TABLE 3.

Characteristics of the studies included

Author#year#country	Study design	Participants	Diagnosis (DSM or ICD)	Treatment context	Model of change/therapeutic	Therapy conditions	eHealth application	Outcome measures	Target behaviour
Individual interventions
1. Lancioni et al. (1997), IT	ABABAB (I), ABABABAB (II)	N = 2, 1F 1M, Age 24 and 60		I. activity centre; II. community home	Not explicated, but BT principles	Sessions 30 min (I), 40 min (II). I. 2–4 times a day, 2 hrs a day device available, 3–4 days a week. II. 2–4 times a week, device available 1–3 hrs a day, sessions 3–5 day/p/week	Battery‐powered electronic unit worn at the chest and connected to an earpiece. The electronic unit consisted of a miniature electret microphone and a two‐stage low frequency amplifier, with dials for setting the loudness limit.	Observation (momentary time interval sampling)	Vocal loudness
2. Lancioni et al. (1998), IT	ABABABAB	N = 1, M Age 20	Autistic‐like behaviour	Activity centre	Prompts, reminders, rewards, positive comments are mentioned, but no theoretical framework.	30 min per session, 5.5 months of duration study	Portable wearable device at the wrist providing visual and auditory feedback	Observation (6 moments during therapy programme)	Vocal loudness
3. Lancioni et al. (1999), IT	ABABAB	N = 1, 1 F Age 56		Activity centre	Not explicated, but BT principles	5 months of 30‐min sessions, no further details	Battery‐powered electronic unit worn at the chest and connected to an earpiece. The electronic unit consisted of a miniature electret microphone and a two‐stage low frequency amplifier, with dials for setting the loudness limit.	Recording of talking and vocal loudness (momentary time interval sampling)	Vocal loudness
4. Lancioni, O’Reilly, et al. (2006), IT	Multiple probe across responses design. Postintervention checks 1,2 and 3 months after intervention	N = 1, 1M Age 12.5 yrs	Congenital cerebropathy with spasticity, minimal residual vision, epilepsy	n.r.	Not explicated, but BT principles	n.r.	Microswitch clusters	Microswitch recorded data movement, sensor monitoring finger mouthing.	Foot and head movements and finger mouthing
5. Lancioni, Singh, et al. (2006), IT	ABAB1B2	N = 7, 1 F 6M Age 7.9–20.7 (M = 14.3)	Sensory impairments, 5 diagnosed with epilepsy	Home or educational context	Not explicated, but BT principles	5–10 min (advice parents/professionals) with a microswitch‐based and a stimulation programme (separated and alternating condition) in a variable amount of sessions	Microswitches (pressure device) were linked to an electronic control system. This was a portable, battery‐powered case connected to a variety of preferred stimuli selected for the study	Microswitch activation responses were recorded directly during the sessions. Observation (partial interval system) of indices of happiness from videotapes	Microswitch activation responses and indices of happiness
6. Lancioni, Smaldone, et al. (2006), IT	ABB1AB1	N = 1, 1 F Age 41	DS, passive and sedentary	Quited activity room	Not explicated, but BT principles	5 min, 3–9 times a day	Microswitch clusters (pressure and mercury devices)	Microswitch activation responses were recorded	Handpushing and face hiding
7. Lancioni et al. (2007), IT	ABB1AB1 design	N = 1, M Age 12.8	Congenital cerebropathy with spastic tetraparesis, minimal residual vision, seizure disorder	Quiet room in a educational context	Not explicated, but BT principles	5 min sessions 3–9 times a day on participant's availability. Intervention sessions 122, 44 and 50 sessions, respectively. Postintervention check 15 sessions.	Microswitch cluster (optical), light wires attached to a headband	Microswitch activation responses were recorded and target behaviour was measured by activation of sensor	Hand mouthing, eye poking and foot movements
