Recent years have seen an emergence of social emotional computer games for individuals with Autism Spectrum Disorder (ASD). These games are heterogeneous in design with few underpinned by theoretically informed approaches to computer-based interventions. Guided by the serious game framework outlined by Whyte et al. (Journal of Autism and Developmental Disorders 45(12):1–12, 2014), this study aimed to identify the key motivating and learning features for serious games targeting emotion recognition skills from the perspectives of 11 youth with ASD and 11 experienced professionals. Results demonstrated that youth emphasised the motivating aspects of game design, while the professionals stressed embedding elements facilitating the generalisation of acquired skills. Both complementary and differing views provide suggestions for the application of serious game principles in a potential serious game.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Admiraal, W., Huizenga, J., Akkerman, S., & Dam, G. T. (2011). The concept of flow in collaborative game-based learning. Computers in Human Behavior, 27(3), 1185–1194. https://doi.org/10.1016/j.chb.2010.12.013.
Alves, S., Marques, A., Queirós, C., & Orvalho, V. (2013). LIFEisGAME prototype: A serious game about emotions for children with autism spectrum disorders. PsychNology Journal, 11(3), 191–211.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Publication.
Bal, E., Harden, E., Lamb, D., Van Hecke, A. V., Denver, J. W., & Porges, S. W. (2010). Emotion recognition in children with autism spectrum disorders: Relations to eye gaze and autonomic state. Journal of Autism and Developmental Disorders, 40(3), 358–370. https://doi.org/10.1007/s10803-009-0884-3.
Baron-Cohen, S., Richler, J., Bisarya, D., Gurunathan, N., & Wheelwright, S. (2003). The systemizing quotient: An investigation of adults with Asperger syndrome or high-functioning autism, and normal sex differences. Philosophical Transactions of the Royal Society B: Biological Sciences, 358(1430), 361–374. https://doi.org/10.1098/rstb.2002.1206.
Baron-Cohen, S., Wheelwright, S., Jolliffe, T. (1997). Is there a “language of the eyes”? Evidence from normal adults, and adults with autism or Asperger syndrome. Visual Cognition, 4(3), 311–331. https://doi.org/10.1080/713756761.
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. https://doi.org/10.1111/j.1469-7610.2008.01920.x.
Beck, C. T. (1993). Qualitative research: The evaluation of its credibility, fittingness, and auditability. Western Journal of Nursing Research, 15(2), 263–266.
Benton, L., Johnson, H., Ashwin, E., Brosnan, M., & Grawemeyer, B. (2012). Developing IDEAS: Supporting children with autism within a participatory design team. Paper presented at the SIGCHI conference on human factors in computing systems, Austin, Texas, USA.
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.
Black, M. H., Chen, N. T. M., Iyer, K. K., Lipp, O. V., Bölte, S., Falkmer, M., et al. (2017). Mechanisms of facial emotion recognition in autism spectrum disorders: Insights from eye tracking and electroencephalography. Neuroscience and Biobehavioral Reviews, 80(Supplement C), 488–515. https://doi.org/10.1016/j.neubiorev.2017.06.016.
Bölte, S. (2014). The power of words: Is qualitative research as important as quantitative research in the study of autism? Autism, 18(2), 67–68. https://doi.org/10.1177/1362361313517367.
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. International Journal of Circumpolar Health, 61(2), 61–68.
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. https://doi.org/10.1037/0735-7044.120.1.211.
Bossavit, B., & Parsons, S. (2016). This is how I want to learn: High functioning autistic teens co-designing a serious game. Paper presented at the CHI conference on human factors in computing systems, California, USA.
Boucenna, S., Narzisi, A., Tilmont, E., Muratori, F., Pioggia, G., Cohen, D., et al. (2014). Interactive technologies for autistic children: A review. Cognitive Computation, 6(4), 722–740. https://doi.org/10.1007/s12559-014-9276-x.
Boyle, E., Connolly, T. M., & Hainey, T. (2011). The role of psychology in understanding the impact of computer games. Entertainment Computing, 2(2), 69–74. https://doi.org/10.1016/j.entcom.2010.12.002.
Carrington, S., & Graham, L. (2001). Perceptions of school by two teenage boys with Asperger syndrome and their mothers: A qualitative study. Autism, 5(1), 37–48.
Catalano, C. E., Luccini, A. M., & Mortara, M. (2014). Guidelines for an effective design of serious games. International Journal of Serious Games, 1(1), 1–13. https://doi.org/10.1089/g4h.2015.0026.
