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Click-East: Evaluating the Impact of an Ipad App On Social Communicative Abilities in Young Children with Autism

Saturday, 4 May 2013: 09:00-13:00
Banquet Hall (Kursaal Centre)
S. Fletcher-Watson1, S. Hammond2, A. O'Hare3, H. Pain4, A. M. Petrou5 and H. McConachie6, (1)Moray House School of Education, University of Edinburgh, Edinburgh, United Kingdom, (2)School of Informatics, University of Edinburgh, Edinburgh, United Kingdom, (3)University of Edinburgh, Edinburgh, United Kingdom, (4)School of Informatics, University of Edinburgh, Edinburgh, Scotland, (5)Heriot-Watt University, East Lothian, United Kingdom, (6)Newcastle University, Newcastle Upon Tyne, United Kingdom
Background: Young children with a diagnosis of ‘core’ autism regularly pay little attention to other people and often struggle to follow social cues. On the other hand, children with autism often have good technological skills and a preference for using technology in leisure and education.  We also know that intervention delivered early appears to have a beneficial effect on outcome. These three issues come together in the promising application of novel technologies to social difficulties of very young children.

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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