European Child & Adolescent Psychiatry

, Volume 26, Issue 8, pp 979–992 | Cite as

‘Emotiplay’: a serious game for learning about emotions in children with autism: results of a cross-cultural evaluation

  • S. Fridenson-Hayo
  • S. Berggren
  • A. Lassalle
  • S. Tal
  • D. Pigat
  • N. Meir-Goren
  • H. O’Reilly
  • S. Ben-Zur
  • S. Bölte
  • S. Baron-Cohen
  • O. GolanEmail author
Original Contribution


Children with autism spectrum conditions (ASC) experience difficulties recognizing others’ emotions and mental states. It has been shown that serious games (SG) can produce simplified versions of the socio-emotional world. The current study performed a cross-cultural evaluation (in the UK, Israel and Sweden) of Emotiplay’s SG, a system aimed to teach emotion recognition (ER) to children with ASC in an entertaining, and intrinsically motivating way. Participants were 6–9 year olds with high functioning ASC who used the SG for 8–12 weeks. Measures included face, voice, body, and integrative ER tasks, as well as parent-reported level of autism symptoms, and adaptive socialization. In the UK, 15 children were tested before and after using the SG. In Israel (n = 38) and Sweden (n = 36), children were randomized into a SG or a waiting list control group. In the UK, results revealed that 8 weeks of SG use significantly improved participants’ performance on ER body language and integrative tasks. Parents also reported their children improved their adaptive socialization. In Israel and Sweden, participants using the SG improved significantly more than controls on all ER measures. In addition, parents in the Israeli SG group reported their children showed reduced autism symptoms after using the SG. In conclusion, Emotiplay’s SG is an effective and motivating psycho-educational intervention, cross-culturally teaching ER from faces, voices, body language, and their integration in context to children with high functioning ASC. Local evidence was found for more generalized gains to socialization and reduced autism symptoms.


Autism spectrum condition Emotion recognition Serious games Cross-cultural study Intervention evaluation 



We would like to acknowledge the contribution of our research teams at all sites. In the UK: Kirsty Macmillan, Nisha Hickin, Mathilde Matthews, and Kate Lindley Baron-Cohen. In Sweden: Sigrid Elfström, Nina Milenkovic, and Anna Råde. In Israel: Michal Landa, Tal Katan, Galit Govezensky, Keren Hadad, and Reut Meidler. Finally, we would like to thank the study’s participants and their families. This study was conducted as part of the ASC-Inclusion Project and has received funding from the European Community’s Seventh Framework Programme (FP7) under grant Agreement No [289021]. The Swedish authors were also supported by the Swedish Research Council. The UK authors were also supported by the Autism Research Trust, by the MRC, and by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Compliance with ethical standards

Conflict of interest

The SG is planned to be sold through Emotiplay in the future. Potential royalties to authors Bölte, Baron-Cohen, and Golan, resulting from intellectual property rights, would be paid to the academic institutions, to be used for autism research.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of PsychologyBar-Ilan UniversityRamat-GanIsrael
  2. 2.Center of Neurodevelopmental Disorders (KIND), Department of Women’s and Children’s HealthKarolinska InstitutetStockholmSweden
  3. 3.Autism Research Centre, Department of PsychiatryUniversity of CambridgeCambridgeUK
  4. 4.Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical SchoolCharlestownUSA
  5. 5.Compedia LtdRamat-GanIsrael
  6. 6.Child and Adolescent Psychiatry, Center of Psychiatry ResearchStockholm County CouncilStockholmSweden

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