537353

research-article2014

FOAXXX10.1177/1088357614537353Focus on Autism and Other Developmental DisabilitiesClark et al.

Article

Professional and Parental Attitudes

Toward iPad Application Use in
Autism Spectrum Disorder

Focus on Autism and Other

Developmental Disabilities
2015, Vol. 30(3) 174181
Hammill Institute on Disabilities 2014
Reprints and permissions:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/1088357614537353
focus.sagepub.com

Megan L. E. Clark, BA1, David W. Austin, PhD2, and Melinda J. Craike, PhD2

Abstract
This study explored the attitudes of parents and professionals who work with children with autism spectrum disorder
(ASD) toward the utilization of iPads and use of iPad applications by children with ASD. A survey of parents (n = 90) and
professionals (n = 31) assessed information and communication technology (ICT) anxiety and self-efficacy, attitude toward
ICT and iPad applications, and iPad utilization. Both parents and professionals held positive attitudes toward ICT and iPad
use for children with ASD. Parents reported high use of iPads by their children, and professionals reported some, albeit
limited, utilization as part of their practice. These findings suggest that iPad applications are not being used by professionals
to a degree that is consistent with their favorable attitudes toward them. iPad use has been enthusiastically adopted by
many parents; however, there appears a need for training in their use and research to establish an evidence base.
Keywords
autism spectrum disorder (ASD), information and communication technologies (ICT), intervention, iPad applications,
technology-related anxiety, attitudes, computer self-efficacy, skill level, education, behavior, parents, children, professionals
The use of information and communication technologies
(ICTs), such as iPad (Apple Computer Inc., 2012) and tablet
applications, as a platform to assist in the education and
skill development of children with autism spectrum disorder (ASD) is a relatively new area of investigation.
Nevertheless, anecdotal evidence supports the potential
usefulness of such applications (Attwood, 2003; Jowett,
Moore, & Anderson, 2012; Ploog, Scharf, Nelson, &
Brooks, 2013). Furthermore, ICTs such as iPad applications
are potentially a time- and cost-effective, innovative, and
widely accessible form of intervention (Abdullah &
Brereton, 2012; Strain, Schwartz, & Barton, 2011). To
assess the potential impact that new generation devices
such as iPads have for children with ASD, it is necessary to
explore the attitudes and behaviors of their parents and the
professionals who work with these children toward this
modality. The attitudes of parents and professionals are
likely to be related to the degree to which children with
ASD are encouraged and supported to use such technology
for the purposes of education, behavior change, and/or
skills development.
As methods of diagnosis for ASD become increasingly
refined, diagnosis can occur as early as 18 months of age.
This has created additional demand for early intervention
for children with ASD. Early intervention typically refers to
a series of individualized programs designed to meet the
developmental needs and goals of the specific child (Ben

Itzchak & Zachor, 2011). Although early intervention has

positive outcomes for children with ASD, the high cost
associated with these therapies place financial pressure on
the health care system and the families of children with
ASD (Bailey, Hebbeler, Scarborough, Spiker, & Mallik,
2004).
A number of experimental studies have demonstrated that
ICT-based programs are effective and engaging to children
with ASD (Hutinger, 1996; Ploog etal., 2013; Rajendran &
Mitchell, 2006; Silver & Oakes, 2001; Werry, Dautenhahn,
& Harwin, 2001). A recent review of the literature concluded
that there is accumulating evidence, albeit limited at this
stage, that ICT-based programs can be used in the treatment
and education of children with ASD to enhance social, communicative, and language development, and that such technologies are likely to play a central role in the treatment of
children with ASD in coming years (Ploog etal., 2013). A
number of factors have been postulated to explain the appeal
of ICT for children with ASD: ICT is inherently less socially
threatening than face-to-face interactions (Goodwin, 2008;
1

Swinburne University of Technology, Hawthorn, Victoria, Australia

Deakin University, Melbourne, Victoria, Australia

Corresponding Author:
David W. Austin, School of Psychology, Deakin University, 221 Burwood
Highway, Burwood, Melbourne, Victoria, 2134, Australia.
Email: david.austin@deakin.edu.au

