Music, computing and health: A roadmap for the current and future roles of music technology for health care and well-being.

Health and self-regulatio

The design principles of edutainment system for autistic children with communication difficulties

The number of children with autism is increasing worldwide. Children with autism face three major problems; socializing, communicating, and behaviour. Approximately 50% of all individuals with autism have difficulties in developing functional language owing to communication deterioration. Mobile devices with installed educational games help these individuals feel more comfortable and relaxed doing such activities. Although numerous mobile applications are available for individuals with autism, they are difficult to use; particularly in terms of user-interface design. This study analysed the existing apps in order to determine the design principles applicable to the Edutainment App being studied. Five applications were involved in this analysis. As outlined in the objectives of this study, identifying these design principles is important in designing the app. The analysis identified fifteen suggestions for the design principles. These suggestions addressed, simple interfaces; image size; number of pictures; home page icon; colour; having images identical to real life objects; the use of caregivers; navigation; password-protection; audio appropriate to the images; the app language used; evaluating parameters to measure the child’s growth; option for photo loading; PECS-based communication; and sentence pronunciation function. These recommendations are offered by this study towards designing and developing a prototype app for autistic children. This study introduces an edutainment-system design principle formulated to help develop the communication skills of children with autism-spectrum disorders. This study also describes the design, implementation, and evaluation of the ICanTalk app-a mobile edutainment app that can be used to improve users’ understanding and communication skills and help them to connect with society and the surrounding environment particularly for autistic children with communication difficulties. This app allows caregivers to create personalized content using pictures and audio on their mobile devices (tablets). The evaluation of the app by teachers suggests that it is useful and easy-to-use. In conclusion, based on the evaluation results, it is found that the ICanTalk app is effective in helping autistic children with communication difficultie

Toward emotional interactive videogames for children with autism spectrum disorder

Technology and videogames have been proven as motivating tools for working attention and complex communication skills, especially in children with autism spectrum disorder (ASD). In this work, we present two experiences that used interactive games for promoting communication and attention. The first game considers emotions in order to measure children’s attention, concentration and satisfaction, while the second uses tangible tabletops for fostering cognitive planning. The analysis of the results obtained allows to propose a new study integrating both, in which the tangible interactive game is complemented with the emotional trainer in a way that allows identifying and classifying children’s emotion with ASD when they collaborate to solve cognitively significant and contextualized challenges. The first application proposed is an emotional trainer application in which the child can work out the seven basic emotions (happiness, sadness, fear, disgust, anger, surprise and neutral). Further, a serious videogame is proposed: a 3D maze where the emotions can be captured. The second case study was carried out in a Special Education Center, where a set of activities for working cognitive planning was proposed. In this case, a tangible interactive tabletop was used to analyze, in students with ASD, how the communication processes with these interfaces affect to the attention, memory, successive and simultaneous processing that compose cognitive planning from the PASS model. The results of the first study, suggest that the autistic children did not act with previous planning, but they used their perception to adjust their actions a posteriori (that explains the higher number of collisions). On the second case study, the successive processing was not explored. The inclusion of the mazes of case study 1 to a semantic rich scenario could allow us to measure the prior planning and the emotions involved in the maze game. The new physiological sensors will also help to validate the emotions felt by the children. The first study has as objective the capability to imitate emotions and resolve a maze without semantic context. The second study organized all the actions from a semantic context close to users. The attention results presented by the second study are coherent with the first study and complement it showing that attention can be receptive or selective. In the first study case, the receptive attention was the focus of analysis. In the second case, both contributed to explain and understand how it can be developed from a videogame

