A randomised controlled trial of an iPad-based application to complement early behavioural intervention in Autism...

Area of Science:

• Pediatric neurology
• Developmental psychology
• Clinical informatics

Background:

• Autism Spectrum Disorder (ASD) interventions are increasingly technology-based.
• Few technology-based interventions undergo rigorous evaluation via randomized controlled trials (RCTs).
• This study addresses the need for RCT evidence on technology-based ASD interventions.

Purpose of the Study:

• To evaluate the efficacy of the "Therapy Outcomes By You" (TOBY) app, a technology-based early intervention for young children with ASD.
• To compare the TOBY intervention plus treatment-as-usual (TAU) against TAU alone in a randomized controlled trial.
• To assess outcomes at 3 and 6 months post-baseline.

Main Methods:

• An RCT involving 80 children (mean age 3.38 years) diagnosed with ASD.
• Participants were randomized to either TAU or TOBY therapy (app-based learning curriculum) plus TAU for 6 months.
• Outcomes measured included the Autism Treatment Evaluation Checklist, Mullen Scale of Early Learning, and MacArthur-Bates Communicative Development Index.

Main Results:

• Children in the TOBY group used the app for an average of 19 minutes/day in the first 3 months, decreasing to 2 minutes/day in the second 3 months.
• No significant group differences were found on the primary outcome (Autism Treatment Evaluation Checklist) at 3 or 6 months.
• Significant improvements were observed in the TOBY group for fine motor skills, visual reception, and receptive language at 6 months.

Conclusions:

• The TOBY app may serve as a cost-effective adjunct to existing therapist-delivered interventions for children with ASD.
• Sustained engagement with the TOBY app over the 6-month intervention period presented a challenge for most participating families.
• Further research is needed to optimize sustained use and long-term efficacy of technology-based interventions for ASD.