GOLIAH (Gaming Open Library for Intervention in Autism at Home): a 6-month single blind matched controlled exploratory study

BackgroundTo meet the required hours of intensive intervention for treating children with autism spectrum disorder (ASD), we developed an automated serious gaming platform (11 games) to deliver intervention at home (GOLIAH) by mapping the imitation and joint attention (JA) subset of age-adapted stimuli from the Early Start Denver Model (ESDM) intervention. Here, we report the results of a 6-month matched controlled exploratory study.MethodsFrom two specialized clinics, we included 14 children (age range 5–8 years) with ASD and 10 controls matched for gender, age, sites, and treatment as usual (TAU). Participants from the experimental group received in addition to TAU four 30-min sessions with GOLIAH per week at home and one at hospital for 6 months. Statistics were performed using Linear Mixed Models.ResultsChildren and parents participated in 40% of the planned sessions. They were able to use the 11 games, and participants trained with GOLIAH improved time to perform the task in most JA games and imitation scores in most imitation games. GOLIAH intervention did not affect Parental Stress Index scores. At end-point, we found in both groups a significant improvement for Autism Diagnostic Observation Schedule scores, Vineland socialization score, Parental Stress Index total score, and Child Behavior Checklist internalizing, externalizing and total problems. However, we found no significant change for by time × group interaction.ConclusionsDespite the lack of superiority of TAU + GOLIAH versus TAU, the results are interesting both in terms of changes by using the gaming platform and lack of parental stress increase. A large randomized controlled trial with younger participants (who are the core target of ESDM model) is now discussed. This should be facilitated by computing GOLIAH for a web platform.Trial registration Clinicaltrials.gov NCT0256041

Videojuegos como herramienta terapéutica : revisión bibliográfica

Treball Final de Màster Universitari en Psicologia General Sanitària. Codi: SBF018. Curs acadèmic: 2019/2020En esta era digital, las tecnologías de la información y la comunicación (TIC) están teniendo un papel cada vez mayor en diferentes ámbitos, entre ellos la psicología, que las está incorporando aprovechando los beneficios que pueden ofrecer para salvar la brecha entre investigación y práctica y facilitar el acceso a las terapias empíricamente validadas. Mientras internet y nuevos entornos como la realidad virtual (RV) ya están siendo usados, otras herramientas se están investigando, como por ejemplo los videojuegos. El objetivo de esta revisión es conocer y recopilar qué videojuegos, tanto comerciales como serios, han sido utilizados hasta el momento como herramienta terapéutica.In this digital age, information and communications technologies are playing an increasing role in different fields, including psychology, which is incorporating them using their benefits to bridge the gap between research and clinical practice and to facilitate access to evidence-based therapies. While the Internet and new environments as Virtual Reality (VR) are already being used, other media are being investigated, such as video games. The objective of this review is to know and gather information about what video games, both commercial and serious, have been used as a therapeutic tool until now

Can you CopyMe?: An expression mimicking serious game

Emotional development is an important aspect in the early years of growth in young children, especially those with psychological disorders like autism spectrum disorders (ASDs), whereby emotional development becomes crucial. However, traditional paper-based interventions for emotional development are mostly laborious and difficult to employ for carers and parents, whilst current computer-aided interventions feel too much like obvious assistive tools and lack timely feedback to inform and aid progress. This paper hence describes the design of CopyMe, a touch-based tablet application that uses game design concepts and state-of-the-art computer vision techniques to provide an engaging experience as well as real-time feedback on the children's progress. © 2013 ACM

Feasibility of a smartphone application to identify young children at risk for Autism Spectrum Disorder in a low-income community setting in South Africa

Introduction and aims More than 90% of children with Autism Spectrum Disorder (ASD) live in low- and middle-income countries (LMIC) where there is a great need for culturally appropriate, scalable and effective early identification and intervention tools. Smartphone technology and application (‘apps’) may potentially play an important role in this regard. The Autism&Beyond iPhone App was designed as a potential screening tool for ASD risk in children aged 12-72 months. Here we investigated the technical feasibility and cultural acceptability of a smartphone app to determine risk for ASD in children aged 12-72 months in a naturalistic, low-income South African community setting. Methodology 37 typically-developing African children and their parents/carers were recruited from community centres in Khayelitsha Township, Cape Town, South Africa. We implemented a mixed-methods design, collecting both quantitative and qualitative data from participants in 2 stages. In stage 1, we collected quantitative data. With appropriate ethics and consent, parents completed a short technology questionnaire about their familiarity with and access to smartphones, internet and apps, followed by electronic iPhone-based demographic and ASD-related questionnaires. Next, children were shown 3 short videos of 30s each and a mirror stimulus on a study smartphone. The smartphone front facing (“selfie”) camera recorded video of the child’s facial expressions and head movement. Automated computer algorithms quantified positive emotions and time attending to stimuli. We validated the automatic coding by a) comparing the computer-generated analysis to human coding of facial expressions in a random sample (N=9), and b) comparing automated analysis of the South African data (N=33) with a matched American sample (N=33). In stage 2, a subset of families were invited to participate in focus group discussions to provide qualitative data on accessibility, acceptability, and cultural appropriateness of the app in their local community. Results Most parents (64%) owned a smartphone of which all (100%) were Android based, and many used Apps (45%). Human-automated coding showed excellent correlation for positive emotion (ICC= 0.95, 95% CI 0.81-0.99) and no statistically significant differences were observed between the South African and American sample in % time attending to the video stimuli. South African children, however, smiled less at the Toys&Rhymes (SA mean (SD) = 14% (24); USA mean (SD) = 31% (34); p=0.05) and Bunny video (SA mean (SD) = 12% (17); USA mean (SD) = 30% (0.27); p=0.006). Analysis of focus group data indicated that parents/carers found the App relatively easy to use, and would recommend it to others in their community provided the App and data transfer were free. Conclusion The results from this pilot study suggested the App to be technically accurate, accessible and culturally acceptable to families from a low-resource environment in South Africa. Given the differences in positive emotional response between the groups, careful consideration should be given to identify suitable stimuli if % time smiling is to be used as a global marker for autism risk across cultures and environments