Rafigh: A Living Media System for Motivating Target Application Use for Children

Digital living media systems combine living media such as plants, animals and fungi with computational components. In this dissertation, I respond to the question of how can digital living media systems better motivate children to use target applications (i.e., learning and/or therapeutic applications)? To address this question, I employed a participatory design approach where I incorporated input from children, parents, speech language pathologists and teachers into the design of a new system. Rafigh is a digital embedded system that uses the growth of a living mushrooms colony to provide positive reinforcements to children when they conduct target activities. The growth of the mushrooms is affected by the amount of water administered to them, which in turn corresponds to the time children spend on target applications. I used an iterative design process to develop and evaluate three Rafigh prototypes. The evaluations showed that the system must be robust, customizable, and should include compelling engagement mechanisms to keep the children interested. I evaluated Rafigh using two case studies conducted in participants homes. In each case study, two siblings and their parent interacted with Rafigh over two weeks and the parents identified a series of target applications that Rafigh should motivate the children to use. The study showed that Rafigh motivated the children to spend significantly more time on target applications during the intervention phase and that it successfully engaged one out of two child participants in each case study who showed signs of responsibility, empathy and curiosity towards the living media. The study showed that the majority of participants described the relationship between using target applications and mushrooms growth correctly. Further, Rafigh encouraged more communication and collaboration between the participants. Rafighs slow responsivity did not impact the engagement of one out of two child participants in each case study and might even have contributed to their investment in the project. Finally, Rafighs presence as an ambient physical object allowed users to interact with it freely and as part of their home environment

A pilot study to assess the usability of a novel psychotherapeutic interactive gaming application as a tool to measure facial emotion recognition in patients with schizophrenia

