A Web-Based Parenting Tutorial for Young Children with Autism: Improving Everyday Skills and Behaviors

Background:  There is a growing consensus that early intervention can significantly improve long-term outcomes for children with autism.  Unfortunately, many children who are eligible for early intervention services do not receive them, due to a critical shortage of trained professionals in this area.  Federally-mandated systems are often not equipped with adequate financial or human resources to provide individualized intervention services, and most states do not provide autism-specialized services. This situation creates a burden for parents, who are often placed in the position of identifying, locating, and paying privately for children’s therapies or acting as primary interventionists themselves.  One way to bridge the gap between the need for services and their availability is to teach parents how to incorporate effective intervention techniques in their daily interactions with their children.  More effective interactions could improve short- and long-term outcomes, by increasing parenting efficacy and help remediate the core deficits associated with autism.  While successful parent training programs have been developed, access to such programs is limited due to the lack of trained clinicians providing such services.  One powerful way to increase accessibility to these programs is through interactive, multi-media, web-based technologies.

Objectives:  To develop and evaluate the feasibility and efficacy of a web-based, multi-media, interactive tutorial (“Enhancing Interactions”), based on evidence-based practices and utilizing the web-based platform to maximize learning. 

Methods:  Participants were 23 parents with a child between 18 months and 6 years of age with an autism spectrum disorder.  Mean age of parents was 33.7 (range 24-51).   Participants were 22% African American, 74% Caucasian, and 4% other.  Sixty-one percent received their child’s diagnosis within the past 6 months.  Pre- and post-test scores of parents’ knowledge of the concepts presented in the tutorial were used to evaluate teaching effectiveness.  User satisfaction was gauged with the System Usability Scale (SUS) (for technical aspects) and the User Satisfaction Questionnaire (for tutorial content).  The tutorial contained modules describing the characteristics of autism, teaching strategies, and ways to improve children’s communication.

Results:  We found a significant increase in the mean number of correct items on the 24-item multiple-choice test of concepts, from 12.6 to 20.4, t(23)=10.72,p<.001.   Seventy-nine percent scored 80% correct or better, compared to only 8% prior to taking the tutorial.  The mean score on the SUS was 85 (SD=17) (scale range is 0-100), corresponding to a score of “Excellent”; 52% had a mean score above 90. All participants found the tutorial user friendly, thought the technical features in the tutorial were well integrated, and 96% (all but one participant) thought it was easy to use, felt confident using the technical features, and would use a tutorial like this again.  On the User Satisfaction Questionnaire all participants found the objectives of the tutorial to be well-organized, the concepts clearly presented and easy to understand, and reported that it increased their knowledge about communicating with their child, and they felt capable of applying these techniques with my child.

Conclusions: The tutorial appears effective in increasing parents’ knowledge and was well accepted with high user satisfaction.