Elaboration of a Framework for Assessment of IT-based Interventions in the Field of Autism Disorder
Authors: Maserat Elham , Mohammadzadeh Zainab , Monaghesh Elham 
Published: September 2021

Background and Objectives Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder in which individuals have difficulty in emotional processes related to social cognition and other behavioral patterns. The use of technology in therapeutic and educational interventions for people with ASD - who face ongoing challenges - is increasing. Therefore, to select the interventions more appropriately and ensure their effectiveness, such interventions need to be evaluated. Thus, this study is an attempt to develop a framework for evaluating IT-based interventions in people with ASD. Material and Methods The present study is a descriptive-applied study examining the information technology-based intervention studies in the field of ASD. The search and review of studies continued without any restrictions until an appropriate and complete framework of interventions was obtained. The required data were extracted and collected in a table focusing on the evaluation of ASD interventions. The data were then analyzed to determine an appropriate framework for the objectives of the study. Finally, the evaluation framework was prepared using the one-step Delphi method and sent to 15 experts in the field of autism and health information technology to obtain their views on changing, modifying, approving the framework. Results In the framework developed in this study, two aspects of the interventions including the type of information technology interventions and their outcome are generally presented. . Moreover, the technologies used were presented from three main aspects: evaluation methods, technical evaluation cases, and clinical evaluation cases. Conclusion The results revealed that technology-based interventions in the treatment, education and increasing social interactions of people with ASD can be of tremendous help and bring about significant effects. Therefore, according to experts, the prepared assessment framework of interventions based on information technology leads to identifying the strengths and weaknesses of interventions, improving technologies as well as choosing appropriate interventions and ultimately increasing the quality of life of people with autism spectrum disorder. Extended Abstract Background and Objectives Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder in which individuals have difficulty in emotional processes related to social cognition and other behavioral patterns. The use of technology in therapeutic and educational interventions for people with ASD - who have ongoing challenges - is increasing. Technology-based interventions have demonstrated a variety of skills for people with autism, including the ability to initiate, maintain or end behavior, recognize emotions, improve functional activities of daily living, learn vocabulary, and reading skills. The unique appeal of electronic technology to children and adolescents with autism has greatly motivated their use in clinical and medical services, education and social communication. Therefore, to select interventions better and ensure their effectiveness, they need to undergo an evaluation. Thus, this study develops a framework for evaluating IT-based interventions in people with ASD. Material and Methods The present study is a descriptive-applied study that examines the information technology-based intervention studies conducted in Iran and the world in the field of ASD. The data were extracted from Databases including Pubmed, Scopus, Science Direct, Embase, Google scholar, SID, Web of Science, Magiran without any time limitation. The search continued until a complete framework of IT-based interventions was obtained. The data collection tool for data extraction was a table containing items with a focus on evaluating interventions in the field of aASD, which examined any type of technology used in the intervention of people with ASD from two perspectives: evaluation method of intervention and technical and clinical cases. The required data were extracted and collected in a table focusing on the evaluation of ASD interventions. In the third step, the extracted data were examined to determine the appropriate framework for the objectives of the study in two aspects, including the type of interventions based on information technology and the outcome of the interventions. Also, based on the objectives of the study, the technologies were evaluated from three main perspectives including evaluation methods, technical evaluation cases, and clinical evaluation cases. Finally, the prepared evaluation framework was sent to 15 experts in the field of autism and health information technology to get their opinions on changing, modifying, or approving the framework. After obtaining the cooperation of these people through the informed consent form, the opinion poll was conducted in 1 stage of Delphi method by e-mail. In general, the results showed that the most common IT-based interventions used in the field of autism included virtual reality, mobile phones, serious games, telemedicine, robots, respectively, wearable technologies, computer technologies, video conferencing and music integration technologies. Each of these technologies was used to achieve specific goals. The most important clinical goal in the interventions of patients with autism is to improve their social interaction. It is also important to improve educational skills and their performance and duties. The use of technology is very valuable and effective in removing barriers to patients’ access to the required health interventions. The least common use of IT-based interventions is to achieve the goal of creating a business for patients. Evaluation of IT-based interventions is very important in order to determine the effectiveness of each and select the appropriate intervention. Various methods are used to evaluate interventions. Based on the findings of the study, observation and interview were found to be the most commonly used assessment method used to evaluate almost all technologies while the least commonly used methods for evaluating interventions were related to the specific method of each. Evaluation of IT-based interventions was conducted from two perspectives, which included the evaluation of the technical cases of the technology used and the evaluation of the clinical cases of technology-based interventions. From the point of view of clinical evaluation, the greatest emphasis of the interventions was related to the improvement of communication skills, and from the aspect of technical evaluation, the greatest emphasis was related to the confidentiality and privacy of individuals. Conclusion According to the results, technology-based interventions in the treatment, education and increasing social interactions of people with ASD can be of enormous help and bring about significant gains. According to experts, the prepared assessment framework of interventions based on information technology can lead to identifying the strengths and weaknesses of interventions, improving technologies as well as choosing appropriate interventions and ultimately increasing the quality of life of people’ with autism spectrum disorder. Therefore, given the effectiveness of information technology-based interventions in the recovery of patients with autism, it is better to increase their use in the treatment of patients. Based on the framework prepared in this study, the evaluation of these interventions was done properly, in fact, different aspects of the evaluation were considered to ensure their correct evaluation. As a result, proper evaluation may lead to improving the quality of the technologies used. In addition, medical professionals can easily select the most appropriate intervention using this framework. Practical implications of research One of the practical consequences of the present study is to increase the precision of the specialists in selecting an intervention based on appropriate technology to treat patients with autism. Therefore, autism specialists would benefit from the use of the framework presented in this study in the selection of the most appropriate technology. Ethical considerations This article has been licensed by the Ethics Committee of Tabriz University of Medical Sciences with ethics code IR.TBZMED.REC.1398.704. Also in the present study, researchers are trustworthy in the use, presentation and publication of scientific materials and all the rights of researchers have been observed. Conflict of interest The authors of this article hereby declare that they have no conflict of interest with each other. Acknowledgement The authors of this article would like to thank all the experts and specialists participating in this research and all the collaborators who contributed in any way tothe implementation of this research.