This work presents the development and the assessment of Feeling Master, a novel psychotherapeutic interactive gaming application that uses cartoon stimuli to measure facial emotion recognition in schizophrenic patients. A pilot study among 24 patients with schizophrenia (PS) and 17 healthy control (HC) subjects was conducted to assess the usability of Feeling Master as a tool to measure facial emotion recognition ability in schizophrenic patients. The usability assessment of the application was based on three criteria: adaptability, effectiveness, and efficiency of the tool (Nielsen, 1994; Schwebel, McClure, & Severson, 2014). The study also attempted to determine whether people with schizophrenia would show emotion recognition deficits and if such deficits would vary among the basic emotions described by Ekman and Friesen (1971). Moreover, our team aimed to relate the results of facial emotion recognition within the schizophrenia group to clinical variables such as the Personal and Situational Attribution Questionnaire (IPSAQ). Descriptive data reveal that Feeling Master is a useful tool for measuring facial emotion recognition in patients with schizophrenia. Schizophrenia patients showed impairments in the emotions recognition. PS subjects remained slower than HC (Average time: F(1.38) = 15.1, p = 0.000). On the other hand, we did not find significant values for the overall emotion discrimination (average accuracy: F(1.38) = 0.733, p>0.05), but we found significant error rates for discrimination in fear: F=(1.38)=8.2, p < 0.007) ) using Fisher¿s exact test to compare errors between PS and HC groups. Using the Feeling Master tool, the performances of patients with schizophrenia were compared to those of healthy control volunteers on computerized tasks of emotion recognition, and the Personal and Situational Attribution Questionnaire (IPSAQ) was administered to determine whether emotion processing deficits were correlated with the attributional style. The correlations between correct response on the Feeling Master and Personal and Situational Attribution Questionnaire (IPSAQ) were not significant, but they showed interesting relations: Sad vs. External Situational Negative, Rho= 0.346, p=0.106; Sad vs. External Situational Positive, Rho=0.320, p=0.136. Finally, the Technology Acceptance Model (TAM) was used to study the acceptance among professionals of the Feeling Master as a tool to measure facial emotion recognition in rehabilitation psychiatric units. The TAM study was conducted among 66 experienced mental health professionals. Except for Perceived Ease of Use (PEOU), which has a high value, the other TAM construct values (i.e., Perceived usefulness (PU), Attitude Toward Using (ATU), Enjoyment (E), and Behavioral Intention (BI)) should be improved. In conclusion, the study puts forward the usability of a novel, psychotherapeutic interactive gaming tool used in Facial Emotion Recognition for people with schizophrenia. These findings lend support to the notion that difficulties in emotion recognition are associated with key cognitive deficits among individuals with schizophrenia. These findings were consistent with previous studies.Este trabajo presenta el desarrollo y la evaluación de Feeling Master, un novedoso videojuego psicoterapéutico que utiliza ilustraciones faciales como estímulos para medir el reconocimiento de emociones en pacientes esquizofrénicos. Se realizó un estudio piloto a 24 pacientes con diagnostico de esquizofrenia (PS) y 17 controles voluntarios (HC) para evaluar la usabilidad de Feeling Master como herramienta para la medición del reconocimiento de emociones faciales en pacientes esquizofrénicos. La evaluación de la usabilidad de Feeling Master se baso en tres criterios: la adaptabilidad, la eficacia y la eficiencia de la herramienta (Nielsen, 1994; Schwebel et al., 2014). Conjuntamente, se intentó determinar si las personas enfermas de esquizofrenia muestran déficits en el reconocimiento de las emociones faciales y si tales déficits varían entre las distintas emociones básicas descritas por Ekman y Friesen (1971). Además, se relacionaron los resultados del reconocimiento de emociones faciales del grupo de personas enfermas de esquizofrenia con variables clínicas como el cuestionario de atribuciones internas, personales y situacionales (IPSAQ). Los resultados obtenidos en este estudio revelan que Feeling Master es una herramienta efectiva para la medición del reconocimiento de emociones faciales en personas enfermas de esquizofrenia. Los pacientes con diagnostico de esquizofrenia mostraron un déficit de reconocimiento de las emociones faciales. El grupo PS necesitó mas tiempo que el grupo HC para el reconocimiento de las emociones (tiempo medio: F (1,38) = 15,1, p = 0,000). El estudio no evidenció valores significativos para la discriminación en general de emociones faciales (precisión media: F (1,38) = 0.733, p> 0,05). Por otra parte, se encontró una tasa de error significativo para la discriminación en el miedo: F = (1 , 38) = 8,2, p <0.007)) con la prueba exacta de Fisher para comparar errores entre los grupos PS y HC. Los resultados del reconocimiento de emociones faciales del grupo PS obtenidos con el Feeling Master, se relacionaron con el IPSAQ para determinar si existen correlaciones entre el déficit de reconocimiento de las emociones y el estilo atribucional. Las correlaciones entre los resultados obtenidos por el Feeling Master y el IPSAQ no fueron significativas, pero se encontraron las siguientes relaciones interesantes: tristeza vs. externa situacional negativa, Rho = 0,346, p = 0,106; tristeza vs. externa situacional positiva, Rho = 0,320, p = 0,136. Por último, se utilizo el modelo de aceptación de la tecnología (TAM) para estudiar la adopción de Feeling Master como herramienta para el reconocimiento de emociones faciales en unidades psiquiátricas de rehabilitación. El estudio TAM se realizó a 66 profesionales experimentados de la salud mental. Excepto por la facilidad de uso percibida, que ha obtenido un alto valor, el resto de los constructos del TAM (utilidad percibida , actitud hacia el uso, placer de uso y la intención hacia el uso) deben mejorar sus valores. hacia el uso) deben mejorar sus valores. Como conclusión podemos afirmar que, este trabajo demuestra la correcta usabilidad de Feeling Master como herramienta para la medición del reconocimiento de emociones faciales en personas enfermas de esquizofrenia. Conjuntamente, los resultados de nuestra investigación confirman la existencia de un déficit de reconocimiento de las emociones faciales en las personas enfermas de esquizofrenia. Estos resultados son consistentes con el resto de la literatura científica. de la salud mental. Excepto por la facilidad de uso percibida, que ha obtenido un alto valor, el resto de los constructos del TAM (utilidad percibida , actitud hacia el uso, placer de uso y la intención hacia el uso) deben mejorar sus valores.Postprint (published version

A serious games platform for cognitive rehabilitation with preliminary evaluation

In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients' attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.- This work has been supported by FCT - Fundacao para a Ciencia e Tecnologia in the scope of the projects: PEst-UID/CEC/00319/2015 and PEst-UID/CEC/00027/2015. The authors would like to thank also all the volunteers that participated in the study

Recommendations for the non-pharmacological treatment of apathy in brain disorders

Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, non-pharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient's cognitive and physical profile and living conditions

Assistive learning technologies for learners with ADHD and ASD: – a review 2006-2016

