Innovation summary

Early diagnosis of autism spectrum disorder (ASD) is crucial, as it enables an early start to interventions that support the best outcomes for children living with ASD.1 In Vietnam, ASD is often not recognized at an early stage, and children with the condition do not receive the support they require to live fulfilled and active lives due to extremely scarce screening and intervention services.2 There is also lack of educational materials in Vietnamese on this condition.

To bridge the gap, the Centre for Creative Initiatives in Health and Population (CCIHP) in collaboration with expertise from Canada, Vietnam and Australia initiated this Smart Care project. The project aims to design mobile apps in Vietnamese to ensure that children with ASD are able to access early and affordable intervention services. The objective of designing these apps is to enhance user’s knowledge on child development and ASD, and to provide tools for screening young children, as well as tools for early home-based intervention for children with ASD.

The project has 3 components:

  1. To develop web-based and mobile platforms in Vietnamese for 3 groups of users: health providers; care-givers of children under 6; and care-givers of children with ASD under 6
  2. To pilot a model of integrating screening into routine health check-ups at My Hao health district centre
  3. To create enabling environments for improved services for children living with ASD

Impact summary

As of 30 Sept 2016:

  • 3,248 children have been screened
  • 60 out of 63 provinces have users
  • 436 children have been involved in the intervention by a365

"I highly appreciate this website. The questions in the tests are very appropriate and thorough. The videos are also good. They helped form a method to apply when doing intervention to my child.” 

 

-Mother of a child with autism, My Hao District

This innovation is funded by Grand Challenges Canada. 

Innovation details

Using the latest technology developed by social entrepreneurs, the Smart Care project have combined technical, social and business innovation, to provide an integrated and scalable package of services based on a website platform to support for children living with ASD. This project consists of 3 main components:

Component 1: Development of A365.vn, a responsive website in Vietnamese that can be accessed via smart phones, tablets and computers. Users, including health professionals, care-givers of children under 6, and the families affected by ASD can use standardized tools for screening, and modeling videos, information sheets (developed from evidence-based intervention) for home-based intervention3-6 and short questionnaires to monitoring their child’s intervention progress.

Component 2: Piloting integrating development screening into health check-ups. The pediatricians of the district health centre and commune health stations at 7 commnunes in My Hao have conducted screening (through tools in a365.vn) for all children visiting their centre for health check-ups and other periodical procedures (immunization, vitamin A).  Children who were identified at risk of ASD or developmental delays, were referred to Hanoi Medical university Hospital or National hospital of Pediatrics for further assessment and diagnosis..

Component 3: creating enabling environments for improved services for children living with ASD. In collaboration with Vietnam Autism Network (VAN), My Hao district health center, government departments and many other partners, a range of communication activities have been organized to raise awareness on ASD, development screening for children and reduce stigma and discrimination toward children with ASD and their families such as Autism Awareness Day workshops, conference to raise awareness of the press in autism, picturing autism photo exhibition, training courses for parents having children with ASD and communication events to some provinces.

 

Key drivers

Collaboration with smart partners

The strong engagement and commitment of smart partners including Vietnam Autism Network (VAN), Magnusmode, My Hao district health center, information technology team, experts from The University of Queensland, National hospital of pediatrics and the private sector are key drivers that ensures the programme is successful and sustainable.

Engagement with endusers

Engagement with end-users is the key. A number of testing with users have been carried out and findings helped improve users’ experience and utility. When conducting user’s testing, we also realized that some interface (pages) made users confused, and some functions were not well recognized. Thus we have redesigned the flows in the website to make it more user-friendly and easier to navigate. 

 

Challenges

  • Underestimation the requirement for the mhealth platform
  • Dilemma in balancing between technical requirements (IT requirement) for a comprehensive back-end system for colleting user’s data to monitoring and measuring effectiveness, and assuring that the online platform is simple and user-friendly.
  • A child with ASD is unique, and children with ASD have various difficulties and at different levels. Therefore, lots of work are needed for development content of intervention modules to meet the needs of parents.
  • Measuring the effectiveness of intervention and having practice tools to support parents monitoring the improvement of their children. In addition, many care-givers of children with ASD did not complete online questionnaires for measurement at post intervention. 

 

Continuation

  • Expand contents of intervention modules
  • Public raising awareness to generate demands for screening and parent-mediated intervention, and reduce stigma and discrimination
  • Mobilize more funding and expertise

 

Partners

This project will bring together expertise from Canada, Vietnam and Australia:

Funder

Evaluation methods

The team evaluates the impact of interventions for children with ASD via self assessment scale from the perspective of care-givers.Care-givers are requested to measure their children's skills and behaviours before downloading the home-based intervention components. Once the app is downloaded and they have begun applying the home-based strategies and intervention components, they are requested to measure their children's skills and behaviours every three months.

Assessments are implemented to measure children’s improvement in each theme of intervention (such as communication skills, behaviour management, play and learning) and also measure comprehensive improvement.

Impact details

As of the end of September, 2016, 3248 children from 9-48 months have been screened.  

436 children diagnosed with autism were registered on the website for using intervention resources in a365.vn.

Results from Autism Treatment Evaluation Checklist (ATEC), a parent self-administered questionnaire, showed that 77.5% of children who were assessed before and after the intervention showed improvement. The difference of scores between pre and post tests was significant (70.7 and 57.7 respectively).

Qualitative interviews with parents having children with ASD using a365 indicated considerable improvement of their child. They also expressed their needs of having more modeling videos, coaching and instruction on goal selection for the intervention.

References

  2. Vu SH, Whittaker A, Whittaker M et al. Living with of autism spectrum disorder in Hanoi, Vietnam. Social Science and Medicine. 2014; 120: 278–285. doi:10.1016/j.socscimed.2014.09.038
  3. Keen D & Rodger S. Working with parents of a newly diagnosed child with an Autism Spectrum Disorder. London, UK: Jessica Kingsley Publishers. 2012.
  4. Keen D, Couzens D, Muspratt S & Rodger S. The effects of a parent-focused intervention for children with a recent diagnosis of autism spectrum disorder on parenting stress and competence. Research in Autism Spectrum Disorders. 2010; 4, 229-241.
  5. Rodger S, Keen D, Braithwaite M & Cook S. Mothers’ satisfaction with a home based early intervention program for children with ASD. Journal of Applied Research in Intellectual Disabilities. 2008; 21(2), 174-182.

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Country

Viet Nam

Affiliated organizations

Center for Creative Initiatives in Health and Population

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