Testing a mobile digital cognitive support system for high functioning adolescents with ASD: Prototype I of the HANDS SYSTEM

HANDS Project is aimed at developing a cognitive support system for high functioning (HF) adolescents with ASD, running on smartphones and PDAs, complemented by a webbased management system. It is designed to teach/facilitate adaptive social behaviours and daily living skills, and is based on a detailed understanding of the cognitiveprofile of ASD, and on evidence‐based intervention techniques. Development of the system was based on recurrent interactions of expert groups from persuasive design, child psychiatry,cognitive psychology, (special) education, software development, and intended users. This paper focuses on the structure and core functions of the system and the methodology and findings of psychological efficiency testing of its first prototype.
Methods
Testing Prototype I involved qualitative and quantitative methods of 3 disciplines:
persuasive software design, educational research, psychology. Psychological testing wasbased partly on standard tools, such as ADOS, ADI‐R and SRS, partly on eye‐tracking (ET)method, and on a newly‐developed tool for measuring specific behavioural effects, called Experimental Task Analysis (ETA). Design of testing is intended to approximate a randomised clinical trial, with a total sample of 54 HF adolescents with ASD (27 test & 27 matched control subjects) in 4 test‐sites, internationally.
Results
In preliminary analysis, SRS measurements did not yield overall conclusive results on the efficiency of the system. E‐T testing was done and analysed on a semi‐qualitative basis, uncovering atypical visual scanning strategies in ASD subjects. ETA proved to be a useful
tool for measuring individual improvements in specific foci of intervention, and showed the HANDS‐supported intervention effective.Prototype I of the HANDS support system, though some clear shortcomings were
revealed, appears an effective and promising toolkit to support intervention. Efficient digital cognitive support systems require specific solutions allowing individualisation not only in terms of content, but also in designing the visual user interface. ETA method is useful for measuring specific efficiency of interventions. These conclusions identify clear tasks for the coming Prototype II of the system and its testing, and, generally, for future digital support systems for individuals with ASD.

Conclusions