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Scarcella I, Marino F, Failla C, Doria G, Chilà P, Minutoli R, Vetrano N, Vagni D, Pignolo L, Di Cara M, Settimo C, Quartarone A, Cerasa A, Pioggia G. Information and communication technologies-based interventions for children with autism spectrum conditions: a systematic review of randomized control trials from a positive technology perspective. Front Psychiatry 2023; 14:1212522. [PMID: 37547218 PMCID: PMC10398379 DOI: 10.3389/fpsyt.2023.1212522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Information and communication technologies (ICTs) have become more widely used in the past years to help people with autism spectrum conditions (ASC). Serious games embedded into computers or tablets, as well as social robots, are the most employed ICT-related tools that are appealing to and appropriate for autistic children. The goal of ICT applications is to enhance behavioral abnormalities associated with ASC while also creating an interactive link between one person and one computer. Comparatively, to human-based therapy, ICT tools aid to inspire autistic children by providing predictability and regularity of tasks. Regaining social skills is the primary behavioral goal for which ICT tools have been designed and implemented. In the past several years, many studies have been created to show how effective it is at improving targeted behaviors. However, only a small number of researchers have used an RCT approach to evaluate its effectiveness. In this systematic review, we only included RCT studies where ICT technologies were used to help children with ASC in improving their social skills. Only 14 RCT studies satisfied the criteria and 12 described significant improvements, showing how the use of technology in educational contexts produced better improvement in developing several social skill facets with respect to the traditional face-to-face approach. Some studies used interventions and outcome measures focused on the core ASC symptoms, but many others addressed neurocognitive functions directly, like social cognition or emotional regulation, while other more general functions such as language or adaptive behaviors. We propose a classification based on processes and outcome measures to foster future research in this specific area of research. The behavioral intervention mediated by technological tools such as computer-based, tablet, and social robotics, undoubtedly provides a comfortable environment that promotes constant learning for people with ASC. Evidence provided in this review highlights the translational potential of this field of study in primary care practice and educational settings.
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Affiliation(s)
- Ileana Scarcella
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Kore University of Enna, Enna, Italy
| | - Germana Doria
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Roberta Minutoli
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Noemi Vetrano
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Department of Cognitive, Psychological Science and Cultural Studies, University of Messina, Messina, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | | | | | | | | | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- S'Anna Institute, Crotone, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
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Bharat R, Uzaina, Yadav T, Niranjan S, Kurade P. mHealth Apps Delivering Early Intervention to Support Parents of Children With Autism Spectrum Disorder: A Scoping Review. Indian Pediatr 2023. [DOI: 10.1007/s13312-023-2840-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Parsons D, Vaz S, Lee H, Robinson C, Cordier R. A twelve-month follow-up of an information communication technology delivered intervention for children with autism spectrum disorder living in regional Australia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 106:103743. [PMID: 32835895 DOI: 10.1016/j.ridd.2020.103743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
This study investigated the long-term follow-up of an information communication techonology based intervention, the Therapeutic Outcomes By You application, for children with autism spectrum disorder living in regional Australia. Fifteen participants who completed a three-month randomised controlled trial of the Therapeutic Outcomes By You were assessed at least 12 months post-intervention to determine the maintenance or continued improvement of their language and social communication skills. Findings demonstrate the receptive language, social skills, pragmatic language and playfulness of children with autism spectrum disorder improved during the three-month intervention period and were maintained at least 12 months after ceasing the Therapeutic Outcomes By You app intervention.
