized that the Strongest Families FASD intervention group will improve child behavior and parental distress. Caregiver satisfaction is anticipated to be positive. Advancing evidence on the effectiveness and acceptance of distance services can inform policy and adoption of eHealth programs.ClinicalTrialClinicalTrials.gov NCT02210455; https://clinicaltrials.gov/ct2/show/NCT02210455 (Archived by WebCite at http://www.webcitation.org/6bbW5BSsT)
Highlights
Prenatal alcohol exposure is the leading known cause of developmental disability in Canada and is the most prevalent preventable cause of congenital neurobehavioral dysfunction in the Western world [1]
Secondary outcomes include (1) internalizing problems and (2) social competence, both measured by the Child Behavior Checklist (CBCL); and (3) parental distress measured by the Depression Anxiety Stress Scale-21
It is hypothesized that the Strongest Families Fetal alcohol spectrum disorder (FASD) intervention group will improve child behavior and parental distress
Summary
Prenatal alcohol (ethanol) exposure is the leading known cause of developmental disability in Canada and is the most prevalent preventable cause of congenital neurobehavioral dysfunction in the Western world [1]. The term fetal alcohol syndrome (FAS) was introduced over 40 years ago [3,4,5] as a diagnosis for children who exhibit the triad of central nervous system (CNS) dysfunction, growth deficiency, and characteristic craniofacial dysmorphology resulting from maternal consumption of alcohol during pregnancy. Of these features, it is the CNS injury that is most debilitating and can manifest as intellectual, neurological, and behavioral abnormalities. The Strongest Families FASD intervention was recently adapted from the Strongest Families “Parenting the Active Child” program to include FASD-specific content delivered via an Internet-based application in conjunction with 11 telephone coaching sessions
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