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

175

Clark et al.
Rajendran, Mitchell, & Rickards, 2005), the nature of communication is more consistent with the autistic style of learning and interaction (Rajendran & Mitchell, 2006), and
children with ASD have a strong attraction to, and fascination for, systems of a mechanical nature, given their inherent
structure and predictable nature.
Technological advances have led to a shift in the use from
more traditional ICT resources such as the computer, to
newer mobile devices such as iPads and tablet computers.
Touch screen devices such as the iPad are becoming a popular choice for many children (both typically developing and
with ASD) and offer many advantages over traditional
devices; they are compact, portable, reinforcing (Murdock,
Ganz, & Crittendon, 2013), and potentially cost-effective.
Research into the effectiveness of iPad applications to deliver
interventions for children with developmental disabilities is
emerging. A recent systematic review evaluated the use of
iPods, iPads, and related devices to deliver educational programs for people with developmental disabilities and found
that outcomes were largely positive, suggesting that these
devices are viable technological aids for individuals with
developmental disabilities (Kagohara etal., 2013). For children with ASD, exploratory research has examined the effectiveness of the iPad as a communication device (Flores etal.,
2012), in the delivery of video modeling treatment (Jowett
etal., 2012), and a play story to increase dialogue (Murdock
etal., 2013). Research to date on the effectiveness of these
devices, however, is limited; thus, there should be some caution in their use (Maglione etal., 2012).
The cost-effectiveness of iPad applications contributes
to their attractiveness as a mode of delivery for early interventions. Applications are low in cost in comparison with
face-to-face educational and therapeutic interventions for
ASD. For example, an in-home intensive Applied
Behavioral Analysis therapy program can cost between
AUS$30,000 and AUS$50,000 per child per annum (Sharpe
& Baker, 2007), making this impractical for use in the public health care or educational systems and inaccessible to
many families. More similar to an iPad is an electronic
communication device such as the DynaVox Maestro. This
is available for approximately AUS$12,000. In contrast,
iPads retail for less than AUS$1000 and ASD-specific iPad
applications can be purchased from between AUS$0.99
(e.g., Autism Track) and AUS$200.00 (e.g.,
Proloquo2Go), with several alternatives available at no
cost (e.g., ABA Flashcards).
Given the potential of iPad applications to enhance and
increase the delivery of educational and/or therapeutic
interventions to children with ASD, it is time to examine
factors that might influence the uptake of such interventions. Examination of parental and professional attitudes
toward iPads for children with ASD is an important component of the uptake of this technology since attitudes are
typically a strong predictor of subsequent behavior (Kadel,

2005; Wang, Ertmer, & Newby, 2004). To better understand

attitudes toward ICT generally, two predictors can be examined: anxiety toward technology and self-efficacy. Early
negative ICT experiences are detrimental to overall technology use, creating an exaggerated, negative set of
responses and cognitions about ones ability to use technology (Brown & Inouye, 1978; Cassidy & Eachus, 2002).
Conversely, positive first experiences with ICTs facilitate
the development of positive self-beliefs about capabilities,
associated with an increase in positive attitudes toward
technology. However, even if one encounters a negative
first experience with technology, continual exposure and
assistance can alleviate some of the anxiety and negative
cognitions associated with that experience. An understanding of anxiety and self-efficacy will assist in the prediction
of attitudes and thus behavior toward ICT.
Although there is minimal research on the attitudes of
parents toward the use of iPad applications for their childrens development, informal commentaries from parents
suggest that they are generally viewed positively. Parents
express expectations that applications might effectively
enhance their childrens growth, communication, cognition,
fine and gross motor, and social interactive skills through
accessible activities for education and treatment (DeCurtis
& Ferrer, 2011).
Professionals who work with children with ASD recognize the role that technology may play assisting children to
reach therapeutic goals (Attwood, 2003). Despite this, many
professionals have expressed concerns regarding implementing iPad use into lesson plans and therapy sessions
(Gasparini & Culen, 2012). Research in related areas suggests that this anxiety toward iPad use might be attributed to
a lack of confidence in the selection and use of applications,
fearing lack of technological experience and awareness
may inhibit children from gaining the maximum benefit
from this adaptive technology (Hennessy, Ruthven, &
Brindley, 2005).
Educators, support staff, therapists, and parents profoundly influence the assimilation of new technologies into
education and therapeutic intervention (Smith, Caputi, &
Rawstorne, 2000). Therefore, it is important for research to
explore the attitudes of those who work with children with
ASD as well as the childrens parents. Attitudes will likely
affect the extent to which iPad applications are integrated
into therapeutic and educational programs delivered both
by professionals and, in the home, by parents.

Research Aims
To date, there has been little research into the attitudes of
parents and professionals toward the use of iPad applications by children with ASD. The aims of this exploratory
study were to (a) examine the attitudes of parents and professionals (engaged in work with children with ASD)

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

176

Focus on Autism and Other Developmental Disabilities 30(3)

Measures

Table 1. Parent and Child Demographic Characteristics.

