Randomized Trial of a Computer-Assisted Intervention for Children With Autism in Schools

Abstract

Objective: Computer-assisted interventions (CAIs) are popular for educating children with autism, but their effectiveness is not well established. This study evaluated the effectiveness of 1 CAI designed to improve children's language, cognitive, and academic skills, TeachTown: Basics, in a large urban school district.

Method: Teachers (n = 59) in autism support classrooms and their consented students in kindergarten through second grade (n = 154) were randomized to TeachTown: Basics or waitlist control. Child outcome was measured at baseline and after 1 academic year using the Bracken Basic Concepts Scale-Receptive and Expressive versions and the Differential Ability Scales, Second Edition (DAS-II). Random effects regression models that included clustering of time within students and students within classrooms were used to test whether the change over time in each outcome differed between groups.

Results: There were no statistically significant differences in outcomes for children who received TeachTown: Basics or treatment as usual. Increased time spent using TeachTown: Basics was associated with worse receptive language outcomes for children in the experimental group after 1 academic year. However, there was no association between minutes spent using TeachTown and changes in expressive language or DAS-II score.

Conclusion: Despite growing enthusiasm for CAIs in autism treatment, the present findings indicate that CAI might not be effective at improving language and cognitive outcomes for children with autism spectrum disorder. The decision to implement CAIs in schools should be carefully balanced against the evidence for effectiveness of these programs. Schools might be better served by investing in treatment strategies with established evidence.

Clinical trial registration information: RCT of TeachTown in Autism Support Classrooms: Innovation and Exnovation; https://ichgcp.net/clinical-trials-registry/NCT02695693" title="See in ClinicalTrials.gov">NCT02695693.

Keywords: autism spectrum disorder; computer-assisted intervention; computer-based intervention; school-based intervention.

Conflict of interest statement

Disclosure: Dr. Pellecchia has received research support from the Institute of Education Sciences. Dr. Marcus has received personal fees from Allergan, Alkermes, Johnson and Johnson, Sage Therapeutics, and Sunovion. He has received research support from the National Institute of Mental Health. Dr. Mandell has received personal fees from Sage Publishing, the State of California, the US Department of Defense, the Pennsylvania State University, Brandeis University, Once Upon a Time Foundation, the University of North Carolina, and Duke University. He has received research support from the National Institutes of Health. Dr. Rump, Ms. Spaulding, Mr. Seidman, Ms. Xie, and Ms. Reisinger report no biomedical financial interests or potential conflicts of interest.

Copyright © 2019 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1. Trial Profile

Note: AS = autism spectrum. a During the course of the year, 3 teachers left and were replaced by new teachers. All 3 new teachers consented to participate and remained in the condition to which the original teachers were assigned.

Figure 2. Association Between Total Minutes Spent on TeachTown Across the year and change in student outcomes