Designing Serious Game Interventions for Individuals with Autism

Abstract

The design of “Serious games” that use game components (e.g., storyline, long-term goals, rewards) to create engaging learning experiences has increased in recent years. We examine of the core principles of serious game design and examine the current use of these principles in computer-based interventions for individuals with autism. Participants who undergo these computer-based interventions often show little evidence of the ability to generalize such learning to novel, everyday social communicative interactions. This lack of generalized learning may result, in part, from the limited use of fundamental elements of serious game design that are known to maximize learning. We suggest that future computer-based interventions should consider the full range of serious game design principles that promote generalization of learning.

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References

  1. Anderson-Handley, C., Tureck, K., & Schneiderman, R. L. (2011). Autism and exergaming: Effects on repetitive behaviors and cognition. Psychology Research and Behavior Management, 4, 129–137.

    Article  Google Scholar 

  2. Bandura, A. (1986). Social foundations for thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  3. Barab, S., Thomas, M., Dodge, T., Cartaeux, R., & Tuzun, H. (2005). Making learning fun: Quest Atlantis, a game without guns. Educational Technology Research and Development, 53(1), 86–107.

    Article  Google Scholar 

  4. Baranowski, T., Buday, R., Thompson, D., & Baranowski, J. (2008). Playing for real: Video games and stories for health-related behavior change. American Journal of Preventative Medicine, 34(1), 74.e10–82.e10.

    Article  Google Scholar 

  5. Battocchi, A., Ben-Sasson, A., Esposito, G., Gal, E., Pianesi, F., Tomasini, D., et al. (2010). Collaborative puzzle game: A tabletop interface for fostering collaborative skills in children with autism spectrum disorders. Journal of Assistive Technologies, 4(1), 4–13.

    Article  Google Scholar 

  6. Bay-Hinitz, A. K., Peterson, R. F., & Quilitch, H. R. (1994). Cooperative games: A way to modify aggressive and cooperative behaviors in young children. Journal of Applied Behavior Analysis, 27, 435–446.

    PubMed Central  Article  PubMed  Google Scholar 

  7. Beaumont, R., & Sofronoff, K. (2008). A multi-component social skills intervention for children with Asperger syndrome: The junior detective training program. Journal of Child Psychology and Psychiatry, 49(7), 743–753.

    Article  PubMed  Google Scholar 

  8. Bernardini, S., Porayska-Pomsta, K., & Smith, T. J. (2014). ECHOES: An intelligent serious game for fostering social communication in children with autism. Information Sciences, 264, 41–60.

    Article  Google Scholar 

  9. Bölte, S., Feineis-Matthews, S., Leber, S., Dierks, T., Hubl, D., & Poustka, F. (2002). The development and evaluation of a computer-based program to test and to teach the recognition of facial affect. Journal of Circumpolar Health, 61, 61–68.

    Google Scholar 

  10. Bölte, S., Hubl, D., Feineis-Matthews, S., Prvulovic, D., Dierks, T., & Poustka, F. (2006). Facial affect recognition training in autism: Can we animate the fusiform gyrus? Behavioral Neuroscience, 120(1), 211–216.

    Article  PubMed  Google Scholar 

  11. Bosseler, A., & Massaro, D. W. (2003). Development and evaluation of a computer-animated tutor for vocabulary and language learning in children with autism. Journal of Autism and Developmental Disorders, 33, 653–672.

    Article  PubMed  Google Scholar 

  12. Catalano, C. E., Luccini, A. M., & Mortara, M. (2014). Best practices for effective design and evaluation of serious games. International Journal of Serious Games, 1(1), e1–e13.

    Article  Google Scholar 

  13. De Freitas, S. (2006). Using games and simulations for supporting learning. Learning, Media, and Technology, 31(4), 343–358.

    Article  Google Scholar 

  14. Dickey, M. D. (2005). Engaging by design: How engagement strategies in popular computer and video games can inform instructional design. Educational Technology Research and Development, 53(2), 67–83.

    Article  Google Scholar 

  15. Dickey, M. D. (2006). Game design narrative for learning: Appropriating adventure game design narrative devices and techniques for the design of interactive learning environments. Educational Technology Research and Development, 54(3), 245–263.

