iPad-presented social stories for young children with autism

Social Story Intervention for Training Expected Behaviors among Preschool Children: A Systematic Review and Meta-Analysis

Promoting appropriate behaviors in early childhood is crucial for children's future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. The references were systematically screened in accordance with the PRISMA statements. Randomized or non-randomized controlled studies, as well as single-subject studies, in which SSs served as a behavioral training approach for children aged 2 to 6 years were included. Information related to study design, characteristics of the participants, target behaviors, and implementation of SS intervention was extracted. A meta-analysis was performed using the random-effects model, where similar outcomes were evaluated by similar intervention across multiple studies. Twenty-one studies were identified for qualitative analysis, while two studies formed the basis of the meta-analysis. SS interventions were employed to teach a variety of behaviors among typically developing children as well as those with various disabilities, such as autism, developmental delay, hearing impairments, attention deficit hyperactivity disorder, or other disabilities. The target behaviors included oral health practices, peer interaction, staying on-task, self-regulation, sleep habits, and controlling aggressive behavior during group activities. The SSs were used either alone or combined with other strategies, such as positive reinforcement, music therapy, role play, group discussion, video self-modeling, immediate practices, or additional audio commentary. Most studies reported improvements in appropriate behaviors and/or reductions in unfavorable behaviors. The meta-analysis indicated that children practiced more toothbrushing steps when using SS interventions compared to conventional oral health instruction (Z = 3.60, MD = 0.66, 95%CI 0.30 to 1.02, p < 0.001). SS interventions have the potential to teach target behaviors, particularly toothbrushing behaviors, among preschool children. More well-designed randomized controlled trials are warranted to determine the efficacy of SS interventions among children with various developmental profiles.

The Need for Technology-Aided Instruction and Intervention Policy for Autistic Youth

This paper examines current technology-aided instruction and intervention (TAII) available for autistic transition-age youth (TAY) and existing policies that may support or hinder the delivery of these interventions. Specifically, we focus on policies that might influence the delivery of TAII to autistic TAY. After a careful review of the literature, we observed that postsecondary policy guiding the delivery of TAII designed to support autistic TAY is lacking. TAII have demonstrated effectiveness, usability, sustainability, and cost-effectiveness, particularly with this population. We suggest possibilities for future policies to support the development, implementation, and evaluation of TAII for autistic TAY.

"A scoping review: Social stories supporting behavior change for individuals with Autism"

Social Stories (also known as social narratives) help individuals participate in and understand social situations. This scoping review identifies and synthesizes social narrative research targeting behavior change in individuals with ASD. Using the following questions as a guide: (a) What is the scope of social narrative interventions used for individuals with ASD, (b) What behavior change outcome measures are evaluated, and (c) What research designs are used; five databases were searched from 2007-to-2018. Fifty-six articles met the criteria. Primary outcomes were sorted into two macro-categories: Reduce Disruptive Behaviors and Increase Desired Behaviors. Most, but not all, studies were found to be effective for various behaviors such as aggressive actions, verbal protests, identifying emotions, executive functioning, following directions, and responding in social situations. Social narratives can be used to promote skills/behaviors in individuals with ASD to enable participation, an important goal in occupational therapy practice. They are an accessible and feasible intervention that can be implemented in various settings for behaviors including activities of daily living, social skills, independence, and self-regulation. Most research reviewed the single subject design, which is a limitation of the research as it makes results difficult to generalize. However, through replication, functional relationships can be determined. Additional research utilizing randomized control trials is recommended.

The impact of using digitally-mediated social stories on the perceived competence and attitudes of parents and practitioners supporting children with autism

A Social Story (SS) is a highly acceptable and widely used intervention by the autism community. Yet, inconsistent implementation of the intervention is reported to be one of the causes of variability in terms of outcome research, particularly in a naturalistic context. This study aimed to (1) investigate whether digitally-mediated social stories (SSs) can improve competence in developing and delivering a SS and thus contribute towards improved implementation, and (2) investigate the impact of the digitally-mediated SS on attitudes towards the SS intervention. Ninety-three participants took an initial pre-engagement survey. Forty-eight of these participants also complete a post-engagement survey. A pre-post design was utilised with the participants who completed both surveys. These 48 participants were invited to develop a digitally-mediated SS with the aim of exploring how digitally-mediated SSs impacted perceived competence and attitudes. Post-engagement data was collected two weeks after the pre-engagement data. Outcomes of this study indicate that both perceived competence and attitudes improved after engaging with digitally-mediated SSs. It is concluded that digitally-mediated SS not only impacted the integrity of how the intervention was delivered but also the beliefs in the participants’ capabilities to develop and deliver a SS. Digitally-mediated SS, thus, has the potential to effectively support development and delivery whilst also addressing challenges related to intervention implementation in a naturalistic context.