Variable
Age
Child
Parent
Education
Did not finish Year 12
Finished Year 12
Undergraduate degree
Postgraduate degree

SD

07
42

2.84
5.75

19
20
33
27

21.1
22.2
36.7
30

Note. Total n = 90.

Table 2. Professional Age and Occupational Characteristics.

Variable
Age (years)
Occupation
Speech pathologist
Education support worker
Special education teacher
Occupational therapist
Psychologist
Integration aide
Teacher
ABA therapist

M (SD)

39 (8.34)
7
4
4
4
4
3
3
2

22.6
12.9
12.9
12.9
12.9
9.6
09.6
06.4%

Note. n = 31. ABA = applied behavioral analysis therapy.

toward ICT generally and iPad application use specifically,

(b) examine the extent to which children with ASD engage
in iPad application use in the home and also the extent to
which professionals utilize iPads in therapeutic settings,
and (c) examine the extent to which education level, technology-related anxiety, and self-efficacy predict attitudes
toward ICT generally and iPad application use specifically.

Method
Demographic Information
Parents (n = 90) were asked to provide information regarding their age, level of education completed, and their childs
age. Professionals (n = 31) were asked to provide information on their age and occupation.
The age of parents ranged from 22 to 63 years (Mage = 42
years, SD = 5.75). Most parents had an undergraduate (n =
33, 36.7%) or postgraduate degree (n = 27, 30.0%). The age
of children with ASD ranged from 2 to 12 years (Mage = 7
years, SD = 2.84). See Table 1.
Professionals ages ranged from 25 to 65 years (Mage =
39 years, SD = 8.34). They came from a range of backgrounds with the most common being speech pathologists
(n = 7, 22.6%). See Table 2.

Technology-related self-efficacy, anxiety, and attitudes: Parent

and professional questionnaires. The three domains of the
49-item Computer Technology Use Scale (CTUS; Conrad
& Munro, 2008) were used to measure computer selfefficacy, technology-related anxiety, and attitudes to
technology.
Computer self-efficacy.Items were derived from the
four mediators of self-efficacy including persistence, goal
setting, attribution, and coping strategies. Participants
responded to 11 items indicating their perceived ability to
effectively use different types of technology using a 7-point
Likert-type scale (1 = strongly disagree, 7 = strongly agree).
In separate samples, Conrad and Munro found the psychometric properties of the 11-item computer self-efficacy
domain were satisfactory, ranging from .72 to .76 (Conrad
& Munro, 2008).
Technology-related anxiety.This domain of the CTUS
measured participant anxiety related to technology (Conrad & Munro, 2008). Based on the unique two-factor structure of this domain, all items loading onto factor 1 concern
computer use, whereas factor 2 refers to the use of technology generally. Items were purposely intended to measure
both unpleasant and positive emotional states. Participants
respond to the 15 items on a 7-point Likert-type scale (1 =
uncomfortable, 7 = comfortable). In separate samples, the
internal consistency was satisfactory, with the overall alpha
coefficients for the 15 items ranging between .76 and .87
(Conrad & Munro, 2008).
Attitudes toward technology. This domain was included to
determine whether attitudes toward various types of technologies were positive (e.g., I can do more things with
technology) or negative (e.g., Technology complicates
peoples lives). Responses were rated using a 7-point Likert-type scale (1 = strongly disagree, 7 = strongly agree).
The internal consistency of the 10-item attitudes to technology domain has been shown to be acceptable across the two
samples, ranging between .70 and .74 (Conrad & Munro,
2008).
Attitude toward iPad applications: Parent and professional
questionnaires.The Attitudes Toward iPad Applications
subscale comprised the 10 items from the Attitudes
Toward Technology subscale of the CTUS (Conrad &
Munro, 2008). In this study, the items were contextualized
to specifically measure attitudes toward iPad application
use, rather than technology use in general. For example,
Question 29 iPad applications enrich peoples lives was
a modification of Item 19 from the original scale Technology Enriches Peoples Lives (Conrad & Munro, 2008).

