Autism Spectrum DisorderEYE-catcherNCT03467464
The Efficacy of EMDR in Youngsters With Autism
A study testing Eye Movement Desensitization and Reprocessing (EMDR) in people with Autism Spectrum Disorder, run by Karakter Kinder- en Jeugdpsychiatrie at 1 site in Netherlands.
Trial summary
Rationale: Currently, for youngsters there is no treatment available that directly targets the core symptoms of autism. EMDR is hypothesized to improve the core symptoms of ASD by reducing the generally high stress levels experienced during social interactions, and increasing the functional connectivity in neuronal… Read more about this study
- Who is it for?
- Ages 12 to 21 years
- Conditions the study is for
- Autism Spectrum Disorder
- What is being tested?
- Eye Movement Desensitization and Reprocessing (EMDR)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteNetherlands
- Study dates
- 1 Dec 2017to Dec 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 12 to 21 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Diagnosed with ASD (with or without comorbid psychiatric disorders, except PTSD and anxiety disorders)
- Full-scale IQ of 80 or more
- Able to understand and speak Dutch
Who cannot join
- Receiving other treatments than medication on a stable dosage.
- PTSD or other comorbid psychiatric disorders that require immediate and continuous treatment.
Trial locations and contacts
1 site in 1 country.
Aleksandra Berezowska, PhD contact
Netherlands1 site, 1 recruiting
- Recruiting
Karakter kinder- en jeugdpsychiatrie
Nijmegen, Gelderland, 6525 GC
Esther Leuning, Msc, 0031 621902722, e.leuning@karakter.com
Aleksandra Berezowska, PhD, a.berezowska@karakter.com
About this study
Official title: The Efficacy of EMDR in Youngsters With Autism: an Explorative Study
Rationale: Currently, for youngsters there is no treatment available that directly targets the core symptoms of autism. EMDR is hypothesized to improve the core symptoms of ASD by reducing the generally high stress levels experienced during social interactions, and increasing the functional connectivity in neuronal networks associated with executive functioning and limbic circuitry.
Objective: The primary objective of the study is to determine if EMDR reduces the core symptoms of ASD and daily experienced stress in youngsters diagnosed with ASD.
Read more
Study design: Longitudinal multiple single case studies. Study population: Youngsters aged 12-21 years who are diagnosed with ASD and have a full-scale IQ of 80 or more (N=20).
Intervention: 10 weekly EMDR sessions.
Main study parameters/endpoints: The main endpoint of the study are autism symptoms, which will be assessed using the Social Responsiveness Scale (SRS-A) and the Autism Diagnostic Observation Schedule (ADOS 2). The SRS-A will be administered prior, during and after treatment. The ADOS 2 will be administered prior to treatment and after treatment completion. In addition, we will also administer the Trauma Symptom Investigation Form in Autism Spectrum Disorders (TIF-ASD) questionnaire prior to, during, and after treatment. Furthermore, to answer more fundamental questions concerning the working mechanism of EMDR in ASD, other secondary outcome measures (i.e. PSS-10, AWMA-2) will be included.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Participants are expected to benefit from treatment. The risks associated with study participation are considered negligible and the burden associated with participation is estimated as low.
- Conditions
- Autism Spectrum Disorder
- Being tested
- Eye Movement Desensitization and Reprocessing (EMDR)
- Keywords
- Autism, EMDR; Children
- Medical subject headings
- Autism Spectrum Disorder, Autistic Disorder
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Eye Movement Desensitization and Reprocessing (EMDR)Other
The intervention consists of 10 weekly EMDR sessions of 60 minutes and targets stressful daily life (i.e. a situation that caused anger, fear or confusion) events rather than traumatic images from the past. For each session, a standardised EMDR protocol is used that consists of the following consecutive steps: 1) determining and visualising a confusing and/or stressful daily life event that occurred during the past week; 2) formulating a negative and a positive thought based on the chosen event; 3) determining the amount of stress that is evoked by the chosen event; 4) patient focuses on the chosen event while being presented with a distracting stimulus; 5) evaluating the amount of stress that is caused by the chosen event; 6) linking positive thoughts to the negative one when the stress caused by the chosen event does no longer exist; 7) evaluation and closure of session.