8. Lancioni, Singh, O’Reilly, Sigafoos, Didden, Oliva, et al. (2008), IT	ABAB with 3 month postintervention	N = 1, 1M Age 29	Congenital encephalopathy, seizure disorder	n.r.	Not explicated, but BT principles	5 min, 3–7 times a day; 47–104 sessions	Microswitch cluster	Microswitch activation responses were recorded and target behaviour was measured by activation of sensor	Object‐contact responses without hand stereotypy
9. Lancioni, Singh, O’Reilly, Sigafoos, Didden, Smaldone, et al. (2008), IT	ABAB with 3 month postintervention	N = 1, 1 F Age 12.2	Seizure disorder (Lennox–Gastaut), visual impairment, MD	n.r.	A section about case conceptualization	10 min a day, 3–8 times a day. Treatment phases included 86 and 105 sessions	Microswitch cluster	Microswitch +optic and minitilt sensors recorded data +observation indices of happiness (partial interval) on videotapes	Object manipulation and hand mouthing
10. Lancioni et al. (2011), IT	Non‐concurrent multiple baseline design across participants	N = 2, congenital encephalopathy 1 F, 1M Age 34 and 31	Motor, sensory disabilities	Care and rehabilitation centre		304 and 129 sessions	Microswitch (pressure) + computer system for stimuli	Computer system automatically recorded responses +observation of indices of happiness on videotapes	Microswitch activation responses and indices of happiness
11. Gaskin et al. (2012); USA	Multiple probe design across skills	N = 1; IQ 66 verbal and 72 performance (WAIS); 1 F 23 yrs		at home	PII module (parent–infant interaction); part of SafeCare® intervention. Social learning is assumed, but not reported explicitly.	Visits home visitor (certified trainer) weekly at home. Five training sessions with a structured approach towards how physical and non physical skills were trained. A booster session was delivered (2 month FU) focused on underutilized skills.	Digital picture frame	Observation of PII skills by the Planned Activities Training checklist, infant version (PAT‐VI) recording demonstration of PII skills +consumer satisfaction by a 10‐question survey	Physical and nonphysical PII target skills
12. Lancioni, O’Reilly, et al. (2013), IT	ABB1AB1 design	N = 2, 1 F, 1M. Age 19 and 20	Visual impairment, non‐ambulatory, one had epilepsy,	Quiet room in the attended centre the persons attended	Not explicated, but BT principles	I. 5 min, 2–6 times a day II. 30 min, once a day.	Microswitch (optic) detected I. hand mouthing and an optical‐touch screen computer monitor activated by the touch response II. Napkin with sensors/microswitches, microprocessor and MP3 device	Observation of frequencies of touch responses, total amount of session time with the presence of hand mouthing were automatically recorded via the computer system	Touch responses, wiping/cleaning and hand mouthing
13. Lancioni, Singh, et al. (2013), IT	I. ABB1AB1 design, II. ABB1AB1B2 design	N = 3, 1 F 2M, Age 10*, 27 and 64 * included	Congenital encephalopathy with spastic tetraparesis	n.r.	Not explicated, but BT principles	I. 10 min, 3 to 6/7 times a day. (Intervention sessions 46, 28 sessions and 84 sessions). II. 15 min, 2–4 times a day	I. a) tilt and optic microswitches connected with the objects react by touching b)microswitch (optic) attached to the wheelchair +headrest was activated with head c) computer control system for preferred stimuli activation.	Observation target responses automatically recorded by computer system, and observation by RA	I. adaptive behaviour (touching objects) and inappropriate posture. II. adaptive behaviour (mouth‐cleaning +object assembling) and drooling
