Development of a Social Communication Intervention Mobile App for Adolescents With Autism Spectrum Disorder and Social Communication Disorder: Protocol for a Pilot Randomized Clinical Trial
Bibliographic record
Abstract
BACKGROUND: Autism spectrum disorder (ASD) and social communication disorder (SCD) are neurodevelopmental disorders characterized by deficits in social communication that hinder social adaptation, with limited pharmacological options for therapy owing to the absence of identified biomarkers. Individuals with ASD or SCD require lifelong interventions tailored to their development stages. However, most existing interventions primarily focus on early childhood, leaving adolescents relatively underserved. Moreover, timely access to interventions is often limited by geographic and economic barriers as specialized clinics and therapists tend to be concentrated in major urban areas. OBJECTIVE: This pilot randomized clinical trial aimed to evaluate the initial safety and efficacy of NDTx-01, a digital therapeutic (DTx) for adolescents with ASD or SCD. NDTx-01 was designed to overcome the accessibility limitations by integrating cognitive behavioral therapy principles, story-based interventions, and gamification elements. METHODS: We introduce a protocol for a multicenter, prospective, assessor-blinded pilot randomized clinical trial involving children and adolescents aged 10 to 18 years diagnosed with ASD or SCD. Participant enrollment was conducted at 3 major medical hospitals. Enrolled participants were randomly assigned to either the intervention group (NDTx-01 and treatment as usual [TAU]) or the control group (TAU only). TAU included medications and therapeutic services. Participants were instructed to use the app approximately 10 minutes per day, 5 days a week. To evaluate the efficacy of NDTx-01, standardized tools were administered, including the Korean version of the Vineland Adaptive Behavior Scales, Second Edition (K-VABS-II); the Social Responsiveness Scale, Second Edition; Clinical Global Impressions-Severity (CGI-S); Clinical Global Impressions-Improvement (CGI-I); the Social Communication Questionnaire; and the Korean version of the Stress Index for Parents of Adolescents. Assessments were conducted in weeks 0, 1, 2, 4, and 6, except for K-VABS-II, CGI-S, and CGI-I, which were administered only in weeks 0, 4, and 6. Statistical analyses were conducted using the SAS software. Between-group differences were assessed using independent 2-tailed 2-sample t tests or Wilcoxon rank sum tests. Within-group changes were evaluated using paired t tests or Wilcoxon signed rank tests. RESULTS: From August 2024 to December 2024, a total of 42 individuals were screened, 39 (93%) participants who met the inclusion criteria were enrolled, and 1 participant withdrew consent; the remaining participants completed the study. The pilot randomized clinical trial was successfully completed, and the results were published in April 2025. As of 2025, we are conducting a confirmatory clinical trial at 5 major hospitals across South Korea. CONCLUSIONS: The results of this pilot clinical trial provided important insights into the initial safety and efficacy of DTx as interventions for adolescents with ASD and SCD. Both groups demonstrated statistically significant improvements in adaptive skills and socialization. TRIAL REGISTRATION: Clinical Research Information Service KCT0009140; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=26713. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66419.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.026 | 0.022 |
| Meta-epidemiology (narrow) | 0.005 | 0.003 |
| Meta-epidemiology (broad) | 0.008 | 0.004 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.005 | 0.008 |
| Insufficient payload (model declined to judge) | 0.074 | 0.011 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".