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

177

Clark et al.
Responses were rated on a 7-point Likert-type scale (1 =
strongly disagree, 7 = strongly agree). This new scale
showed good internal consistency with a Cronbachs alpha
coefficient of .83, comparing favorably with the original
CTUS. This indicated that the modified scale did not suffer
psychometrically; indeed, it showed higher internal consistency than the original.
Frequency and duration of iPad use: Parent questionnaire.This
domain was developed for the current study and included
items to measure frequency of the childs iPad use (i.e.,
percentage of time spent engaging with iPad apps in the
past 5 days) and duration of iPad use (i.e., provide an estimation of the amount of time your child spent engaging
with iPad apps in the last 5 days). The parents were also
asked to report on the amount of time (months/years) their
child with ASD had been using an iPad.
Frequency and duration of iPad use: Professional questionnaire.Length of iPad use in months/years was estimated
with the item Provide an indication of how long you have
been using an iPad as part of your occupation with children
with an AD. Professionals responded to the following item
reporting an estimation of their total iPad use in the past
working week: provide an indication of how many days
you have used an iPad as part of your occupation in the past
5 working days. In an attempt to differentiate the use of
iPad applications for therapy/education and or reinforcement/reward, the following items were included: How
often were iPad applications of a therapeutic and/or educational nature used by children with ASD as part of your
occupation and How often were iPad applications used
by children with AD as part of your occupation for purposes
other than education/therapy (i.e., reinforcement, reward, or
entertainment).

Procedure
Parents of children with ASD and professionals working
with children with ASD were recruited through advertisements placed in school or organizational newsletters or on
school/organizational websites. Autism-specific organizations, early intervention centers, mainstream primary
schools, parent support groups, and special education facilities Australia-wide were contacted during the recruitment
process. All participants were asked to complete an online
questionnaire that took approximately 20 min to complete.
Due to the online administration of the questionnaire,
participants were not required to sign a consent form.
However, all participants were asked to read a brief introduction to the study that included a statement explaining
their consent would be implied through completion of the
questionnaire. The project was approved by an accredited
University Human Research Ethics Committee.

Data Analysis
Descriptive statistics (frequency percentage, M, SD) were
used to analyze sample characteristics, computer self-efficacy, technology-related anxiety, attitude toward technology and iPad use, and iPad-related behavior for parents and
professionals.
Two independent samples t-tests were conducted to
compare general attitudes to technology, as well as attitudes
specifically toward iPad applications, across parents and
professionals. Correlation analyses were performed to
investigate the relationship between attitudes and behaviors
toward iPad applications for both professionals and parents.
Four multiple linear regression analyses were conducted to
explore the extent to which anxiety, self-efficacy, and level
of education (for parents only) predicted Attitudes Toward
Technology and iPad application use for parents and professionals. Total attitude toward iPad apps and Total attitudes toward technology were entered as the dependent
variable while education level (for parents only), computer
self-efficacy, and technology-related anxiety were entered
as predictors.

Results
Anxiety, Self-Efficacy, Attitudes, and Behaviors:
Technology and iPad Applications
The attitudes toward technology in general and iPad applications specifically were favorable among both parents and
professionals. The results of t-tests revealed no significant
difference in mean parent attitudes (M = 45.15, SD = 8.15)
and professional attitudes (M = 46.14, SD = 6.65) toward
general technology use, t(121) = 0.594, p = .55.
Furthermore, there were no significant difference in parent
attitudes (M = 51.73, SD = 9.26) and professional attitudes
(M = 50.62, SD = 9.19) toward iPad application use, t(120)
= 0.565, p = .57. No significant difference in mean technology-related anxiety was identified between professionals
and parents, t(113) = 0.838, p = .40, although professionals did have a slightly higher (although non-significant)
mean technology-related anxiety (M = 85.83, SD = 11.88)
than parents (M = 83.51, SD = 14.97) Comparisons of mean
computer self-efficacy for parents (M = 49.40, SD = 8.37)
and health professionals (M = 47.54, SD = 8.10) revealed
no significant difference between the groups, t(117) = 1.30,
p = .19.

iPad Application Use

As professionals and parents were asked slightly different
questions in the Behavior Toward iPad Applications subscale, the variable total behavior toward iPad applications
was computed separately for both groups.

