Results of a pilot randomized controlled trial of Tuning in to Kids for children with FASD in nonbiological parent care.

Background: Emotion regulation difficulties and placements with nonbiological parents are common in children with fetal alcohol spectrum disorders (FASD). We tested whether the Tuning in to Kids (TIK) intervention would improve emotion regulation in children with FASD living with nonbiological parents by targeting caregiver emotion socialization.

Method: A two-arm pilot randomized controlled trial of the 8-week, group-based TIK program was conducted from 8/2017 to 9/2021 (ClinicalTrials.gov #NCT03524664). Multimethod data collection occurred at baseline, post-intervention, and three-month follow-up. Eighty-nine children (ages 4-12) with FASD and their caregivers were enrolled, with 87 randomly assigned to study conditions (54 TIK, 33 waitlist control). At the onset of COVID-19, intervention delivery and data collection were transitioned to remote methods. Data were analyzed using multivariate regression.

Results: A total of 37 (68.5%) caregivers completed at least five TIK group sessions. Ratings of satisfaction and perceived impact of the program were high. Findings of exploratory analyses indicated that families with younger caregivers responded more favorably to TIK, as evidenced by improvements in both caregiver (p = 0.005) and child (p = 0.04) emotion regulation, and caregiver empathy (p = 0.008) and emotion coaching (p < 0.001) immediately post-intervention. No significant effects were found at three-month follow up (ps > 0.05).

Conclusions: The TIK program did not lead to significant improvement compared to waitlist controls overall in this sample. Findings suggest caregiver age is an important consideration in emotion coaching interventions in these settings.