Smart Technology to Empower Collaborative Partnerships Among Behavior Practitioners and Caregivers to Deliver Quality ABA

该项目解决了NIH的一项关键使命，即通过以下方式改善智力和发育障碍（IDD）： 开发和应用智能技术治疗自闭症谱系障碍儿童 （ASD）。到2025年，ASD的护理每年将花费美国公民4610亿美元，超过2010年的年度护理费用。 糖尿病多动症和中风提高高质量应用行为分析（阿坝）的可用性， 有效和科学验证的方法来修复与ASD相关的损伤，可以减少 这些成本。最佳做法要求每周至少25小时的高质量阿坝，然而，大多数儿童 由于供应商短缺和成本，每周接收不到10小时。该项目利用智能 * 利用性别问题信息和联网系统，使自闭症儿童的照料者能够成为积极的合作伙伴， 行为实践者在他们的孩子的阿坝治疗，弥合差距留下的不足获得治疗， 行为实践者的可用性有限，这尤其影响到边缘化社区。性别问题认识信息和联网系统是 智能技术平台，独特地结合了阿坝理论和实践的知识个性化， 具有发展挑战的个体。与驾驶员导航系统类似，性别问题信息和联网系统也是一个 独特的导航系统，为教师和护理人员实施阿坝治疗计划，帮助学习者 获得技能并改善亲社会行为。性别问题信息和联网系统的创新将进一步加强合作 通过授权护理人员成为行为实践者更有效的眼睛和耳朵， 提供更合适的报告，使护理人员能够更容易地了解 他们的孩子与行为实践者达成相互理解。临床疗效评价 智能技术使护理人员能够教他们患有ASD和相关疾病的孩子生活技能， （1）性别问题认识信息和联网系统在由照顾者使用时是否能提高儿童独立生活技能的表现？2)是 性别问题认识信息和联网系统的指导是否足以使照料者向儿童传授生活技能？3)性别问题信息和联网系统是否有用， 教授生活技能研究设计。使用变化标准（CC）的单一病例研究设计（SCRDs）。 这允许对干预效果进行严格的实验评估，并为建立 因果推论使用试验数据的功效分析至少需要8对，但将招募12对。 参与者：从美国三个州（2/3）的临床研究中心招募的二元组（ASD儿童和护理人员） 农村、服务不足的人口）。设置：家庭住宅。自变量：性别问题信息和联网系统专家指导 利用任务分析、链接和提示来支持生活技能教学的技术。主要结局：儿童 独立生活技能表现百分比（12名儿童中至少有8名达到至少90%的独立能力 与性别问题信息与联网系统的绩效）。次要结局：手术保真度;感知的可用性和有用性 技术;与目标、程序和护理人员努力/儿童结果相关的社会有效性调查;以及 照顾者使用性别问题信息和联网系统的频率和持续时间。

This project addresses a key NIH mission to ameliorate intellectual and developmental disabilities (IDD) by developing and applying smart technologies for the treatment of children with Autism Spectrum Disorder (ASD). Care for ASD will cost U.S. citizens $461 billion annually by 2025, exceeding yearly care costs for diabetes, ADHD, and stroke. Increasing availability to high-quality Applied Behavior Analysis (ABA), the most effective and scientifically-validated approach to remediate impairments associated with ASD, could reduce these costs. Best practices call for at least 25 hours per week of high-quality ABA, however, most children receive less than 10 hours per week due to provider shortage and costs. This project leverages smart technology (GAINS) to empower caregivers of children with ASD to become active, collaborative partners with behavior practitioners in their children’s ABA therapy, bridging gaps left by insufficient access to therapy and limited availability of behavior practitioners, which especially affects marginalized communities. GAINS is a smart technology platform that uniquely incorporates knowledge of ABA theory and practice personalized for the individual with developmental challenges. In a similar way to navigation systems for drivers, GAINS is a unique navigation system for instructors and caregivers implementing ABA therapy programs that help learners acquire skills and improve prosocial behaviors. Innovations to GAINS will further enhance collaborative partnerships by empowering caregivers to be more effective eyes and ears of behavior practitioners and providing caregiver-appropriate reporting so caregivers can more easily understand the progress and needs of their children to achieve a mutual understanding with behavior practitioners. Clinical evaluation of the efficacy of smart technology to empower caregivers to teach their children with ASD and related disorders life skills will be evaluated: 1) Does GAINS improve child independent life skill performance when used by a caregiver? 2) Is GAINS guidance sufficient for caregivers to teach life skills to children? 3) Is GAINS useful and usable for teaching life skills? Research design. Single Case Research Designs (SCRDs) using changing criterion (CC). This allows rigorous experimental evaluation of intervention effects and provides a strong basis for establishing causal inferences. Power analysis using pilot data requires a minimum of 8 dyads, but 12 will be recruited. Participants: Dyads (child with ASD and a caregiver) recruited from clinical sites in three U.S. states (2 of 3 rural, underserved populations). Setting: family homes. Independent Variable: GAINS expert guiding technology to support teaching life skills using task analysis, chaining, and prompting. Primary Outcome: child independent life skill performance percentage (at least 8 of 12 children reach at least 90% independent performance with GAINS). Secondary Outcomes: Procedural fidelity; perceived usability and usefulness of the technology; social validity survey related to the goals, procedures, and caregiver effort/child results; and caregiver frequency and duration of GAINS use.