JMIR Publications

ABSTRACT

Background:

Approximately 1 in 6 U.S. children a developmental disability. Early detection is crucial but often delayed, especially in families with limited access to resources. Current paper-based screening methods, like the Ages and Stages Questionnaire, face challenges such as cultural barriers and timing issues. Digital tools can improve parent engagement and screening accuracy. This research explores new technologies to enhance long-term parent involvement in developmental screening.

Objective:

To understand if features of a digital intervention specifically designed to engage parents in developmental screening are effective over long-term period.

Methods:

A randomized controlled trial with 139 families over 20 months was conducted, along with follow up interviews and surveys. The intervention consisted of an interactive web portal that combined developmental and sentimental record-keeping, family-friendly visualizations, and the ability to answer screening questions via multiple modalities (e.g., text messaging, web). The control condition consisted of an online portal with no specific engagement features, modeled after standard online developmental screening tools.

Results:

Specific strategies to improve parent engagement were effective. Addition of text messaging feature resulted in the greatest gains in parent completion of milestone questionnaires. There was no significant difference between the groups in the small numbers of parents who contacted a service for connections to early intervention, which were low overall. Overall, features specifically designed to engage parents can result in better screening completion rates. Combining sentimental record keeping with developmental record keeping is promising but saw low engagement and would benefit from integration with existing tools parents already use. Text messaging overall was successful in engaging parents in screening and likely has the largest payoff compared to the effort it took to design and implement. Additional research with higher risk populations and more attention to mechanisms for connecting parents to early intervention services is needed.

Conclusions:

This study demonstrates that a human-centered design approach for technology-based interventions can significantly enhance parent engagement and completion rates of developmental screening questionnaires. However, further research is needed with a larger sample to determine if such features effectively prompt parents to seek early intervention services. Future studies should focus on engaging more diverse and underserved populations to validate these findings.