14. Stasolla and O’Caffò (2013), IT	Multiple probe design across behaviours for each participant	N = 2, 2 F Age 12 and 17	Rett's syndrome, withdrawal, stereotyped behaviours, motor problems and epilepsy	At home	Not explicated, but BT principles	5 min 3–4 times a day, 4 days a wk. The intervention programme lasted approximately 6 months. (Intervention I = 50 sessions, Intervention II = 50 sessions)	A wobble microswitch in the first phase, adopted microswitch = two optic sensors (photocells fixed to the lateral panels of the walker device)	Frequencies of responses of object manipulation (automatically count by device) + observation (partial interval and event) of indices of happiness and stereotype behaviour	Hand washing, body rocking (stereotypies), access to preferred stimuli and step responses
15. Stasolla et al. (2013), IT	ABAB sequence with a postintervention check after 15 days	N = 3, 3M Age 6–9	Cerebral palsy and MD	At home	Based on learning principles	10 min sessions, 2–4 times a day, 3 days a week. The intervention programme lasted approximately 6 months. (Intervention I 40 sessions, Intervention II 60 sessions).	Laptop computer equipped with a Clicker 5 software package, microswitch (pressure) + a connecting interface +mouse (Intervention II)	Observation of happiness signs (partial interval) and number of requested item	Independent choice behaviour and mood
16. Kim et al. (2014); KR	Multiple probe design across participants	N = 3; IQ < 55 (KISE‐KIT) severe ID, adaptive scores 49–76 (KISE‐SAB), 1 F, 2M Age 17		Separated room in school	ABA Antecedent‐based intervention; providing alternative behavioural strategies by using Social Stories	Before school starts the teacher provided the intervention (7–17 sessions; varied to participant involved)	Galaxy Tap smart tablet with Social Story created on Prezi and accessed via QR	Observation of disruptive behaviour and academic engagement	Disruptive behaviour and academic engagement
17. Lancioni, Singh, O’Reilly, Green, et al. (2014), IT	ABAB design	N = 2; MID/MoID, 2M Age 43 (I) and 34 (II)only data II included, I focused on support	II. total blindness, severe hearing disability	Living room of the centre	Not explicated, but BT principles	Sessions 20–30 min, 34 and 47 intervention sessions (3 introduction sessions before start of intervention)	Battery‐powered sound‐detecting unit fixed at the chest and connected with a throat microphone, an airborne microphone, a vibration box fixed at the shoulder. Sound‐detecting unit was triggered when signals conveyed at about 85 dB.	Observation of speaking and vocal loudness by momentary time sampling procedure	Vocal loudness
18. Lancioni, Singh, O’Reilly, Sigafoos, et al. (2014), IT	ABAB design (MPD across settings was used for participant 1).	N = 2; MoID and SID, 2M, Age 33 and 42	Blind; and one participant suffered from epilepsy; both congenital encephalopathy	Activity area and large dining room for participant 1 (MoID/SID); activity room, corridor and 2 small rooms for participant 2 (SID/PMID).	Not explicated, but BT principles	One or two sessions per day, 3–5 days a week and 10 practical sessions to introduce the technology.	Orientation technology included a sound source at each of the destinations, a mini radio‐coded device worn by participants on the shirt or belt, and a portable control device to activate such source. Short sentences from the apparatus encourage orientation in the right direction	Observation of anxiety‐related behaviour (partial interval)	Anxiety‐related behaviour
19. Stasolla, Damiani, et al. (2014), IT	Non‐concurrent multiple baseline design across participants	N = 2, 2M Age 8–9	FXS, motor and speech disabilities	at home	Matching behavioural responses to environmental consequences, DRO +self‐determination	10 min sessions, 2–4 sessions a day, 4 days per wk. Study lasted approximately 5 months.	Optic sensors connected with battery‐powered control system unit.	Observation of stereotypic behaviour +indices of happiness +control system unit counts of performance of target behaviour	Occupation and choice opportunities, stereotyped behaviour and happiness
