International Meeting for Autism Research: Self-Monitoring with Handheld Computers by Teens with High Functioning Autism/Asperger's Syndrome in Mainstream Settings

Self-Monitoring with Handheld Computers by Teens with High Functioning Autism/Asperger's Syndrome in Mainstream Settings

Friday, May 21, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
9:00 AM
M. Levine , SymTrend, Inc., Belmont, MA
K. Hearsey , Division TEACCH, University of North Carolina at Chapel Hill, Carrboro, NC
G. Mesibov , Psychiatry, University of North Carolina at Chapel Hill, Carrboro, NC
R. J. Calvanio , Neurology Stroke Service, Massachusetts General Hospital, Boston, MA
Background: Recent studies have shown that skill acquisition is improved in intense programs in which HFA/AS students (in a ASD-only school or camp setting) self-record their skill execution on a handheld computer and receive supervisor feedback about their recordings. Intensive use means that frequent recordings followed by feedback are 1) done under professional supervision and occur 2) on the same day, 3) every day, 4) throughout the day.

Objectives: To determine under what less intense program conditions the computer self-recording with feedback paradigm would prove successful. In particular, we tested to see if the paradigm would be successful under less ideal conditions in mainstream settings, where the training and feedback 1) was provided by non-professional strangers, 2) was less frequent, and 3) occurred only during part of the day.

Methods: Sample: Forty-two students identified as having HFA/AS by special education staff at 11 middle and high schools in Massachusetts and North Carolina participated; 30 Intervention Group students (IG’s) and 9 Wait List Control Group students (WL’s) provided data for this report. Parents and students provided consent for participation. Parents and teachers completed standardized tests prior to data collection. The students spent all or nearly all of their day in mainstream classrooms. Procedure: Baseline: Trained adults observed the students for four weeks 3x/week in three classes, using Palm handheld computers with software from SymTrend, Inc. (software is now on the iPod touch). Observers recorded data using six classroom behavior scales, checklists of positive and negative social pragmatic behaviors, and seven mood/arousal rating scales. Training: IG’s were then trained on self-recording with a similar protocol; training typically started with visual images on paper; the students were then taught to translate the content to responses on the handheld. Intervention: IG’s then self-recorded during two classes daily for up to 10 weeks, while the adult observers monitored them simultaneously. Adults met with the students twice/week to show charts displaying both data sets together. They discussed strategies for coping with problems uncovered during the observations. WL did not use handheld computers.
Results: For the WL’s, substantial feelings improvement occurred spontaneously for nearly half the students (44%). This feelings improvement was not accompanied by a behavioral improvement.  Indeed, in 22% of WL’s with feelings improvement, there was a substantial behavioral worsening. The IG’s showed a quite different profile of improvement and worsening.  The IG’s produced a greater incidence of substantial behavioral improvement: 27% (vs. 11%).  More than half of this 27% (i.e., 17%) also showed feelings improvement compared to none in the WL’s. The primary areas of improvement in the IG’s were in feeling more calm and confident and improving self-control and self-expression. 

Conclusions: WL’s showed considerable spontaneous feelings improvement with little behavioral improvement. The intervention produced considerably more instances of substantial behavioral improvement, and did so with feelings improvement half the time. Despite a much more limited protocol implementation in mainstream settings, the recording-feedback paradigm shows promise for improving classroom social behavior.