A randomised controlled trial of a computerised intervention for children with social communication difficulties to support peer collaboration

An intervention aiming to support children with social communication difficulties was tested using a randomised controlled design. Children aged 5–6 years old (n = 32) were tested and selected for participation on the basis of their scores on the Test of Pragmatic Skills (TPS) and were then randomly assigned to the intervention arm or to the delayed intervention control group. Following previous research which suggested that computer technology may be particularly useful for this group of children, the intervention included a collaborative computer game which the children played with an adult. Subsequently, children's performance as they played the game with a classmate was observed. Micro-analytic observational methods were used to analyse the audio-recorded interaction of the children as they played. Pre- and post-intervention measures comprised the Test of Pragmatic Skills, children's performance on the computer game and verbal communication measures that the children used during the game. This evaluation of the intervention shows promise. At post-test, the children who had received the intervention, by comparison to the control group who had not, showed significant gains in their scores on the Test of Pragmatic Skills (p = .009, effect size r = −.42), a significant improvement in their performance on the computer game (p = .03, r = −.32) and significantly greater use of high-quality questioning during collaboration (p < .001, r = −.60). Furthermore, the children who received the intervention made significantly more positive statements about the game and about their partners (p = .02, r = −.34) suggesting that the intervention increased their confidence and enjoyment

Evaluating ‘enhancing pragmatic language skills for young children with social communication impairments’ (E-PLAYS): protocol for a feasibility randomised controlled trial study

Background: A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The proposal presented in this article describes a feasibility study for a trial to test an intervention (‘E-PLAYS’) aimed at supporting children with social communication impairments. E-PLAYS harnesses technology in the form of a novel computer game in order to develop collaborative and communication skills. Preliminary studies by the authors show that when E-PLAYS was administered by the research team, children with social communication impairments showed improvements on communication test scores and on observed collaborative behaviours. The study described here is a pragmatic trial to test the application of E-PLAYS delivered by NHS speech and language therapists together with schools. Methods: This protocol outlines a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with treatment as usual control arm, with randomisation at the level of the speech and language therapist. The aim of this study is to ascertain whether it will be feasible to progress to running a full-scale definitive trial to test the effectiveness of E-PLAYS in an NHS setting. Data relating to recruitment and retention, the appropriateness of outcomes and the acceptability of E-PLAYS to participants will be collected. Speech and language therapists will select suitable children (ages 4–7 years old) from their caseloads and deliver either the E-PLAYS intervention (experimental group) or treatment as usual (control group). Assessments will include blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. There will also be a qualitative process evaluation. Discussion: The findings of this study will inform the decision as to whether to progress to a full-scale definitive randomised controlled trial to test the effectiveness of E-PLAYS when delivered by speech and language therapists and teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions

Appreciating the world of autism through the lens of VIG-Exploring perceptions, experiences and emerging narratives on autism

D. App. Ed. Psy.The current research volume encompasses three chapters; initially considering existing literature, then methodological considerations, followed by the current empirical research project. Initially a systematic synthesis of literature was conducted to explore how video has been applied as an active intervention tool in interaction-focused interventions for children labelled with an Autism Spectrum Disorder (ASD). The synthesis highlighted the tentative promise of using Video Interactive Guidance (VIG) to promote synrhythmia and attunement between parents and children with ASD. Following this the bridging document allowed for a more specific consideration of epistemological, methodological and ethical factors in preparation for the empirical research. The final chapter outlines the empirical research which aimed to identify understandings and narratives around ASD through the application of VIG. Findings of the current study suggest that VIG offers an effective tool for in-depth exploration of complex, multi-storied understandings of ASD and the perceived parental role. The intervention was perceived to promote greater awareness of the child‘s communication skills, beyond the ‗common‘ understandings of ASD, by providing a novel outsider perspective on interactions. The intervention also promoted parental efficacy through recognition of parenting skills in supporting the development of strength-based narratives. VIG was seen to provide a platform for an exploration of existing narratives and the construction of new, preferred realities

Implementing Gameplay Skills to Increase Eye Contact and Communication for Students with Emotional Behavioral Disorder and Comorbid Disabilities

This study was conducted to examine the effectiveness of gameplay activities using a structured social skills program to increase both eye contact responses and the number of verbal responses during peer relationships for students with comorbid disabilities in a clinical setting. This SEL intervention was modified for children with comorbid autism spectrum disorder (ASD) and emotional and behavioral disorder (EBD). A single-subject, multiple-baseline, across-participants design was used. Participants included adolescents (n = 6) with comorbid disabilities, predominantly ASD and EBD, their board-certified behavior analysts (BCBA), and six behavior technicians. The researcher established and maintained face-to-face reciprocal peer social engagements (communication) and direct eye gaze (contact) with participants in dyad groups. Each session included a 60-minute video of peer social interactions. Direct observations, differential reinforcement of other behaviors (DRO), and pre- and post-Social Skills Improvement System-Rating Scales (SSIS-RS) were examined. Evidence of SEL intervention effectiveness was measured by percentage of nonoverlapping data points (PND). Social validity was measured using the multiple-rater SSIS-RS and intervention fidelity checklists evaluating the Sanford Harmony intervention. Results from data and visual analysis revealed all participants significantly increased their direct eye contact, verbal reciprocity, and social engagements after implementing the Harmony program. In addition, a PND value of 100% was calculated for each dependent variable indicating the Harmony program was a highly effective intervention increasing eye contact, verbal reciprocity, and social engagements for students with EBD and comorbid disabilities

Interacting with others: the role of Temporal Contingency and Motor Interpersonal Synchrony in Autism Spectrum Disorder and in Typical Development

openInterpersonal synchrony (IS) is the spontaneous rhythmic and temporal coordination of actions, emotions, thoughts, behavioural, neurological, and physiological process that occurs between two or more people. All the levels of IS appear to have a great impact on facilitating social interaction in the typical population (TD). The synchronization seems to be decreased or absents in the Autistic Spectrum Disorder (ASD), in which the social and communication difficulties are the main traits. The present work investigates Motor Interpersonal Synchrony throughout a meta-analysis of eleven dyadic studies on TD and ASD participants. The aim is to understand if ASD individuals display difficulties in synchronizing within a social context. Furthermore, an experimental paradigm tests if two aspects, the temporal contingency (the closeness between an action and the environmental answer) and presence of engaging and non-engaging social stimuli, interfere with the synchronization process and with the preference for social stimuli. This experimental paradigm involves TD and ASD children and adolescents. Finally, the clinical implications of the Interpersonal Synchrony, of Temporal contingency and Engagement are discussed

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

Multimodal Data Analysis of Dyadic Interactions for an Automated Feedback System Supporting Parent Implementation of Pivotal Response Treatment

abstract: Parents fulfill a pivotal role in early childhood development of social and communication skills. In children with autism, the development of these skills can be delayed. Applied behavioral analysis (ABA) techniques have been created to aid in skill acquisition. Among these, pivotal response treatment (PRT) has been empirically shown to foster improvements. Research into PRT implementation has also shown that parents can be trained to be effective interventionists for their children. The current difficulty in PRT training is how to disseminate training to parents who need it, and how to support and motivate practitioners after training. Evaluation of the parents’ fidelity to implementation is often undertaken using video probes that depict the dyadic interaction occurring between the parent and the child during PRT sessions. These videos are time consuming for clinicians to process, and often result in only minimal feedback for the parents. Current trends in technology could be utilized to alleviate the manual cost of extracting data from the videos, affording greater opportunities for providing clinician created feedback as well as automated assessments. The naturalistic context of the video probes along with the dependence on ubiquitous recording devices creates a difficult scenario for classification tasks. The domain of the PRT video probes can be expected to have high levels of both aleatory and epistemic uncertainty. Addressing these challenges requires examination of the multimodal data along with implementation and evaluation of classification algorithms. This is explored through the use of a new dataset of PRT videos. The relationship between the parent and the clinician is important. The clinician can provide support and help build self-efficacy in addition to providing knowledge and modeling of treatment procedures. Facilitating this relationship along with automated feedback not only provides the opportunity to present expert feedback to the parent, but also allows the clinician to aid in personalizing the classification models. By utilizing a human-in-the-loop framework, clinicians can aid in addressing the uncertainty in the classification models by providing additional labeled samples. This will allow the system to improve classification and provides a person-centered approach to extracting multimodal data from PRT video probes.Dissertation/ThesisDoctoral Dissertation Computer Science 201

The use of Analog and Digital Games for Autism Interventions

Many interventions that target improvements in social communication and other cognitive, learning, and physical issues have been developed to help autistic people. The gamification of interventions offers an alternative approach to fostering and assessing desired behaviors and cognitions in a more naturalistic and emergent setting. In this scoping review aimed at educators, practitioners, and parents of those with autism, we detail studies that have tested game-based approaches to improving the lives of autistic children, adolescents, and adults, focusing on how research into gamification and autism can both progress and can be progressed and implemented. We offer parents, professionals and academics resources to incorporate game-based psycho-educational programs into their current practice