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

178

Focus on Autism and Other Developmental Disabilities 30(3)

Parental reports of child iPad use. Parental reports of child

iPad use showed that almost half of the children (46%) had
begun using an iPad 12 to 18 months ago, while 30% had
begun using an iPad in the past 6 months. Only a small percentage of children in the sample (3%) had never used an
iPad. iPad use was high for children with ASD, with the
mean frequency of use reported as a total of 4.6 days (SD =
1.74) out of the previous 5 days. Child iPad usage was further broken down into estimated time spent using the device
across the 5-day period: 22% of parents reported a total of 5
to 6 hr use by their child across the 5-day period. Furthermore, 16% of parents stated their childs iPad use exceeded
10 hr, with a mean of approximately 2 hr (SD = 2.03) of
iPad use per day.
Professional iPad use. Based on self-report data, professionals iPad usage was quite irregular: 26% of professionals
had been using an iPad in their work with ASD children for
less than 6 months. Furthermore, 35% of professionals
reported having never used an iPad as part of their occupation. Although approximately half of the sample reported
limited to no use of iPads, the remaining half of the sample
demonstrated some use of the iPad across three of the five
previous working days, either for therapeutic intervention
(16%) or purposes other than therapy, such as reward, reinforcement, and play (16%).

Relationship Between Attitudes and iPad Use

There was a moderate positive, but not significant, relationship between Attitudes Toward iPad Applications and use
of iPad applications (frequency/duration) for professionals,
r(28) = .40, p = .38. Furthermore, a strong positive relationship, r(88) = .57, p = <.001, between iPad application use
and Attitudes Toward iPad Applications was found in the
parent group. When investigating the association between
Attitudes Toward Technology generally and iPad use, a
strong positive relationship was identified among parents,
r(86) = .52, p = .001. In contrast, a weak positive relationship between Attitudes Toward Technology generally and
iPad use was found in the professional group, r(28) = .18,
p = .348. This association was not significant.

Predictors of Parent and Professional Attitudes

Parental attitudes. Together, the factors computer self-efficacy, technology-related anxiety, and highest level of
education accounted for 39% of the total variance in parental Attitudes Toward Technology. The standardized beta
coefficients reveal technology-related anxiety was the
strongest predictor of parental Attitudes Toward Technology and iPads (see Table 3).
An R2 value of .23 indicated that 23% of the total variance in parents Attitudes Toward iPad Applications was

Table 3. Predictors of Parental Attitudes Toward Technology.

Statistic

Self-efficacy

Anxiety

Education

Parents

SE
R2 = .39

0.211**
0.092**

0.599**
0.048**

0.198**
0.659**

Note. n = 90. Self-efficacy = computer self-efficacy; Education = highest

level of education completed; Anxiety = technology-related anxiety.
*p < .05. **p < .001.

Table 4. Predictors of Parental Attitudes Toward iPad

Applications.
Statistic

Self-efficacy

Anxiety

Education

Parents

SE
R2 = .23

0.131**
0.109**

0.501**
0.062**

0.018**
0.828**

Note. n = 90. Self-efficacy = computer self-efficacy; Education = highest

level education completed; Anxiety = technology-related anxiety.
**p < .001.

explained by computer self-efficacy, technology-related

anxiety, and highest level of education combined.
Standardized beta coefficients indicate that technologyrelated anxiety was the most significant predictor of parental Attitudes Toward iPad Applications (see Table 4).
Professional attitudes. Predictors of professionals Attitudes
Toward Technology revealed that combined computer
self-efficacy and technology-related anxiety explained
39% of their Attitudes Toward Technology. Consistent
with parental attitudes, technology-related anxiety was
the strongest predictor of professionals Attitudes Toward
Technology.
An R2 value of .21 indicated that 21% of the total variance in professional Attitudes Toward iPad Applications
was explained by computer self-efficacy and technology-related anxiety, combined. The standardized beta
coefficients showed that technology-related anxiety was
the strongest predictor of professionals attitudes toward
iPad applications (see Tables 5 and 6).

Discussion
The present study was the first study, to the authors knowledge, to examine parental and professional attitudes and
behaviors toward ICT-based support materials generally,
and iPad application use specifically for use by children
with ASD. Our findings indicated that both parents and
professionals held positive attitudes toward ICT and iPad
use and, for parents, positive attitudes were positively

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

179

Clark et al.
Table 5. Predictors of Professionals Attitudes Toward
Technology.
Statistic
Professionals

SE
R2 = .39

Self-efficacy

Anxiety

0.14**
0.077**

0.65**
0.042**

Note. n = 31. Self-efficacy = computer self-efficacy; Anxiety = technologyrelated anxiety.

**p < .001.

Table 6. Predictors of Professionals Attitudes Toward iPad

Applications.
Statistic
Professionals

SE
R2 = .21

Self-efficacy

Anxiety

.037*
.099

0.47**
0.058

Note. n = 31. Self-efficacy = computer self-efficacy; Anxiety = technologyrelated anxiety.