Charlop-Christy, M. H., Le, L., & Freeman, K. A. (2000). A comparison of video modeling with in vivo modeling for teaching children with autism. Journal of Autism and Developmental Disorders, 30(6), 537–552.
Cheak-Zamora, N. C., & Teti, M. (2014). “You think it’s hard now… It gets much harder for our children”: Youth with autism and their caregivers perspectives of health care transition services. Autism, 19(8), 992–1001.
Constantin, A., Johnson, H., Smith, E., Lengyel, D., & Brosnan, M. (2017). Designing computer-based rewards with and for children with autism spectrum disorder and/or intellectual disability. Computers in Human Behavior, 75, 404–414. https://doi.org/10.1016/j.chb.2017.05.030.
Cooperative Research Centre for Living with Autism. (2016). Inclusive research practice guides and checklist for autism research: Version 2. Brisbane, Queensland: Autism CRC Ltd.
de Freitas, S. I. (2006). Using games and simulations for supporting learning. Learning, Media and Technology, 31(4), 343–358. https://doi.org/10.1080/17439880601021967.
Dewinter, J., Van Parys, H., Vermeiren, R., & van Nieuwenhuizen, C. (2016). Adolescent boys with an autism spectrum disorder and their experience of sexuality: An interpretative phenomenological analysis. Autism, 21(1), 1–8. https://doi.org/10.1177/1362361315627134.
Dilorio, C., Hockenberry-Eaton, M., Maibach, E., & Rivero, T. (1994). Focus groups: An interview method for nursing research. Journal of Neuroscience Nursing, 26(3), 175–180.
Frauenberger, C., Good, J., Alcorn, A., & Pain, H. (2013). Conversing through and about technologies: Design critique as an opportunity to engage children with autism and broaden research(er) perspectives. International Journal of Child-Computer Interaction, 1(2), 38–49. https://doi.org/10.1016/j.ijcci.2013.02.001.
Frauenberger, C., Good, J., & Keay-Bright, W. (2011). Designing technology for children with special needs: Bridging perspectives through participatory design. CoDesign, 7(1), 1–28. https://doi.org/10.1080/15710882.2011.587013.
Fridenson-Hayo, S., Berggren, S., Lassalle, A., Tal, S., Pigat, D., Meir-Goren, N., et al. (2017). ‘Emotiplay’: A serious game for learning about emotions in children with autism: Results of a cross-cultural evaluation. European Child and Adolescent Psychiatry, 26(8), 979–992. https://doi.org/10.1007/s00787-017-0968-0.
Goh, D. H., Ang, R. P., & Tan, H. C. (2008). Strategies for designing effective psychotherapeutic gaming interventions for children and adolescents. Computers in Human Behavior, 24(5), 2217–2235. https://doi.org/10.1016/j.chb.2007.10.007.
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, 18(2), 591–617. https://doi.org/10.1017/S0954579406060305.
Grossard, C., Grynspan, O., Serret, S., Jouen, A.-L., Bailly, K., & Cohen, D. (2017). Serious games to teach social interactions and emotions to individuals with autism spectrum disorders (ASD). Computers and Education, 113(Supplement C), 195–211. https://doi.org/10.1016/j.compedu.2017.05.002.
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. https://doi.org/10.1177/1362361313476767.
Habgood, M. P. J., & Ainsworth, S. E. (2011). Motivating children to learn effectively: Exploring the value of intrinsic integration in educational games. Journal of the Learning Sciences, 20(2), 169–206. https://doi.org/10.1080/10508406.2010.508029.
Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., et al. (2015). Sex and gender differences in autism spectrum disorder: Summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6(1), 36. https://doi.org/10.1186/s13229-015-0019-y.
Harms, M. B., Martin, A., & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychology Review, 20(3), 290–322. https://doi.org/10.1007/s11065-010-9138-6.
Hopkins, I. M., Gower, M. W., Perez, T. A., Smith, D. S., Amthor, F. R., Wimsatt, F., et al. (2011). Avatar assistant: Improving social skills in students with an ASD through a computer-based intervention. Journal of Autism and Developmental Disorders, 41(11), 1543–1555. https://doi.org/10.1007/s10803-011-1179-z.
Howlin, P., Moss, P., Savage, S., & Rutter, M. (2013). Social outcomes in mid- to later adulthood among individuals diagnosed with autism and average nonverbal IQ as children. Journal of the American Academy of Child and Adolescent Psychiatry, 52(6), 572–581. https://doi.org/10.1016/j.jaac.2013.02.017.
Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687.
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.
Kapp, K. M. (2012). The gamification of learning and instruction: Game-based methods and strategies for training and education. San Francisco: Wiley.
