JMIR Publications

ABSTRACT

Background:

In children with autism spectrum disorder (ASD), problem behaviors play a dysfunctional role, causing as much difficulty with daily living and adjustment as the core symptoms. If these problem behaviors are not effectively addressed, they can result in physical, economic, and psychological suffering not only for the individual but also for family members.

Objective:

We aimed to develop and evaluate the feasibility of a mobile-assisted parent training program for reducing problem behaviors in children with ASD using mobile.

Methods:

This single-blind, single center, randomized controlled trial (RCT) was conducted among parents of children with ASD aged 3-6 years. Children were recruited from the Department of Psychiatry at Seoul National University Hospital. Participants were randomly assigned (1:1) by a blinded researcher. Randomization was performed using a stratified block randomization (with a block size of 4). Parents in the intervention group completed the mobile parent training program at home over a 12-week period. During the 12-week program, the intervention group could continue to receive their usual non-drug treatment in addition to the mobile assisted parent training program. The control group in this study continued to receive their usual non-pharmaceutical treatments for 12 weeks without receiving the intervention of the parent training program. The primary outcome measure was the median change in the Korean Child Behavior Checklist (K-CBCL) scores from pre-to post-intervention. The K-CBCL indicates that the lower the scores indicate a decrease in overall problem behavior.

Results:

Between November 2022, and December 2022, 64 participants were enrolled. Overall, 42 children (median [Interquartile range (IQR)] month, intervention group: 49.0 [41.0–52.5]; control group: 49.0 [42.0–58.0]) participated in the program. The intervention group included 20 participants (48%), and the control group included 22 participants (52%). In the intervention group, the K-CBCL total score showed a decrease post-intervention, with a median difference of -0.5 (95% CI: -4.5 to 3.0). Pervasive developmental disorder scores also showed a decrease, with a median difference of -2.1 (95% CI: -8.5 to 2.5). However, there was no significant difference in CGI-S scores post-intervention for both the control and intervention groups. K-SCQ scores showed further decrease post-intervention in the intervention group (Median difference (95% CI); -2.0 (-4.0 to 1.0)). Caregiver's stress evaluated using K-PSI-4-SF did not show any statistically significant differences between the control and intervention groups. There were no adverse events related to study participation. There were no adverse events related to study participation.

Conclusions:

The finding of this study demonstrated the feasibility of using mobile devices for evidence-based parent training to reduce problem behaviors in children with ASD. Mobile devices' accessibility and flexibility may be a viable alternative for offering early intervention for problem behaviors in children with ASD. Clinical Trial: The trial is registered with CRIS Registration Number; KCT0007841