NIDRR Research Spotlight, Volume 1 Number 2

Could an iPod Touch ® be the key to successful employment for people with autism?

A NIDRR-funded study at Virginia Commonwealth University (VCU) suggests that these hand-held computers offer support to people on the autism spectrum who are entering the workforce.

People with autism spectrum disorders (ASD) face many obstacles when transitioning from school to full- or part-time employment. They often experience difficulty with time management, interacting with co-workers and managing complex task sequences. They may have trouble performing scheduled activities, such as taking medications or getting to work on time, and may find it hard to control behavioral challenges in the workplace. Finding and keeping employment under these circumstances is a challenge.

The VCU researchers want to know whether a small, hand-held computer can help address these difficulties. Participants in this study, people with ASD who are starting an employment trial with a job coach, are randomized into two groups. Participants in the first group are provided with an iPod Touch and trained in its use to manage work duties as soon as they begin their jobs. Members of the second group work for three months with job coaching support before they receive the device. Job performance, retention, hours of job coaching support needed, and worker and co-worker satisfaction are compared during this three month period, when one group has an iPod Touch and one does not. The study also examines how participants use the iPod Touch, the strategies they use on the job, and their satisfaction in using it in the workplace.

Participants are trained to use the iPod Touch in a variety of ways. Everyone so far has used reminder alarms to stay on schedule, most have used checklist applications for job duties, and many have utilized custom-made videos to find their way on the job site, model complex tasks, and self-coach customer care behaviors. One participant used a metronome application to help maintain a steady and productive pace at a repetitive task. Another used personal finance applications to manage his budget. A third interacts with his off-site job coach via wi-fi video chat using the Apple Facetime application. Each intervention is individualized for the participant's job needs, but all leverage the varied functions of an iPod Touch in support of successful work habits.

So far, 18 people have participated in the study. By the end of the project, more than 50 participants will have been trained to use the iPod Touch to support their employment activities. The researchers have found that participants can learn to operate these devices, that they use them independently for job duties and take care of them (only one has broken so far). Early findings show that using an iPod Touch on the job, as trained by an occupational therapist:

  • Reduces the hours of job coaching support needed,
  • Improves on-time performance of job-related duties,
  • Supports independent performance of complex work tasks,
  • Supports appropriate social behavior in the workplace,
  • Improves worker’s sense of self-efficacy, and
  • Is accepted by co-workers as a useful support.

These preliminary findings are encouraging, but the researchers are waiting until the study is completed to analyze and disseminate quantitative results on this first randomized controlled trial of a PDA as a cognitive-behavioral aid for people with autism.

 

VCU Assistant Professor of Occupational Therapy Tony Gentry, OTR/L PhD, the lead investigator on the project, highlighted some of the advantages of the handheld device: ”The iPod Touch is small enough to be carried in a pocket or on a belt clip. It has many of the same useful reminder functions of older PDAs but includes applications that far exceed that. For instance, using a video chat application such as Facetime or Skype, job coaches and clients can interact even when the job coach is not onsite. Video modeling allows users to play and pause videos of complex task sequences right when they need them. Inexpensive augmentative communication applications can speak for non-verbal workers.”

The iPod Touch by Apple is a multi-featured PDA. It features a touch screen and hosts a wide variety of applications (called “apps”) for productivity, education, organization, and entertainment. It is small enough to fit in a pocket and can hold up to 64 Gb of memory. Compared to some assistive technology products, it is relatively inexpensive, ranging from $180 to $350. Individual applications range from free to less than $30. Study participants have said that they find the devices to be "cool". There is no social stigma to using an iPod Touch, unlike many other disability-specific technologies the participants have previously used.

Previous studies by the same team of researchers at Virginia Commonwealth University looked at the use of hand-held devices to improve cognitive functioning for people with multiple sclerosis, traumatic brain injury, and autism. All three disabilities can cause difficulties in learning, memory, task completion, and adaptive behavior. In those studies, Dr. Gentry's team found that hand-held devices such as PDAs improved functional performance and satisfaction in everyday life. They helped organize tasks, keep calendars, and alert participants to events and tasks to be completed. This current study, using a more rigorous design of randomized controlled trial, seeks to provide stronger evidence that PDAs are both functionally effective and cost effective for people with autism on the job. As Dr. Gentry says, “The technology has changed so much in just a few years, and we have so much to learn about how to leverage these devices for people with disabilities. The older PDAs functioned primarily as reminder systems. With its versatility and functionality, the iPod Touch can support job coaching in a multitude of ways!"

For more information on this project, please visit http://www.vcu-autism.org/study/index.cfm

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