| Study group | Role | What they receive |
|---|---|---|
| Intervention | Experimental | EMDR treatment Receives: Other: Eye Movement Desensitization and Reprocessing (EMDR) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in autism symptoms
Change in autism symptoms is assessed with the SRS-A, which measures youngsters' ability to engage in reciprocal social behaviour in natural social settings, among all domains of autistic symptoms. The SRS-A consist of 5 subscales: 1) Social Awareness, 2) Social Cognition, 3) Social Communication 4) Social Motivation, and 5) Autistic Mannerisms. In total the five subscales comprise 65-items that are answered on a 4-point scale ranging from never true to almost always true. Completion of the questionnaire takes about 15 minutes. The SRS-A is completed by both parents and youngsters separately. Considering that SRS-A scores provided by youngsters are likely to be less reliable, the total score of the parents will serve as the primary outcome measure. In a secondary analysis, the total score of the youngsters will be used to determine the extent to which they perceive EMDR as an effective treatment.
Measured: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention
Change in autism symptoms
Using the Autism Diagnostic Observation Schedule 2 (ADOS 2) changes in autism symptoms prior to and after treatment will be assessed. The ADOS is administered by observing the youngster during a semi-structured observation schedule. With the ADOS, the clinician elicits social, communicative, stereotyped and play behavior to observe symptoms of ASD. Activities are performed with a 40 to 60 minutes protocol. Observations of the clinician are categorized and a score is assigned for each domain of ASD symptoms. Total scores on the ADOS are compared pre-treatment and post-treatment.
Measured: 3 weeks before intervention; 1 week after intervention
Change in autism symptoms
Using the Trauma Symptom Investigation Form in Autism Spectrum Disorders (TIF-ASD) changes in autism symptoms prior to, during, and after treatment will be assessed. The TIF-ASD assesses the impact of traumatic events on five core symptoms of autism: 1) social and (verbal) communication skills; 2) behavioral problems; 3) stereotypical \& ritualistic behaviors; 4) self-care skills; 5) vegetative symptoms. The total scale consists of 20 items which are completed by an observer (in our case the parents). Items are answered on a 5-point scale ranging from never to always. Completing all items takes about 5 minutes. The TIF-ASD is the only measurement, assessing the traumatic symptoms and behavioral aspects related to ASD due to traumatic events.
Measured: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention
Secondary outcomes (5)
Change in disease severity
Youngsters' disease severity and global improvement will be assessed with the Clinical Global Impression Scales (CGI). To assess severity and afterwards improvement, both pre- and post-treatment assessments will be conducted. Assessment are conducted by a clinician who observes a youngster for about 15 minutes while interacting with others. Based on one's past experience with similar patients, the CGI-S enables a clinician to rate the severity of a patient's illness. Severity is assessed on a 7-point scale ranging from not at all ill to extremely ill. Opposed to the CGI-S, the CGI-I enables a clinician to assess the extent to which the severity of a patient's illness has improved or worsened relative to the baseline assessment. Improvement is assessed on a 7-point scale ranging from very much improved to very much worsened.
Measured: 3 weeks before intervention; 1 and 12 weeks after intervention
Change in experienced stress
Experienced stress will be measured by the Perceived Stress Scale-10 (PSS-10) that assess the degree to which individuals find their lives unpredictable, uncontrollable, and overloading. The 10 items are answered on a 5-point scale ranging from never to very often. Completion time is about 3 minutes.
Measured: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention
Change in general well-being
General well-being will be measured with the Quality of Life - Questionnaire (QoL-Q). This questionnaire consist of four subscales: satisfaction, competence or productivity, empowerment or independence, and social belonging or community integration, which result in an overall quality of life score. Each subscale contains 10 items, scored on a 3-point scale ranging from not satisfied to very satisfied. Higher scores indicate higher subjective quality of life. Completion time is about 5 minutes.
