GoFAR

Parents and children ages 4 to 9 years old with fetal alcohol spectrum disorders (FASD) whom have problems with self-regulation and adaptive functioning

GoFAR is a manualized intervention program for parents and children ages 4 to 9 years old with fetal alcohol spectrum disorders (FASD) whom have problems with self-regulation and adaptive functioning. GoFAR aims to improve self-regulation, reduce disruptive behavior, and improve adaptive functioning in the home. The GoFAR program focuses on disorders of affective and cognitive control that are central to behavioral and adaptive disorders from infancy through young adulthood. By school age, such problems often present as attentional problems, deficits in executive functioning, and disorders in conduct and behavior. GoFAR addresses these problems in young children by bringing together computer game technology and behavioral techniques for affective and cognitive control. The methodology is based on previous work that suggests that a metacognitive technique (FAR: – Focus/Plan,– Act, – Reflect) is helpful in improving behavioral and educational outcomes in FASD. An important element is the GoFAR computer game, which supports the understanding and development of metacognitive control techniques and reinforces its use by clinically referred children, ages 5 to 10 years old. The game is incorporated into a 10-week, manualized intervention program, which focuses on improving adaptive functioning and behavior.

Claire D. Coles

• Title: PhD
• Website: http://msacd.emory.edu/Research/GOFAR.html
• Email: ccoles@emory.edu

Homework

This program does not include a homework component.

Languages

GoFAR has materials available in the following languages other than English:

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed in this page).

Publicly available information indicates there is some training available for this program. See contact info.

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for GoFAR.

Formal Support for Implementation

There is no formal support available for implementation of GoFAR.

Fidelity Measures

There are no fidelity measures for GoFAR.

Established Psychometrics

There are no established psychometrics for GoFAR.

Fidelity Measures Required

No fidelity measures are required for GoFAR.

Implementation Guides or Manuals

There are no implementation guides or manuals for GoFAR.

Implementation Cost

There are no studies of the costs of GoFAR.

Research on How to Implement the Program

Research has not been conducted on how to implement GoFAR.

Child Welfare Outcome: Child/Family Well-Being

"What is included in the Relevant Published, Peer-Reviewed Research section?"

• Coles, C. D., Kable, J. A., Taddeo, E., Strickland, D. C. (2015). A metacognitive strategy for reducing disruptive behavior in children with fetal alcohol spectrum disorders: GoFAR pilot. Alcoholism: Clinical and Experimental Research, 39(11), 2224–2233.https://doi.org/10.1111/acer.12885

  Type of Study: Randomized controlled trial

  Number of participants: 30

  Population:

  • Age — 5–10 years
  • Race/Ethnicity — 46% Caucasian, 30% African American, and 24% Mixed
  • Gender — 60% Male
  • Status — Participants were families with children with fetal alcohol spectrum disorders reported to have disruptive behavior problems. In addition, they were recruited while applying for clinical services at a pediatric neurodevelopmental exposure clinic.

  Location/Institution: Not specified

  Summary:

  The purpose of the study was to examine the relative effectiveness of adding presentation through the GoFAR game to the child to presentation of the GoFAR technique to parents during individual therapy sessions in modifying children's disruptive behavior. The intervention has 3 components: (i) GoFAR: a 'serious game' designed to teach a metacognitive control strategy in a computer game environment; (ii) parent training on child behavioral regulation; and (iii) Behavior Analog Therapy (BAT) sessions, a practical application of the metacognitive learning methodology by parent and child in the context of learning adaptive skills. The learning strategy (FAR) teaches the child to Focus and make a plan, Act out the plan, and Reflect back on the plan. Participants were randomized to 3 groups: (i) GoFAR; (ii) FACELAND; or (iii) Control. The intervention groups, GoFAR and FACELAND, used computer games to instruct children. Both groups also received 5 sessions of parent training followed by 5 sessions of joint parent/child therapy (BAT). Assessment of disruptive behavior, including frequency of temper tantrums, frustration tolerance, impulsivity, destructiveness, aggression, and maintaining attention were carried out before enrollment at midtreatment, when game play and parent training were completed, and finally, after completing the BAT sessions. Measures utilized include the Disruptive Behavior Record Form and the Differential Ability Scales, 2nd Edition (DAS). Results indicate that parental reports of disruptive behavior overall were significantly reduced in the GoFAR group after the first components, game play, and parent training; after the BAT sessions in the FACELAND group; and with no changes in the Control group over time. Limitations include small sample size, lack of generalizability to other populations, reliance on self-report measures, and lack of follow-up.

  Length of controlled postintervention follow-up: None.

• Coles, C. D., Kable, J. A., Taddeo, E., & Strickland, D. A. (2018). GoFAR: Improving attention, behavior, and adaptive functioning in children with fetal alcohol spectrum disorders (FASD): Brief report. Developmental Neurorehabilitation, 21(5), 345–349. https://doi.org/10.1080/17518423.2018.1424263

  Type of Study: Randomized controlled trial

  Number of participants: 30

  Population:

  • Age — Children: 5–10 years; Caregivers: 49.6–51.5 years
  • Race/Ethnicity — Children: 46% Caucasian, 30% African American, and 24% Mixed; Caregivers: Not specified
  • Gender — Children: 60% Male; Caregivers: 90% Female
  • Status — Participants were families with children with fetal alcohol spectrum disorders reported to have disruptive behavior problems. In addition, participants were recruited from families applying for clinical services at a pediatric neurodevelopmental exposure clinic.

  Location/Institution: Not specified

  Summary:

  The study used the same sample as Coles et al. (2015). The purpose of the study was to describe the GoFAR intervention designed to improve attention, behavior, and adaptive functioning in children with fetal alcohol spectrum disorders (FASD), ages 5 to 10 years. Participants were randomized to 3 groups: GoFAR; FACELAND; or Control. Over 10 sessions children and caregivers learned a metacognitive strategy (FAR) designed to improve cognitive control of behavior and adaptive functioning and practiced it during behavior analog therapy. Attention, behavior problems, and adaptive skills were measured pre- and post-intervention. Measures utilized include the Neurocognitive: Test of Variables of Attention (TOVA), the Child Behavior Questionnaire (CBQ), the Achenbach Child Behavior Checklist (CBCL), the Behavior Rating Scale of Executive Function (BRIEF), and the Adaptive Functioning: Vineland Adaptive Behavior Scales (VABS), 2nd Edition. Results indicate that from pre- to post-testing the GoFAR intervention group improved on the Test of Variables of Attention (TOVA). Both intervention groups improved in daily living skills. Limitations include small sample size, lack of generalizability to other populations, and lack of follow-up.

  
  

  Length of controlled postintervention follow-up: None.

There are currently no references available for GoFAR.