Objectives: The Click-East research project aims to investigate whether it is possible to teach the fundamentals of social attention to pre-schoolers with autism through a specially designed iPad app.
Methods: The app has been developed using a participatory design process with children with ASD, parents, teachers, and other professionals. A series of pilot tests formally explored the responses of children and parents to the app, and to working with an iPad more generally. The completed app is now being evaluated in a rigorously designed randomised controlled trial (n=60) with immediate and delayed intervention groups, membership stratified by autism severity. Evaluations at time one include the Mullen Scales of Early Learning, the Autism Diagnostic Observation Schedule, a parent-child free play session, and background questionnaire data. There is follow-up immediately after a two month intervention period and again at 6 month follow-up. The primary outcome measure will be the ADOS-C (ADOS-change) to look for differences in social and communicative behaviour during parent-child interaction.
Results: Participatory design and pilot data demonstrate that the app is motivating, user-friendly and practical in a family setting. Eleven families in the immediate intervention group have now completed the intervention period, producing an average of 8 hours and 40 minutes game play, or 8.5 minutes per day. Parent report measures indicate a very high level of satisfaction with the intervention and evidence of motivated and enthusiastic engagement with the app by the participating children. There is anecdotal evidence of generalized skill development including learning new vocabulary and improvements in single-finger pointing. Additionally, many families use the iPad as a reward for positive behaviour. By IMFAR 2013 we will be able to present equivalent post-intervention data from the full sample of 30 families in the immediate intervention group, including data collected within the app and associated parent-report and behavioural measures.
Conclusions: The early signs are that this new technology holds great potential for work with children with autism. We will consider our findings in the light of pragmatic approaches to education and support: technological solutions can be delivered quickly and cheaply and provide spin-off benefits for families (e.g. peer respect, increased on-task behaviour). In this context, the intervention may be worthwhile even if therapeutic outcomes are relatively modest. We hope to go on to develop a suite of apps for children with ASDs across a range of ages and ability levels, and are actively seeking industry partners to support this work
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