The purpose of this study is to evaluate the safety of NDTx-03 used together with treatment as usual (TAU) and to determine whether NDTx-03 plus TAU is more effective than TAU alone in improving social situation recognition and interaction in children and adolescents with autism spectrum disorder (ASD) or social communication disorder (SCD).
This is a multicenter, prospective, randomized, evaluator-blinded, superiority, confirmatory clinical trial of NDTx-03 in children and adolescents with ASD or SCD. Participants who meet all eligibility criteria will be randomized in a 1:1 ratio to the experimental group or the control group. All participants will maintain their existing ASD/SCD-related treatment, rehabilitation, or education program as Treatment-As-Usual (TAU) during the study. Experimental group: Participants will receive NDTx-03 in addition to TAU from baseline. NDTx-03 will be used five times per week for 8 weeks (40 sessions), consisting of a 6-week basic application period followed by a 2-week advanced application period. Control group: Participants will receive TAU alone for 8 weeks. After the Day 56 end-of-study visit, participants who wish to receive NDTx-03 may receive it under a separate post-study access consent process. This optional post-study use is not part of the randomized clinical trial intervention or efficacy-assessment period. Study assessments include screening, baseline (Day 0), a telephone visit at Day 21, an in-person assessment at Day 42, and the end-of-study visit at Day 56. The primary efficacy endpoint is the between-group difference in change from baseline to Day 42 in the K-VABS-II Adaptive Behavior Composite score. Secondary efficacy assessments include K-VABS-II, SRS-2, K-PRQ-CA, CGI-S, and CGI-I. Other pre-specified assessments include KIPR, EQ-5D-5L, NDTx-03 satisfaction, adolescent smartphone addiction self-diagnosis, and TAU-related expenditures. Adverse events are recorded after written informed consent. Participants with adverse events are followed for up to 30 days after the last NDTx-03 application or until resolution, as applicable.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
156
NDTx-03 is digital medical device software intended to improve social situation recognition and interaction in children and adolescents aged 10 to 18 years with ASD or SCD. It integrates cognitive behavioral therapy (CBT), the social information processing (SIP) model, and social skills training (SST) to address recognition and interpretation of social cues, goal setting, response generation and selection, and behavioral execution. The program adjusts difficulty according to the user's cognitive ability, diagnosis, and performance. In the experimental group, NDTx-03 is used on a smartphone five times per week for 8 weeks (40 sessions, a 6-week basic application period followed by a 2-week advanced application period).
TAU consists of ASD/SCD-related treatment, rehabilitation, or education that the participant was already receiving. TAU continues during the study, but medications or treatment/rehabilitation/education programs that may significantly affect sociality should remain stable as specified in the protocol.
Daegu Catholic University Medical Center
Daegu, South Korea
RECRUITINGWonkwang University Hospital
Iksan, South Korea
RECRUITINGAsan Medical Center
Seoul, South Korea
Change from baseline in K-VABS-II Adaptive Behavior Composite (ABC) score at Day 42
K-VABS-II is a blinded-assessor-administered scale for individuals aged 0 to 99 years that evaluates social adaptive behavior. The ABC score is based on standardized scores for Communication, Daily Living Skills, and Socialization. The change from baseline to Day 42 will be compared between groups.
Time frame: Baseline (Visit 2, Day 0) and Day 42 (Visit 4, Day 42 +/- 3 days)
Change from baseline in K-VABS-II ABC score at Day 56
The change from baseline to Day 56 in the K-VABS-II ABC score will be evaluated as a secondary efficacy endpoint. The Korean Vineland Adaptive Behavior Scales-II (K-VABS-II) Adaptive Behavior Composite (ABC) score ranges from 20 to 160, with higher scores indicating better adaptive functioning.
Time frame: Baseline (Visit 2, Day 0) and Day 56 (Visit 5, Day 56 +/- 3 days)
Change from baseline in K-VABS-II domain scores
K-VABS-II domain scores include Communication, Daily Living Skills, and Socialization. The Korean Vineland Adaptive Behavior Scales-II (K-VABS-II) domain scores range from 20 to 160 with higher scores indicating better adaptive functioning.