Mothers' and practitioners' insights on the use of digitally-mediated social stories with children on the autism spectrum: A convergent mixed-methods study

BACKGROUND

While end-user interest in digitally-mediated Social Story (SS) intervention for children on the autism spectrum is growing, research on the use of SSs in digital form is currently lacking.

AIMS

This study aimed to investigate how digital-mediation can influence parents' and practitioners' attitudes towards the SS intervention as well as impact their perceived competence in their ability to administer the intervention.

METHODS AND PROCEDURES

This study used a convergent mixed-method design. Nineteen participants (ten practitioners and nine mothers) participated in two focus group sessions. Participants then engaged with a digitally-mediated SS and completed a pre- and post-engagement survey measuring attitude, competence and user experience with the intervention.

OUTCOMES AND RESULTS

The mothers' perceived competence ratings improved after engaging with digitally-mediated SSs. Mothers and practitioners also indicated that digitally-mediated SSs increased their perceived efficiency, while mothers felt it improved their autonomy and further empowered them as end-users.

CONCLUSION AND IMPLICATIONS

Digitally-mediated SS has the potential to effectively address challenges related to intervention implementation whilst also empowering further the end-user.

Electroencephalographic Correlate of Mexican Spanish Emotional Speech Processing in Autism Spectrum Disorder: To a Social Story and Robot-Based Intervention

Socio-emotional impairments are key symptoms of Autism Spectrum Disorders. This work proposes to analyze the neuronal activity related to the discrimination of emotional prosodies in autistic children (aged 9 to 11-year-old) as follows. Firstly, a database for single words uttered in Mexican Spanish by males, females, and children will be created. Then, optimal acoustic features for emotion characterization will be extracted, followed of a cubic kernel function Support Vector Machine (SVM) in order to validate the speech corpus. As a result, human-specific acoustic properties of emotional voice signals will be identified. Secondly, those identified acoustic properties will be modified to synthesize the recorded human emotional voices. Thirdly, both human and synthesized utterances will be used to study the electroencephalographic correlate of affective prosody processing in typically developed and autistic children. Finally, and on the basis of the outcomes, synthesized voice-enhanced environments will be created to develop an intervention based on social-robot and Social Story^TM for autistic children to improve affective prosodies discrimination. This protocol has been registered at BioMed Central under the following number: ISRCTN18117434.

A Pilot Randomised Control Trial of Digitally-Mediated Social Stories for Children on the Autism Spectrum

Social stories is a widely used intervention for children on the autism spectrum, particularly within an educational context. To date, systematic reviews and meta analyses of the research evaluating social stories has produced mixed results, often due to a lack of methodological rigour and variability in the development and delivery of the social stories. To address the gap in methodological rigour, a pilot Randomised Control Trial (RCT) was conducted, incorporating a social stories intervention group (n = 9 children on the autism spectrum) and an attentional control group who received a poem (n = 6 children on the autism spectrum) using a digital platform to address variability. Digitally-mediated social stories were found to be effective in producing beneficial changes in behaviour outcomes, which were sustained at a six-week follow up.

Assessing the Effectiveness and Use of Bibliotherapy Implementation Among Children with Autism by Board-Certified Behavior Analysts

Bibliotherapy is the use of reading supplements as a form of therapy and children with autism are a population that could benefit significantly from the implementation of such treatment. Board-Certified Behavior Analysts (BCBA) are instrumental in creating a curriculum to shape the behavior of those with autism. This study surveyed BCBAs throughout the United States on their use and knowledge of bibliotherapy, as well as different practices related to its utilization. Overall, 89 BCBAs responded to the survey. Results revealed that BCBAs who used bibliotherapy did not have previous knowledge of the practice. BCBAs who did implement bibliotherapy did not have formal training. Further research is necessary to better understand bibliotherapy as a potential resource for children with autism.