20. Stasolla, Perilli, et al. (2014), IT	ABB1AB1	N = 3, 3M Age 8.4–10.2 (M = 9.36)	ASD, motor and speech disabilities	Quiet room at home	Not explicated, but BT principles	5 min, 3–5 times a day, 4 days per week. 125 sessions. Duration study: 3 months.	Microswitch clusters programme	Recording adaptive response device, hand mouthing was detected by activation of optic sensor fixed with an adapted frame on the chin. Observation of indices of happiness (video)	Object manipulation, hand mouthing and happiness
21. Jonker et al. (2015); NL	Pre‐experimental, quantitative approach	N = 1; MoID IQ = 47; 1M Age 27	Visual impairment	Residential group home in care for ID and VI	Safe haven and secure base attachment intervention	First phase automatic responses received from a computer on the emotion message send by participant, second phase caregiver response on distance and conversation between person with ID and caregiver about the exchanged messages according a protocol based on the Circle of Security when reunited in person.	iPhone with app	ABCL, BSI, frequency and intensity of behaviour at work and at home. Frequency of messages. Social Validity questionnaire caregivers and client.	Separation anxiety and challenging behaviour
22. Stasolla et al. (2015), IT	Multiple probe design across responses for each participant	N = 3, 3 F Age 9–12	Rett's syndrome, withdrawal, isolation, passivity, motor disabilities, stereotyped behaviours	At home	Not explicated, but BT principles	10 min. 2–4 times per day, 4 days per week. Duration study: approximately 6 months. 225 sessions for each participants.	Containers with photocells +laptop equipped with a Clicker 5 software package and a connecting interface	Observation of mood signs +percentage of interval stereotyped behaviour +computer counting inserted objects	Choice strategies, stereotyped behaviour and happiness
23. Singh et al. (2017); USA	Multiple baseline design across participants with a 12 month follow‐up	N = 3 teachers and N = 3 students; mild intellectual disability no IQ scores reported 3M, Age 10–11		School	Mindfulness	Week 1 daily 30 min recognize precursor of anger +aggression and use SoF procedure to effectively control his anger, week 2 daily 15 min sessions reviewing SoF procedure. Week 3 reminding the student to use the SoF procedure. Teacher recorded the SoF instruction on an iPad for self‐instruction at school and at home.	iPad for recording mindfulness exercises for students. iPad and Google Hangout for treatment fidelity training SoF and check. iPhone and app for recording target behaviour of participants.	Observation of frequency of physical and verbal aggression tapped on iPhone by 2 teacher aides independently	Physical and verbal aggression
24. Cooney et al. (2017); UK	A 2 * 3 RCT	N = 24 (cCBTG); 12 MID, 12 MoID, 16 F 8M Age 42 (12.85); N = 25 (TAU); 8 MID, 17 MoID, 14 F 11M Age 39.24 (9.14).	Anxiety, depression, comorbid anxiety and depression, or recurring anxiety or depression (DSM IV)	MHID team, a specialist secondary care service for non‐crisis mental health services for adults with ID and mental health needs	CBT	7 consecutive weekly sessions, therapist guided during sessions	PeskyGnats: TheFeelGoodIsland prototype CBT computer game	Primary: GAS‐ID, GDS‐LD. Secondary: CORE‐LD.	Mood (anxiety/depression)
25. Hoffman et al.(2017); NL	Pre‐experimental within‐group design with multiple baselines and staggered intervention start‐points	N = 6; MID and MoID (IQ scores n.r)with visual impairment, 1 F, 5M; Age 27–56	Separation anxiety	Group homes at an organization	Safe haven and secure base attachment intervention	Messages sent by automatic response of a computer. Messages by caregiver. Discussion about the exchanged message	iPhone with app	ABCL anxiety subscale, BSI, PIMRA, IDQOL, frequency of each type of message. Frequency and intensity of behaviour at home and at work.	Separation anxiety and challenging behaviour
