Figure 3: Designing the User Experience UPA Framework

An Exploration of the Effectiveness of the use of communication Apps through mobile devices on children with Autism Spectrum Disorders (ASD)

Introduction Autism Spectrum Disorder (ASD) is a complex neurological disorder which effects people in

relation to their communication, social and behavioural skills (Bluestone, 2005). As a result

of experiencing impaired communication some people with ASD utilise Augmentative and

Alternative Communication (AAC) methods; one such method is the Picture Exchange

Communication System (P.E.C.S.) (Overcash et al., 2010). P.E.C.S involves the use of

symbols/photographs to communicate a message with the vocabulary stored in a folder. In

line with rapid technology developments, the development of communication Apps based

on P.E.C.S. has occurred. The use of these communication Apps with mobile devices with

children with ASD is a relatively new area of research; particularly in Ireland.

Literature ReviewThe literature review highlighted two primary gaps:

1. the route of development (O’ Cionnaith, 2010) and

2. the lack of empirical evidence pre and post App implementation (De Leo et al., 2010).

The research available is limited and originates from either America, Canada or

Australia.

The development routes of these types of Apps required evaluation. Traditionally the

development took two routes; 1) by software developers or 2) bespoke requests by parents

of children with ASD. Thus, these gaps required representation within the research and as a

result a multi-disciplinary approach was adapted to this research.

This research adapted an action research

design methodology with User Centred

Design (UCD) while utilising a mixed method

approach. The choice of methodology was

taken as a result of two reasons; 1) to

develop a communication App with children

with ASD as opposed to for them (McEwen,

2014), and 2) to explore the effects that the

App had on participants (Chien et al., 2015;

McNaughton and Light, 2013). The

effectiveness of the intervention was

assessed based on five categories:

communication, independence, social

inclusion, attention span and behaviours that

challenge. Figure 3 is an illustration of the

UCD process taken throughout this research.

0

20

40

60

80

100

120

Obs 1 Obs 2 Obs 3 Obs 4 Obs 5

Results from The Autism Treatment Evaluation Checklist (ATEC)

Participant 1 Participant 2 Participant 3 Participant 4 Participant 5

Participant 6 Participant 7 Participant 8 Participant 9 Participant 10

Theme ResultEngaging with App camera feature It was discovered that one participant could spell

independently; his parents and staff were unaware of this.

Increased verbal abilities “he's talking mad since he came back [from mid-term break” (stakeholder comment).

Increased self-esteem “he loves knowing this is his App; he controls it and charges it himself” (stakeholder comment).

Participant access to the App and mobile device Restricted, at times, by stakeholders; thus, limiting participant potential for an effective intervention.

Discussions & RecommendationsThe presentation of results indicated that this was an effective intervention for all

participants in at least one of the five areas: communication, independence, social

inclusion, attention span and behaviours that challenge. Five recommendations were

made for research:

Recommendation CommentFuture Multi-disciplinary approaches 1. Upskilling of social care professionals prior to

entering the health and social care informatics area and

2. Utilisation of current tools for rapid App development.

Training The need for formal and accessible training for stakeholders in relation to P.E.C.S. and mobile devices.

Evidenced based approaches to assessing mobile devices and Apps

Recommendation of mobile devices and Apps should not be based on ad-hoc information. It is important to meet the needs of the person rather than attempting to make them ‘fit’ a particular device or App.

Department of Education Hands on support is required from the DOE to assist stakeholders to utilise these types of technologies.

Policy recommendations Adaptation of current Assistive Technology policies in Ireland to facilitate social change within this area.

ConclusionThis research set out to explore the effects of a communication App on children with

ASD while adapting a multi-disciplinary approach to development. The results

indicated that this was an effective intervention for all participants in at least one of

the five areas explored. However, it became evident throughout the research that

participants were dependent upon stakeholders to experience success.

ReferencesBluestone, J., 2005, The Fabric of Autism- weaving the threads into a cogent theory, Sapphire Enterprises, LLC, 1300 Dexter Avenue North, #110 The Casey FamilyBuilding Seattle, WA 98109.

Overcash A., Horton C. and Bondy A., 2010, The Picture Exchange Communication System- Helping Individuals Gain Functional Communication, Autism Advocate,3rd Edition, pg.21-24.

De Leo G., Gonzales C.H., Battagiri P. and Leroy G., 2010, A Smart-Phone Application and a Companion Website for the Improvement of the Communication Skillsof Children with Autism: Clinical Rationale, Technical Development and Preliminary Results, Journal of Medical Systems, Volume 35 No.4, pg. 703-711.Chien M.E., Jheng C.M., Lin N.M., Tang H., Taele P., Tseng W.S. and Chen M.Y., 2015, iCan: A tablet-based pedagogical system for improving communication skillsof children with autism, International Journal of Human-Computer Studies, Volume 73, pg. 79-90.McEwen R., 2014, Mediating sociality: the use of iPod Touch devices in the classrooms of students with autism in Canada, Information, Communication andSociety, Volume 17, Issue 10, pg. 37-41.McNaughton D. and Light J., 2013, The iPad and Mobile Technology Revolution: Benefits and Challenges for Individuals who require Augmentative and AlternativeCommunication, Augmentative and Alternative Communication, Volume 29, Issue 2, pg. 107-116.O’ Cionnaith F., 2010, Grace iPhone app makes a difference, available from: http://www.irishexaminer.com/ireland/kfkfeygbcwkf,rss2, accessed on 25/11/2015.

Results The quantitative results presented are those from the Autism Treatment Evaluation

Checklist (ATEC). This scale is used to measure the effectiveness of interventions and is

scored out of 180; the greater the decrease in the score the greater the improvement the

child has experienced. The observations with participants 5 and 6 were suspended at the

beginning of observation three due to circumstances beyond the control of the researcher.

The figure 3 illustrates the improvements made by each participant.

Figure 4: Individual results from the ATEC

Table 1: Examples of Qualitative Results

Table 2: Recommendations from the research

AcknowledgementsMs. Anne O’ Brien, Department of Computer Science, Institute of Technology TraleeMr. Keith O Faolain, IMaRIrish Association of Social Care Educators (IASCE)Children, their parents and staff of Nano Nagle School Listowel

Contact Ms. Miriam O’ Sullivan (@mirz01)Post-Graduate Researcher,Institute of Technology Tralee,miriam.osullivan@research.ittralee.ie085-7020111.

The qualitative aspect of this research was evaluated on an individual basis with

each participant making unique developments and improvements. Some of the

results gathered in this section are presented in the table below.

Figure 1: Example of a Picture Exchange Communication System (P.E.C.S.) book

NANO NAGLE SCHOOL LISTOWEL

Ms. Miriam O’ Sullivan1, Mr. Peter Given2 & Dr. Tom Farrelly1

1. Department of Social Science, Institute of Technology Tralee2. Department of Computer Science, Institute of Technology Tralee

Methodology

Figure 2: Onei Communication App