Neuroscience
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A Familiarization Protocol Facilitates the Participation of Children with ASD in Electrophysiological Research
Chapters
Summary July 31st, 2017
Electrophysiological research is an important tool for identifying biomarkers of developmental disorders, including Autism Spectrum Disorders (ASD), but data collection in these populations remains challenging. This work presents a familiarization protocol to accompany research that includes electroencephalography (EEG) to improve the likelihood of collecting EEG data from children with ASD.
Transcript
The overall goal of this familiarization protocol is to increase understanding as well as potentially reduce anxiety for child participants, resulting in a greater likelihood of the successful completion of the research protocol for the collection of EEG data. This method can help support the ethical application of research for all fields of study, especially those that involve vulnerable participants such as individuals with linguistic and cognitive challenges. The main advantage of this technique is the use of evidence-based practices to increase knowledge and understanding of the activities of the research protocol, while ensuring ongoing participant consent.
This protocol may extend the capability of other researchers to obtain reliable data from all participants as it provides a model that is easily adapted and replicated for use with different research protocols. Generally, individuals new to this protocol may struggle with lack of familiarity with EBP. However, resources exist to support development and implementation of these techniques.
Visual demonstration of the key steps of this method is critical, as singular components, while relatively easy to implement, may be more challenging as part of a collective package. Begin by escorting the participant to the designated play area, containing various toys on the ground. Show the participant the five-point emotion rating scale, and ask them to point to the picture that best represents how they feel.
If the participant selects a one or two, proceed by reading and reviewing a social narrative with them. Now we're gonna look over all the games we're gonna play today. Please let me know if you have any questions of anything you might not be sure of, alright?
Following the review of the social narrative, assess the participant's emotional state and readiness to continue with the research by showing them the self-rating emotion scale and asking how they feel. At the same time, have the research assistant use a separate scale to rate the participant to ensure that some of the anxiety has been reduced. Next, hand a consent form to the parent and read it with the child participant if they are unable to read the form independently.
Ask the participant if they would like to continue and complete the activities described in the social narrative. Then have the participant and parent sign the consent form. After the form is signed, introduce the participant to the visual schedule.
These are all the games that we will be playing today. At the end of the game you can take down each card for completing the game. Then point to the take a break card and tell the participant that they may use this card if they need to take a break.
Point to the stop card and tell them that they may use this card if they do not want to play any more games for the day. Finally, after the participant has completed half of the assessments, evaluate the participant's emotions using both emotion rating scales and ensure that they maintain a level one or two emotion rating prior to continuing activities. Begin by introducing the participant to a stuffed bear and model the use of the electroencephalography or EEG cap on it.
Then read the section in the social narrative that describes use of the cap to the participant. Show the participant how the cap is placed on the bear's head. Allow the participant to touch the cap and interact with it by placing it on the bear's head.
Next, apply a modified version of the Premack Principle by saying-Would you like to wear the net hat? If you wear the net hat, then you will get a gift card. If you choose not to, we can do something else.
Then use a tape measure to measure the participant's head circumference to determine the cap size. Soak the appropriate cap in the warm electrolyte solution. After this initial measurement, determine the Cz electrode location by measuring from the inion, a location on the back of the skull, to the nasion, a location between the eyebrows above the nose, as well as from the right to left ear.
Mark the intersection of these two measurements with a cross using a washable marker. Then place a towel around the participant's neck to prevent water from dripping on their clothing. Tell the participant to close their eyes while the cap is being placed on their head.
Carefully line up the vertex electrode on the cap with the intersection mark to ensure that the cap is aligned properly. Once the cap is placed on the head and adjusted, let the participant know that they can open their eyes. After the final activity, assess the participant's emotions one last time to ensure that a one or two emotion level was maintained throughout the protocol, and that wearing the cap did not increase anxiety or decrease the participant's level of comfort.
Finally, after the mock EEG experiment is complete, provide the participant with the promised compensation and thank them for their participation. On the next visit, begin by presenting the participant with a social narrative that describes the step of the second appointment. Ask the participant if they are willing to wear the cap in the same manner as the prior visit.
Present the participant with a visual schedule that includes all the EEG data collection procedures. Prep the participant for the EEG procedure in the same manner as the familiarization visit. Once the EEG can be seen on a computer screen, ask the participant to blink and move their hands and feet.
Then have the child look at the distortion that is created in the EEG when they move. Next, start the stimulus presentation. Ask the child to sit very still like a statue while pointing to the visual sign that shows this behavior.
Finally, after completing the EEG portion of the experiment, provide the participant with the promised compensation and thank them for their participation. As part of a series of studies on eye gaze and audio-visual speech perception, an initial cohort of 25 participants with ASD and average IQs was recruited using a similar EEG protocol. 72%of the children in this previous cohort completed the EEG protocol.
In the current cohort, thus far, 15 participants with ASD were recruited, 12 of whom participated in the familiarization protocol. Of the 12 that completed the familiarization protocol, 100%completed the full EEG acquisition protocol. While attempting this procedure, it's important to remember to adhere to the protection of participants through the provision of ongoing consent.
In addition, each EVP technique contains specific requirements and criteria that must be adhered to to ensure fidelity of development and implementation. Following this procedure, other EBP methods like video modeling can be developed and implemented to support participant engagement. After watching this video, you should have a good understanding of how to implement a familiarization protocol that uses EBP during research activities while adhering to NIH guidelines as well as your specific research protocol.
Don't forget that engaging participants in research activities that require adherence to particular behavioral expectations may be challenging for individuals with linguistic and cognitive challenges.
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