Time frame: Baseline (Visit 2, Day 0), Day 42 (Visit 4, Day 42 +/- 3 days), and Day 56 (Visit 5, Day 56 +/- 3 days)
Change from baseline in K-VABS-II subscale V-scale scores
K-VABS-II subscale V-scale scores include Receptive, Expressive, Written, Personal, Domestic, Community, Interpersonal Relationships, Play and Leisure, Coping Skills, Internalizing, and Externalizing. The V-scale scores range from 1 to 24. Higher scores indicate better adaptive functioning for Receptive, Expressive, Written, Personal, Domestic, Community, Interpersonal Relationships, Play and Leisure, and Coping Skills, whereas higher Internalizing and Externalizing scores indicate greater maladaptive behavior.
Time frame: Baseline (Visit 2, Day 0), Day 42 (Visit 4, Day 42 +/- 3 days), and Day 56 (Visit 5, Day 56 +/- 3 days)
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Samsung Medical Center
Seoul, South Korea
RECRUITINGThe Catholic University of Korea, Seoul St. Mary's Hospital
Seoul, South Korea
RECRUITINGKorea University Guro Hospital
Seoul, South Korea
RECRUITINGPusan National University Yangsan Hospital
Yangsan, South Korea
RECRUITINGChange from baseline in SRS-2 total score
The Korean Social Responsiveness Scale-2 (SRS-2) is a parent-rated 65-item scale used to identify the presence and severity of social impairment in autism and distinguish it from impairment related to other disorders. The total score ranges from 0 to 195 with higher scores indicating greater severity of social impairment.
Time frame: Baseline (Visit 2, Day 0), Day 42 (Visit 4, Day 42 +/- 3 days), and Day 56 (Visit 5, Day 56 +/- 3 days)
Change from baseline in SRS-2 subscale T-scores
The Korean Social Responsiveness Scale-2 (SRS-2) is a parent-rated 65-item scale used to identify the presence and severity of social impairment in autism and distinguish it from impairment related to other disorders. Subscale T-scores include Social Awareness, Social Cognition, Social Communication, Social Motivation, Restricted Interests and Repetitive Behavior (RRB), and Social Communication and Interaction (SCI). The subscale T-scores are estimated to range from 34 to 128 with higher scores indicating greater severity of social impairment.
Time frame: Baseline (Visit 2, Day 0), Day 42 (Visit 4, Day 42 +/- 3 days), and Day 56 (Visit 5, Day 56 +/- 3 days)
Change from baseline in K-PRQ-CA score
The Korean Parenting Relationship Questionnaire - Child \& Adolescent (K-PRQ-CA) is a parent/caregiver-rated scale for children and adolescents from elementary school through high school. It measures the parent or primary caregiver perspective on the parent-child relationship and consists of 71 items. The K-PRQ-CA subscale T-scores are estimated to range from 20 to 80 (T-score means 50, standard deviation 10). Higher scores indicate better parent-child relationships functioning for Attachment, Communication, Discipline, Involvement, Parenting Confidence, and Satisfaction with School, whereas higher Relational Frustration scores indicate greater relational frustration.
Time frame: Baseline (Visit 2, Day 0), Day 42 (Visit 4, Day 42 +/- 3 days), and Day 56 (Visit 5, Day 56 +/- 3 days)
Change from baseline in CGI-S score
The Clinical Global Impression-Severity (CGI-S) is a clinician-rated 1-item scale scored from 1 to 7. It evaluates the current severity of symptoms compared with previous patients diagnosed with the same condition.
Time frame: Baseline (Visit 2, Day 0), Day 42 (Visit 4, Day 42 +/- 3 days), and Day 56 (Visit 5, Day 56 +/- 3 days)
CGI-I score
The Clinical Global Impression-Improvement (CGI-I) is a clinician-rated 1-item scale scored from 1 to 7. It evaluates whether the participant's mental disorder has improved compared with a specified previous time point.
Time frame: Day 42 (Visit 4, Day 42 +/- 3 days) and Day 56 (Visit 5, Day 56 +/- 3 days); additional exploratory assessment at Day 98 (Visit 7, Day 98 +/- 3 days)