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Affiliation(s)
- Dave Parsons
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Kent St., Bentley, Western Australia, 6102 Perth, Australia.
| | - Sharmila Vaz
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Kent St., Bentley, Western Australia, 6102 Perth, Australia
| | - Hoe Lee
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Kent St., Bentley, Western Australia, 6102 Perth, Australia
| | | | - Reinie Cordier
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Kent St., Bentley, Western Australia, 6102 Perth, Australia; Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
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Rogerson J, Falkmer M, Cuomo B, Falkmer T, Whitehouse AJO, Granich J, Vaz S. Parental experiences using the Therapy Outcomes by You (TOBY) application to deliver early intervention to their child with autism. Dev Neurorehabil 2019; 22:219-227. [PMID: 29485349 DOI: 10.1080/17518423.2018.1440259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE As computer-based interventions become commonplace for parents of children with neurodevelopmental disorders, this study sought to understand the experience of using a parent-delivered supplementary early intervention therapy for children with autism spectrum disorder grounded in a variety of behavioral, sensory, developmental, and relationship-based approaches and delivered via a tablet device. METHODS Parental experiences using the 'Therapy Outcomes by You' (TOBY) application were collected through semi-structured interviews with 17 parents. RESULTS Parents reported TOBY facilitated parent-child engagement, provided ideas for therapeutic activities, created feelings of empowerment, and positively impacted their child's development. Barriers to use included preparation time, execution of the intervention, and individual strengths and weaknesses of their child. CONCLUSION The overall parental experience of TOBY was positive when use of the application aligned with parental proficiency, opportunities for use, and importantly, the needs of the child.
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Affiliation(s)
- Jessica Rogerson
- a School of Occupational Therapy & Social Work , CHIRI, Curtin University , Perth , Western Australia
| | - Marita Falkmer
- a School of Occupational Therapy & Social Work , CHIRI, Curtin University , Perth , Western Australia.,b School of Education and Communication, CHILD Programme , Institute of Disability Research, Jönköping University , Jönköping , Sweden
| | - Belinda Cuomo
- a School of Occupational Therapy & Social Work , CHIRI, Curtin University , Perth , Western Australia
| | - Torbjorn Falkmer
- a School of Occupational Therapy & Social Work , CHIRI, Curtin University , Perth , Western Australia.,c School of Health and Welfare , Jönköping University , Jönköping , Sweden.,d Department of Medical and Health Sciences , Linköping University , Linköping , Sweden
| | - Andrew J O Whitehouse
- e Telethon Kids Institute , The University of Western Australia , Perth , Western Australia
| | - Joanna Granich
- e Telethon Kids Institute , The University of Western Australia , Perth , Western Australia
| | - Sharmila Vaz
- a School of Occupational Therapy & Social Work , CHIRI, Curtin University , Perth , Western Australia
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Parsons D, Cordier R, Lee H, Falkmer T, Vaz S. A Randomised Controlled Trial of an Information Communication Technology Delivered Intervention for Children with Autism Spectrum Disorder Living in Regional Australia. J Autism Dev Disord 2019; 49:569-581. [PMID: 30209645 DOI: 10.1007/s10803-018-3734-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This exploratory randomised controlled trial tested the effectiveness of a tablet-based information communication technology early intervention application to augment existing therapy with the aim of improving visual motor, imitation, language and social skills in young children with ASD who reside in regional areas. Fifty-nine participants were recruited and randomised to either a therapy-as-usual group or intervention group. With the exception of the expressive language subscale on the Mullen Scales of Early Learning, no significant between-group differences were recorded for visual motor, imitation, receptive language and social skills of participants between baseline and post-intervention. When all participants were pooled and measured over time, improvements were shown in receptive and pragmatic language and social skills; these gains were maintained, thus suggesting skill acquisition.
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Affiliation(s)
- Dave Parsons
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Kent St., Bentley, Perth, WA, 6102, Australia.
