{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:50:41Z","timestamp":1791561041334,"version":"4.3.4"},"reference-count":34,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2027,9,24]],"date-time":"2027-09-24T00:00:00Z","timestamp":1821744000000},"content-version":"am","delay-in-days":388,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100006459","name":"Children's Hospital Los Angeles","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019462","name":"Saban Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019462","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001855"],"award-info":[{"award-number":["UL1TR001855"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["academicpedsjnl.net","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Academic Pediatrics"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.acap.2026.103387","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:13:07Z","timestamp":1783440787000},"page":"103387","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Smart Inhaler Randomized Controlled Trial for Improving Inhaler Technique in Adolescents With Intellectual and Developmental Disabilities and Asthma"],"prefix":"10.1016","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4283-2160","authenticated-orcid":false,"given":"Sophia","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Deavenport-Saman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2772-7926","authenticated-orcid":false,"given":"My H.","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Durazo-Arvizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-4676","authenticated-orcid":false,"given":"Hyunbin","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5891-3393","authenticated-orcid":false,"given":"Jeanne","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2280-1963","authenticated-orcid":false,"given":"Christine B.","family":"Mirzaian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2381-0669","authenticated-orcid":false,"given":"Caitlin","family":"Sayegh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naydelli","family":"Mendoza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Osumo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1631-7836","authenticated-orcid":false,"given":"Megan","family":"Enciso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aneli","family":"Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.acap.2026.103387_bib1","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1016\/j.jaci.2007.09.029","article-title":"National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): guidelines for the diagnosis and management of asthma\u2014summary report 2007","volume":"120","year":"2007","journal-title":"J Allergy Clin Immunol"},{"key":"10.1016\/j.acap.2026.103387_bib2","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1542\/peds.110.2.315","article-title":"Trends in childhood asthma: prevalence, health care utilization, and mortality","volume":"110","author":"Akinbami","year":"2002","journal-title":"Pediatrics"},{"key":"10.1016\/j.acap.2026.103387_bib3","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1089\/089426803769017613","article-title":"Assessment of handling of inhaler devices in real life: an observational study in 3811 patients in primary care","volume":"16","author":"Molimard","year":"2003","journal-title":"J Aerosol Med"},{"key":"10.1016\/j.acap.2026.103387_bib4","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.jaip.2017.01.004","article-title":"Inhaler errors in the CRITIKAL study: type, frequency, and association with asthma outcomes","volume":"5","author":"Price","year":"2017","journal-title":"J Allergy Clin Immunol Pract"},{"key":"10.1016\/j.acap.2026.103387_bib5","doi-asserted-by":"crossref","first-page":"A4786","DOI":"10.1016\/j.chest.2016.08.017","article-title":"Measuring competence in metered dose inhaler use using Capmedic electronic inhaler monitoring tool","volume":"150","author":"Biswas","year":"2016","journal-title":"Chest"},{"key":"10.1016\/j.acap.2026.103387_bib6","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.chest.2016.03.041","article-title":"Systematic review of errors in inhaler use: has patient technique improved over time?","volume":"150","author":"Sanchis","year":"2016","journal-title":"Chest"},{"key":"10.1016\/j.acap.2026.103387_bib7","doi-asserted-by":"crossref","first-page":"406","DOI":"10.4104\/pcrj.2013.00084","article-title":"Asthma patients' inability to use a pressurised metered-dose inhaler (pMDI) correctly correlates with poor asthma control","volume":"22","author":"Levy","year":"2013","journal-title":"Prim Care Respir J"},{"key":"10.1016\/j.acap.2026.103387_bib8","doi-asserted-by":"crossref","first-page":"361","DOI":"10.12788\/jhm.3195","article-title":"Critical errors in inhaler technique among children hospitalized with asthma","volume":"14","author":"Samady","year":"2019","journal-title":"J Hosp Med"},{"key":"10.1016\/j.acap.2026.103387_bib9","unstructured":"Centers for Disease Control and Prevention. Developmental Disability Basics. Available at: \u3008https:\/\/www.cdc.gov\/child-development\/about\/developmental-disability-basics.html\u3009."},{"key":"10.1016\/j.acap.2026.103387_bib10","series-title":"StatPearls [Internet]","article-title":"Developmental Delay","author":"Khan","year":"2023"},{"key":"10.1016\/j.acap.2026.103387_bib11","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s10803-017-3292-0","article-title":"Health concerns and health service utilization in a population cohort of young adults with autism spectrum disorder","volume":"48","author":"Weiss","year":"2018","journal-title":"J Autism Dev Disord"},{"key":"10.1016\/j.acap.2026.103387_bib12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1352\/1934-9556-56.2.101","article-title":"Health services use and costs for Americans with intellectual and developmental disabilities: a national analysis","volume":"56","author":"Fujiura","year":"2018","journal-title":"Intellect Dev Disabil"},{"key":"10.1016\/j.acap.2026.103387_bib13","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/jir.12554","article-title":"High health care costs among adults with intellectual and developmental disabilities: a population-based study","volume":"63","author":"Lunsky","year":"2019","journal-title":"J Intellect Disabil Res"},{"key":"10.1016\/j.acap.2026.103387_bib14","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1111\/jar.12994","article-title":"Unscheduled healthcare for children with intellectual disabilities: a systematic scoping