Measured: 3 weeks before intervention; 1 and 12 weeks after intervention
Change in working memory capacity
Working memory capacity is assessed using the letters mix task of the Alloway Working Memory Assessment (AWMA-2). The task is administered before and after treatment completion. The completion of these task takes about 10 minutes.
Measured: 3 weeks before intervention; 1 week after intervention
Change in working memory capacity
Working memory capacity is assessed using the turning figures task of the Alloway Working Memory Assessment (AWMA-2). The task is administered before and after treatment completion. The completion of these task takes about 10 minutes.
Measured: 3 weeks before intervention; 1 week after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Mar 2018
- Study start1 Dec 2017
- Primary completionDec 2018 (estimated)
- Study completionDec 2018 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Autism Spectrum DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 20 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Karakter Kinder- en Jeugdpsychiatrie
- Sponsor type
- University, hospital or other
- Collaborators
- Fonds Psychische Gezondheid
- Responsible party
- Sponsor
- Investigators
- Martine Van Dongen-Boomsma, PhD, Principal investigator, Karakter Child and Adolescent Psychiatry University Centre
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03467464
- Sponsor's protocol ID
- NL6002609116
- Acronym
- EYE-catcher
- Status last verified
- Oct 2017
- First submitted
- 6 Oct 2017
- Last updated
- 16 Mar 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Mar 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Efficacy of EMDR in Youngsters With Autism: an Explorative Study
- ClinicalTrials.gov ID
- NCT03467464
- Acronym / sponsor ID
- EYE-catcher / NL6002609116
- Conditions
- Autism Spectrum Disorder
- Keywords
- Autism, EMDR; Children
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 20 participants (estimated)
- Lead sponsor
- Karakter Kinder- en JeugdpsychiatrieUniversity, hospital or other
- Collaborators
- Fonds Psychische Gezondheid
- Study start
- 1 Dec 2017 (actual)
- Primary completion
- Dec 2018 (estimated)
- Study completion
- Dec 2018 (estimated)
- First posted
- 16 Mar 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Rationale: Currently, for youngsters there is no treatment available that directly targets the core symptoms of autism. EMDR is hypothesized to improve the core symptoms of ASD by reducing the generally high stress levels experienced during social interactions, and increasing the functional connectivity in neuronal networks associated with executive functioning and limbic circuitry.
Objective: The primary objective of the study is to determine if EMDR reduces the core symptoms of ASD and daily experienced stress in youngsters diagnosed with ASD.
Study design: Longitudinal multiple single case studies. Study population: Youngsters aged 12-21 years who are diagnosed with ASD and have a full-scale IQ of 80 or more (N=20).
Intervention: 10 weekly EMDR sessions.
Main study parameters/endpoints: The main endpoint of the study are autism symptoms, which will be assessed using the Social Responsiveness Scale (SRS-A) and the Autism Diagnostic Observation Schedule (ADOS 2). The SRS-A will be administered prior, during and after treatment. The ADOS 2 will be administered prior to treatment and after treatment completion. In addition, we will also administer the Trauma Symptom Investigation Form in Autism Spectrum Disorders (TIF-ASD) questionnaire prior to, during, and after treatment. Furthermore, to answer more fundamental questions concerning the working mechanism of EMDR in ASD, other secondary outcome measures (i.e. PSS-10, AWMA-2) will be included.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Participants are expected to benefit from treatment. The risks associated with study participation are considered negligible and the burden associated with participation is estimated as low.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Intervention | Experimental | Other: Eye Movement Desensitization and Reprocessing (EMDR)EMDR treatment |
Who may qualify
- Ages
- 12 to 21 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (3 listed)
- Diagnosed with ASD (with or without comorbid psychiatric disorders, except PTSD and anxiety disorders)
- Full-scale IQ of 80 or more
- Able to understand and speak Dutch
Key exclusion criteria (2 listed)
- Receiving other treatments than medication on a stable dosage.
