Values and Guidelines of Using Electronic Devices on Children with ASD

[:en]It is a fact that technology is an enormous part of the modern era. Electronic devices such as smartphones and tablet computers have been wildly used among people across all age groups. Reasonably, many people are concerned about the negative effects brought by electronic devices on young children.

The latest guidelines issued by the World Health Organization (WHO) suggested:

1. Screen time is not recommended to infants who are below 1 year of age
   
2. For those who are 2 to 4 years old, sedentary screen time should not be over 1 hour each day

However, what does this mean to children with ASD? Does it mean absolute zero screen time even if it functions as powerful reinforcer or effective teaching medium for our children when learning essential skills?

According to the DMS 5, ASD is manifested by persistent impairments in social communication and social interaction across contexts, limited and repetitive interests and activities. Given their lower interests and skills in social and play, it is possible that some children with ASD spent too much time on electronic devices.



The situation could be complicated by behavioral issues such as poor compliance and inflexibilities which leads to disruptive behaviors when devices are withheld, terminated, or not being used in a certain way. Furthermore, self-stimulatory behaviors, for instance fixation on calculator on smartphones, or jumping in and out of apps without actually playing them could be seen in children with ASD as well.

Nevertheless, the values of electronic devices in the treatment for children with ASD are undeniable. For example:

1. They could serve as effective reinforcers to increase learning motivation
2. Digital presentations allow children to learn and apply acquired skills in electronic formats which is beneficial for generalization
3. New language, cognitive, and play skills can also be learnt through educational and non-educational apps
4. They are helpful in closing the gap between ASD and typical children

While electronic devices can bring positive effects to treatment, it is imperative to use them with caution.

Guidelines of Using Electronic Devices

1. Develop Compliance
   To avoid disruptive behaviors induced by termination or denial of electronic devices, we must first increase our children’s compliance so that we have full control of how and when to use them. If a child displays high-level of disruptive behaviors when devices are terminated or denied, it is best to strength his/her general compliance in other contexts before including electronic devices in the training.
   
   
2. Terminate at the ‘Right’ Time
   How would you feel if someone interrupts you or tries to take away your device when you are about to break record while playing your favorite game? This is not to suggest to let your child plays until record has been broken. Yet, it is useful to terminate devices in the most optimal time, for example right after finishing one level but before starting the next or immediately after the game is over.
3. Do Not Overly Rely on Electronic Devices
   It is natural for us to go back to the same thing if it works. Nonetheless, relying heavily on electronic devices as reinforcer can lead to satiation and does not favor expanding our children’s play skills and scoops of interest. Moreover, the majority of games/apps is solitary which might hinder social development and interaction opportunity.

Although whether or not screen time should be allowed to young children and how much screen time is the most appropriate are still under debate, we do need to realize the needs and challenges of children with ASD is unique and it is important to consider the pros and cons of electronic devices before making a decision.

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Information provided by Autism Partnership

Autism Partnership (AP) is one of the most established Applied Behavior Analysis (ABA) service providers for Autism Spectrum Disorders (ASD) in the world. Formed in 1994 in the United States, AP is run by professional clinicians and specializes in providing one-on-one therapy, group interventions and overseas consultation for children with ASD and their families.

 

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[:zh]科技與現代人的生活息息相關，各個年齡層的人群都頻繁地使用智能手機和平板電腦等電子設備。因此，許多人開始擔心電子產品對孩童造成的負面影響。

世界衛生組織最新發佈的指引表示：

1. 不建議一歲以下的嬰幼兒接觸電子設備
   
2. 二至四歲的小孩每天久坐屏幕前的時間不宜超過一小時

可是，電子產品對患有自閉症譜系障礙（以下簡稱「自閉症」）的兒童又有甚麼影響呢？是不是在孩子學習必要的技巧時即使電子設備能作為有力的強化物或有效的教學工具，我們也不能使用？ 根據「精神疾病與診斷手冊（第五版）」（DSM – V），自閉症患者在社交溝通和人際交往方面出現缺損，而且很有機會做高度重複的行為和擁有狹窄的興趣。鑒於他們對於社交和遊戲的興趣和技巧都較低，部份自閉症兒童可能會過份沉迷和花大量時間在電子產品上。



如自閉症兒童本身不太願意遵從指令或對事固執的話，當成人拒絕拿出、收起或未有按照他們某種方式使用電子設備時，棘手的行為問題便可能會出現。除此之外，自我刺激的行為，例如沉迷於智能手機上的計算器，或毫無意義地反復打開關閉應用程式等，也有機會在自閉症兒童身上觀察得到。

話雖如此，電子產品對於治療自閉症兒童有不可否認的價值。例如：

1. 可用作有效的強化物增強學生的學習動機
2. 數碼媒體能夠讓學生以電子化的形式學習並應用所學技巧，有助於泛化
3. 透過教育或非教育應用程式來學習新的語言、認知和遊戲技巧

雖然電子產品能為治療帶來積極的影響，使用時也需要小心謹慎。

電子設備使用指引

1. 培養服從性
   為了避免因終止或被拒絕使用電子產品而引發的不良行為，我們必須先提高孩子的服從性，這樣我們才能完全掌握如何及何時使用電子設備。如果孩子在被終止或拒絕使用電子設備時表現出較為嚴重的行為問題，最好先在其他的情況下改善他/她的服從性，之後再在練習在使用電子產品時也要服從和配合。
   
   
2. 當「機」立斷
   試想你玩電子遊戲快要破紀錄時，突然有人打斷你或試圖拿走你的設備，你會有何感受？當然我們並非每次也讓孩子成功過關後才把他們叫停止；可是在適當的間結束或暫停也十分重要。最佳時機可以是剛好通過一關但是尚未開始下一關，或是緊接遊戲結束之後。
3. 不要過度依賴電子設備
   當我們發現一個物件有用時，很自然地就會想重複地使用。然而，過度依賴電子設備作為強化物會降低他們的強化效能，並且不利於擴展孩子的遊戲技巧和興趣範圍。此外，大多數遊戲/應用程式屬於單人操作，這也可能會阻礙孩子的社交發展和跟別人互動的機會。

雖然在應否讓幼兒接觸電子產品和甚麼為之適當的使用時間到現在還沒有定論，但我們需要意識到自閉症兒童的需求和他們所面的挑戰的獨特性，並在決定是否使用電子產品前，充分考慮其優點和缺點。

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資訊由Autism Partnership提供

Autism Partnership （AP）於1994年在美國成立，是全球最具規模為自閉症患者提供『應用行為分析』(ABA) 治療的專業機構。AP是由多位專業臨床心理學家、應用行為分析治療顧問及治療師管理，為患有自閉症譜系障礙（ASD）的兒童及其家庭提供一對一治療、行為干預小組訓練及海外諮詢服務。

 

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