Technology-based interventions

This is a brief overview of information about technology-based interventions, taken from the Autism CRC report, Interventions for children on the autism spectrum: A synthesis of research evidence (Autism Interventions Evidence Report).

There are seven other category overviews available to help people learn about different interventions and their research evidence. To understand the information in its full context, we encourage you to access the full report.

Why are technology-based interventions supposed to support children's development?

Technology-based interventions predominantly use computer technology as the primary medium of intervention delivery. The theoretical underpinnings differ across practices, but generally centre on the premise that children on the autism spectrum may have an affinity with technology due to behavioural characteristics that are often observed in this population^1,2.

For example, computerised technology may reduce the social demands of an intervention, complement a special interest a child may have in computers, and/or provide consistency in instruction that aligns with a child’s preference for routine and sameness. These differences in intervention delivery may make learning through this modality equally, or even more, effective than via solely human interaction^1,2.

How are these interventions used in clinical practice?

Kientz, Goodwin, Hayes, and Abowd³ proposed eight categories of technology-based interventions:

• personal computers and the internet;
• video and multimedia;
• mobile technologies;
• shared active surfaces;
• virtual reality and augmented reality;
• sensor based and wearables;
• robotics; and
• natural user interfaces.

These technologies may be used by children independently (e.g., to complete online social skills training), to support daily activities (e.g., using video modelling as one of several practices aimed at teaching dressing skills), or as an alternative modality for interacting with people (e.g., avatar based interaction in online environments).

The development of interventions in this category has occurred broadly in parallel with the emergence of these technologies in society more generally, and has included the use of mainstream technologies as well as bespoke applications³.

For the purpose of this review, augmentative and alternative communication interventions were included in this category, with the exception of the Picture Exchange Communication System which is based primarily on behavioural principles. Augmentative and alternative communication interventions include both low-tech (e.g., picture boards) and high-tech (tablet-based communication apps) systems that are external to the person’s body, which aligns with the classification as technology-based intervention. However, it is noted that augmentative and alternative communication also includes unaided gesture and sign language, which do not align well with this category classification.

What are the principles that underpin the use of technology-based interventions?

There is no universal set of principles relating to technology-based interventions for children on the autism spectrum. However, where core principles have been articulated – such as with the use of augmentative and alternative communication interventions ⁴ – key aspects have been highlighted relating to the interaction of the technology, the individual and their environment. These principles include:

• The importance of an individual’s strengths serving as the foundation for the intervention practice.
• Ensuring a supportive alignment between the technology and the broader environment around the child, including other aspects of an intervention program.
• Providing opportunities for learned skills to be applied in real world contexts.

Who delivers these interventions?

Children on the autism spectrum often have needs across multiple domains of learning, and physical and mental health. Accordingly, children and families may benefit from the expertise of a range of clinical practitioners spanning health, education and medical disciplines.

For all intervention categories, it is essential that clinical practitioners have acquired appropriate qualifications, are regulated (e.g., by a professional or government body), and deliver interventions that are within their scope of practice. A detailed explanation is provided in the full report.

What is the evidence for the effect of technology-based interventions on child and family outcomes?

Below is a summary of the evidence for the effect of technology-based interventions on child and family outcomes, taken from systematic reviews published since 2010. This means that a range of relevant individual studies have been considered, and thus reflects the best available evidence at this point in time.

Listed first are findings from systematic reviews that considered a mixture of technology-based interventions. Following that are findings relating to specific technology-based intervention practices.

		Core autism characteristics				Related skills and development									Education and participation				Family wellbeing
Interventions	No. of systematic reviews	Overall autistic characteristics	Social-communication	Restricted and repetitive interests and behaviours	Sensory behaviours	Communication	Expressive language	Receptive language	Cognition	Motor	Social-emotional/ challenging behaviour	Play	Adaptive behaviour	General outcomes	School/ learning readiness	Academic skills	Quality of life	Community participation	Caregiver communication and interaction strategies	Caregiver social emotional wellbeing	Caregiver satisfaction	Caregiver financial wellbeing	Child satisfaction
Systematic reviews of assorted technology-based interventions*	5		M			L			L	L	M	L	L	L L	L	L					M
Apps	2		H			H	H	H	H	H
Augmentative and Alternative Communication (AAC)	3		L M			L				L	L	L		L		L					M
Computer-based instruction	2		L													L
Facilitated communication	1													L
Robots	1		L
Sign instruction	1													L

View the full evidence table for all intervention categories

Intervention category overviews

• Behavioural interventions
• Developmental interventions
• Naturalistic developmental behavioural interventions
• Sensory-based interventions
• Technology-based interventions
• Animal-assisted interventions
• Cognitive behaviour therapy
• Treatment and Education of Autistic and related Communication-handicapped Children (TEACCH) interventions