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Brief Report: A Novel Digital Therapeutic that Combines Applied Behavior Analysis with Gaze-Contingent Eye Tracking to Improve Emotion Recognition in Children with Autism Spectrum Disorder

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Abstract

This study examined the feasibility, acceptability, and efficacy of a video game-based digital therapeutic combining applied behavior analysis techniques and gaze-contingent eye tracking to target emotion recognition in youth with autism spectrum disorder (ASD). Children aged 4–14 years with ASD were randomized to complete Lookware™ (n = 25) or a control video game (n = 29). Results from a 2 × 2 mixed ANOVA revealed that children in the intervention condition demonstrated significant improvements in emotion recognition from pre- to post-intervention compared to children in the control condition, F(1,52) = 17.48, p < 0.001. Children and staff perceived high feasibility and acceptability of Lookware™. Study results demonstrated the feasibility, acceptability, and preliminary efficacy of Lookware™.

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Acknowledgements

We would like to thank the children and members of their family who gave their time and effort to participate in this study. The study was sponsored by BioStream Technologies, LLC. We would also like to thank the following individuals and organizations for their participation in the study: David Sides, Philadelphia, PA, Amy Golden, Cherry Hill, NJ, Mary E. Keefe, Point Pleasant Beach, NJ, Y.A.L.E. School, Cherry Hill, NJ, Partners in Learning, Inc., Williamstown, NJ, Els for Autism Foundation, Jupiter, FL, Nashoba Learning Group, Inc., Bedford, MA, Positive Behavior Supports Corporation, Stuart, FL, The Pathway School, Jeffersonville, PA, Christopher Hoopes, Wilmington, DE, Justin Patterson, Alexandria, VA, Bhupinderjit Dhanoa, Voorhees, NJ, and Grant Ervin, Raleigh, NC.

Funding

This study was sponsored by BioStream Technologies, LLC. The company provided financial support in the form of payment to the following research sites for work performed on the study: Mary E. Keefe, Partners in Learning, Inc., Els for Autism Foundation, and Positive Behavior Supports Corp.

Author information

Authors and Affiliations

  1. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    David W. Sosnowski

  2. Department of Psychology, University of Cincinnati, Cincinnati, OH, USA

    Cathleen Odar Stough

  3. Endicott College, Beverly, MA, USA

    Mary Jane Weiss

  4. Positive Behavior Supports Corporation, Stuart, FL, USA

    Tahra Cessna

  5. Nashoba Learning Group, Inc., Bedford, MA, USA

    Amy Casale

  6. Partners in Learning, Inc., Williamstown, NJ, USA

    Adrienne Foran & Melanie Erwinski

  7. Y.A.L.E. School, Cherry Hill, NJ, USA

    John Wilson

  8. Department of Embryology, Carnegie Institution for Science, Baltimore, MD, USA

    Steven A. Farber

  9. BioStream Technologies, LLC, Moorestown, NJ, USA

    Michael A. Farber

Authors
  1. David W. Sosnowski
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  2. Cathleen Odar Stough
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  3. Mary Jane Weiss
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  4. Tahra Cessna
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  5. Amy Casale
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  7. Melanie Erwinski
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  8. John Wilson
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  9. Steven A. Farber
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  10. Michael A. Farber
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Contributions

MJW and MAF jointly conceived and designed the study. MJW and MAF enlisted the support of different research sites. DWS conducted the data analyses with input from COS and COS drafted the manuscript with input from DWS, MJW, TC, AC, AF, ME, JW, SAF, and MAF. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michael A. Farber.

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Conflict of interest

Authors DWS and COS are consultants of BioStream Technologies, LLC and received monetary compensation from the company for the work performed for the study. TC, AF, and ME were employed by a research site that received funding from BioStream Technologies, LLC to conduct the research. SAF is a consultant of BioStream Technologies, LLC and received a financial interest in the company for the work performed for the study. MJW served as an employee, and is currently a consultant, of BioStream Technologies, LLC. MJW received both monetary compensation from the company and a financial interest in the company for the work performed for the study. MAF has an indirect financial interest in BioStream Technologies, LLC.

Ethical Approval

All procedures performed in this study with human participants were in accordance with the ethical standards of the institutional research board committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This included obtaining informed parental consent and child assent (as required) for all participants.

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Sosnowski, D.W., Stough, C.O., Weiss, M.J. et al. Brief Report: A Novel Digital Therapeutic that Combines Applied Behavior Analysis with Gaze-Contingent Eye Tracking to Improve Emotion Recognition in Children with Autism Spectrum Disorder. J Autism Dev Disord 52, 2357–2366 (2022). https://doi.org/10.1007/s10803-021-05101-w

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