Abstract:
One important evidence-based component of early communication interventions
in high-income countries is teaching parents and other primary caregivers
to provide communication opportunities in daily activities to stimulate
the development of beginning communication skills. To address some of the
barriers to communication interventions for children with developmental disorders
(DD) in rural South Africa, we developed a prototype Web-based selfguided
app for caregivers to use at home with their children with DD who
were at the beginning stages of communication development. The purpose of
this study is to examine how this app intervention functioned for caregivers
and its secondary effects on their children. Fifty-one caregiver-child dyads
were randomly assigned to either a typical care intervention group (a 30-
minute hospital-based intervention once a month) or the self-guided mobile
health technology (MHT) app plus the typical care intervention. We assessed
both the caregivers and their children. The majority of the 27 caregiver-child
dyads (81%) assigned to the app group used the app and completed a mean of
35.8 sessions across the 48 sessions (mean range = 5.08–15.75). Eighty percent
of these caregivers employed the “help” function of the app (M per caregiver
= 9.89). The caregivers who completed 44–48 sessions reported that more than half of the children moved from pre-symbolic forms of communication
(e.g., crying) to symbolic forms of communication (e.g., words) by the end of
the intervention. Compared to the typical care group, the caregivers perceived
that their children's success increased even though their difficulties remained
stable. The app group showed a very modest gain in expressive language while
the typical care group did not. The findings suggest that the self-guided app
framework shows promise as a supplement to traditional monthly speechlanguage intervention in South Africa.
