Randomised controlled trial of an iPad based early intervention for autism: TOBY playpad study protocol
This is only the recipe; the real test of an iPad parent-EIBI app is still cooking.
01Research in Context
What this study did
Granich et al. (2016) wrote the plan for a future trial. They will ask parents of toddlers with autism to use an iPad app called TOBY at home. The app gives short lessons that copy early intensive behavioral intervention. Half the families will get TOBY plus usual therapy. The other half will keep their normal therapy only. The team will track which group learns faster.
What they found
This paper only shows the plan. No kids have used the app yet. The real results will come later.
How this fits with other research
Eldevik et al. (2026) pooled 15 older trials and showed that classic, therapist-led EIBI gives medium-to-large gains in IQ and daily skills. TOBY wants to match those gains with parents and an iPad.
Snijder et al. (2022) is running a similar tablet study for toddlers at high autism risk. Both trials test the same idea: parents can coach their kids with an app instead of sitting in a clinic.
Guthrie et al. (2023) proved that starting parent coaching at 18 months beats waiting until 27 months. TOBY plans to enroll toddlers of the same young age to catch that early window.
Why it matters
If the TOBY trial succeeds, you can give families a low-cost tool to boost therapy hours at home. While they wait for clinic slots, parents can open the app during meals or playtime and still stay inside the EIBI model. Watch for the full results; they may show that an iPad can stretch your clinical impact without stretching your budget.
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02At a glance
03Original abstract
Evidence for early intensive behavioural interventions (EIBI) by therapists as an effective treatment for children with an Autism Spectrum Disorder (ASD) is growing. High-intensity and sustained delivery of quality EIBI is expensive. The TOBY (Therapy Outcomes by You) Playpad is an App-based platform delivering EIBI to facilitate learning for young children with ASD, while enabling parents to become co-therapists. Intervention targets include increasing joint attention, imitation and communication of children with ASD. The primary aim of the study presented in this protocol is to determine the effectiveness of the TOBY App in reducing ASD symptoms when used as a complement to conventional EIBI. The secondary aim is to examine parental attributes as a result of TOBY App use. Children aged less than 4;3 years diagnosed with ASD and parents will be recruited into this single-blind, randomised controlled trial using a pragmatic approach. Eligible participants will be randomised to the treatment group ‘TOBY therapy + therapy as usual’ or, the control group ‘therapy as usual’ for six months. The treatment will be provided by the TOBY App and parent where a combination of learning environments such as on-iPad child only (solo), partner (with parent) and off-iPad – Natural Environment (with parent) Tasks will be implemented. Parents in the treatment group will participate in a TOBY training workshop. Treatment fidelity will be monitored via an App-based reporting system and parent diaries. The primary outcome measure is the Autism Treatment Evaluation Checklist. The secondary outcome measures involve diagnostics, functional and developmental assessments, including parent questionnaires at baseline (T0), three months (T1) and six months (T2). This trial will determine the effectiveness of the TOBY App as a therapeutic complement to other early interventions children with ASD receive. The trial will also determine the feasibility of a parent delivered early intervention using the iPad as an educational platform, and assess the impact of the TOBY App on parents’ self-efficacy and empowerment in an effort to reduce children’s ASD symptoms. The outcomes of this trial may have EIBI services implications for newly diagnosed children with ASD and parents. ACTRN12614000738628 retrospectively registered on 1st of July, 2014. UTN: U1111-1158-6423.
BMC Pediatrics, 2016 · doi:10.1186/s12887-016-0704-9