26. Stasolla, Perilli, Damiani, et al. (2017), IT	ABCAC experimental sequence, 3 month FU	N = 6, 6M, Age 6.4–10.5 (M = 8.2)	ASD (severe conditions due to CARS score), isolated, passive and withdrawn, motor an communicative disabilities	At home	Results can be comparable to a procedure of differential reinforcement of incompatible behaviours.	5 min, 5 sessions a day, 5 days a week. Duration of study: 5 months 205 sessions per participant.	2 microswitches (optic sensors) connected to battery‐powered control unit system.	Recording of adaptive behaviour by sensors fixed within the containers +recording challenging behaviour by sensor embedded in a specific frame fixed on the chin. Observation of indices of happiness (partial interval with 20 observation per session)	Adaptive behaviour and hand/object mouthing
27. Stasolla, Perilli, Caffò, et al. (2017), IT	Single‐subject reversal experimental design (included two BL and two intervention phases). Follow‐up phase after 3 months.	N = 3, 3M Age 8–10	FXS, quite passive and isolated, exhibiting withdrawal and stereotyped behaviours (hand mouthing and flapping), motor and communicative disabilities	At home	Not explicated, but BT principles	Sessions of 5 min, 4–6 sessions a day, 4 days a week. Study lasted approximately 5 months. 150 sessions per participant. Before start 6 familiarization sessions.	Optic sensors connected with an interface, to a laptop. The laptop automatically record a behavioural response, automatically ignored a new behavioural response within the stimulation period and providing participants with positive stimulation during the intervention and follow‐up	Adaptive response was recorded by the computer +Observation of stereotyped behaviour, hand mouthing and indices of happiness	Adaptive response, hand mouthing and happiness
28. Perilli et al. (2019), IT	ABB1AB1 design	N = 6; 6M, Age 13–19	FXS	Individually at participants’ homes	Not explicated, but BT principles	BL 5 sessions within 2 days; B 30 sessions within 3 wks; B1 30 session within 3 wks. BL2 5 sessions within 2 days. FU (after 1 yr) 30 sessions within 3 wks. Sessions lasted 10 min	Micro switch cluster technology	Computer system automatically recorded responses +Observation of positive participation (video)	Adaptive response, hand biting and positive participation
Countries: ABCL, Adult behaviour checklist; BSI, Brief Symptom Inventory; BT, behavioural therapeutic; CARS, Childhood Autism Rating Scale; CB, challenging behaviour; cCBTG, computerized Cognitive Behavior Therapy Group; cg, care giver; CORE‐LD, Clinical Outcomes in Routine Evaluation ‐ Learning Disability; DMT, dance and movement therapy; DSM IV, Diagnostic and Statistical Manual of Mental Disorders; F, female; FXS, fragile X syndrome; GAS‐ID, Glasgow Anxiety Scale for people with Intellectual Disability; GDS‐LD, Glasgow Depression Scale for people with Learning Disability; ID, intellectual Disability; IDQOL, Intellectual Disability Quality of Life; IQ, intelligence quotient; IT, Italy; KISE‐KIT, Korea Institute for Special Education‐Korea Intelligence Test for Children; KISE‐SAB, Korea Institute for Special Education‐Scales of Adaptive Behavior; KR, Korea; M, male; M, mean; MARA, Movement Assessment and Reporting App; MD, multiple disabilities; MHID, Mental Health of Intellectual Disability team; MoID, moderate intellectual disability; n.r., not reported; NC, not clear; NL, the Netherlands; PII, parent–infant interactions; PIMRA, Psychopathology Instrument for Mentally Retarded Adults; PMID, profound multiple intellectual disability; QR, quick response; RA, research assistant; RA2, second research assistant; RCT, randomized controlled trial; SD, standard deviation; SID, severe intellectual disability; SoF, Soles of Feet mindfulness training; TAU, treatment as usual; TBI, traumatic brain injured; UK, United Kingdom; USA, United States of America; WAIS, Wechsler Adult Intelligence Scale.
