Autism & Technology. Research on the use of technology for children and adolescents with autism. Sue Fletcher-Watson. Tønsbergkonferansen, June 2018

Transcription

1 Autism & Technology Research on the use of technology for children and adolescents with autism Sue Fletcher-Watson Tønsbergkonferansen, June 2018

2 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

3 @suereviews

4 @suereviews Neurodiversity framework Autism as difference, not disability intellectual disability, but co-occurs with it in some cases requires understanding, acceptance and sometimes adjustments by others ability based on interactions between people and environment (post-social model) #nothingaboutuswithoutus co-occurs with other sources of discrimination (intersectionality)

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6 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

7 Tech use and autism Autistic users: Use technology a lot Can learn a range of skills effectively from technology Need integrated support to generalise these skills to other contexts May derive spin-off benefits from working with technology Can use technology as a communication aid Alcorn et al, 2011, 2015; Fletcher-Watson, 2014; Grynszpan, Weiss, Perez-Diaz & Gal, 2013; Mineo, Ziegler, Gill & Salkin, 2009; Moore & Calvert, 2000; Orsmond & Kuo, 2011; Pennington, 2010; Ramdoss et al., 2011a; Ramdoss et al., 2011b; Ramdoss et al, 2012; Shane & Albert, 2008; Williams, Wright, Callaghan & Coughlan, 2002

8 Our latest survey Data from three countries (UK, Belgium, Spain) n=415, parents including those with adult children Broad range of largely recreational uses Mostly commercial and non-autismspecific techs Comparable patterns across age and ability Higher reading & language = more devices and interfaces Longer time using tech relates to higher reported concerns

9 What is it about tech? Avoidance of social contact? Evidence that adolescents and adults on the spectrum do not use phones for social purposes Anecdotal evidence suggests the opposite Preference for repetition? For predictability? No concrete evidence but very plausible Match with visuo-spatial skills? Untested assumption Technology is not a visual medium

10 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

11 Foundation in theory Development of social attention Attention to people Following gaze and pointing Foundation of social and communication skills Atypical trajectory common in autism

12 Foundation in data

13 Foundation in literature Children and adults with ASD are extensive users of technology: Instinctive, motivating, engaging, accessible, personal Part of our [social] world Experimental studies report improvements in target skills and on-task behaviour But generalisation is limited only one tool in the box New early years accessibility Fletcher-Watson & Durkin, 2014; Fletcher-Watson, 2014; Kagohara 2013; Shane & Albert 2008

14 Foundation in user needs

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18 Conclusions?

19 Overall Child play Child like Parent like Easy to use Faults Percentage Parent Responses Our app is no good? 100 % 90 % 80 % 70 % 60 % 50 % 40 % 30 % 20 % 10 % Negative Neutral Positive 0 %

20 Parent experiences

21 Measuring family experience I was very skeptical whether she understands what she's supposed to do but after she figured it out she played the game for the whole hour. She even didn't want to give it back to me :) I'm sure she will have a lot of good time with the ipad. I was very proud of her that she knows what to do.

22 Measuring digital literacy From my point of view technology is an invaluable resource in the development of A in the last year A has learnt words, songs, social stories, the alphabet and numbers through using his ipad. He has done all of this through watching YouTube and it has also led him on to age appropriate interests like Marvel superheroes... The FindMe app may not have caused the direct improvement in A but it did lay the foundations of understanding how to open and app, the cause and effect of touching the screen and closing the app down.

23 Measuring engagement

24 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

25 Innovation in technology Using technology as a motivator, or facilitator, for social interaction

26 Innovation in measurement -42ms +215ms

27 Innovation in concepts (not just) measuring whether it has effects on skills Do people want to use it? Does it have unanticipated benefits: tech skills, well-being Is it good value for money against size of benefit Is there a beneficial experience as well as outcome? Can we learn about more than [this piece of tech]?

28 Innovation in participation Building personal relationships Trust Planning & preparation Fair payment Transparency, honesty Mutual Respect Principles of Engagement Listening & learning Willingness to change

29 Up next: research into practice

30 Time for a break And any questions?

31 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

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33 What is screentime? Television and Film Box sets and on demand TV Cinema? YouTube? Computers and laptops Homework versus leisure time Software versus internet Tablets and smartphones Apps: educational or not? Texts, social media, dating Calendars, planning The internet Virtual worlds, gaming Online shopping, online news Wikipedia, Google Pornography Tracking and monitoring Play SatNav, google maps Wearables Xbox, Nintendo Wii Sport, Tangibles

34 What is screentime? Television and Film Box sets and on demand TV Cinema? YouTube? Computers and laptops Homework versus leisure time Software versus internet Tablets and smartphones Apps: educational or not? Texts, social media, dating Calendars, planning The internet Virtual worlds, gaming Online shopping, online news Wikipedia, Google Pornography Tracking and monitoring Play SatNav, google maps Wearables Xbox, Nintendo Wii sports, tangibles

35 What is engagement?

36 What is benefit? Links to obesity No causal relationships Do not control for relevant confounders In fact Active games can lead to benefit Touchscreens develop some important fine motor skills What about mental health?

37 What is social?

38 What can we do right now? Teach children to manage their own diet quality (design, complexity, structure) variety timing Digital etiquette and skills Security and safety online Ask how, not how much Question the evidence

39 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

40 The (digital) research/practice gap Herrera, G (2015) Aplicaciones móviles para personas con TEA. Smarthealth

41 The scale of the challenge Search for autism: App store > 1000 results Google Play ~ 250 results Not to mention Robots Wearables Computer games Websites

42 BETA: Building evidence for technology and autism Co-developed, accessible evidence-based practice framework Systematic review: evaluation & design Delphi study Autistic people & parents Practitioners Apply framework to existing app databases Publish framework as a tool for consumers & practitioners

43 Potential forms of evidence Theoretical grounding User-led design Expert consultation Proportional to claims & price Reviews and awards (independent research)

44 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

45 Tech for well-being Identity Peer respect Normality Self expression Play skills Concentration Flexibility

46 Tech for growth Intervention Work arounds Independence Curriculum learning Classroom support Communication Relaxation Relationships

47 Things to think about Integration into the context Once you ve started, you can t stop User Recording and monitoring Continuing process not just the device Other people How tech is used Interface keeping pace with user progress using the settings Device Look at the bigger picture motivation, self-confidence, empowerment, confidence

48 Outline What s autism? What s technology? The state of the art How and how much are autistic people using tech? Design & evaluation: teaching social skills with an app Innovations in the field: technologies and methods Research into Practice Tackling community concerns Building Evidence for Autism & Technology (BETA) Functions and Choices Final points

49 New research challenges Comparison of technologies against each other Understanding interactivity versus passive viewing Optimal levels of challenge Studies embedded in real world settings & capitalising on commercial resources / consumer choices Designing for specific populations or not?

50 Ideals for the future Working more closely with neurodivergent communities Valuing technology interaction skills in themselves Recognising and measuring quality of life impact of technology Positively integrating technology into a varied range of opportunities for learning, play, and daily living Technology to educate others about disability Online communities of support (for families)

51 Thank you! Any questions? Mihaela Dragomir, Alyssa Alcorn, Maggi Laurie, Vanessa Zervogianni