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Kent St., Bentley, Perth, WA, 6102, Australia
| | - Hoe Lee
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Kent St., Bentley, Perth, WA, 6102, Australia
| | - Torbjorn Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Kent St., Bentley, Perth, WA, 6102, Australia
- Department of Medicine and Health Sciences (IHM) and Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Sharmila Vaz
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Kent St., Bentley, Perth, WA, 6102, Australia
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Whitehouse AJO, Granich J, Alvares G, Busacca M, Cooper MN, Dass A, Duong T, Harper R, Marshall W, Richdale A, Rodwell T, Trembath D, Vellanki P, Moore DW, Anderson A. A randomised controlled trial of an iPad-based application to complement early behavioural intervention in Autism Spectrum Disorder. J Child Psychol Psychiatry 2017; 58:1042-1052. [PMID: 28543302 DOI: 10.1111/jcpp.12752] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Technology-based interventions for Autism Spectrum Disorder (ASD) have proliferated, but few have been evaluated within the context of a randomised controlled trial (RCT). This RCT evaluated the efficacy of one technology-based early intervention programme (Therapy Outcomes By You; TOBY) in young children with ASD. METHODS TOBY is an app-based learning curriculum designed for children and parents as a complement to early behavioural intervention. Eighty children (16 female) were recruited to this RCT within 12 months of receiving a diagnosis of ASD (M age = 3.38; SD = 0.69) and randomised to receive either treatment-as-usual (community-based intervention, n = 39) or the TOBY therapy (at least 20 min/day) plus treatment-as-usual (n = 41) for a period of 6 months. Outcomes were assessed at 3 and 6 months postbaseline. (Australian New Zealand Clinical Trials Registry: ACTRN12614000738628; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365463). RESULTS Children in the TOBY intervention group averaged 19 min/day engaging with the app in the first 3 months, but only 2 min/day during the second 3 months. There was no group difference in scores on the primary outcome, the Autism Treatment Evaluation Checklist, at either the 3- or 6-month follow-up. However, significant improvements at the 6-month follow-up were observed in the TOBY intervention group relative to the treatment-as-usual group on three secondary outcomes: the Fine Motor and Visual Reception subscales of the Mullen Scale of Early Learning and the Total Words Understood scale of the MacArthur-Bates Communicative Development Index. Statistical trends towards improvement in the TOBY intervention group were observed on measures of adaptive function, although these decreased in magnitude from the 3- to 6-month follow-up. CONCLUSIONS This study provides evidence that technology-based interventions may provide a relatively low-cost addition to existing therapist-delivered interventions for children with ASD. However, sustained use of the app over the full 6-month period was a challenge for most families.
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Affiliation(s)
| | - Joanna Granich
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Gail Alvares
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Margherita Busacca
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Vic., Australia
| | - Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Alena Dass
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Thi Duong
- School of Information Technology, Deakin University, Geelong, Vic., Australia
| | - Rajes Harper
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Vic., Australia
| | | | - Amanda Richdale
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Vic., Australia
| | | | - David Trembath
- Griffith Health Institute, Griffith University, Brisbane, Qld, Australia
| | - Pratibha Vellanki
- School of Information Technology, Deakin University, Geelong, Vic., Australia
| | - Dennis W Moore
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Vic., Australia
| | - Angelika Anderson
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Vic., Australia
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Granich J, Dass A, Busacca M, Moore D, Anderson A, Venkatesh S, Duong T, Vellanki P, Richdale A, Trembath D, Cairns D, Marshall W, Rodwell T, Rayner M, Whitehouse AJO. Randomised controlled trial of an iPad based early intervention for autism: TOBY playpad study protocol. BMC Pediatr 2016; 16:167. [PMID: 27760533 PMCID: PMC5069784 DOI: 10.1186/s12887-016-0704-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 09/29/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Evidence for early intensive behavioural interventions (EIBI) by therapists as an effective treatment for children with an Autism Spectrum Disorder (ASD) is growing. High-intensity and sustained delivery of quality EIBI is expensive. The TOBY (Therapy Outcomes by You) Playpad is an App-based platform delivering