*p < .05. **p < .001.

associated with extent of use of iPad applications by their

children with ASD. Parents reported a high level of iPad
application use by their children, and professionals incorporated some, albeit irregular, use of iPads into their work
with children with ASD. Thus, for professionals, the lower
reported iPad use did not appear to be the result of less
favorable attitudes toward them (or to technology generally). Surprisingly, technology-related anxiety was the
strongest predictor of positive Attitudes Toward Technology
and iPads for both parents and professionals.
Parents reported a high level of iPad use by their children; 22% of parents reported that their child with ASD had
used the iPad for approximately 5 to 6 hr in total across the
past 5-day period. This is the first study to the authors
knowledge to assess the extent of iPad use by children with
ASD. In the broader area of the use of touch screen devices
for people with disabilities, it has been acknowledged that
the use of portable touch devices is a rapidly growing area
of research (Stephenson & Limbrick, 2013). Research on
the extent and type of iPad use for typically developing
children is scarce; however, a 2011 study conducted in the
United States found that 52% of 0- to 8-year-olds had access
to a new mobile device such as a smartphone, video iPod, or
iPad/tablet. In a typical day, 11% of 0- to 8-year-olds used a
smartphone, video iPod, iPad, or similar device to play
games, watch videos, or use other applications, and these
children spend an average of 43 min a day on such devices
(Common Sense Media, 2011).
Our findings indicated that, despite the lack of strong
evidence confirming the efficacy of iPad applications as an

educational or therapeutic intervention for ASD (Maglione

etal., 2012), parents reported a high uptake of this technology. Research investigating alternative treatment methods
in ASD suggests that many parents do not wait for treatments to be empirically supported, with some parents using
a trial and error system of intervention for their child
(Christon, Mackintosh, & Myers, 2010). Parents appear to
adopt a similar approach toward iPad application use for
their children with ASD, with literature in health and disability reports suggesting that parents have emerged as the
primary driving force behind iPad use in ASD (Australian
Government, 2013). Given this high rate of uptake by parents, it is important to educate them on the appropriate use
of iPad applications for their children with ASD and also to
caution parents regarding the lack of scientific evidence for
many of these applications.
There are several possible explanations for the limited
uptake of iPads by professionals working with children
with ASD. Professionals are trained to wait for evidencebased intervention to ensure best practice (Hennessy etal.,
2005), and the lack of scientific validation of iPad applications may explain their limited use. A lack of confidence
may also explain the limited use of these devices. In the
formal education context, Price (2011) proposed that lack of
training and unfamiliarity with ICT devices such as the iPad
leaves educators and clinicians lacking confidence when
attempting to integrate the use of applications into a lesson
plan or one-on-one therapy session.
Training or professional development in the use of ICT
devices for professionals working with children with ASD
may increase their confidence in the utilization of iPad
applications for the delivery of education and goal-based
intervention in the future. As well as a dearth of available
specialist training and evidence of the efficacy of iPad
applications, other factors such as time pressures and an
inflexibility of existing curricula/intervention models to
incorporate the use of iPad applications are potential factors
which could explain the limited iPad use reported by professionals. Nevertheless, further research is required to
clearly identify the predictors of use of iPad applications by
professional educators, therapists, and clinicians.
Education level, computer self-efficacy, and technologyrelated anxiety predicted positive Attitudes Toward
Technology use in general by parents. These findings support the expectation that higher levels of education and
higher computer self-efficacy would result in more positive
attitudes toward general technology use (Conrad & Munro,
2008).
Technology-related anxiety was identified as the most
significant predictor of both attitudes to technology generally, and iPad applications specifically for both parents and
professionals. The direction of this relationship suggested
that higher technology-related anxiety was associated with
more positive attitudes toward both technology generally

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

180

Focus on Autism and Other Developmental Disabilities 30(3)