    Article  Google Scholar 

  16. Diehl, L. A., Souza, R. M., Alves, J. B., Alejandro, G., Estevez, R. Z., George, M., & Coelho, I. (2013). InsuOnline, a serious game to teach insulin therapy to primary care physicians: Design of the game and a randomized control trial for educational validation. JIMR Research Protocols, 2(1), e5.

    Article  Google Scholar 

  17. Faja, S., Webb, S. J., Jones, E., Merkle, K., Kamara, D., Bavaro, J., et al. (2012). The effects of face expertise training on the behavioral performance and brain activity of adults with high functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(2), 278–293.

    PubMed Central  Article  PubMed  Google Scholar 

  18. Fisher, M., Holland, C., Merzenich, M., & Vinogradov, S. (2009). Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. American Journal of Psychiatry, 166, 805–811.

    PubMed Central  Article  PubMed  Google Scholar 

  19. Gal, E., Bauminger, N., Goren-Bar, D., Pianesi, F., Stock, O., Zancanaro, M., & Weis, P. L. (2009). Enhancing social communication of children with high-functioning autism through a co-located interface. AI & SOCIETY, 24(1), 75–84.

    Article  Google Scholar 

  20. Garaigordobil, M., Maganto, C., & Etxeberria, J. (1996). Effects of a cooperative game program on socio-affective relations and group cooperation capacity. European Journal of Psychological Assessment, 12(2), 141–152.

    Article  Google Scholar 

  21. Garris, R., Ahlers, R., & Driskell, J. E. (2002). Games, motivation, and learning: A research and practice model. Simulation Gaming, 33(4), 441–467.

    Article  Google Scholar 

  22. Gee, J. P. (2003). What video games have to teach us about learning and literacy. New York: Palgrave Macmillan.

    Google Scholar 

  23. Getchell, N., Miccinello, D., Blom, M., Morris, L., & Szaroleta, M. (2012). Comparing energy expenditure in adolescents with and without autism while playing Nintendo Wii games. Games for Health Journal, 1(1), 58–61.

    Article  PubMed  Google Scholar 

  24. Golan, O., & Baron-Cohen, S. (2006). Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology, 2, 591–617.

    Google Scholar 

  25. Greitemeyer, T., & Cox, C. (2013). There is no I in team: Effects of cooperative video games on cooperative behavior. European Journal of Social Psychology, 43(3), 224–228.

    Article  Google Scholar 

  26. Grynszpan, O., Weiss, P. L., Perez-Diaz, F., & Gal, E. (2014). Innovative technology-based interventions for autism spectrum disorders: A meta-analysis. Autism, 18(4), 346–361.

    Article  PubMed  Google Scholar 

  27. Habgood, M. P. J., & Ainsworth, S. E. (2011). Motivating children to learn effectively: Exploring the value of intrinsic integration in educational games. Journal of Learning Sciences, 20(2), 169–206.

    Article  Google Scholar 

  28. Heimann, M., Nelson, K. E., Tjus, T., & Gillberg, C. (1995). Increasing reading and communication skills in children with autism through an interactive multimedia computer program. Journal of Autism and Developmental Disorders, 25(5), 459–480.

    Article  PubMed  Google Scholar 

  29. Hilton, C. L., Cumpata, K., Klohr, C., Gaetke, S., Artner, A., Johnson, H., & Dobbs, S. (2014). Effects of exergaming on executive function and motor skills in children with autism spectrum disorder: A pilot study. American Journal of Occupational Therapy, 68(1), 57–65.

    Article  PubMed  Google Scholar 

  30. Hopkins, I. M., Gower, M. W., Perez, T. A., Smith, D. S., Amthor, F. R., Wimsatt, F. C., & Biasini, F. J. (2011). Avatar Assistant: Improving social skills in students with an ASD through a computer-based intervention. Journal of Autism and Developmental Disorders, 41, 1543–1555.

    Article  PubMed  Google Scholar 

  31. Kandalaft, M. R., Didehbani, N., Krawczyk, D. C., Allen, T. T., & Chapman, S. B. (2013). Virtual reality social cognition training for young adults with high functioning autism. Journal of Autism and Developmental Disorders, 43(1), 34–44.

