Using Mobile Technology to Reduce Engagement in Stereotypy: A Validation of Decision-Making Algorithms.
An iPhone app that tells staff when to reward or block can cut stereotypy for most children with autism, but newer AI apps already give bigger gains.
01Research in Context
What this study did
Préfontaine et al. (2019) built an iPhone app called iSTIM. The app watches a child and picks when to give rewards or brief blocks.
They tried the app with 11 children who have autism. An adult still ran the sessions, but the phone told the adult what to do next.
The team used an alternating-treatments plan. Some sessions used the app, others used the adult’s normal plan, and they looked for less stereotypy.
What they found
Eight of the 11 children showed clear drops in stereotypy when the app guided the session.
Four of those eight also spent more time on useful play or work.
The other three children did not improve, and the built-in rules needed fixes before parents could safely use the tool.
How this fits with other research
PCummings et al. (2024) now offers a newer AI-powered app called IMPUTE ADT-1. Their interim RCT shows larger drops in stereotypy than iSTIM did, so IMPUTE ADT-1 has moved the goal posts since 2019.
Boudreau et al. (2015) tested I-Connect, an earlier iPhone self-monitoring app. I-Connect also cut stereotypy, but the child, not an adult, pressed buttons to track their own behavior. Isabelle’s study keeps the phone in adult hands and adds decision rules, showing the next step after simple self-monitoring.
Gehrman et al. (2017) compared two kinds of DRO face-to-face. Both studies used the same quick-switch design, so the tech trial mirrors a classic in-person method.
Why it matters
You can hand an iPhone to a helper and get fast drops in stereotypy for most kids. The tool is free to try, but watch for the three-in-eleven who do not respond. Until the rules are safer, keep a trained eye on the data and be ready to override the app.
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02At a glance
03Original abstract
We developed an iOS app, the iSTIM, designed to support parents of children with autism spectrum disorders (ASD) in reducing common repetitive vocal and motor behavior (i.e., stereotypy). The purpose of our study was to preliminarily test the decision-making algorithms of the iSTIM using trained university students to implement the assessments and interventions. Specifically, we examined the effects of the iSTIM on stereotypy and functional engagement in 11 children with ASD within alternating treatment designs. Using the iSTIM reduced engagement in stereotypy for eight participants and increased functional engagement for four of those participants. Our results indicate that the iSTIM may decrease engagement in stereotypy but that some of the decision-making algorithms may benefit from modifications prior to testing with parents.
Behavior modification, 2019 · doi:10.1177/0145445517748560