Autism Spectrum Disorder (ASD)

Autism is a condition resulting from a brain disorder that manifests in the first 2 and a half years of life [1]. Autism Spectrum Disorder (ASD) is characterized by impairment in three aspects: social cognition, communication, and imagination. These three deficits are considered among the most common and severe developmental disabilities [2,28,29]. Some studies indicate that this neurodevelopmental condition occurs in the United States with a frequency of one in 110 children and one in 625 children in Malaysia [3,4]. Five main types of autism are recognized: Autistic disorder Markedly; Asperger's syndrome; Rett's disorder; Childhood disintegrative disorder; Pervasive developmental disorder not otherwise [5].

It is acknowledged that children with autism differ from the group, and the manifestation of autism varies significantly from one child to another [6]. Although children with autism may appear similar to others, their condition compels them to interpret the world differently. Autism Spectrum Disorder represents a pervasive developmental disorder that affects individuals with various shades of impairment [7]. However, several common elements are observed in most people with autism, such as limited or absent motor control, an interest in technology and video games [8], and a strong attraction to a particular topic defined as a "special interest" (e.g., dinosaurs, trains, or outer space). The number of children receiving an autism diagnosis is steadily increasing [9]. Despite significant strides in early diagnosis, the outlook for most children with autism remains unfavorable, with only a few able to achieve independence in adulthood [10,11,12].

Proceedings of the Digital Innovations for Learning and Neurodevelopmental Disorders, May24-25, 2024, Rome, Italy vincenzo.suriani@unibas.it(V. Suriani); dott.giancarlomarzano@gmail.com (G. Marzano); bonannir@gmail.com(R. Bonanni); 0000-0003-1199-83580 (V. Suriani);0009-0003-6362-5040 (R.Bonanni); 0009-0004-9154-9783 (G.Marzano);

Serious games and ASD

The term "Serious Games" refers to digital games with an educational design and entertainment orientation [13]. The goal of serious games is to leverage the latest gaming technologies for educational purposes, examining the educational, therapeutic, and social effects of digital games developed with or without specific learning objectives [14].A systematic study by Noor et al. (2012) in the field of serious games for autism conducted between 2002 and 2011 demonstrated that serious games developed for autism primarily serve two purposes: therapy and education, encompassing both learning and training. In terms of educational serious games, they are designed to provide support to teachers and students in the teaching and learning process [15]. 2011). The former focuses on improvising language fluency in autistic children, requiring players to pronounce names of objects shown on the screen within a short time [19]. The latter aims to improve everyday language in children and adolescents with autism. This system, consisting of two separate applications, offers a personalized solution centered on individual needs. Results, showing the percentage of correct pronunciation for each word, can be exported and stored to monitor progress over time [20]. Regarding serious games with therapeutic functions, an innovative intervention was introduced by Mohammed E. Hoque et al. (2009) to improve language production in autistic children through the use of vocal games. This personalized approach involved identifying difficulties in language production areas from both clinical and computational perspectives. Preliminary results indicated positive and effective participant engagement in the proposed intervention. Another study devised an interactive computer game aimed at improving language clarity in autistic children, adding a therapeutic option to the traditional approach. Research results confirmed the effectiveness of this additional therapy [24,29].In the context of promoting collaboration among children with ASD, Alberto Battocchi et al. ( 2009) introduced the Collaborative Puzzle Game (CPG), an interactive game. The innovative feature of "forced collaboration" embedded in systemic rules made the interaction more intricate but positively contributed to improving collaboration among children during the game. Finally, another study introduced "Serious" Games based on EEG for Medical Applications, analyzing neurofeedback games using electroencephalogram (EEG). The use of fractal dimension improved the efficiency of the classification algorithm, paving the way for future developments in the medical application of such games [26].

Conclusion

In conclusion, based on the analyzed meta-analyses, it is evident how games are highly effective in the areas of therapy and education for autistic children. The systematic review has delved into the directions of development and research on the positive impacts of serious games in the context of autism. They clearly emerge as crucial tools in the therapeutic and educational domains for children with Autism Spectrum Disorder (ASD), improving communication, facilitating learning, and promoting appropriate social behaviors. The analysis underscores the importance of customizing the design of digital games to meet the individual needs of children with ASD, recognizing the diversity of autism manifestations. The variety of therapeutic approaches, from language therapy to the promotion of social collaboration, provides diversified solutions to address challenges related to autism. Furthermore, technological innovation, such as the integration of electroencephalogram (EEG) in serious games, opens promising prospects for future developments in the medical application of such games, enabling personalized and targeted interventions [27; 28]. In summary, the convergence of technology and therapies for autism through serious games offers a continuously evolving field with the goal of improving the quality of life and well-being of children with ASD.