Parents act as intermediary users for their children when using assistive technology for cognition in everyday planning: Results from a parental survey

Figures & data

Figure 1. The reported number of ATCs in the three groups: Typical development, Disability group, and Habilitation group. *** = p < .001.

Table 1. Mean and SD reported ATC per respondent divided on each group.

		ID/ASD			ADHD			TD			All Groups together
ATC classification	Example of ATC	Median	Mean	SD	Median	Mean	SD	Median	Mean	SD	Median	Mean	SD
Altering	Timer	1	0.57	0.50	0	0.49	0.50	0	0.24	0.43	0	0.46	0.50
Micro-prompting	Sequence schema	0	0.42	0.62	0	0.20	0.50	0	0.02	0.15	0	0.24	0.52
Reminding	Daily or weekly schedule	2	1.82	1.42	1	1.35	1.12	1	0.87	0.88	1	1.41	1.24
Storing and displaying	Camera or diary	0.5	0.76	0.85	0	0.20	0.44	0	0.15	0.42	0	0.40	0.68
Others/Mixed	Mobile phone	1	1.04	0.88	0	0.54	0.80	0	0.15	0.42	0	0.64	0.83
Sum of ACT		4	4.61	2.71	2	2.78	2.31	1	1.43	1.15	3	3.15	2.58

Table 2. The definition of the themes from the thematic analysis.

Theme	Quote	Description
Parents being there	“I as a parent keep track of everything and enter the events into the calendar. Reminds and supports when needed”	A recurrent theme was that a parent (or another adult) was often around in the planning situation. The parent was reminding, setting up the plan, and making the schedules. Thus, the analysis revealed that it was not the children who made plans by operating ATCs, instead, it was the parents who set up the ATCs for the child to later execute the pre-defined plan. For instance, parents would make the schedule or set the timer, and then the child followed the instructions.
Time- and energy consuming	“It requires a lot of energy, time and presence from me”	It was very common for the parents to report that the planning took a lot of their time and energy. The most reported feature the ATCs were lacking was off-loading for parents. Further, the parents asked for an ATC that would encourage children to make their own plans to become more independent. To reduce their parental workload, parents asked for more advanced ATCs and extra resources, such as help from other people.
Supports memory.	“S/he can check the schedule as many times as s/he wishes in order to finish what s/he’s supposed to do.”	The parents reported that the ATCs were regularly used to support memory. The ATC supported working memory, long term memory, and prospective memory. The use of schemas off-loaded the child’s working memory and graphically displayed different activities and made it easier to remember what steps to perform while doing an activity. The ATCs were also used to help the child remember activities events that had happen yesterday and to help the child remember what will happen tomorrow. Parents also reported, especially the Disability group, that weekly schedules enabled children to check for themselves what was going to happen that week or day.
Facilitated time management and cognitive flexibility.	“By using a timer, it facilitates to finish a task on a given time, I feel that it makes it easier when the time becomes visual and not abstract”	Parents from all groups reported that ATCs helped their child’s cognitive flexibility and supported shifting from one activity to another. Timers are used as a cue for the finish of one task and beginning of the next. They also help children represent the timing of events, for example, understanding the concept that something is going to happen within the next hour. However, parents reported they were missing ATC that helped their child to understand how long they should take on one activity and still have time for the next activity.
Facilitated higher-level cognitive functions and abstractions.	“With a schedule of images, the son’s uncertainty concerning what will happen reduces, making him feel more confident in what will happen during the day.”	Parents to children with disability reported they used pictures and other graphics to make events visual and supported the child’s difficulty in managing sequential tasks. The parents had made sequence schemas for supporting the division of larger goals into sub-goals such as what steps are included in having a shower and thus supporting higher-level cognitive functions of planning and ordering and thus creating an overview of the situation. Additionally, ATC was commonly used to make abstract information visual. Pictures provided both visual support and made the tasks more comprehensible for children in all groups with diagnoses.