Schemes of eStories for Children with Social Communication Difficulties

The current paper presents the development and the evaluation of an Arabic application (app) for electronic stories (eStories) that can be used as an assistive tool in the rehabilitation of children with social communication difficulties. The development process involved engineers and researchers and speech and language pathologists (SLPs) from a rehabilitation hospital, who formulated the design methodology of the Arabic app. This process is critical when designing tools for children with communication difficulties since they have a wide range of differences in their abilities. The evaluation of the app from the standpoint of the SLPs at a local school suggests that the app is easy to use, and the involvement of these SLPs helped in developing a better solution. The results of the usability study on twenty-five students showed positive evaluation with an average score that signifies that the app has above-average usability. This paper highlights the importance of the evaluation process in catering the app for successful user experience.

Efficacy of Social Story Intervention in Training Toothbrushing Skills Among Special-Care Children With and Without Autism

Toothbrushing is a routine practice for oral hygiene maintenance. It is also a challenging task for young children with special care needs. In this study, social stories were employed to teach toothbrushing skills for preschool children with special needs. Those children were recruited from the Special Child Care Centers, including 87 children with autism and 94 children without autism. A validated toothbrushing social story was used to demonstrate the toothbrushing procedure for all the recruited children. Parents were encouraged to show the stories to their children before or during their daily toothbrushing. Children's toothbrushing performance, oral hygiene status, and gingival health status were assessed at baseline and 6 months. Toothbrushing performance, oral hygiene, and gingival status of the recruited children were significantly improved after using social stories. Moreover, children with autism showed better oral hygiene status (P = 0.01) and better gingival status (P < 0.001) than their peers without autism. However, there were no significant differences in the toothbrushing performance among children with and without autism. The regression models indicated that the improvement of children's toothbrushing performance and oral health status were associated with children's intellectual functioning and parents' attitudes toward the usefulness of social story intervention. The principal findings suggested that social story intervention could be used to improve toothbrushing skills among children with or without autism, while it was more efficient in improving the oral hygiene status among children with autism. Autism Res 2020, 13: 666-674. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Toothbrushing is considered as a basic self-care practice that should be advocated in early childhood. We used social stories to train toothbrushing skills among preschoolers with special care needs. The toothbrushing skills of the recruited children were significantly improved after 6-months intervention, and children with autism showed better oral hygiene status than their peers without autism. These findings suggested that social story-based health promotion could be implemented among children with special needs.

Effectiveness of Social Stories in Teaching Abduction-Prevention Skills to Children with Autism

The purpose of the present study was to examine the effectiveness of social stories in teaching abduction-prevention skills to children with autism spectrum disorder (ASD). Three male participants with ASD, aged 4-12 years, participated in the study, which was conducted using a multiple-probe-across-participants design. Thirty-nine voluntary adults participated in the study as strangers who presented lures to the participants. The findings of the study showed that social stories were effective on promoting acquisition for all students with ASD. All the participants were able to learn the target skill and maintain their learning. Social validity data were also collected from participants and their parents. Social validity findings revealed that the opinions of the participants and their parents were positive overall.

Tablet-based interventions for individuals with ASD: Evidence of generalization and maintenance effects

BACKGROUND

Despite positive effects of and established empirical evidence for tablet-based interventions for individuals with autism spectrum disorder (ASD), it is not known whether such findings can be applicable to maintenance and generalization effects of those interventions.

AIMS

This systematic review evaluated peer-reviewed single-case experimental design (SCED) studies concerning evidence of generalization and maintenance effects of tablet-based interventions for individuals with ASD.

METHODS

To evaluate the methodological rigor of the literature in terms of generalization and maintenance effects, the authors adopted four of the basic design standards developed by What Works Clearinghouse (WWC; Kratochwill et al., 2010/2014). In addition, the authors used Tau-U effect size measure and attempted to calculate effect sizes differentiated by the type of generalization and maintenance teaching strategies.

