Special Issue on Designing With and For Users on the Autism Spectrum

Autism is a lifelong neurodevelopmental condition that affects how a person communicates with and relates to other people, and to the world around them. It is estimated that around 1 in 68 people are autistic (Christensen et al., 2016 Christensen, D. L., Baio, J., Van Naarden Braun, K., Bilder, D., Charles, J., Constantino, J. N., … Yeargin-Allsopp, M. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years

Creating wheelchair-controlled video games: challenges and opportunities when involving young people with mobility impairments and game design experts

Although participatory design (PD) is currently the most acceptable and respectful process we have for designing technology, recent discussions suggest that there may be two barriers to the successful application of PD to the design of digital games: First, the involvement of audiences with special needs can introduce new practical and ethical challenges to the design process. Second, the use of non-experts in game design roles has been criticised in that participants lack skills necessary to create games of appropriate quality. To explore how domain knowledge and user involvement influence game design, we present results from two projects that addressed the creation of movement-based wheelchair-controlled video games from different perspectives. The first project was carried out together with a local school that provides education for young people with special needs, where we invited students who use wheelchairs to take part in design sessions. The second project involved university students on a game development course, who do not use wheelchairs, taking on the role of expert designers. They were asked to design concepts for wheelchair-controlled games as part of a final-year course on game design. Our results show that concepts developed by both groups were generally suitable examples of wheelchair-controlled motion-based video games, but we observed differences regarding level of detail of game concepts, and ideas of disability. Additionally, our results show that the design exercise exposed vulnerabilities in both groups, outlining that the risk of practical and emotional vulnerability needs to be considered when working with the target audience as well as expert designers

Participatory Methods to Engage Autistic People in the Design of Digital Technology: A Systematic Literature Review

Purpose Many technology designers strive to involve end users in the design process, aiming to produce better outcomes. However, designers may struggle to engage autistic users effectively due to a lack of understanding of autistic characteristics and preferences. This systematic literature review aimed to identify how autistic adolescents and adults can best be engaged in effective participatory design activities. Methods Seven databases were searched for articles reporting technology design involving autistic people, returning 276 results. Using the PRISMA approach, 258 were excluded due to not meeting the inclusion criteria. The remaining 18 articles were then quality assessed. Results A thematic analysis revealed five core themes: (1) Engagement: the importance of investment in, and ownership of, the design process to create engagement, (2) Relationships: building relationships through collaboration and careful facilitation, (3) Skills development: the development of personal skills such as teamwork, design and self-advocacy in order to grow confidence, (4) Structure: providing context and structure to make the design experience feel safe and predictable, and (5) Support: the importance of support and consideration of individual needs as well as discouraging negative behaviours. Conclusion Valuing participants as equal partners in design emerged as an, arguably, universal principle. The specific needs and preferences of autistic people must be understood and respected by designers. This goes beyond obvious accommodations such as providing a quiet and safe environment, and requires a deeper, more personal engagement with the individuals and their interests. We provide tangible recommendations for increasing engagement and aiding the design process

Toolkits for the Development of Hybrid Games: from Tangible Tabletops to Interactive Spaces

