Effectiveness of Using a Mobile App Parent Training Program to Increase Language in Children with Autism

Background: Communication intervention in early life can significantly impact long term outcomes for children with autism spectrum disorder (ASD) (Howlin et al., 2004). Evidence-based practices such as naturalistic approaches (e.g. Koegel et al., 1987; Ingersoll & Schreibman, 2006) are found to be promising in improving communication in children with autism. However, limited resources and high costs have hindered children from receiving prompt and timely intervention. Parents of children with ASD can be vital and important intervention resources and, training them to be therapists can help reduce costs for intervention. The current study aims to evaluate the use of a mobile application as a training medium to disseminate intervention skills of naturalistic language intervention to parents in an effective and efficient way.

Objectives:  The primary purpose of this project is to examine the effectiveness of using a mobile application (1) to train parents to implement naturalistic language intervention (Laski, Charlop, & Schreibman, 1988) with their young child with autism; and (2) to increase their child’s spontaneous communication and requesting language skills. 

Methods: A mobile app was developed with the instructional design of behavioral modeling training (BMT) (Bandura, 1976; key components include modeling, retention, behavioral rehearsal, feedback, and transfer of training) to deliver a curriculum of naturalistic language intervention.  A multiple baseline single case experimental design was conducted across 3 parent-child dyads (i.e., children with ASD aged 2 to 5 years) to evaluate the impact of using iPad to teach parents on naturalistic language intervention. Video recordings on parent’s intervention with the child were collected via a one-push button on iPad and the network. Behaviors of both parents (10 parent behaviors) and children (5 child behaviors) were measured in 5 phases: baseline, parent training, post-training intervention, generalizations and 1 month follow up. Interrater reliability on target parent behaviors and child behaviors were collected for at least 33% of total sessions and an average agreement of over 85% was achieved. Procedural integrity of parents’ intervention techniques were above 80% on average during post training intervention. Parents’ acceptability of the mobile app and program satisfaction ratings were administered with survey forms. 

Results: The current results indicate that (a) parents achieved an increase in knowledge on the principles of naturalistic language intervention via the mobile application during the course of parent training, (b) parents showed an increase in the application of intervention techniques in naturalistic settings, and (c) their respective children showed an increase in spontaneous word use. 

Conclusions: The results show that mobile applications are a promising means for improving efficiency and effectiveness in disseminating evidence-based practices for autism intervention. Mobile platforms will close the research-practice gap, multiply intervention resources in both developed and developing countries for individuals with autism, and provide prompt intervention without delays. Further research on generalizations of the current intervention is expected to be completed by 2014 to assess parent and child behavioral gains in different home and community contexts.