    PubMed Central  Article  PubMed  Google Scholar 

  32. Kapp, K. M. (2012). The gamification of learning and instruction: Game-based methods and strategies for training and education. San Francisco, CA: Pfeifer.

    Google Scholar 

  33. Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H. (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: A randomized trial. Pediatrics, 112(2), e305–e317.

    Article  Google Scholar 

  34. Ke, F., & Im, T. (2013). Virtual-reality-based social interaction training for children with high-functioning autism. Journal of Educational Research, 106(6), 441–461.

    Article  Google Scholar 

  35. Klimmt, C., Roth, C., Vermeulen, I., Vorderer, P., & Roth, F. S. (2012). Forecasting the experience of future entertainment technology: Interactive storytelling and media enjoyment. Games and Culture, 7(3), 187–208.

    Article  Google Scholar 

  36. Knapp, M., Romeo, R., & Beecham, J. (2009). Economic cost of autism in the UK. Autism, 13(3), 317–336.

    Article  PubMed  Google Scholar 

  37. Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  38. Kuo, M. H., Orsmond, G. I., Cohn, E. S., & Coster, W. J. (2013). Friendship characteristics and activity patterns of adolescents with an autism spectrum disorder. Autism, 17(4), 481–500.

    Article  PubMed  Google Scholar 

  39. Lang, R., Koegel, L. K., Ashbaugh, K., Register, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565–576.

    Article  Google Scholar 

  40. Lange, B., Koenig, S., Chang, C., McConnell, E., Suma, E., Bolas, M., & Rizzo, A. (2012). Designing informed game-based rehabilitation tasks leveraging advances in virtual reality. Disability and Rehabilitation, 34(22), 1863–1870.

    Article  PubMed  Google Scholar 

  41. Lepper, M. R., & Chabay, R. W. (1985). Intrinsic motivation and instruction: Conflicting views on the role of motivational processes in computer-based education. Educational Psychologist, 20(4), 217–230.

    Article  Google Scholar 

  42. Lu, A. S., Thompson, D., Baranowski, J., Buday, R., & Baranowski, T. (2012). Story immersion in a health video game for childhood obesity prevention. Games for Health Journal: Research, Development, and Clinical Applications, 1(1), 37–44.

    Article  Google Scholar 

  43. Marchiori, E. J., Torrente, J., del Blanco, A., Moreno-Ger, P., Sancho, P., & Fernandez-Manjon, B. (2012). A narrative metaphor to facilitate educational game authoring. Computers & Education, 58, 590–599.

    Article  Google Scholar 

  44. Mayer, R. E., Mautone, P., & Prothero, W. (2002). Pictorial aids for learning by doing in a multimedia geology simulation game. Journal of Educaitonal Psychology, 94, 171–185.

    Article  Google Scholar 

  45. Medalia, A., & Choi, J. (2009). Cognitive remediation in schizophrenia. Neuropsychology Review, 19(3), 353–364.

    Article  PubMed  Google Scholar 

  46. Mishra, J., & Gazzaley, A. (2014). Harnessing the neuroplastic potential of the human brain & the future of cognitive rehabilitation. Frontiers in Human Neuroscience, 8(218), e1–e4. doi:10.3389/fnhum.2014.00218.

    Google Scholar 

  47. Moore, M., & Calvert, S. (2000). Vocabulary acquisition for children with autism: Teacher or computer instruction. Journal of Autism and Developmental Disorders, 30(4), 359–362.

    Article  PubMed  Google Scholar 

  48. O’Neil, H. F., Chung, K. W. K., Kerr, D., Vendlinski, T. P., Buschang, R. E., & Mayer, R. E. (2014). Adding self-explanation prompts to an educational computer game. Computers in Human Behavior, 30, 23–28.

    Article  Google Scholar 

  49. Orsmond, G. I., & Kuo, M. H. (2011). The daily lives of adolescents with an autism spectrum disorder: Discretionary time use and activity patterns. Autism, 15(5), 579–599.

    PubMed Central  Article  PubMed  Google Scholar 

  50. Pan, Y. C., & Frey, G. C. (2006). Physical activity patterns in youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 31, 257–263.