Durante los últimos años, los dispositivos tabletop han sido considerados el entorno ideal para los juegos híbridos, los cuales combinan técnicas de juego tradicional, como el uso de objetos físicos para interactuar con el juego de una forma natural, con las nuevas posibilidades que los tabletops ofrecen de aumentar el espacio de juego con imágenes digitales y audio.Sin embargo, los juegos híbridos no se restringen simplemente a tabletops, pudiéndose jugar también en entornos más amplios en los que convergen otros paradigmas de interacción. Por esta razón, el uso de juegos híbridos en Espacios Interactivos está ganando fuerza, pero el número y heterogeneidad de dispositivos y estilos de interacción que se encuentran en estos entornos hace que el diseño y prototipado de juegos sea una tarea difícil. Por lo tanto, el gran reto se encuentra en ofrecer a diseñadores y desarrolladores herramientas apropiadas para la creación de estas aplicaciones.En esta línea de trabajo, el grupo Affective Lab lanzó el proyecto JUGUEMOS (TIN2015-67149-C3-1R), un proyecto nacional centrado en el desarrollo de juegos híbridos en entornos interactivos. Esta Tesis Doctoral se enmarca en este proyecto.El primer paso de la realización de esta tesis fue establecer los dos objetivos principales (Capítulo 1):1) El primer objetivo que se estableció fue profundizar en el uso de tabletops tangibles en terapia con niños con necesidades especiales. Durante los últimos años el grupo Affective Lab había visto la potencialidad de los tabletops tangibles para el trabajo con niños pequeños, pero todavía era necesario llevar a cabo más experiencias y evaluaciones en el ámbito terapéutico, así como explorar si otros grupos de usuarios (adultos con problemas cognitivos) podían beneficiarse de las características de los tabletops.2) El segundo objetivo consistió en diseñar e implementar un toolkit para el desarrollo de juegos híbridos para espacios interactivos. Se decidió que el toolkit estuviera dirigido a desarrolladores para facilitar su trabajo a la hora de crear este tipo de aplicaciones.Una vez establecidos los objetivos, se realizó un estado del arte a su vez dividido en dos partes (Capítulo 2):1) Se realizó una categorización de juegos híbridos para entender y extraer sus principales características, así como los principales retos que surgen al desarrollar este tipo de juegos. También se estudiaron toolkits cuyo objetivo era el desarrollo de juegos híbridos.2) Se estudiaron juegos híbridos desarrollados para niños con necesidades especiales y adultos con problemas cognitivos que hacían uso de la Interacción Tangible y tabletops, así como toolkits dirigidos a terapeutas o educadores para ayudarles en la creación de actividades para sus pacientes.Para llevar a cabo las experiencias y evaluaciones relacionadas con el primer objetivo, se hizo uso del tabletop tangible NIKVision, desarrollado previamente por el grupo Affective Lab, y el toolkit KitVision, una herramienta dirigida a profesionales sin conocimientos de programación para la creación de actividades tangibles y que fue desarrollado durante el Proyecto Final de Carrera de la autora. En el Capítulo 3 de esta Tesis se comenta brevemente el tabletop NIKVision y la arquitectura de KitVision, se describen las evaluaciones que se llevaron a cabo con terapeutas con el objetivo de mejorar y probar la utilidad del toolkit, y se explica una experiencia de un año durante la cual una terapeuta ocupacional de ASAPME, una asociaciónque trabaja con adultos con problemas cognitivos, estuvo usando el tabletop y el toolkit sin supervisión.En el Capítulo 4 se describen diferentes experiencias con KitVision que se llevaron a cabo:- Gracias a una colaboración con la Residencia Romareda, NIKVision y KitVision fueron instalados provisionalmente en la residencia y, tras una evaluación inicial, se desarrollaron tres nuevas actividades para los usuarios de la residencia.- Gracias a la colaboración con ENMOvimienTO y con uno de los centros de Atención Temprana del Instituto Aragonés de Servicios Sociales (IASS), ambos enfocados a trabajar con niños con problemas de aprendizaje, se pudieron realizar evaluaciones que nos permitieron mejorar KitVision y crear nuevas actividades específicamente diseñadas para ellos.- Finalmente, gracias a una colaboración con Atenciona, pudimos evaluar actividades con niños con Trastorno por Déficit de Atención e Hiperactividad (TDAH) y extraer una serie de directrices para diseñar actividades para este tipo de niños. También pudimos llevar a cabo una experiencia de Diseño Participativo con estos niños.El completo desarrollo del toolkit JUGUEMOS, para la creación de juegos híbridos en espacios interactivos, se explica en el Capítulo 5. En este apartado primero se describe el Espacio Interactivo JUGUEMOS que sirvió de base para desarrollar el toolkit. Después se explican con detalle las decisiones de diseño que se tomaron, el modelo de abstracción que se usó para diseñar los juegos, y la arquitectura del toolkit. También se detallan las distintas fases de implementación que se llevaron a cabo, basadas en los tres retos que se extrajeron en el estado del arte: (1) integrar diferentes dispositivos, (2) gestionar salidas gráficas diversas y (3) facilitar la codificación del juego. Finalmente, se presentan dos prototipos de juegos que se desarrollaron durante las dos estancias de investigación que la autora realizó.Finalmente, en el Capítulo 6 se describen los tres casos de uso que se realizaron para tener una primera valoración de la usabilidad del toolkit JUGUEMOS: (1) una evaluación con estudiantes de Máster en la que se implementó un juego completamente funcional para el Espacio Interactivo JUGUEMOS, (2) un juego que fue completamente desarrollado usando el toolkit JUGUEMOS una vez que éste se acabó de implementar, (3) una experiencia que involucró a dos grupos multidisciplinares compuestos por diseñadores y desarrolladores, en la que tuvieron que colaborar para diseñar e implementar dos prototipos de juegos híbridos para el espacio interactivo.<br /

