Information and communication technologies-based interventions for children with autism spectrum conditions: a systematic review of randomized control trials from a positive technology perspective

Information and communication technologies (ICTs) have become more widely used in the past years to help people with autism spectrum conditions (ASC). Serious games embedded into computers or tablets, as well as social robots, are the most employed ICT-related tools that are appealing to and appropriate for autistic children. The goal of ICT applications is to enhance behavioral abnormalities associated with ASC while also creating an interactive link between one person and one computer. Comparatively, to human-based therapy, ICT tools aid to inspire autistic children by providing predictability and regularity of tasks. Regaining social skills is the primary behavioral goal for which ICT tools have been designed and implemented. In the past several years, many studies have been created to show how effective it is at improving targeted behaviors. However, only a small number of researchers have used an RCT approach to evaluate its effectiveness. In this systematic review, we only included RCT studies where ICT technologies were used to help children with ASC in improving their social skills. Only 14 RCT studies satisfied the criteria and 12 described significant improvements, showing how the use of technology in educational contexts produced better improvement in developing several social skill facets with respect to the traditional face-to-face approach. Some studies used interventions and outcome measures focused on the core ASC symptoms, but many others addressed neurocognitive functions directly, like social cognition or emotional regulation, while other more general functions such as language or adaptive behaviors. We propose a classification based on processes and outcome measures to foster future research in this specific area of research. The behavioral intervention mediated by technological tools such as computer-based, tablet, and social robotics, undoubtedly provides a comfortable environment that promotes constant learning for people with ASC. Evidence provided in this review highlights the translational potential of this field of study in primary care practice and educational settings

Applications of Robotics for Autism Spectrum Disorder: a Scoping Review

Robotic therapies are receiving growing interest in the autism field, especially for the improvement of social skills of children, enhancing traditional human interventions. In this work, we conduct a scoping review of the literature in robotics for autism, providing the largest review on this field from the last five years. Our work underlines the need to better characterize participants and to increase the sample size. It is also important to develop homogeneous training protocols to analyse and compare the results. Nevertheless, 7 out of the 10 Randomized control trials reported a significant impact of robotic therapy. Overall, robot autonomy, adaptability and personalization as well as more standardized outcome measures were pointed as the most critical issues to address in future research

Psychophysiological analysis of a pedagogical agent and robotic peer for individuals with autism spectrum disorders.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by ongoing problems in social interaction and communication, and engagement in repetitive behaviors. According to Centers for Disease Control and Prevention, an estimated 1 in 68 children in the United States has ASD. Mounting evidence shows that many of these individuals display an interest in social interaction with computers and robots and, in general, feel comfortable spending time in such environments. It is known that the subtlety and unpredictability of people’s social behavior are intimidating and confusing for many individuals with ASD. Computerized learning environments and robots, however, prepare a predictable, dependable, and less complicated environment, where the interaction complexity can be adjusted so as to account for these individuals’ needs. The first phase of this dissertation presents an artificial-intelligence-based tutoring system which uses an interactive computer character as a pedagogical agent (PA) that simulates a human tutor teaching sight word reading to individuals with ASD. This phase examines the efficacy of an instructional package comprised of an autonomous pedagogical agent, automatic speech recognition, and an evidence-based instructional procedure referred to as constant time delay (CTD). A concurrent multiple-baseline across-participants design is used to evaluate the efficacy of intervention. Additionally, post-treatment probes are conducted to assess maintenance and generalization. The results suggest that all three participants acquired and maintained new sight words and demonstrated generalized responding. The second phase of this dissertation describes the augmentation of the tutoring system developed in the first phase with an autonomous humanoid robot which serves the instructional role of a peer for the student. In this tutoring paradigm, the robot adopts a peer metaphor, where its function is to act as a peer. With the introduction of the robotic peer (RP), the traditional dyadic interaction in tutoring systems is augmented to a novel triadic interaction in order to enhance the social richness of the tutoring system, and to facilitate learning through peer observation. This phase evaluates the feasibility and effects of using PA-delivered sight word instruction, based on a CTD procedure, within a small-group arrangement including a student with ASD and the robotic peer. A multiple-probe design across word sets, replicated across three participants, is used to evaluate the efficacy of intervention. The findings illustrate that all three participants acquired, maintained, and generalized all the words targeted for instruction. Furthermore, they learned a high percentage (94.44% on average) of the non-target words exclusively instructed to the RP. The data show that not only did the participants learn nontargeted words by observing the instruction to the RP but they also acquired their target words more efficiently and with less errors by the addition of an observational component to the direct instruction. The third and fourth phases of this dissertation focus on physiology-based modeling of the participants’ affective experiences during naturalistic interaction with the developed tutoring system. While computers and robots have begun to co-exist with humans and cooperatively share various tasks; they are still deficient in interpreting and responding to humans as emotional beings. Wearable biosensors that can be used for computerized emotion recognition offer great potential for addressing this issue. The third phase presents a Bluetooth-enabled eyewear – EmotiGO – for unobtrusive acquisition of a set of physiological signals, i.e., skin conductivity, photoplethysmography, and skin temperature, which can be used as autonomic readouts of emotions. EmotiGO is unobtrusive and sufficiently lightweight to be worn comfortably without interfering with the users’ usual activities. This phase presents the architecture of the device and results from testing that verify its effectiveness against an FDA-approved system for physiological measurement. The fourth and final phase attempts to model the students’ engagement levels using their physiological signals collected with EmotiGO during naturalistic interaction with the tutoring system developed in the second phase. Several physiological indices are extracted from each of the signals. The students’ engagement levels during the interaction with the tutoring system are rated by two trained coders using the video recordings of the instructional sessions. Supervised pattern recognition algorithms are subsequently used to map the physiological indices to the engagement scores. The results indicate that the trained models are successful at classifying participants’ engagement levels with the mean classification accuracy of 86.50%. These models are an important step toward an intelligent tutoring system that can dynamically adapt its pedagogical strategies to the affective needs of learners with ASD

