Development of an Interactive, E-Learning Tool to Support Parent Implementation of an Executive Function Intervention

Background: Research has shown that parenting an autistic child is often characterized as complex (Hayes & Watson, 2013), requiring particular vigilance (Woodgate et al., 2008) and advocacy (Boshoff et al., 2016), as parents leverage available resources to overcome barriers and manage constraints, notably those related to time, finances, and discontinuous service provision (Brown, Ouellette-Kuntz, Kelley, & Cobigo, 2012). Parents of autistic children work to promote success in daily life while remaining highly future-oriented in their pursuit to optimize long-term outcomes. Research has also shown that parents are effective at using professional guidance to teach their autistic children specific skills (Wong et al., 2015). Web-based learning can be a cost-effective way to manage the constraints parents frequently encounter while preparing them to teach specific skills.

Executive function (EF) skills are a promising skill acquisition target because of their impact on adaptive behavior, successful participation in daily life, and long-term outcomes. A recent home- and school- based EF intervention, Unstuck and On Target (UOT; Cannon et al., 2011; 2018) has been shown to be effective in two RCTs (Kenworthy, et al. 2014; Anthony, et al., in prep) at improving EF skills and classroom behavior. E-Unstuck adapts essential UOT intervention components into e-learning modules. Should research find that e-Unstuck is effective, it would also need to be an acceptable, appealing, and valuable product in order to elicit intervention uptake. Therefore, product evaluation data is a critical step in the development process.

Objectives: Develop an interactive, e-learning program for parents of autistic children using a stepwise process.

Systematically evaluate product quality, value, and usability.

Methods: Parents (n=44) of children on the autism spectrum without an intellectual disability (mean age=10.0 years; mean IQ=103.6) participated in e-Unstuck learning modules. Parents also completed an online product evaluation, providing feedback on aspects including quality, value, usefulness, and appeal through 5-point Likert scale items (1= strongly disagree to 5= strongly agree) and open-ended questions. Parents were also invited to provide additional product evaluation feedback through focus groups.

Results: The quality, value, and usability of e-Unstuck were all rated highly by parents (M ≥ 4 on a 5-point scale). Furthermore, parents reported that they would use e-Unstuck again (M = 4.68, SD = .53) and recommend e-Unstuck to a friend (M = 4.54, SD = .77). They also indicated that e-Unstuck would make UOT training more accessible to parents of children with ASDwoID (M=4.49, SD=.65). A consensus of parent responses to open-ended product evaluation questions and focus group discussions showed important positive feedback related to the flexibility and convenience of self-paced module completion. Parents also reported a primary barrier related to the difficulty in setting aside time to complete each module; however, this is a potential barrier for any intervention.

Conclusions: These findings indicate that e-Unstuck is an e-learning tool of high quality, value, and usability. Parent experiences also support that e-Unstuck can help make intervention more accessible to parents, offering flexibility that accommodates time constraints while providing useful information.