Playful E-textile Sonic Interaction for Socially Engaged and Open-Ended Play Between Autistic Children

Research on the potential benefits of technology for autistic children is an emergent field in Human-Computer Interaction (HCI), especially within the Child-Computer Interaction Community. This thesis contributes a design approach grounded in theories of play, cognitive development, and autism to expand the discourse on methodological guidelines for performing empirical studies with non-verbal autistic children and to extend the design space to cater to the socio-emotional and sensory needs of this population. The thesis reveals how sonic e-textile Tangible User Interfaces (TUIs) can be used effectively to mediate children’s social participation in playful activities. This is demonstrated through developing three explorative field-studies conducted at a specialist school based in North-East London where two sonic e-textile playful TUIs, namely Mazi and Olly, have been created and tested with three groups of autistic children aged between 5-10. The three studies ran over the period of three years and were designed to investigate the potentials of TUIs as shareable toys during leisure and recreational activities to a) support social and playful interactions among peers and b) provide opportunities for self-regulation. The key contributions of this thesis are the designs of two tangible user interfaces, which offer a set of design approaches to guide researchers through creating shareable and playful tangibles for non-verbal autistic children; a framework for analysis and a thorough evaluation process that other researchers could use to assess the efficacy of playful TUI designs for nonverbal autistic children; and an in-depth discussion about the research process, which offers a new perspective about holistic designs and evaluation of technologies that aim to scaffold play in groups non-verbal autistic children

The use of a Kinect-based technology within the school environment to enhance sensory-motor skills of children with autism

This research explored the effect of Pictogram Room, a Kinect-based technology, on the sensory-motor skills of children with autism in a school setting. It focused on the overall development of sensory-motor skills, how these skills developed in different environments, and which of the sensory-motor subdomains improved the most. Theoretically, the study drew upon gaming theory and embodied cognition. It was a mixed methods study, with the quantitative data being the dominant method of data collection and the qualitative data having a more supportive role. During the first year, the intervention was implemented with the intervention group (n=5), twice a week for 15 minutes, over the course of nine weeks. The following year, a wait-list control group was recruited (n=5). The findings from the researcher’s checklist, as well as those from the standardised assessments, showed that sensory-motor skills in the intervention group were significantly improved, and there was also generalisation of these skills to other environments. Finally, as a result of the teachers’ interviews, social play and adaptive behaviours were also evaluated, with positive results for the intervention group

Avances en la tecnología para el desarrollo de la competencia social del alumnado con trastorno del espectro autista. Revisión sistemática

