Can mobile devices really make a difference for children with ASD?
Imagine for a second that the world you take for granted suddenly became unpredictable. You no longer understand people’s facial expressions, everyday social interactions become confusing and unsettling, and your ability to organise your life, make plans and control your emotions is seriously impaired. For many young people on the autistic spectrum, this is what life can be like.
Autism is a cluster of impairments in social communication, social interaction and flexibility of thought. So someone with autism might have difficulty understanding gestures, facial expressions or tone of voice. They might find it hard to recognise their own feelings and those of others, and may be more comfortable with set routines.
If you have had the opportunity to work with children with autism in your classroom, a classic phrase used by autism practitioners – “if you’ve worked with one kid with autism, then you’ve worked with one kid with autism” – might resonate. It’s called the autistic spectrum for a reason, because although we can identify broad patterns, how the condition is expressed can vary enormously from child to child.
There are also varying perspectives on how to think about autism. For example, Lauren Mottron, Professor of Psychiatry at the University of Montreal, published an article in the scientific journal Nature, in 2011, where he talked about how he employs people with autism in his lab because they have excellent attention to detail and can often make unusual and creative connections between concepts. In a similar vein, many people with autism, including Temple Grandin, have written about how their autism has been, in many ways, a positive aspect of their lives. Nevertheless, in order for young people on the spectrum to make a success of their time in school, they need the support of their teachers. Many teachers and schools are increasingly aware of autism as a condition, and are adopting a range of strategies to include young people with autism effectively in mainstream school life.
At the same time, concerns about kids playing with their mobiles in class notwithstanding, some schools are actively experimenting with how mobile technology – smartphones and tablets – can be used as learning aids in the classroom. So can we bring the two together? Can mobile tech help young people with autism be successful inside and outside of the classroom? There has been some level of interest in this question since the smartphone revolution took off, back in 2007. Now, in 2013, as the mobile tech market has shown massive development and tablets have become a part of everyday life, there has been a similar boom in interest in the possible benefits of apps for autism. For example, in April, AT&T held an Autism Hackathon in conjunction with leading autism charity “Autism Speaks”. This event, held in San Francisco, challenged developers to come up with their best mobile app for people with autism. The prize for best overall app went to a design which seeks to relieve sensory overload by allowing the user to concentrate on a calming, fun scene involving playing with a guinea pig.
An appetite for apps
As well as developers, parents and teachers getting involved in making apps, the autism research community has been giving some thought as to how we can investigate if mobile tech really can make a difference to the educational and social inclusion of users with ASD – or is it, as with so much in the history of education tech, just another flash in the technology pan? After all, it is relatively easy to come up with an idea and not that difficult to create an app, if you have the right skills. That’s a long way, though, from being able to say with confidence that your app will actually be of real value to the person using it. For young people with autism, as well as for their teachers and parents, this is a significant issue. A school might decide to commit significant financial and other resources to implementing a mobile tech solution for their students on the spectrum. Before doing so, they may well want to have some idea of whether the use of these resources is likely to be effective or not. Luckily, there have been a few research projects that have explored the use of apps for autism, including HANDS, Azahar and ECHOES-2.
So what are the issues? Well, going back to “if you’ve worked with one kid with autism..”, it is unlikely that any one app is going to be a wonder panacea. Autism is too complex a condition for that. An app or a suite of apps might make a difference to some children, and help them with some aspects of their condition, but no autism app is going to be a “magic cure” for autism. Another related point is that apps that allow some degree of customisation may well produce better outcomes. If you can tailor the app to the specific needs of the individual child, it’s more likely to have an impact for them. So an app for emotional management that allows you to choose the images that the child or young person is presented with when he is feeling angry should be more appropriate than an app which just uses a set of stock of images. If the app allows the user to upload a picture of his favourite footballer, his mum or dad, or whatever it is that will work for him, it’s got more chance of making a difference.
How can schools help?
There is also the question of whether mobile tech is something that young people can effectively use by themselves. This may well be the case in some instances, and it’s important, of course, to make sure that mobile tech makes young people with autism feel more, not less, independent and in control of their lives. However, the research experience suggests that, a lot of the time, apps will be more effective if their use is mediated by adults, particularly in schools. As with much other educational technology, it is the teacher, quite possibly in conjunction with the parents, who needs to work with the young person to fit the use of the app to his needs.
The teacher also needs to think about how the use of the app will fit in to the broader context of working with that child. So, if the app is concerned with emotional management, the “offline” interventions – what the teacher and the school say and do to help the child manage their emotions – needs to be integrated with the “online” intervention coming from the app. This might, at a basic level, involve the teacher and the parent prompting the child to use the app, at least at the beginning. Simply reminding the child to charge his mobile device can also be important; if there is no charge, there is no app. In actuality, given the fact that many young people with autism have issues with organisational skills, schools should probably think about putting in place a strategy for charging the device, if they want apps for autism to be a success in their school. Of course, the device itself can be used to help with this, with the use of things like programmed reminders. App designers can also help by making sure that the app itself does not drain the battery unnecessarily.
On a more advanced level, the teacher might work with the child to help him customise the app to meet his specific needs, as well as sitting down with him regularly to reflect on how the app is or is not helping him, and how to modify its use so that it continues to be effective. One significant thing that the research evidence suggests is that apps will only be effective in changing a particular behaviour if the young person with autism is signed up to making that change. So if the child thinks it’s fine to act out in class whenever he feels angry, just introducing an app about emotional regulation is not going to make him magically change. The child has to want to change, and again this is where the online intervention offered by the app needs to be integrated with the teacher’s offline intervention.
You might well be thinking that this sounds like it could all involve a lot of work for the teacher. If so, you would be right. Teachers and schools need to think carefully about the workload involved in using mobile tech effectively. Cooperative working with parents, who can potentially share the burden, can be important here. Working in tandem with parents is, in any event, more likely to make for successful use of an autism app, particularly as many issues around social inclusion spread across home and school. Increasingly, in fact, it is parents who are taking the initiative in introducing the use of apps, but again they need the cooperation of teachers if the use of an app is to make a real difference to the life of their child. So if your child has issues with anger management, this problem will express itself, in many cases, as much at school as at home. Consistent use of an app across home and school may lead to increased impact from the use of the app. In fact, the use of an app can serve to develop closer and more cooperative home-school links.
So, the overall message is that mobile tech can make a difference to the lives of some children with autism. The research evidence suggests this quite strongly. However, the phrase “some children” is crucial. Not every app will work for each child with autism, and some trial and error is needed to work out which ones might work with which child. Neither are there any quick fixes; it will often take time and effort on the part of teachers and parents to get the most out of an app.
Just before you decide it’s probably not worth the bother, think about this research finding: it seems that for some children with autism, they may actually prefer to receive messages about behaviour change from a mobile device than from a teacher or parent. This is probably because they can take their time to process the information at the speed they want to and because, in some cases, they feel less nagged when the technology tells them something. In other words, it can increase their sense of empowerment and autonomy, a key objective for any teacher working with young people with autism.
The possibilities with apps for autism are there, but it’s up to teachers and parents to help young people make the most of them.
Dr Joseph Mintz is Lecturer in Education at the Institute of Education, London. He was the UK Principal Investigator on the HANDS (Helping Autism Diagnosed Navigate and Develop Socially) autism apps project. The findings of the project are discussed in his book Touching the Future Technology for Autism?: