Baby Steps: Evaluation of a Computing System to Support Parent Reporting of Early Childhood Development

Background: Parents of children that are diagnosed with autistic spectrum disorders and other developmental disabilities often report that they saw early warning signs in their children with respect to cognitive and social skills. If these signs can be noticed and shared sooner, a diagnosis can be made earlier, which has the benefits of early intervention and access to services.  Thus, accurate and timely record-keeping and review of children's developmental progress is an important goal. In addition, parents report that they are motivated to keep track of their child's development, but that they fail to do so because of forgetfulness or time constraints.

Objectives: We hypothesized that a computing system, called Baby Steps, could enable parents to track more of their child's developmental milestones more often and with higher confidence, and that this in turn could benefit parent-pediatrician communication.

Methods: We developed Baby Steps as a software application that stores developmental information about a child using the metaphor of a baby book. We studied the use of this system through a 3 month study of 8 families who were randomly assigned to use either an experimental or control version of the system. The experimental version included 4 additional features 1) a proactive reminder system, 2) the ability to create sentimental keepsakes, 3) online data sharing capabilities, and 4) an integrated device to capture videos and pictures. Interviews, software logs, and pre- and post-study questionnaires were used to measure records kept, timeliness, confidence, and communication with pediatricians.

Results: Compared to the control group, the experimental group accessed their child's records more frequently (C:9.75 days; E:17.5 days; p<.05) and recorded a higher number of records (C:48.5 milestones; E:90.5 milestones; p = .16).  From pre- to post-study, pediatricians rated parents in the experimental group higher with regard to knowledge about their child's development and the productiveness of their visit (C: +0.18; E: +0.51; p=0.01).  Self-reported confidence in records-kept (on a scale from 1 to 5) increased from pre- to post-study for both groups (C: +0.53; E: +0.55).

Conclusions: As hypothesized, this study found that a well-designed computing system can improve aspects of parents’ record-keeping.  It is encouraging that parents in the experimental condition spent more time reflecting on their child's developmental milestones, which could perhaps lead to earlier communications of concerns to the pediatrician. Parents in the experimental condition were viewed as more competent by the physician, thus, this could perhaps lead to earlier coordination of intervention efforts for a child that is showing atypical development. Because of limited statistical differences between experimental and control group, future studies should further investigate this difference and whether this translates to sooner referrals to specialists. We also will explore how a computational system can be implemented and deployed to a larger population that may have limited access to technology in the home.