The primary aim of this research is to determine the degree of association between sociodemographic and occupational factors and teachers’ attitudes towards the inclusion of students with disabilities in the school system. This study adopts a basic quantitative approach with a descriptive-correlational scope, employing a non-experimental cross-sectional design. The research tool used was a survey based on the questionnaire developed by Tárraga-Mínguez et al. (2013), adapted by Clavijo et al. (2016). The questionnaire comprises 15 items, distributed across three dimensions: 1) beliefs (9 items); 2) predisposition to act (4 items); and 3) emotions (2 items), all adapted on a Likert scale. The survey was administered to a random probabilistic sample of 90 teachers working in four educational institutions in District 09D09, Zone 8 in Ecuador. The reliability of the instrument, as assessed by Cronbach’s alpha, was 0.8462. Key findings indicate a higher proportion of women compared to men who exhibit a favorable attitude towards inclusion. Additionally, teachers who have received training in inclusive education tend to display a lower degree of negativity and indifference, favoring a positive attitude towards inclusion. Having access to human resources and support materials also promotes a positive attitude towards inclusion.Las tecnologías digitales han mostrado ser potencialmente beneficiosas para el apoyo educativo de las habilidades sociales de los alumnos con trastornos del espectro autista (TEA). Sin embargo, en ocasiones puede ser difícil para los docentes saber qué tipo de tecnologías están disponibles para cada metodología de trabajo y qué evidencia científica respalda su uso. El objetivo de esta revisión es analizar la evidencia científica sobre la eficacia de las intervenciones tecnológicas individuales, colaborativas y cooperativas en el desarrollo de la competencia social de los niños con TEA. Se realizó una revisión sistemática que analizó de manera cualitativa las publicaciones científicas de las revistas indexadas en las bases de datos Scopus, Web of Science, PubMed, ERIC, IEEE Xplore y ACM Digital Library, de acuerdo con los criterios establecidos en la declaración PRISMA. La literatura destaca el potencial del entrenamiento basado en tecnologías digitales para mejorar la interacción social de los estudiantes con TEA, y los estudios controlados muestran datos a favor de su efectividad. Los avances en tecnología muestran una tendencia a utilizar soportes multimodales en contextos virtuales o reales de interacción que proporcionan retroalimentación en tiempo real y a distancia, lo que favorece el aprendizaje y la inclusión social del alumno

Avanços na tecnologia para o desenvolvimento da competência social de alunos com transtorno do espectro autista. Revisão sistemática

Digital technologies have been shown to be potentially beneficial for educational support of the social skills of students with Autism Spectrum Disorders (ASD). However, it can sometimes be difficult for teachers to know what kind of technologies are available for each work methodology and what scientific evidence supports their use. The aim of this review is to analyze the scientific evidence on the effectiveness of individual, collaborative and cooperative technological interventions in the development of social competence of children with ASD. A systematic review was carried out, which qualitatively analyzed the scientific publications of the journals indexed in the databases Scopus, Web of Science, PubMed, ERIC, IEEE Xplore and ACM Digital Library following the criteria set out in the PRISMA declaration. The literature highlights the potential of training based on digital technologies to improve students' social interaction with ASD and controlled studies show data in favor of its effectiveness. Advances in technology show a tendency to use multimodal supports in virtual or real contexts of interaction that provide feedback in real time and at a distance, favoring learning and social inclusion of the student.Las tecnologías digitales han mostrado ser potencialmente beneficiosas para el apoyo educativo de las habilidades sociales de los alumnos con trastornos del espectro autista (TEA). Sin embargo, en ocasiones puede ser difícil para los docentes saber qué tipo de tecnologías están disponibles para cada metodología de trabajo y qué evidencia científica respalda su uso. El objetivo de esta revisión es analizar la evidencia científica sobre la eficacia de las intervenciones tecnológicas individuales, colaborativas y cooperativas en el desarrollo de la competencia social de los niños con TEA. Se realizó una revisión sistemática que analizó de manera cualitativa las publicaciones científicas de las revistas indexadas en las bases de datos Scopus, Web of Science, PubMed, ERIC, IEEE Xplore y ACM Digital Library, de acuerdo con los criterios establecidos en la declaración PRISMA. La literatura destaca el potencial del entrenamiento basado en tecnologías digitales para mejorar la interacción social de los estudiantes con TEA, y los estudios controlados muestran datos a favor de su efectividad. Los avances en tecnología muestran una tendencia a utilizar soportes multimodales en contextos virtuales o reales de interacción que proporcionan retroalimentación en tiempo real y a distancia, lo que favorece el aprendizaje y la inclusión social del alumno.As tecnologias digitais têm se mostrado potencialmente benéficas para o apoio educacional das habilidades sociais de alunos com Transtorno do Espectro Autista (TEA). No entanto, às vezes pode ser difícil para os professores saberem que tipo de tecnologias estão disponíveis para cada metodologia de trabalho e quais evidências científicas apoiam seu uso. O objetivo desta revisão é realizar uma análise das evidências científicas sobre a eficácia das intervenções tecnológicas individuais, colaborativas e cooperativas no desenvolvimento da competência social em crianças com TEA. Foi realizada uma revisão sistemática que analisou qualitativamente publicações científicas de periódicos indexados nos bancos de dados Scopus, Web of Science, PubMed, ERIC, IEEE Xplore e ACM Digital Library, seguindo os critérios estabelecidos na declaração PRISMA. A literatura destaca o potencial do treinamento baseado em tecnologias digitais para melhorar a interação social de alunos com TEA, e estudos controlados mostram dados a favor de sua eficácia. Os avanços tecnológicos mostram uma tendência ao uso de suportes multimodais em contextos de interação virtual ou real que fornecem feedback remoto e em tempo real, favorecendo o aprendizado e a inclusão social do aluno

