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

该项目致力于美国国立卫生研究院改善智力和发育障碍(IDD)的关键任务，方法是 开发和应用智能技术治疗儿童自闭症谱系障碍 (ASD)。到2025年，ASD的护理费用将达到美国公民每年4610亿美元，超过 糖尿病、多动症和中风。提高对高质量应用行为分析(ABA)的可用性， 有效且经过科学验证的方法来补救与ASD相关的损害，可以减少 这些成本。最佳实践要求每周至少25个小时的高质量ABA，然而，大多数儿童 由于供应商短缺和成本，每周收到的时间不到10个小时。该项目利用SMART 技术(收益)使患有自闭症儿童的照顾者成为积极、合作的合作伙伴 行为实践者在他们的孩子的ABA治疗中，弥合因获得治疗机会不足和 行为实践者的可获得性有限，这尤其影响到边缘化社区。收益是一种 智能技术平台，独一无二地结合了ABA理论和实践的知识，为 有发展挑战的个体。与司机的导航系统类似，Gain是一种 为实施ABA治疗计划的教师和照顾者提供独特的导航系统，帮助学习者 掌握技能，改善亲社会行为。从创新到收益将进一步加强协作 通过使照顾者成为行为实践者的更有效的耳目和 提供适合护理者的报告，以便护理员可以更轻松地了解 他们的孩子与行为实践者实现了相互理解。临床疗效评价 智能技术使照顾者能够向患有自闭症和相关障碍的孩子传授生活技能 被评估：1)当被照顾者使用时，收益是否提高了儿童独立生活技能的表现？2)是 获得的指导足以让照顾者向孩子们传授生活技能？3)获得的指导对以下方面有用和有用 传授生活技能？研究设计。单病例研究设计(SCRD)使用改变标准(CC)。 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Pilot数据进行功率分析需要至少8个二元组，但将招募12个二元组。 参与者：从美国三个州的临床站点招募的DIADS(患有自闭症的儿童和照顾者)(3个州中的2个 农村、服务不足的人口)。环境：家庭住宅。自变量：收益专家指导 使用任务分析、链接和提示来支持教学生活技能的技术。主要结果：儿童 独立生活技能表现百分比(12名儿童中至少8名达到至少90%的独立能力 有收益的业绩)。次要结果：程序保真度；感知的有用性和 技术；与目标、程序和照顾者努力/儿童结果相关的社会有效性调查；以及 护理者使用增益的频率和持续时间。

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.