Title

Oxytocin and Social Cognitive Skills Groups
Integrated Oxytocin and Nonverbal, Emotion Recognition, and Theory of Mind Training for Children With Autism Spectrum Disorder
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Status

    Completed No Results Posted
  • Intervention/Treatment

    oxytocin ...
  • Study Participants

    83
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).
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.
Study Started
Jun 15
2016
Primary Completion
Sep 30
2021
Study Completion
Sep 30
2021
Last Update
Oct 18
2023

Drug Oxytocin

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.

Behavioral Social Cognitive Skills Training

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.

Behavioral Facilitated Play Therapy

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.

ION-ASD Experimental

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).

Facilitated Play Active Comparator

The active comparison condition is a facilitated play therapy group.

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
No Results Posted