    Google Scholar 

  51. Patall, E. A., Cooper, H., & Robinson, J. C. (2008). The effects of choice on intrinsic motivation and related outcomes: A meta-analysis of research findings. Psychological Bulletin, 134(2), 270–300.

    Article  PubMed  Google Scholar 

  52. Peng, W., Lin, J., & Crouse, J. (2011). Is playing exergames really exercising? A meta-analysis of energy expenditure in active video games. Cyberpsychology, Behavior, and Social Networking, 14(11), 681–688.

    Article  Google Scholar 

  53. Ploog, B. O., Scharf, A., Nelson, D., & Brooks, P. J. (2013). Use of computer-assisted technologies (CAT) to enhance social, communicative, and language development in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 301–322.

    Article  PubMed  Google Scholar 

  54. Przybylski, A. K., Rigby, C. S., & Ryan, R. M. (2010). A motivational model of video game engagement. Review of General Psychology, 14(2), 154–166.

    Article  Google Scholar 

  55. Ramdoss, S., Machalicek, W., Rispoli, M., Mulloy, A., Lang, R., & O’Reilly, M. (2012). Computer-based interventions to improve social and emotional skills in individuals with autism spectrum disorders: A systematic review. Developmental Neurorehabilitation, 15(2), 119–135.

    Article  PubMed  Google Scholar 

  56. Ravaja, N., Saari, T., Turpeinen, M., Laarni, J., Salminen, M., & Kivikangas, M. (2006). Spatial presence and emotions during video game playing: Does it matter with whom you play?. Presence: Teleoperators and Virtual Environments, 15(4), 381–392.

    Article  Google Scholar 

  57. Reiber, L. P. (1996). Seriously considering play: Designing interactive learning environments based on the blending of microworlds, simulations, and games. Educational Technology Research and Development, 44(2), 43–58.

    Article  Google Scholar 

  58. Rimmer, J. H., Chen, M., McCubbin, J., Drum, C., & Peterson, J. (2010). Exercise intervention research in persons with disabilities: What we know and where we need to go. American Journal of Physical Medicine and Rehabilitation, 89(3), 249–263.

    Article  PubMed  Google Scholar 

  59. Ryan, R., & Deci, E. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.

    Article  PubMed  Google Scholar 

  60. Ryan, R. M., Rigby, C. S., & Przybylski, A. (2006). The motivational pull of video games: A self-determination theory approach. Motivation and Emotion, 39(4), 344–360.

    Article  Google Scholar 

  61. Saperstein, A., & Kurtz, M. (2013). Current trends in the empirical study of cognitive remediation for schizophrenia. The Canadian Journal of Psychiatry, 58(6), 311–318.

    Google Scholar 

  62. Shernoff, D. J., Csikszentmihalyi, M., Schneider, B., & Shernoff, E. (2003). Student engagement in high school classrooms from the perspective of flow theory. School Psychology Quarterly, 18(2), 158–176.

    Article  Google Scholar 

  63. Silver, M., & Oakes, P. (2001). Evaluation of a new computer intervention to teach people with autism or Asperger syndrome to recognize and predict emotions in others. Autism, 5(3), 299–316.

    Article  PubMed  Google Scholar 

  64. Smyth, J. (2007). Massively multiplayer online role-playing games [MMORPGS], reported health, and social behavior. Cyberpsychology & Behavior, 10, 717–721.

    Article  Google Scholar 

  65. Strickland, D. C., Coles, C. D., & Southern, L. B. (2013). JobTIPS: A transition to employment program for individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(10), 2472–2483.

    PubMed Central  Article  PubMed  Google Scholar 

  66. Suh, S., Kim, S. W., & Kim, N. J. (2010). Effectiveness of MMORPG-based instruction in elementary English education in Korea. Journal of Computer Assisted learning, 26(5), 370–378.

    Article  Google Scholar 

  67. Swettenham, J. (1996). Can children with autism be taught to understand false belief using computers? Journal of Child Psychology and Psychiatry, 37(2), 157–165.