Digital Youth with Disabilities

An examination of media and technology use by school-aged youth with disabilities, with an emphasis on media use at home.Most research on media use by young people with disabilities focuses on the therapeutic and rehabilitative uses of technology; less attention has been paid to their day-to-day encounters with media and technology—the mundane, sometimes pleasurable and sometimes frustrating experiences of “hanging out, messing around, and geeking out.” In this report, Meryl Alper attempts to repair this omission, examining how school-aged children with disabilities use media for social and recreational purposes, with a focus on media use at home. In doing so, she reframes common assumptions about the relationship between young people with disabilities and technology, and she points to areas for further study into the role of new media in the lives of these young people, their parents, and their caregivers.Alper considers the notion of “screen time” and its inapplicability in certain cases—when, for example, an iPad is a child's primary mode of communication. She looks at how young people with various disabilities use media to socialize with caregivers, siblings, and friends, looking more closely at the stereotype of the socially isolated young person with disabilities. And she examines issues encountered by parents in selecting, purchasing, and managing media for youth with such specific disabilities as ADHD and autism. She considers not only children's individual preferences and needs but also external factors, including the limits of existing platforms, content, and age standards

A systematic review of game technologies for pediatric patients

[EN] Children in hospital are subjected to multiple negative stimuli that may hinder their development and social interactions. Although game technologies are thought to improve children's experience in hospital, there is a lack of information on how they can be used effectively. This paper presents a systematic review of the literature on the existing approaches in this context to identify gaps for future research. A total of 1305 studies were identified, of which 75 were thoroughly analyzed according to our review protocol. The results show that the most common approach is to design mono-user games with traditional computers or monitor-based video consoles, which serve as a distractor or a motivator for physical rehabilitation for primary school children undergoing fearful procedures such as venipuncture, or those suffering chronic, neurological, or traumatic diseases/injures. We conclude that, on the one hand, game technologies seem to present physical and psychological benefits to pediatric patients, but more research is needed on this. On the other hand, future designers of games for pediatric hospitalization should consider: 1. The development for kindergarten patients and adolescents, 2. Address the psychological impact caused by long-term hospitalization, 3. Use collaboration as an effective game strategy to reduce patient isolation, 4. Have purposes other than distraction, such as socialization, coping with emotions, or fostering physical mobility, 5. Include parents/caregivers and hospital staff in the game activities; and 6. Exploit new technological artifacts such as robots and tangible interactive elements to encourage intrinsic motivation.This work is supported by the Spanish Ministry of Economy and Competitiveness and the European Development Regional Fund (EDRF-FEDER) with Project TIN2014-60077-R.El Jurdi, S.; Montaner-Marco, J.; García Sanjuan, F.; Jaén Martínez, FJ.; Nácher-Soler, VE. (2018). A systematic review of game technologies for pediatric patients. Computers in Biology and Medicine. 97:89-112. https://doi.org/10.1016/j.compbiomed.2018.04.019S891129