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Reducing Challenging Behaviors In Children With Autism Through Digital Health

通过数字健康减少自闭症儿童的挑战性行为

基本信息

批准号：
9977382
负责人：
Heather J Nuske
金额：
$ 17.99万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-17 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9977382
关键词：
Address Administrator Adoption Adult Behavior Behavioral Case Study Cellular Phone Child Collaborations Communities Data Detection Development Discipline Distress Education Effectiveness Emotions Environment Evaluation Evidence based practice Exhibits Family Foundations Future Health Heart Rate Hospitalization Individual Informatics Intervention Interview Measurement Measures Mobile Health Application Movement Needs Assessment Notification Outcome Parents Participant Pediatric Hospitals Personal Satisfaction Philadelphia Physiological Pilot Projects Preparation Psychophysiology Randomized Reporting Research Research Personnel Sampling School-Age Population Schools Sensory Signal Transduction Specificity Strategic Planning Stress Structure Students Surface System Technology Testing Time Training Waiting Lists Work affective neuroscience autism spectrum disorder autistic children base burnout clinical decision support community partnership data reduction design digital effectiveness evaluation emotion dysregulation emotion regulation evidence base experience follow-up implementation science implementation strategy improved indexing mHealth meetings novel personalized medicine personalized strategies prevent prototype school district showing emotion stress management stress reduction teacher tool usability

项目摘要

PROJECT SUMMARY The project will develop and pilot test a personalized medicine mobile health EMOtion REgulation application (m-health EMORE app) that incorporates physiological stress measurement to support evidence-based practices for reducing challenging behavior in children with autism spectrum disorder (ASD). As much as 80% of children with ASD exhibit challenging behaviors that can have a devastating impact on personal and family well-being, contribute to teacher burnout and require frequent hospitalization. Evidence-based practices for reducing these behaviors emphasize uncovering triggers, yet parents and teachers often report that challenging behaviors surface without warning. Challenging behaviors caused by emotion dysregulation can be the most difficult to predict, as children with ASD often have difficulty communicating their distress before it results in challenging behavior. Exciting recent advances in digital technology now allow measurement of momentary emotion dysregulation, using physiological indices. Our pilot data from four separate samples demonstrate that increased heart rate predicts onset of challenging behavior in children with ASD. In order to tailor the m-health EMORE app to end users and avoid potential barriers to its adoption, in Aim 1, we will evaluate the acceptability, feasibility, and appropriateness of app, and the needs of educational teams in managing stress in children with ASD and challenging behaviors, by conducting interviews with teachers of children with ASD, parents of children with ASD and school administrators, and conducting structured in-class observations with teachers. Through the activities of Aim 2, we will improve our m-health EMORE app, building on our initial app prototype, in collaboration with our established research partner, the Translational Informatics Unit, Children’s Hospital of Philadelphia, and our established community partner, the School District of Philadelphia. We will do this through 1) exploratory work on the specificity of heart rate increase to challenging behavior, on app clinical decision support timing, and on the association of app false positives and negatives to movement or child factors; 2) monthly advisory board meetings with expert stakeholders for app development guidance, and; 3) rapid-cycle prototyping of the app with 10 educational teams (i.e. 1-2 children with ASD, and their teacher and classroom aide, if they have one). This will allow for iterative improvement based on each user’s experience. Through Aim 3, we will test the app for usability, acceptability, feasibility and appropriateness, as well as preliminary effectiveness with 30 educational teams in a randomized waitlist field trial over a 3-month period. Successful completion of these aims will result in a novel m-health app designed to help teachers support emotion regulation, and reduce or prevent challenging behavior in children with ASD, using evidence-based strategies. These activities will lay the foundation for an R01 to evaluate the effectiveness of the m-health EMORE app in a full- scale randomized field trial. Our proposal aligns with the strategic plan of the Interagency Autism Coordinating Committee, to maximize the potential for technology-based interventions to improve the lives of people with ASD.

项目总结