RESULTS

A total of 21 studies assessed generalization and/or maintenance effects. In the first evaluation of evidence of generalization and maintenance effects, it was found that more than half of the studies included in this review collected interobserver agreement (IOA) on at least 20% of sessions across all generalization and maintenance conditions and met the minimum quality thresholds of IOA. Meanwhile, less than one third of the studies included more than three data points in each generalization and maintenance condition. With regard to maintenance of effects, about half of the reviewed studies did not report the latency to the maintenance measure, which may hamper the assessment of the clinical and practical significance of the effect of the tablet-based intervention. In the second evaluation, the omnibus Tau-U effect size for baseline to generalization comparisons resulted in a moderate effect. For the contrasts between intervention and generalization comparisons resulted in a small effect. The omnibus Tau-U effect size for baseline and maintenance comparisons resulted in a strong effect. For the contrasts between intervention to maintenance comparisons, the omnibus Tau-U effect size resulted in a small effect.

CONCLUSIONS AND IMPLICATION

Findings in this review suggest that efforts should be made to establish a system for appraising generalization and maintenance procedures in SCED studies. In addition, future studies should investigate if tablet-based interventions are truly effective in creating sustainable behavioral change in individuals with ASD.

Meta-analysis of Tablet-Mediated Interventions for Teaching Academic Skills to Individuals with Autism

Portable touch-screen devices have been the focus of a notable amount of intervention research involving individuals with autism. Additionally, popular media has widely circulated claims that such devices and academic software applications offer tremendous educational benefits. A systematic search identified 19 studies that targeted academic skills for individuals with autism. Most studies used the device's built-in video recording or camera function to create customized teaching materials, rather than commercially-available applications. Analysis of potential moderating variables indicated that participants' age and functioning level did not influence outcomes. However, participant operation of the device, as opposed to operation by an instructor, produced significantly larger effect size estimates. Results are discussed in terms of recommendations for practitioners and future research.

Effectiveness of a preparatory aid in facilitating oral assessment in a group of Saudi children with autism spectrum disorders in Central Saudi Arabia

OBJECTIVES

To evaluate the effectiveness of a specially-designed dental book (preparatory aid) on the behavior of a group of Autism Spectrum Disorder (ASD) Saudi children during their first dental visit to the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Methods: A cross-sectional double-blinded pre-and post clinical study consisting of 2 parts; a survey targeting the parents, and a clinical oral examination of their ASD children was conducted between January and June of 2016.  Results: A total of 40 children (75% males and 25% females) with an average age of 6.1 years were included. Approximately 47.5% children acted positively during the dental procedure. The dental book had a positive effect on the behavior of 37.5%  children according to their parents' evaluation and highly effective in enhancing the parents' dental knowledge (67.5%).  Conclusion: Parents expressed positive opinions regarding the use of preparatory aids in the dental environment. Approximately half of the ASD children benefit from the preparatory aid used according to the parents' opinion, and the follow up survey showed improvement in the parent's dental knowledge and oral hygiene practices.

A meta-analysis of single-case research on the use of tablet-mediated interventions for persons with ASD

BACKGROUND

There is a growing amount of single-case research literature on the benefits of tablet-mediated interventions for individuals with autism spectrum disorder (ASD). With the development of tablet-based computers, tablet-mediated interventions have been widely utilized for education and treatment purposes; however, the overall quality and evidence of this literature-base are unknown.

AIMS

This article aims to present a quality review of the single-case experimental literature and aggregate results across studies involving the use of tablet-mediated interventions for individuals with ASD.

METHODS AND PROCEDURES

Using the Tau nonoverlap effect size measure, the authors extracted data from single-case experimental studies and calculated effect sizes differentiated by moderator variables. The moderator variables included the ages of participants, participants' diagnoses, interventions, outcome measures, settings, and contexts.

OUTCOMES AND RESULTS

Results indicate that tablet-mediated interventions for individuals with ASD have moderate to large effect sizes across the variables evaluated. The majority of research in this review used tablets for video modeling and augmentative and alternative communication.

CONCLUSIONS AND IMPLICATIONS

To promote the usability of tablet-mediated interventions for individuals with ASD, this review indicates that more single-case experimental studies should be conducted with this population in naturalistic home, community, and employment settings.

Effect of a social script iPad application for children with autism going to imaging

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.