and iPad applications specifically. These results are inconsistent with previous research that has identified high technology-related anxiety as being associated with negative
Attitudes Toward Technology (Cassidy & Eachus, 2002;
Conrad & Munro, 2008; Smith etal., 2000). Despite the
technology-related anxiety, the positive Attitudes Toward
Technology may be attributed to parental first-hand experiences of the benefits of technology for children with ASD.
It is important to note that the scale used in this study to
investigate technology-related anxiety was developed in
1990 and was therefore based on technological devices,
including the videocassette recorder and microwave oven,
considered modern in that period. Technology-related anxiety today may best be understood in the context of interactive devices such as the iPad and smart phones. These
devices are exponentially more complicated and serve more
purposes than technology from the 1990s, and so technology-related anxiety in 1990 was likely a somewhat different
construct to technology-related anxiety today. As this is the
first study to find a strong relationship between technologyrelated anxiety and positive Attitudes Toward Technology,
it is important for future research to explore this further.
Future research on the use of iPads would also benefit from
the development of scales specifically focused on this
modality, rather than the use and adaptation of scales based
on ICT generally.
The strengths of this study are that it provides insights
into the complex interactions between anxiety, self-efficacy,
attitudes, and behavior toward the use of ICT-based
resources in parents of children with ASD and professionals
who work with these children. There are some limitations
that need to be taken into account when interpreting the
results of this study. This study attempted to gauge an
aggregated use of the iPad by the child with ASD over a
5-day period, as reported by parents. However, it is evident
that providing an accurate measure of time spent using the
device is difficult. Data were not collected regarding the
type of applications that were used by children at home or
parental views on the purpose of the applications being used
(i.e., were they seen as beneficial for educational or skill
development or for other purposes such as entertainment).
Furthermore, relying on self-report of behavior is problematic, as the information obtained is subjective and retrospective. Perhaps future research could attempt to develop an
electronic mechanism, such as an iPad application, that
accurately measures iPad use by children. Validated
research in this area may help clarify current usage norms in
this population.
Although this study provides insight into the attitudes of
parents and professionals toward iPad application use in
ASD, further research is required to provide scientific evidence for the effects of iPad use. It is important to acknowledge that there is likely to be differential efficacy across
iPad applications depending on the applications themselves,

user variables such as childs skill level and severity of

ASD. Thus, several factors should be considered when
assessing the use of iPad applications for children with
ASD. The rapidly increasing use of iPads among this population, and the potential they hold as a means for delivering
time- and cost-effective, education and goal-based intervention to children with ASD, suggests that the research
work should progress as a matter of some urgency.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.

Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.

References
Abdullah, M. H. L., & Brereton, M. (2012). A child led participatory approach for technology-based intervention. In E.
Tunstall & M. Clausen (Eds.), 2012 Participatory Innovation
Conference Digital Proceedings (pp. 15). Melbourne,
Australia: Swinburne University.
Apple Computer Inc. (2012). Apple iPad. Retrieved from http://
www.apple.com/ipad/specs/
Attwood, T. (2003). Understanding and managing circumscribed
interests. In M. Prior (Ed.), Learning and behavior problems in Asperger syndrome (pp. 126147). New York, NY:
Guilford Press.
Australian Government. (2013). Helping children with Autism.
Canberra, Australia: Department of Families, Housing,
Community Services and Indigenous Affairs.
Bailey, D. B., Hebbeler, K., Scarborough, A., Spiker, D., &
Mallik, S. (2004). First experiences with early intervention: A
national perspective. Pediatrics, 113, 887896.
Ben Itzchak, E., & Zachor, D. A. (2011). Who benefits from
early intervention in autism spectrum disorders? Research in
Autism Spectrum Disorders, 5, 345350.
Brown, I., & Inouye, D. K. (1978). Learned helplessness through
modeling: The role of perceived similarity in competence.
Journal of Personality and Social Psychology, 36, 900908.
Cassidy, S., & Eachus, P. (2002). Developing the Computer User
Self-Efficacy (CUSE) Scale: Investigating the relationship
between computer self-efficacy, gender and experience with
computers. Journal of Educational Computing Research, 26,
133153.
Christon, L. M., Mackintosh, V. H., & Myers, B. J. (2010). Use
of complementary and alternative medicine (CAM) treatments by parents of children with autism spectrum disorders.
Research in Autism Spectrum Disorders, 4, 249259.
Common Sense Media. (2011). Zero to eight: Childrens media
use in America. San Francisco, CA: Common Sense Media.
Conrad, A. M., & Munro, D. (2008). Relationships between
computer self-efficacy, technology, attitudes and anxiety: Development of the Computer Technology Use Scale