This literature review was a part of a research project investigating how technologies can be utilised to support learners with developmental and attention deficit to be included in mainstream learning contexts. &nbsp;The review contains research within the field of assistive learning technologies for learners with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder from 2006 to 2016. The review is conducted, by using systematic and qualitative academically acknowledged literature search methods. Seven categories of technology-based interventions are recognised from current research, where technologies have been used to support: 1) memory disabilities and/or brain training, 2) increasing focusing attention, 3) time and task management, 4) communication, 5) reading, writing, language and literacy skills, 6) changing behaviour and 7) group work and collaboration. The results indicate that the overall findings of the rendered studies present mixed conclusions. The review calls for more research in a mainstream learning context with a universal design for learning approach

Insights from mechanistic and digital intervention approaches

Eine effektive Förderung des Sozialverhaltens autistischer Kinder erfordert ein tiefgehendes Verständnis der Ursachen maladaptiver Reaktionen und die Bereitstellung eines leicht verfügbaren Förderangebots. Hier haben digitale Angebote ein großes Potential. Ebenso wie bei der Ursachenforschung mangelt es jedoch an Forschungsansätzen, welche eine Vielzahl an kognitiven und emotionalen Prozessen in die digitale Förderung integrieren. Dementsprechend untersuchte die Dissertation zunächst das Zusammenspiel verschiedener Ursachen aggressives Sozialverhaltens anhand eines etablierten Modells der sozial-kognitiven Informationsverarbeitung. Durch die Integration verschiedener Facetten der Empathie und deren zugrundeliegende Kompetenzen in ein digitales Förderangebot sollte im zweiten Schritt eine Verbesserung des Sozialverhaltens autistischer Grundschüler:innen erreicht werden. Es zeigte sich, dass Emotionsdysregulation verschiedene Formen aggressiven Sozialverhaltens und damit assoziierte feindselige Attributionen verstärkt. Letztere stand vor allem mit verbalen und verdeckten Aggressionsformen sowie mit guten Emotionserkennungsfertigkeiten im Zusammenhang. Eine Verbesserung des Sozialverhaltens und der Emotionsregulation konnte mittelfristig durch das sechswöchige, eltern-begleitete eLearningprogramm „Zirkus Empathico“ erreicht werden. Die multizentrische, randomisiert kontrollierte Studie ergab zudem kurzfristige und moderate Interventionseffekte für Empathie und Emotionserkennung als primäre Endpunkte. Insgesamt unterstreicht die Dissertation die Validität etablierter Modelle der sozialen Informationsverarbeitung sowie die Relevanz, diese zukünftigen Forschungs- und Interventionsansätzen zugrunde zu legen. Durch die Integration verschiedener sozio-emotionaler Kompetenzen scheint die digitale Intervention Zirkus Empathico prosoziales Verhalten autistischer Kinder auf effektive und praktikable Weise zu fördern.Effective training of autistic children`s social behavior requires an in-depth understanding of the causes of maladaptive responses and the provision of easily accessible support services. In this context, digital interventions have great potential. However, there is a lack of research approaches that integrate a variety of cognitive and emotional processes into both, explanation and digital support. The present dissertation first examined the interplay of different causes of aggressive social behavior by applying an established model of social-cognitive information processing to a sample of autistic elementary school students. Second, by integrating different facets of empathy and their underlying competencies into a digital program, the social behavior of autistic elementary school children should be improved. First, it was shown that emotion dysregulation strengthens various forms of aggressive social behavior and associated hostile attribution biases. The latter was mainly related to verbal and covert forms of aggression and good emotion recognition skills. Second, the parent-assisted eLearning program "Zirkus Empathico" led to a medium-term improvement in social behavior and emotion regulation after a six-week training. In addition, the multicenter randomized controlled trial showed moderate intervention effects on empathy and emotion recognition as primary outcomes, which were no longer detectable three months later. Overall, the dissertation highlights the validity of established models of social information processing and the relevance of using them as a foundation for future research and intervention. By integrating various socio-emotional competencies, the digital intervention Zirkus Empathico seems to strengthen autistic children’s prosocial behavior effectively and feasibly