- PTSD or other comorbid psychiatric disorders that require immediate and continuous treatment.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Eye Movement Desensitization and Reprocessing (EMDR)The intervention consists of 10 weekly EMDR sessions of 60 minutes and targets stressful daily life (i.e. a situation that caused anger, fear or confusion) events rather than traumatic images from the past. For each session, a standardised EMDR protocol is used that consists of the following consecutive steps: 1) determining and visualising a confusing and/or stressful daily life event that occurred during the past week; 2) formulating a negative and a positive thought based on the chosen event; 3) determining the amount of stress that is evoked by the chosen event; 4) patient focuses on the chosen event while being presented with a distracting stimulus; 5) evaluating the amount of stress that is caused by the chosen event; 6) linking positive thoughts to the negative one when the stress caused by the chosen event does no longer exist; 7) evaluation and closure of session. | Other | Intervention |
Primary outcome
Change in autism symptoms
Time frame: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention
Change in autism symptoms is assessed with the SRS-A, which measures youngsters' ability to engage in reciprocal social behaviour in natural social settings, among all domains of autistic symptoms. The SRS-A consist of 5 subscales: 1) Social Awareness, 2) Social Cognition, 3) Social Communication 4) Social Motivation, and 5) Autistic Mannerisms. In total the five subscales comprise 65-items that are answered on a 4-point scale ranging from never true to almost always true. Completion of the questionnaire takes about 15 minutes. The SRS-A is completed by both parents and youngsters separately. Considering that SRS-A scores provided by youngsters are likely to be less reliable, the total score of the parents will serve as the primary outcome measure. In a secondary analysis, the total score of the youngsters will be used to determine the extent to which they perceive EMDR as an effective treatment.
Change in autism symptoms
Time frame: 3 weeks before intervention; 1 week after intervention
Using the Autism Diagnostic Observation Schedule 2 (ADOS 2) changes in autism symptoms prior to and after treatment will be assessed. The ADOS is administered by observing the youngster during a semi-structured observation schedule. With the ADOS, the clinician elicits social, communicative, stereotyped and play behavior to observe symptoms of ASD. Activities are performed with a 40 to 60 minutes protocol. Observations of the clinician are categorized and a score is assigned for each domain of ASD symptoms. Total scores on the ADOS are compared pre-treatment and post-treatment.
Change in autism symptoms
Time frame: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention
Using the Trauma Symptom Investigation Form in Autism Spectrum Disorders (TIF-ASD) changes in autism symptoms prior to, during, and after treatment will be assessed. The TIF-ASD assesses the impact of traumatic events on five core symptoms of autism: 1) social and (verbal) communication skills; 2) behavioral problems; 3) stereotypical \& ritualistic behaviors; 4) self-care skills; 5) vegetative symptoms. The total scale consists of 20 items which are completed by an observer (in our case the parents). Items are answered on a 5-point scale ranging from never to always. Completing all items takes about 5 minutes. The TIF-ASD is the only measurement, assessing the traumatic symptoms and behavioral aspects related to ASD due to traumatic events.
5 secondary outcomes
Change in disease severity
Time frame: 3 weeks before intervention; 1 and 12 weeks after intervention
Change in experienced stress
Time frame: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention
Change in general well-being
Time frame: 3 weeks before intervention; 1 and 12 weeks after intervention
Change in working memory capacity
Time frame: 3 weeks before intervention; 1 week after intervention
Change in working memory capacity
Time frame: 3 weeks before intervention; 1 week after intervention
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Mar 2018.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Aleksandra Berezowska, PhD contact
Martine Van Dongen-Boomsma, PhD principal investigator
Karakter Child and Adolescent Psychiatry University Centre
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Eye Movement Desensitization and Reprocessing (EMDR) in people with Autism Spectrum Disorder, run by Karakter Kinder- en Jeugdpsychiatrie at 1 site in Netherlands.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 16 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Esther Leuning, Msc (0031 621902722, e.leuning@karakter.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in autism symptoms (time frame: 0, 1, 2, 3 weeks before intervention; week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 of intervention; 1 and 12 weeks after intervention). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Mar 2018.