Khaled, R., & Vasalou, A. (2014). Bridging serious games and participatory design. International Journal of Child-Computer Interaction, 2(2), 93–100. https://doi.org/10.1016/j.ijcci.2014.03.001.
Kitzinger, J. (1994). The methodology of focus groups: The importance of interaction between research participants. Sociology of Health and Illness, 16(1), 103–121.
Kitzinger, J. (2008). Focus groups. In C. Pope & N. Mays (Eds.), Qualitative research in health care (Vol. 3, pp. 21–31). London: BMJ Books.
Lai, M.-C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2015). Sex/gender differences and autism: Setting the scene for future research. Journal of the American Academy of Child and Adolescent Psychiatry, 54(1), 11–24. https://doi.org/10.1016/j.jaac.2014.10.003.
Levy, A., & Perry, A. (2011). Outcomes in adolescents and adults with autism: A review of the literature. Research in Autism Spectrum Disorders, 5(4), 1271–1282. https://doi.org/10.1016/j.rasd.2011.01.023.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. California: Sage.
Malinverni, L., Mora-Guiard, J., Padillo, V., Valero, L., Hervás, A., & Pares, N. (2017). An inclusive design approach for developing video games for children with autism spectrum disorder. Computers in Human Behavior, 71, 535–549. https://doi.org/10.1016/j.chb.2016.01.018.
Mazurek, M. O., Engelhardt, C. R., & Clark, K. E. (2015). Video games from the perspective of adults with autism spectrum disorder. Computers in Human Behavior, 51, 122–130. https://doi.org/10.1016/j.chb.2015.04.062.
Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(8), 1757–1767. https://doi.org/10.1007/s10803-011-1413-8.
Minshew, N. J., Meyer, J., & Goldstein, G. (2002). Abstract reasoning in autism: A dissociation between concept formation and concept identification. Neuropsychology Review, 16(3), 327–334. https://doi.org/10.1037/0894-418.104.22.1687.
Morse, J. M. (1995). The significance of saturation. Qualitative Health Research, 5(2), 147–149.
Morse, J. M. (2015). Critical analysis of strategies for determining rigor in qualitative inquiry. Qualitative Health Research, 25(9), 1212–1222.
Müller, E., Schuler, A., & Yates, G. B. (2008). Social challenges and supports from the perspective of individuals with Asperger syndrome and other autism spectrum disabilities. Autism, 12(2), 173–190. https://doi.org/10.1177/1362361307086664.
Parsons, S., & Cobb, S. (2014). Reflections on the role of the ‘users’: Challenges in a multi-disciplinary context of learner-centred design for children on the autism spectrum. International Journal of Research & Method in Education, 37(4), 421–441. https://doi.org/10.1080/1743727X.2014.890584.
Parsons, S., Millen, L., Garib-Penna, S., & Cobb, S. (2011). Participatory design in the development of innovative technologies for children and young people on the autism spectrum: The COSPATIAL project. Journal of Assistive Technologies, 5(1), 29–34. https://doi.org/10.5042/jat.2011.0099.
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.
Pope, C., Ziebland, S., & Mays, N. (2006). Analysing qualitative data. In C. Pope & N. Mays (Eds.), Qualitative research in health care (3rd ed., pp. 63–81). Malden: Blackwell Publisher.
Porayska-Pomsta, K., Frauenberger, C., Pain, H., Rajendran, G., Smith, T., Menzies, R., et al. (2012). Developing technology for autism: An interdisciplinary approach. Personal and Ubiquitous Computing, 16(2), 117–127. https://doi.org/10.1007/s00779-011-0384-2.
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. https://doi.org/10.1037/a0019440.
QSR International Pty Ltd. (2012). NVivo qualitative data analysis software (Version 11).
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. https://doi.org/10.3109/17518423.2011.651655.
Rao, P. A., Beidel, D. C., & Murray, M. J. (2008). Social skills interventions for children with Asperger’s Syndrome or high-functioning autism: A review and recommendations. Journal of Autism and Developmental Disorders, 38(2), 353–361. https://doi.org/10.1007/s10803-007-0402-4.
Rooney, P. (2012). A theoretical framework for serious game design: Exploring pedagogy, play and fidelity and their implications for the design process. International Journal of Game-Based Learning, 2(4), 41–60. https://doi.org/10.4018/ijgbl.2012100103.
Rump, K. M., Giovannelli, J. L., Minshew, N. J., Strauss, M. S., Rump, K. M., Giovannelli, J. L., et al. (2009). The development of emotion recognition in individuals with autism. Child Development, 80(5), 1434–1447. https://doi.org/10.1111/j.1467-8624.2009.01343.x.