Group interventions (with individual elements)
29. Hetzroni and Banin (2017); IL	Single‐subject multiple baseline design across situations	N = 5; mild ID (IQ scores n.r.), 5M Age 11–15	Axenfeld‐Rieger syndrome, psycho‐motor behaviour disorder and epilepsy	School	Social information processing theory and social modelling and simulation	Small group activities (50 min): observation of video clips (adequate and non‐adequate behaviours), followed by discussions related to the demonstrated behaviours. Participation in simulations of the social skill learned. At the end of each session students played the educational computer games. Group sessions included one participant and 5–6 other school peers	Computer, video modelling clips	Observation of socially adequate behaviour (before, during and after intervention in three situations). A observation form was developed with information about the participant, activity and what behaviour was exposed in what situation	Action, verbal and non‐verbal behaviour in three social situations
30. Dunphy and Hens (2018); AUS	Mixed method: Observational data and interviews and focus groups with participants, centre staff, managers and parents	N = 12; MoID and MID, IQ scores, gender and age n.r.		Day centre for people with ID	Dance and movement therapy	16 weekly sessions	MARA app with iPad	Observation scores on behaviour linked to 2 objectives DMT in six sessions (beginning, mid and final sessions) + interviews participants on experiences DMT and reviewing video clips and therapist scores of DMT sessions	Exposing behaviour on objectives (physical domain and interpersonal domain)
31. Hronis et al. (2019); AUS	Feasibility study by case series design	N = 21: 2 groups juniors N = 10 MoID/MID, 10 F Age 13–15; seniors N = 11 MoID/MID 11 F Age 14–18	SAS‐TR school anxiety, SUDS and ID	All‐girls school supporting children with special needs	CBT	10 face‐to‐face group sessions twice weekly and an online programme	FearlessMe! Online programme with exercises related to CBT	Scores on SUDS of participants, SAS‐TR reported by teachers. Parents outcome measures were not reported due to low response rate	Anxiety
Countries: AUS, Australia; CBT, Cognitive Behavior Therapy; IL, Israel; MID, mild intellectual disability; MoID, moderate intellectual disability; SAS‐TR, Social Anxiety Scale‐Teacher Report; SUDS, subjective units of distress score.
Dyad interventions
32. Simacek et al. (2017); USA	Single‐case experimental designs; MPD and ABAB design embedded	N = 3; IQ n.r., low adaptive range VABS; 2 ASD and 1 Rett's syndrome. 3 F Age 3.5–4 yrs	ASD, Rett's disorder (severe neurodevelopmental disability)	At home	ABA	Functional communication training delivered by parents up to 7 daily sessions with a 5 min/3 trial block with a prior functional assessment and psycho‐education of parents supported a certified coach via telehealth	Screen‐recording software on computer, headset, secure internet and storage of data. Videoconferencing software (Google Hangout) and webcam.	Observation of idiographic responses and requests using PECS cards/microswitch for requests and problem behaviour. Treatment Acceptability Rating Scale‐Revised parents	Adaptive request to parents and yelling, tantrum, and hitting object
33. Monlux et al.(2019); USA	Not reported	N = 10 parent–child dyads with eight dyads completed the treatment.; IQ n.r. mean adaptive behaviour composite standard score 62.1 (SD = 8.3, range = 50–73). Age 3–10	FXS	at home	ABA	12‐weeks 1‐h telehealth‐supported to implement a functional communication plus extinction training on a daily basis delivered by parent	Apple iPad Air® with a built‐in webcam, a Bluetooth® earpiece and a HIPAA compliant videoconferencing programme	Observation of the rate of problem behaviour and functional communication response during 1 h telehealth session. Treatment Acceptability Rating Scale‐Revised parents	Problem behaviour and child minds
Country: ABA, Applied Behavior Analysis; ASD, autism spectrum disorder; BIF, borderline intellectual functioning; F, female; FXS, fragile X syndrome; HIPAA, Health Insurance Portability and Accountability Act; M, male; MID, mild intellectual disability; MoID, moderate intellectual disability; PECS, Picture Exchange Communication System; USA, United States of America; VABS, Vineland Adaptive Behavior Scale.