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Using an Ipad Application to Prepare Children with ASD for Research MRI
Undergoing an MRI for a research study can be stressful for children with ASD and their parents. Many children have trouble staying still in the scanner due to the overwhelming sensory experience, including noise. There is limited research on technology to prepare children for the new experience of research study MRIs in order to decrease their stress and gain their compliance. Our past research found that ill children with ASD and their parent had less anxiety (than the control group that received typical care) and challenging behaviors and better compliance with diagnostic imaging when they were prepared with an iPad application (app) that foreshadowed the imaging process and appropriate behavior.
Objectives:
(1) To assess the experience of undergoing research study MRI for a child with ASD or a typically developing child (TYP) and an accompanying parent.
(2) To evaluate the feasibility, efficacy and acceptability of the ‘Going to MRI for a Research Study’ iPad app consisting of research task, mock scanner and MRI photographs and audio recording.
Methods:
We recruited 10 English-speaking parent/child dyads [(n=5 male children with ASD) (aged 14.8 ± 1.2 years)] and n=5 TYP [(4 male, 1 female) (aged 14.2 ± 3.2 years)] who were offered the option of using the app before the MRI in an interdisciplinary study on neural correlates of goal directed movement. Diagnosis of ASD or TYP was confirmed by the Autism Spectrum Screening Scale, and the Autism Diagnostic Observation Schedule, along with normal or corrected normal vision, and Intelligence Quotient > 70. Frequencies were calculated for app use and MRI completion rates and demographics were collected to describe the sample. Qualitative data were collected by individual, one-time, question guide facilitated, audiotaped telephone interviews. Audiotapes were transcribed into a Word document. Two researchers discerned themes via an iterative process, guided by the Family Self Management Theory, for participant experience with the research MRI, and the feasibility, efficacy and acceptability of the app for those that chose to use it.
Results:
Seven of the 10 children (70%) completed the MRI (n=2 ASD with app; n=1 no app but prior MRI experience; n=1 TYP with app; n=3 TYP no app). Three children (30%) did not complete the MRI (n=2 ASD no app; n=1 TYP claustrophobic) (see Figure). All parent/child dyads (N=10 parents and 10 children) were white, and the majority of parents were college educated with a Bachelor’s degree or higher (n=8, 80%). Two themes emerged from the transcripts: (1) Desire to help others with autism (2) ASD child/parent without app had trouble with expectations for MRI. Participants described the iPad app’s feasibility, efficacy, and acceptability (see Table).
Conclusions:
The results demonstrate the effectiveness of the app for preparing ASD children and their parent for completion of research study MRI. Use of the app could strengthen the protective factors that positively impact the child experience with MRI and family experience during research MRI. Results of the study will guide the development of interdisciplinary intervention studies of ASD parents and children undergoing MRI.