Russo-Ponsaran, N. M., Evans-Smith, B., Johnson, J., Russo, J., & McKown, C. (2016). Efficacy of a facial emotion training program for children and adolescents with autism spectrum disorders. Journal of Nonverbal Behavior, 40(1), 13–38. https://doi.org/10.1007/s10919-015-0217-5.
Russo-Ponsaran, N. M., Evans-Smith, B., Johnson, J. K., & McKown, C. (2014). A pilot study assessing the feasibility of a facial emotion training paradigm for school-age children with autism spectrum disorders. Journal of Mental Health Research in Intellectual Disabilities, 7(2), 169–190. https://doi.org/10.1080/19315864.2013.793440.
Schuller, B., Marchi, E., Baron-Cohen, S., O’Reilly, H., Robinson, P., Davies, I., et al. (2013). ASC-Inclusion: Interactive emotion games for social inclusion of children with Autism Spectrum Conditions. Paper presented at the 1st Intelligent Digital Games for Empowerment and Inclusion Crete, Greece.
Scott, M., Falkmer, M., Girdler, S., & Falkmer, T. (2015). Viewpoints on factors for successful employment for adults with autism spectrum disorder. PLoS ONE, 10(10), 1–15.
Serret, S., Hun, S., Iakimova, G., Lozada, J., Anastassova, M., Santos, A., et al. (2014). Facing the challenge of teaching emotions to individuals with low-and high-functioning autism using a new serious game: A pilot study. Molecular Autism, 5(1), 1. https://doi.org/10.1186/2040-2392-5-37.
Shenton, A. K. (2004). Strategies for ensuring trustworthiness in qualitative research projects. Education for Information, 22(2), 63–75.
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. https://doi.org/10.1177/1362361301005003007.
Thomas, E., & Magilvy, J. K. (2011). Qualitative rigor or research validity in qualitative research. Journal for Specialists in Pediatric Nursing, 16(2), 151–155. https://doi.org/10.1111/j.1744-6155.2011.00283.x.
Trevisan, D. A., & Birmingham, E. (2016). Are emotion recognition abilities related to everyday social functioning in ASD? A meta-analysis. Research in Autism Spectrum Disorders, 32, 24–42. https://doi.org/10.1016/j.rasd.2016.08.004.
Wainer, A. L., & Ingersoll, 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(1), 96–107. https://doi.org/10.1016/j.rasd.2010.08.002.
Whyte, E., Smyth, J., & Scherf, K. S. (2014). Designing serious game interventions for individuals with autism. Journal of Autism and Developmental Disorders, 45(12), 1–12. https://doi.org/10.1007/s10803-014-2333-1.
Williams, B., & Gray, K. (2013). Are emotion recognition skills related to autism symptom severity in children with autism? International Journal of Developmental Disabilities, 59(2), 118–133. https://doi.org/10.1179/2047387713Y.0000000013.
Williams, C., Wright, B., Callaghan, G., & Coughlan, B. (2002). Do children with autism learn to read more readily by computer assisted instruction or traditional book methods? A pilot study. Autism, 6(1), 71–91.
Yusoff, A. (2010). A conceptual framework for serious games and its validation. Southampton: University of Southampton.
The researchers would like to extend our gratitude to youth on the autism spectrum and the professionals for the time and effort taken to participate in this focus group as well as Melissa Black, who assisted in data collection and Greg Lynn who provide assistance in data transcription.
This research is supported by the Cooperative Research Centre for Living with Autism (Autism CRC) [Project Number 3.032RS], established and supported under the Australian Government’s Cooperative Research Centres Program. JT is supported through an Australian Government Research Training Program Scholarship.
Conflict of interest
The authors declare that they have no conflict of interest. SB reports no direct conflict of interest related to this article. SB discloses that he has in the last 5 years acted as an author, consultant or lecturer for Shire, Medice, Roche, Eli Lilly, Prima Psychiatry, GLGroup, System Analytic, Kompetento, Expo Medica, and Prophase. He receives royalties for text books and diagnostic tools from Huber/Hogrefe, Kohlhammer and UTB.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Tang, J.S.Y., Falkmer, M., Chen, N.T.M. et al. Designing a Serious Game for Youth with ASD: Perspectives from End-Users and Professionals. J Autism Dev Disord 49, 978–995 (2019). https://doi.org/10.1007/s10803-018-3801-9
- Autism spectrum disorder
- Educational game