Patient centric intervention for children with high functioning autism spectrum disorder. Can ICT solutions improve the state of the art ?

In my PhD research we developed an integrated technological platform for the acquisition of neurophysiologic signals in a semi-naturalistic setting where children are free to move around, play with different objects and interact with the examiner. The interaction with the examiner rather than with a screen is another very important feature of the present research, and allows recreating a more real situation with social interactions and cues. In this paradigm, we can assume that the signals acquired from the brain and the autonomic system, are much more similar to what is generated while the child interacts in common life situations. This setting, with a relatively simple technical implementation, can be considered as one step towards a more behaviorally driven analysis of neurophysiologic activity. Within the context of a pilot open trial, we showed the feasibility of the technological platform applied to the classical intervention solutions for the autism. We found that (1) the platform was useful during both children-therapist interaction at hospital as well as children-parents interaction at home, (2) tailored intervention was compatible with at home use and non-professional therapist/parents. Going back to the title of my thesis: 'Can ICT solution improve the state-of-the-art ?' the answer could be: 'Yes it can be an useful support for a skilled professional in the field of autis

COMSI®—A Form of Treatment That Offers an Opportunity to Play, Communicate and Become Socially Engaged through the Lens of Nature—A Single Case Study about an 8-Year-Old Boy with Autism and Intellectual Disability

This case study shows how an 8-year-old boy with autism and mild intellectual disability underwent positive psychological development in terms of play, social communication, and mentalization during a year and a half of group-based therapy using COMSI®-(COMmunication and Social Interaction). This eclectic treatment has a relational approach and is based on developmental psychology, knowledge of autism, and the impact of nature and animals on human health. The change in the child was been studied using both quantitative and qualitative methods. His general intellectual capacity was measured using the Wechler Preschool and Primary Scale of Intelligence, and his Mentalization Ability/Theory of Mind was assessed using three tests: Eva and Anna, Hiding the fruit and Kiki and the cat. Throughout the study period, change was documented with the help of the therapists’ process notes and the parents’ descriptions. The results show that support for the child comes from three different sources: nature, animals, and the therapists. Animals and nature form the basis for episodes of coordinated attention in conversation and play with therapists. The therapists’ approach used sensitivity and compliance with the child’s needs and focus of interest

Study of social behavior through mixed methodology in the context of a social-skills program for children and adolescents with autism spectrum disorder in a community setting

