Abstract
BACKGROUND: Children with intellectual disability are at a higher risk of presenting with behaviours that challenge. Video Interaction Guidance (VIG) is a brief, personalised, strengths-based therapy that focuses on improving the parent-child relationship and interactions. A strong parent-child relationship may reduce the risk of behaviours that challenge. Access to support is difficult for families of children with intellectual disability. Remotely delivered support may enhance access to therapy for those who might otherwise struggle to access support. To date, no definitive effectiveness trial of VIG, or remotely delivered VIG, has been conducted, including in intellectual disability. METHODS: A feasibility randomised controlled trial (RCT) aimed to recruit 50 parents of a child with intellectual disability (aged 6-12) referred to specialist mental health services. Participants were randomised on a 1:1 basis to VIG plus treatment as usual (TAU) or just TAU. Measures were collected remotely at baseline, 3-month, and 6-month follow-up. A parallel economic study explored the feasibility of a future economic evaluation, while an embedded process evaluation explored feasibility and acceptability through qualitative interviews. A survey investigated TAU in specialist mental health services. A Parent Carer Advisory Group of 10 parents of children with intellectual disability worked with the research team on design, recruitment, data analysis and interpretation. RESULTS: Forty-four parents consented to participate in the study and 40 were randomised to the RCT. Of those, 75% remained in the study at 6-month follow-up, and 70% of the VIG-arm participants completed at least 3 cycles of VIG. At 6-month follow-up, between 83.3% and 100% of parent-completed questionnaires were completed, including the Developmental Behaviour Checklist (DBC2 at 86.7% completion rate). The acceptability of VIG was high among parents and practitioners. Parents identified few barriers to participation when VIG was delivered remotely. The cost of VIG was calculated at £153.35 per session and £306.70 per cycle. Video-feedback interventions are not typically part of TAU: just 15% of 66 specialist mental health services reported offering any video-feedback intervention to parents of children with intellectual disability. CONCLUSIONS: Findings supported the feasibility and acceptability of a definitive trial of remotely delivered VIG to parents of children with intellectual disability referred for support to specialist mental health services. Adaptations will be needed to enhance recruitment and align some of the study outcomes and processes more closely to parent preferences. TRIALS REGISTRATION: ISCTRN 13171328, Registration date 28 December 2022.