Can an app identify autism as well as a doctor?

Autism researchers from La Trobe University are about to test whether a smartphone app can identify potential signs of autism as accurately as healthcare professionals.

Salesforce earlier this year contributed a team of its engineers, developers and designers to researchers from the Olga Tennison Autism Research Centre (OTARC) to convert their work into code.

The result was ASDetect, an app available for iOS and Android. It has garnered 10,000 downloads in the first six months of availability, 75 percent from Australia. The researchers used Salesforce’s Dreamforce conference this month to officially launch the app in markets outside of Australia.

With critical mass starting to build, they are now looking at projects to gauge just how effectively the app performs compared to traditional means of early detection.

The app is underpinned by techniques developed by Dr Josephine Barbaro - a research fellow at the centre - and traditionally used by maternal and child health nurses in Australia as well as early childhood professionals, to identify “potential ‘red flag’ signs of autism spectrum disorder”.

It asks parents between 12 and 14 questions when their child turns 12 months, 18 months and 24 months.

Parents watch an explanatory video of certain behaviours – “such as use of eye contact, responding to name, pointing, pretend play,” Dr Barbaro said – and select whether the child “rarely” or “mostly” displays that behaviour.

At the end they receive an assessment of the “likelihood” of autism.

“It stresses that it’s not a diagnosis, and to go to your doctor,” Dr Barbaro told iTnews.

Parents receive an email they can take to a healthcare professional which displays the results as well as an explanation of the OTARC research.

However, it is unclear just how accurately the app codifies a technique that healthcare professionals have used for some time – and Dr Barbaro is keen to find out.

“We want to see, based on results, how accurate the app is in determining whether or not a child does actually have autism or not,” Dr Barbaro told iTnews on the sidelines of Dreamforce.

“The way that we’re going to do that is by recruiting families to use and interact with the app, and then if it provides a high likelihood then we’ll invite parents to come to the university where we’ll do assessments with their children every six months until they’re two, and then we’ll determine at two whether they have autism or not.

“We don’t feel the app will be as accurate as healthcare professionals of course because healthcare professionals are experts in child development.

“But we do hope that it will at least be accurate enough that parents can use it and then go to their doctor and have a conversation, and that [it will pick up] some kind of developmental condition, whether it’s a language or developmental delay, or autism, in the majority of kids exposed to it.”

Further research will also occur on how healthcare professionals react when confronted by parents with the likelihood assessment.

The researchers are cognisant of the ‘Dr Google’ phenomenon, where people attempt self-diagnosis using the internet, and are working to establish ASDetect as a legitimate tool both for professionals and parents.

“We don’t know yet [how health professionals react] because we’ve only just launched the app, but that is a real interest of mine,” Dr Barbaro said.

“I would like to do a survey of practitioners who have had parents come to them with these types of results.

“With the email that parents receive, they not only see the results but we’ve also detailed what the research is so that practitioners don’t just think the parents are Dr Googling.

“We’re saying, ‘This has an evidence base. Please take the parents’ concerns seriously’. But the next step for us now is to do evaluations and some focus groups, even just a questionnaire – ‘You’ve had parents come to you with app results. What did you feel?’”

Part of legitimising ASDirect may come from a professional version of the tool, which is currently under development.

“That’s the next step - to develop a professional version of this that they can have in their offices so that they can monitor kids for autism and they also know when a parent comes in with ASDetect [results] they know what that means,” Dr Barbaro said.

Ry Crozier attended Dreamforce as a guest of Salesforce.