e-Unstuck:Interactive e-Learning Software for Parents to Support Executive Functioning and Behavior Regulation in Children With Autism Spectrum Disorder

Background and Significance: The current prevalence of Autism Spectrum Disorder is 1 in 68
children, and 69% of these children do not have an intellectual disability (ASDwoID).
Individuals with ASDwoID are at considerable risk for maladaptive adult outcomes (e.g., un-
or underemployment), and executive functioning (EF) impairments significantly contribute to
this risk. Unstuck and On Target (UOT) is the only empirically supported EF intervention
specifically targeted to the needs of the ASDwoID population. It has improved both EF and
social skills in children with ASDwoID in a randomized controlled trial. Despite its
demonstrated success, there are significant geographical, scheduling, and financial barriers
to parental adaptation of the Unstuck and On Target (UOT) curriculum.

Goal and Innovation: The goal of this project is to develop and test e-Unstuck, an e-learning
intervention that (1) provides advanced training to parents of children with ASDwoID on how
to implement the evidence-based UOT curriculum at home and (2) is built on 3C's proprietary,
state-of-the-art, Dynamic e-Learning Platform, an established platform with high ratings of
quality, value, usability, and feasibility from end users. e-Unstuck will make UOT more
accessible to parents with geographical, scheduling, and/or financial constraints and will
provide parents with key tools (e.g., video modeling, virtual simulations, personalized
reports) to increase efficacious adoption of UOT principles, above and beyond those provided
in the UOT manual. e-Unstuck will be the first dynamically adaptive, personalized,
interactive software product specifically designed to deploy an evidence-based EF
intervention to parents of children with ASDwoID.

Specific Aims: The investigators will accomplish five specific aims, two in Phase I, and
three in Phase II: (1) develop a prototype of e-Unstuck, (2) conduct a feasibility test of
e-Unstuck with parents of children with ASDwoID between the ages of 8-12, (3) fully develop
the e-Unstuck software and conduct iterative usability testing with parents of children with
ASDwoID, (4) conduct a pilot efficacy test in which 110 parents of children with ASDwoID are
randomly assigned to the e-Unstuck intervention or to a control condition in which they
receive in-person training on the UOT curriculum, and (5) prepare e-Unstuck for
commercialization.

Hypotheses: As a result of the pilot efficacy test, the investigators hypothesize that (1)
parents who interact with the e-Unstuck software will report greater knowledge and use of UOT
principles, less parenting stress and greater parenting sense of competence, and improved
child EF and social skills compared to control parents, (2) parents who spend more time
engaged with the intervention will show greater improvements in outcome variables, and (3)
parents who interact with the e-Unstuck software will find the software to be of high
quality, value, usability, and feasibility.

Commercialization Plan: e-Unstuck will be a unique commercial offering within a large
underserved niche market. Revenue will be generated through direct sales to parents of
children with ASDwoID and volume sales to organizations (e.g., schools, clinics, parent
support agencies) who work with children with ASDwoID and their parents.

Inclusion Criteria (Parents):

- be fluent English speakers,

- have a child aged 8-12 years old who has received an ASD diagnosis without
intellectual disability from a community mental health professional, and

- have a child that (1) Qualify for an ASD diagnosis based on expert clinical judgment
using DSM-5 criteria and by meeting criteria on the Autism Diagnostic Observation
Schedule (ADOS), (2) IQ and verbal mental age will not be impaired on an IQ test, and
(3) Shift Scale or Plan/Organize Scale will also show clinical impairment on the
BRIEF.

- be able to access a computer with internet.

- be able to travel to study sites in Rockville, MD and Washington, DC.

Inclusion Criteria (Children)

- Qualify for an ASD diagnosis based on expert clinical judgment using DSM-5 criteria
and Social Affect and Restricted and Repetitive Behavior Total ≥ 7 on the ADOS/ADOS-2,

- IQ ≥ 70 and verbal mental age ≥ 8 years on the WASI-II, and

- Shift Scale or Plan/Organize Scale ≥ 60 on the BRIEF.

Exclusion Criteria:

- Parents who previously participated in feasibility testing (Phase I, Aim 2), usability
testing (Phase II, Aim 1), a prior study of the Unstuck and On Target (UOT) curriculum, or
in-person training of the UOT curriculum will be excluded due to their familiarity with the
curriculum.