PICO – A Decision Making Tool for Selecting Apps
Contributed by Kristie Lofland, M.S., CCC-A
New mobile technologies for individuals with autism spectrum disorders, communication disorders and other disabilities are creating new opportunities at an exponential rate. This “mobile revolution” has changed the way teachers, therapists and families help those on the spectrum to meet their individualized goals. While we can maximize the diagnostic, educational and therapeutic power of iDevices, deciding on which device and which apps are best utilized to meet the needs of clients and students can be overwhelming. With over half a million apps to select from, there are tools that can assist you in selecting the right apps for your students and staff to incorporate using iOS devices and quality educational software.
Historically, when deciding on how to choose which app one should purchase or download, the following criteria typically were looked at. The first criterion that seems to be the most widely used is involves looking at the opinions and recommendations of other professionals. While peer review often times yields good information, it can be time consuming and can be based on the biases of that professional’s experience. Opinions of other people are just that; opinions. It is difficult to make clinical decisions based on other’s opinions without knowing what the specific outcomes are you want for your student or client, looking at the evidence, and making comparisons of various apps to see which app is best suited for the outcomes you are striving for.
The second option is to look at app reviews found on the iTunes site or website. Unfortunately, app reviews are not necessarily helpful. For one, we don’t who is writing the review. It could actually be the developer of the app. Often times the reviews will be lacking discussions of evidence based practices or descriptions of any research evidence. Testimonies from bloggers do not always represent level s of evidence and typically use only one source of data.
Then there is the old scientific method of “trial and error”. When I first purchased my iPad, I found myself so excited by what was offered at the app store, that I was like a kid in a candy shop. I purchased numerous apps base on the methods above mentioned only to find that had I done a little more research, I could have saved myself some time and money. There are apps that look great but really don’t do what they tout or what I needed for my students.
Two SLP’s, Lara Wakefield, Ph.D., CCC-SLP and Theresa Schaber, M.S., CCC-SLP, developed a decision making tool for SLP’s to use when selecting apps. The PICO template is a purposeful tool for selection of apps instead of the “grab and go” method. PICO stands for Population, Intervention, Comparison, and Outcome. The first step with population has you asking yourself critical questions such as who are you working with? You need to consider the age, diagnosis and the purpose of contact. With the intervention step, you need to know what skills you want to target and in what context. Will you be introducing a new method when using a particular app? It is then important to do a comparison with a comparative group. For example, if you are looking for an app that will help teach basic concepts in preschoolers, you need to know what is the typical acquisition of basic concepts for that age group. And lastly, what is the goal or your expected outcome. What data will you be tracking and measuring? What results will you are looking for?
Once you have established your PICO template, the next step in the app selection process should begin with a narrow search in the apps store. For example, if you type in the word “articulation” in the search box you will not only get apps for speech articulation but you may also get mechanical articulation, orthopedic articulation, etc. It is important to be as specific as possible in your search and broaden your search from there. Set a time limit as to how long you want to search for apps. It is reasonable to believe that a productive search can take only up to fifteen minutes. Set criteria for the application that you want. What device will you be using? What are the cost parameters? Are there periodic updates? Is there any technical support? When possible, compare the app you are considering with similar ones.
Other considerations we need to make before integrating iDevices into our programs for individuals with ASD, is looking at the individual’s values and beliefs. Does the individual value technology? What are their physical limitations and/or fine motor concerns? What is the cost/risk vs. benefit factor? Will there be sufficient support and resources for both the professional and the individual with ASD?
Changes in information technology today occur at a faster rather than any publication. It is possible that by the time an app or information about an app is available, it may contain outdated material. The attractiveness and excitement of using an iDevice makes it easy for practioners to forget that they still have to plan the service they are delivering, use appropriate reinforcement and guide student learning just like with any other educational tool. Apps may have many, many features but they will never replace the knowledge and skills of the professionals.
Schaber, T., & Wakefield, L., (2011). The PICO Template for Reviewing Speech-language Apps: A Decision-Making Tool for SLPs. Retrieved from http://www.speechpathology.com/
ASHA (2011). What to Ask When Evaluating Any Treatment Procedure, Product or Program. Retrieved from http://www.asha/org/slp/evaluate/
ASHA (2008). Evidence-Based Practice (EBP). Retrieved from http://www.asha.org/member/ebp/
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