review","volume":"35","author":"Nicholson","year":"2022","journal-title":"J Appl Res Intellect Disabil"},{"key":"10.1016\/j.acap.2026.103387_bib15","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1183\/20734735.014716","article-title":"Asthma in intellectual disability: are we managing our patients appropriately?","volume":"12","author":"Davis","year":"2016","journal-title":"Breathe (Sheff)"},{"key":"10.1016\/j.acap.2026.103387_bib16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/s40521-023-00328-7","article-title":"Electronic monitoring devices to support inhalation technique in patients with asthma: a narrative review","volume":"10","author":"Eikholt","year":"2023","journal-title":"Curr Treat Options Allergy"},{"key":"10.1016\/j.acap.2026.103387_bib17","first-page":"A4786","article-title":"Utilizing capmedic electronic device to measure and improve inhaler technique in clinic","volume":"201","author":"Paronyan","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"issue":"5 Pt 2","key":"10.1016\/j.acap.2026.103387_bib18","doi-asserted-by":"crossref","first-page":"48R","DOI":"10.1203\/PDR.0b013e3182130c54","article-title":"Sensory processing in autism: a review of neurophysiologic findings","volume":"69","author":"Marco","year":"2011","journal-title":"Pediatr Res"},{"key":"10.1016\/j.acap.2026.103387_bib19","doi-asserted-by":"crossref","first-page":"3161","DOI":"10.1007\/s10803-014-2179-6","article-title":"Evidence for diminished multisensory integration in autism spectrum disorders","volume":"44","author":"Stevenson","year":"2014","journal-title":"J Autism Dev Disord"},{"key":"10.1016\/j.acap.2026.103387_bib20","unstructured":"World Health Organization. Adolescent health. Available at: \u3008https:\/\/www.who.int\/health-topics\/adolescent-health\u3009."},{"issue":"10","key":"10.1016\/j.acap.2026.103387_bib21","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1177\/0009922809357339","article-title":"Asthma in 10- to 13-year-olds: challenges at a time of transition","volume":"49","author":"Clark","year":"2010","journal-title":"Clin Pediatr (Phila)"},{"key":"10.1016\/j.acap.2026.103387_bib22","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/pst.185","article-title":"Sample size of 12 per group rule of thumb for a pilot study","volume":"4","author":"Julious","year":"2005","journal-title":"Pharm Stat"},{"key":"10.1016\/j.acap.2026.103387_bib23","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap) \u2013 a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"10.1016\/j.acap.2026.103387_bib24","first-page":"737","article-title":"A prospective observational study of the impact of a new education programme (the 'triple A\u2032 programme) on the prevalence of inhaler misuse in a cohort of patients with asthma","volume":"186","author":"MacHale","year":"2017","journal-title":"Ir J Med Sci"},{"key":"10.1016\/j.acap.2026.103387_bib25","first-page":"715","article-title":"Development and validation of the Inhaler Technique Questionnaire (InTeQ) for patients with asthma and COPD","volume":"16","author":"Lizano-Barrantes","year":"2022","journal-title":"Patient Prefer Adherence"},{"key":"10.1016\/j.acap.2026.103387_bib26","unstructured":"Centers for Disease Control and Prevention. How to Use Your Inhaler. Available at: \u3008https:\/\/www.cdc.gov\/asthma\/pdfs\/inhaler_in_mouth_factsheet.pdf\u3009."},{"key":"10.1016\/j.acap.2026.103387_bib27","first-page":"169","article-title":"The distinctive features of a feasibility study: objectives and guiding questions","volume":"35","author":"Orsmond","year":"2015","journal-title":"OTJR (Thorofare N J)"},{"key":"10.1016\/j.acap.2026.103387_bib28","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s12913-017-2031-8","article-title":"Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework","volume":"17","author":"Sekhon","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.acap.2026.103387_bib29","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1093\/tbm\/ibab048","article-title":"Acceptability of digital health interventions: embracing the complexity","volume":"11","author":"Perski","year":"2021","journal-title":"Transl Behav Med"},{"key":"10.1016\/j.acap.2026.103387_bib30","doi-asserted-by":"crossref","DOI":"10.2196\/64210","article-title":"Swedish version of the System Usability Scale: translation, adaption, and psychometric evaluation","volume":"12","author":"\u00c5vik Persson","year":"2025","journal-title":"JMIR Hum Factors"},{"key":"10.1016\/j.acap.2026.103387_bib31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v082.i13","article-title":"lmerTest package: tests in linear mixed effects models","volume":"82","author":"Kuznetsova","year":"2017","journal-title":"J Stat Softw"},{"key":"10.1016\/j.acap.2026.103387_bib32","series-title":"RStudio: Integrated Development Environment for R [Computer Program]","author":"team","year":"2025"},{"key":"10.1016\/j.acap.2026.103387_bib33","doi-asserted-by":"crossref","first-page":"e1186","DOI":"10.1542\/peds.2008-0292","article-title":"At what age do children start taking daily asthma medicines on their own?","volume":"122","author":"Orrell-Valente","year":"2008","journal-title":"Pediatrics"},{"key":"10.1016\/j.acap.2026.103387_bib34","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.acap.2018.01.006","article-title":"Knowledge of inhaled therapy and responsibility for asthma management among young teens with uncontrolled persistent asthma","volume":"18","author":"Frey","year":"2018","journal-title":"Acad Pediatr"}],"container-title":["Academic Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1876285926001695?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1876285926001695?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:08:23Z","timestamp":1791558503000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1876285926001695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S1876285926001695"],"URL":"https:\/\/doi.org\/10.1016\/j.acap.2026.103387","relation":{},"ISSN":["1876-2859"],"issn-type":[{"value":"1876-2859","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Smart Inhaler Randomized Controlled Trial for Improving Inhaler Technique in Adolescents With Intellectual and Developmental Disabilities and Asthma","name":"articletitle","label":"Article Title"},{"value":"Academic Pediatrics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.acap.2026.103387","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2026 by Academic Pediatric Association All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"103387"}}