Al llarg de l'última dècada s'han realitzat s'han realitzat nombrosos estudis per avaluar l'eficàcia dels grups d'intervenció en habilitats socials per a persones amb trastorn de l'espectre autista (TEA). Segueix existint molta controvèrsia sobre quins factors beneficien a determinats pacients i quina metodologia es fa servir per a detectar-los, específicament en els contextos comunitaris. Els objectius d'aquesta tesi van ser: valorar l'efecte de l'adaptació d'un programa d'habilitats socials per a infants i adolescents amb TEA en un context hospitalari, analitzant l'efectivitat de el programa per disminuir símptomes de comorbiditat i augmentar les conductes socials i, utilitzar metodologia observacional per identificar els canvis socials. Es va adaptar l'escala observacional de Bauminger i es van codificar 10 sessions de grup. Les dades es van analitzar amb la tècnica de coordenades polars. Els resultats obtinguts en els tres estudis indiquen que la simptomatologia afectiva disminuir després de la intervenció. També s'observen resultats marginalment significatius en alguns comportaments socials, específicament el contacte ocular i la comunicació funcional. Observem que aquells pacients amb major coeficient intel·lectual verbal (CIV) van obtenir millor resposta a al tractament en els anteriors paràmetres. Malgrat aquests resultats obtinguts, cada participant segueix un curs únic. Cal seguir investigant els factors que influeixen en l'eficàcia d'aquests programes, com l'edat o el IQ, de manera que s'implementin intervencions que generin canvis significatius en aquests contextos comunitaris, on resulta més complex arribar a un major nombre de persones.A lo largo de la última década se han realizado se han realizado numerosos estudios para evaluar la eficacia de los grupos de intervención en habilidades sociales para personas con trastorno del espectro autista (TEA). Sigue existiendo mucha controversia sobre qué factores benefician a determinados pacientes y qué metodología se emplea para detectarlos, específicamente en los contextos comunitarios. Los objetivos de esta tesis fueron: valorar el efecto de la adaptación de un programa de habilidades sociales para niños y adolescentes con TEA en un contexto hospitalario, analizando la efectividad del programa para disminuir síntomas de comorbilidad y aumentar las conductas sociales y, utilizar metodología observacional para identificar los cambios sociales. Se adaptó la escala observacional de Bauminger y se codificaron 10 sesiones de grupo. Los datos se analizaron con la técnica de coordenadas polares. Los resultados obtenidos en los tres estudios indican que la sintomatología afectiva disminuyó después de la intervención. También se observan resultados marginalmente significativos en algunos comportamientos sociales, específicamente el contacto ocular y la comunicación funcional. Observamos que aquellos pacientes con mayor coeficiente intelectual verbal (CIV) obtuvieron mejor respuesta al tratamiento en los anteriores parámetros. A pesar de estos resultados obtenidos, cada participante sigue un curso único. Es necesario seguir investigando los factores que influyen en la eficacia de estos programas, como la edad o el IQ, de modo que se implementen intervenciones que generen cambios significativos en estos contextos comunitarios, donde resulta más complejo llegar a un mayor número de personas.Over the past decade, numerous studies have been conducted in order to evaluate the effectiveness of social skills intervention groups for people with autism spectrum disorder (ASD). Much controversy remains about which factors benefit certain patients and what methodology is used to detect them, specifically in community settings. The objectives of this thesis were: to assess the effect of the adaptation of a social skills program for children and adolescents with ASD in a hospital context, analyzing the effectiveness of the program to decrease comorbidity symptoms and increases social behaviors and, to use observational methodology to identify social changes. The Bauminger observational scale was adapted and 10 group sessions were coded. Data were analyzed with the polar coordinate technique. The results obtained in the three studies indicate that the affective symptomatology decreased after the intervention. Marginally significant results were also seen in some social behaviors, specifically eye contact and functional communication. We observed that those patients with a higher verbal intelligence quotient (IQ) obtained a better response to treatment in the above parameters. Despite these results, each participant followed a unique course. It is necessary to continue investigating the factors that influence the effectiveness of these programs, such as age or IQ, so that the implemented interventions generate significant changes in these community contexts, where it is more complex to reach a greater number of people