Zirkus Empathico 2.0, A serious game to foster emotional and collaborative skills in children with Autism Spectrum Disorder (ASD)

Autismus-Spektrum-Störung (ASD) ist eine neurologische Entwicklungsstörung, die durch eine Reihe von Entwicklungsstörungen gekennzeichnet ist, die zu einem Mangel an sozialen, kommunikativen und kooperativen Fähigkeiten führen. Sozio-kommunikative Beeinträchtigungen können durch von Verhaltenstherapeuten konzipierte und durchgeführte Trainingsprogramme für soziale Kompetenzen verbessert werden. Computergestützte Therapien zur Lösung sozio-kommunikativer Schwierigkeiten bei Kindern, Jugendlichen und Erwachsenen mit ASD haben ermutigende Ergebnisse gezeigt. Das Serious-Game-Format ist eine Form der Intervention. Seriöse Spiele sind pädagogisch wertvoll, aber oft attraktiver als offensichtliche pädagogische Hilfsmittel. Zirkus Empathico 2.0 ist ein Serious Game für mehrere Spieler mit verschiedenen Levels und Bühnen in einer Zirkusumgebung. Die Auswertung erfolgte über einen Zeitraum von acht Wochen. Sechzig Kinder mit ASD im Alter von fünf bis elf Jahren wurden vor und nach der Behandlung untersucht. Zu den primären Ergebnissen gehörten die Empathiebewertung durch die Eltern und objektiv gemessene Fähigkeiten zur Emotionserkennung. Die Bewertung der Effektivität und Verwendbarkeit des Spiels für das Training sozialer Kompetenzen zeigte, dass es eine plausible Lernumgebung schuf, indem es das Bewusstsein der Studienteilnehmer für Fähigkeiten und neurotypisches Verhalten steigerte und ihre vorhergesagte Angst in zukünftigen sozialen Situationen verringerte. Nach der Behandlung wurden signifikante Behandlungseffekte festgestellt. Sowohl bei Kurz- als auch bei Langzeitbeurteilungen. Zirkus Empathico 2.0 ist erfolgreich bei der langfristigen Verbesserung der sozio-emotionalen Fähigkeiten in realen Situationen. Zukünftige Forschung sollte sich auf die spezifischen Prozesse konzentrieren, die den Übertragungs- und Aufrechterhaltungsvorteilen von Empathie und Emotionserkennung zugrunde liegen.Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a spectrum of developmental abnormalities that result in a lack of social, communicative, and collaborative abilities. Socio-communicative impairments can be improved through behavioral therapist-designed and delivered social-skills training programs. Computer-based therapies to resolve socio-communicative difficulties in children, adolescents, and adults with ASD have demonstrated encouraging outcomes. The serious game format is one type of intervention. Serious games are educational but often appeal more than overt pedagogical tools. Zirkus Empathico 2.0 is a multi-player serious game set with various levels and stages in a circus environment. It was evaluated over eight weeks. Sixty children with ASD aged five to eleven years were evaluated before treatment and post-treatment. Primary outcomes included empathy rating by parents and objectively measured emotion recognition abilities. Secondary outcomes were assessed as emotional awareness, emotion management, well-being, and personal therapy goals. The assessment of the game's effectiveness and usability for social-skills training indicated that it established a plausible learning environment by boosting trial participants' awareness of abilities and neurotypical behavior and decreasing their predicted fear in future social situations. Following treatment, significant treatment effects were detected. In both short- and long-term assessments, moderate impacts were observed on emotional awareness, emotion management, and autistic social symptomatology. Parents reported that therapy goals were met, and that treatment was transferred well. Zirkus Empathico 2.0 is successful at improving long-term socio-emotional abilities in real-world situations. Future research should focus on the specific processes behind empathy and emotion recognition's transmission and maintenance benefits