Making Progress Monitoring Easier and More Motivating: Developing a Client Data Collection App Incorporating User-Centered Design and Behavioral Economics Insights.

Heather J Nuske,Emily M Becker-Haimes,Kelly Zentgraf,Brinda Ramesh,David S Mandell,Jacqueline E Buck

doi:10.3390/socsci11030106

Abstract

Data collection is an important component of evidence-based behavioral interventions for children with autism, but many one-to-one aides (i.e., behavioral support staff) do not systemically collect quantitative data that are necessary for best-practice client progress monitoring. Data collection of clients' behaviors often involves labor-intensive pen-and-paper practices. In addition, the solitary nature of one-to-one work limits opportunities for timely supervisor feedback, potentially reducing motivation to collect data. We incorporated principles from behavioral economics and user-centered design to develop a phone-based application, Footsteps, to address these challenges. We interviewed nine one-to-one aides working with children with autism and seven supervisors to ask for their app development ideas. We then developed the Footsteps app prototype and tested the prototype with 10 one-to-one aides and supervisors through three testing cycles. At each cycle, one-to-one aides rated app usability. Participants provided 76 discrete suggestions for improvement, including 29 new app features (e.g., behavior timer), 20 feature modifications (e.g., numeric type-in option for behavior frequency), four flow modifications (e.g., deleting a redundant form), and 23 out-of-scope suggestions. Of the participants that tested the app, 90% rated usability as good or excellent. Results support continuing to develop Footsteps and testing its impact in a clinical trial.

Highlights

Introduction iationsThe use of technology in the delivery, coordination, and monitoring of therapeutic or behavioral health interventions continues to grow (Raney et al 2017)
Children with autism in Pennsylvania often qualify for a one-to-one aide because they present with challenging behaviors that require additional support
Free form text field, available once at least one quantitative behavior form has been entered during a session

Summary

Introduction

The use of technology in the delivery, coordination, and monitoring of therapeutic or behavioral health interventions continues to grow (Raney et al 2017). There are few mobile applications available for one-to-one aides (i.e., behavioral support staff) or therapists to track clients’ progress. Data collection often relies on pen-and-paper methods, which are subject to error and impede the delivery of services in fast-paced and busy therapeutic environments 2007; Le Jeannic et al 2014; Riggleman 2021) This reliance on pen-and-paper methods complicates behavior tracking over time and data sharing among team members (Riggleman 2021). Managing children’s challenging behaviors while keeping up with data collection requirements can be extremely difficult and stressful for one-to-one aides and therapists (Riggleman 2021). Data show that challenging behaviors in children with

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Discussion

Conclusion