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016

181

Clark et al.
(CTUS). Journal of Educational Computing Research, 39,
5173.
DeCurtis, L. L., & Ferrer, D. (2011). Toddlers and technology:
Teaching the techniques. The ASHA Leader. Retrieved from
http://www.asha.org/Publications/leader/2011/110920/
Toddlers-and-Technology.htm
Flores, M., Musgrove, K., Renner, S., Hinton, V., Strozier, S.,
Franklin, S., & Hil, D. (2012). A comparison of communication using the Apple iPad and a picture-based system.
Augmentative and Alternative Communication, 28, 7484.
Gasparini, A., & Culen, A. (2012, September). Acceptance factors: An iPad in classroom ecology. Paper presented at the
International Conference on e-Learning and e-Technologies
in Education (ICEEE), Lodz, Poland.
Goodwin, M. S. (2008). Enhancing and accelerating the pace of
autism research and treatment. Focus on Autism and Other
Developmental Disabilities, 23, 125128.
Hennessy, S., Ruthven, K., & Brindley, S. (2005). Teacher
perspectives on integrating ICT into subject teaching:
Commitment, constraints, caution, and change. Journal of
Curriculum Studies, 37, 155192.
Hutinger, P. L. (1996). Computer applications in programs for
young children with disabilities: Recurring themes. Focus on
Autism and Other Developmental Disabilities, 11, 105114.
Jowett, E. L., Moore, D. W., & Anderson, A. (2012). Using an
iPad-based video modelling package to teach numeracy skills
to a child with an autism spectrum disorder. Developmental
Neurorehabilitation, 15, 304312.
Kadel, R. (2005). How teacher attitudes affect technology integration. Learning and Leading with Technology, 32(5), 3435.
Kagohara, D. M., van der Meer, L., Ramdoss, S., OReilly, M. F.,
Lancioni, G. E., Davis, T. N., . . .Sigafoos, J. (2013). Using
iPods and iPads in teaching programs for individuals with
developmental disabilities: A systematic review. Research in
Developmental Disabilities, 34, 147156.
Maglione, M. A., Gans, D., Das, L., Timbie, J., & Kasari, C.
(2012). Nonmedical interventions for children with ASD:
Recommended guidelines and further research needs.
Pediatrics, 130(Supp. 2), S169S178.
Murdock, L. C., Ganz, J., & Crittendon, J. (2013). Use of an
iPad play story to increase play dialogue of preschoolers with autism spectrum disorders. Journal of Autism and
Developmental Disorders, 43, 21742189.

Ploog, B. O., Scharf, A., Nelson, D., & Brooks, P. J. (2013).

Use of computer-assisted technologies (CAT) to enhance
social, communicative, and language development in children with autism spectrum disorders. Journal of Autism and
Developmental Disorders, 43, 301322.
Price, A. (2011). Making a difference with smart tablets: Are
iPads really beneficial for students with Autism? Teacher
Librarian, 39(1), 3134.
Rajendran, G., & Mitchell, P. (2006). Text chat as a tool for referential questioning in Asperger syndrome. Journal of Speech,
Language, and Hearing Research, 49, 102112.
Rajendran, G., Mitchell, P., & Rickards, H. (2005). How do
individuals with Asperger syndrome respond to nonliteral
language and inappropriate requests in computer-mediated
communication? Journal of Autism and Developmental
Disorders, 35, 429443.
Sharpe, D. L., & Baker, D. L. (2007). Financial issues associated with having a child with Autism. Journal of Family and
Economic Issues, 28, 247264.
Silver, M., & Oakes, P. (2001). Evaluation of a new computer
intervention to teach people with autism or Asperger syndrome to recognize and predict emotions in others. Autism,
5, 299316.
Smith, B., Caputi, P., & Rawstorne, P. (2000). Differentiating computer experience and attitudes toward computers: An empirical
investigation. Computers in Human Behavior, 16, 5981.
Stephenson, J., & Limbrick, L. (2013). A review of the use of
touch-screen mobile devices by people with developmental
disabilities. Journal of Autism and Developmental Disorders.
Advance online publication. doi:10.1007/s10803-013-1878-8
Strain, P. S., Schwartz, I. S., & Barton, E. E. (2011). Providing
interventions for young children with autism spectrum disorders: What we still need to accomplish. Journal of Early
Intervention, 33, 321332.
Wang, L., Ertmer, P., & Newby, T. (2004). Increasing preservice teachers self-efficacy beliefs for technology integration. Journal of Research on Technology in Education, 36,
231252.
Werry, I., Dautenhahn, K., & Harwin, W. (2001, September).
Investigating a robot as a therapy partner for children with
autism. Proceedings of the 6th European Conference for the
Advancement of Assistive Technology. Ljubljana, Slovenia,
Procs AAATE 2001, 6, 15.

Downloaded from foa.sagepub.com at PONTIFICIA UNIV CATOLICA PERU on February 17, 2016