EIBI to facilitate learning for young children with ASD, while enabling parents to become co-therapists. Intervention targets include increasing joint attention, imitation and communication of children with ASD. The primary aim of the study presented in this protocol is to determine the effectiveness of the TOBY App in reducing ASD symptoms when used as a complement to conventional EIBI. The secondary aim is to examine parental attributes as a result of TOBY App use. METHODS AND DESIGN Children aged less than 4;3 years diagnosed with ASD and parents will be recruited into this single-blind, randomised controlled trial using a pragmatic approach. Eligible participants will be randomised to the treatment group 'TOBY therapy + therapy as usual' or, the control group 'therapy as usual' for six months. The treatment will be provided by the TOBY App and parent where a combination of learning environments such as on-iPad child only (solo), partner (with parent) and off-iPad - Natural Environment (with parent) Tasks will be implemented. Parents in the treatment group will participate in a TOBY training workshop. Treatment fidelity will be monitored via an App-based reporting system and parent diaries. The primary outcome measure is the Autism Treatment Evaluation Checklist. The secondary outcome measures involve diagnostics, functional and developmental assessments, including parent questionnaires at baseline (T0), three months (T1) and six months (T2). DISCUSSION This trial will determine the effectiveness of the TOBY App as a therapeutic complement to other early interventions children with ASD receive. The trial will also determine the feasibility of a parent delivered early intervention using the iPad as an educational platform, and assess the impact of the TOBY App on parents' self-efficacy and empowerment in an effort to reduce children's ASD symptoms. The outcomes of this trial may have EIBI services implications for newly diagnosed children with ASD and parents. TRIAL REGISTRATION ACTRN12614000738628 retrospectively registered on 1st of July, 2014. UTN: U1111-1158-6423.
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Affiliation(s)
- Joanna Granich
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, 100 Roberts Rd, Subiaco, 6008 WA Australia
| | - Alena Dass
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Margherita Busacca
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Australia
| | - Dennis Moore
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Australia
| | - Angelika Anderson
- Krongold Centre, Faculty of Education, Monash University, Melbourne, Australia
| | - Svetha Venkatesh
- Centre for Pattern Recognition and Data Analytics (PRaDA), Deakin University, Geelong, Australia
| | - Thi Duong
- Centre for Pattern Recognition and Data Analytics (PRaDA), Deakin University, Geelong, Australia
| | - Pratibha Vellanki
- Centre for Pattern Recognition and Data Analytics (PRaDA), Deakin University, Geelong, Australia
| | - Amanda Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - David Trembath
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Darin Cairns
- The Charles Street Clinic, North Perth, Australia
| | | | | | - Madeleine Rayner
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
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Johnson N, Bree O, Lalley EE, Rettler K, Grande P, Gani MO, Ahamed SI. Effect of a social script iPad application for children with autism going to imaging. J Pediatr Nurs 2014; 29:651-9. [PMID: 24836052 DOI: 10.1016/j.pedn.2014.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 04/18/2014] [Accepted: 04/18/2014] [Indexed: 11/17/2022]
Abstract
This randomized controlled trial feasibility study tested the effectiveness of an iPad® application (app) social script intervention for children with autism spectrum disorder (ASD) going to imaging and their parent (n=32 parent/child dyads). Parents of the children exposed to the app (n=16) had lower state anxiety compared to the parents whose children were not exposed to the app (n=16) (effect size 0.33). Children exposed to the app had fewer externalized challenging behaviors than the control group (effect size 0.56). The results demonstrate feasibility and efficacy of the intervention. Further study of the iPad app is warranted.
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Affiliation(s)
- Norah Johnson
- Marquette University, College of Nursing, Milwaukee WI.
| | - Octavia Bree
- Marquette University, College of Nursing, Milwaukee WI
| | - Erin E Lalley
- Park Nicollet Clinic - Gastroenterology, Minneapolis MN
| | - Kelly Rettler
- Children's Hospital of Wisconsin, Child Life Department, Milwaukee, WI
| | - Pam Grande
- Children's Hospital of Wisconsin, Imaging Department, Milwaukee, WI
| | - Md O Gani
- Marquette University, Math, Statistics, and Computer Science Dept., Milwaukee, WI
| | - Sheikh I Ahamed
- Marquette University, Math, Statistics, and Computer Science Dept., Milwaukee, WI
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