    Article  PubMed  Google Scholar 

  68. Tanaka, J. W., Wolf, J. M., Klaiman, C., Koenig, K., Cockburn, J., Herlihy, L., et al. (2010). Using computerized games to teach face recognition skills to children with ASD: The Let’s Face It program. The Journal of Child Psychology and Psychiatry, 51(8), 944–952.

    Article  PubMed  Google Scholar 

  69. Thompson, D., Baranowski, T., & Buday, R. (2010). Conceptual model for the design of a serious video game promoting self-management among youth with Type 1 diabetes. Journal of Diabetes Science and Technology, 4(3), 744–749.

    PubMed Central  Article  PubMed  Google Scholar 

  70. Vygotsky, L. (1933/1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.

  71. Wainer, A. L., & Ingersol, B. R. (2011). The use of innovative computer technology for teaching social communication to individuals with autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 96–107.

    Article  Google Scholar 

  72. Wang, M., & Anagnostou, E. (2014). Virtual reality as treatment tool for children with autism. In V. B. Patel, V. R. Preedy, & C. R. Martin (Eds.), Comprehensive guide to autism (pp. 2125–2141). New York: Springer.

  73. Whalen, C., Liden, L., Ingersol, B., Dallaire, E., & Liden, S. (2006). Behavioral improvements associated with computer-assisted instruction for children with developmental disabilities. Journal of Speech-Language Pathology and Applied Behavior Analysis, 1(1), 11–26.

    Article  Google Scholar 

  74. Whalen, C., Moss, D., Ilan, A. B., Vaupel, M., Fielding, P., Macdonald, K., et al. (2010). Efficacy of TeachTown: Basics in computer-assisted intervention for the intensive comprehensive autism program in Los Angeles unified school district. Autism, 14(3), 179–197.

    Article  PubMed  Google Scholar 

  75. Whyatt, C., & Craig, C. (2013). Sensory-motor problems in autism. Frontiers in Integrative Neuroscience, 7, e1–e12. doi:10.3389/fnint.2013.00051.

    Article  Google Scholar 

  76. Wilkinson, D. A., Best, C. A., Minshew, N. J., & Strauss, M. S. (2010). Memory awareness for faces in individuals with autism. Journal of Autism and Developmental Disorders, 40, 1371–1377.

    PubMed Central  Article  PubMed  Google Scholar 

  77. Wouters, P., Paas, F., & Van Merrienboer, J. J. G. (2008). How to optimize learning from animated models: A review of guidelines based on cognitive load. Review of Educational Research, 78(3), 645–675.

    Article  Google Scholar 

  78. Wouters, P., van Nimwegen, C., van Oostendorp, H., & van der Spek, E. D. (2013). A meta-analysis of the cognitive and motivational effects of serious games. Journal of Educational Psychology, 106(2), 249–265.

    Article  Google Scholar 

  79. Wouters, P., & van Oostendorp, H. (2013). A meta-analytic review of the role of instructional support in game-based learning. Computers & Education, 60(1), 412–425.

    Article  Google Scholar 

  80. Young, M., Slota, S., Cutter, A. B., Jalette, G., Mullin, G., Lai, B., et al. (2012). Our princess is in another castle: A review of trends in serious gaming for education. Review of Educational Research, 82, 61–89.

    Article  Google Scholar 

  81. Zuckerman, K. E., Hill, A. P., Guion, K., Voltolina, L., & Fombonne, E. (2014). Overweight and obesity: Prevalence and Correlates in a large clinical sample of children with autism spectrum disorder. Journal of Autism and Developmental Disorders.

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Acknowledgments

This work was supported by Pennsylvania Department of Health SAP Grant 4100047862. This research was also supported by Penn State’s Center for Online Innovation in Learning.

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The authors report no potential conflicts of interest.

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Correspondence to Elisabeth M. Whyte.

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Whyte, E.M., Smyth, J.M. & Scherf, K.S. Designing Serious Game Interventions for Individuals with Autism. J Autism Dev Disord 45, 3820–3831 (2015). https://doi.org/10.1007/s10803-014-2333-1

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Keywords

  • Autism
  • Serious game
  • Virtual reality
  • Technology
  • Computer-based intervention
  • Cognitive training