=Paper=
{{Paper
|id=Vol-3751/short5
|storemode=property
|title=Serious Games and Autism: an overview
|pdfUrl=https://ceur-ws.org/Vol-3751/short5.pdf
|volume=Vol-3751
|authors=Vincenzo Suriani,Riccardo Bonanni,Giancarlo Marzano
|dblpUrl=https://dblp.org/rec/conf/dilend/SurianiBM24
}}
==Serious Games and Autism: an overview==
https://ceur-ws.org/Vol-3751/short5.pdf
Serius Games and Autism: an overview
Vincenzo Suriani1, Riccardo Bonanni2 and Giancarlo Marzano2
1
UNIBAS - Scuola di Ingegneria, Via dell'Ateneo Lucano, Potenza.
2
Walk-On Società Cooperativa Sociale, Via AnielloFalcone, 394, Napoli, 80127 (Italy)
Abstract
This article proposes a systematic review to explore the current directions of development and ongoing
research on the positive impacts brought about by serious games in the context of autism. Autism
Spectrum Disorder (ASD) represents a pervasive developmental disorder involving individuals with
varying degrees of impairment. Currently, numerous studies have been conducted on serious games
designed for children with autism. They are digital games with educational and entertainment purposes
that have been explored as useful tools in autism education and therapy. The systematic review reports
that serious games for autism mainly focus on therapy and education. These serious games dedicated to
autism have shown positive outcomes in terms of education, communication therapy, psychomotor
treatment, and enhancement of social behavior.
Keywords
ASD, serious games, autism, systematic review, education, therapy.
1
1. 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);
© 2023 Copyright for this paper by its authors.
Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).
CEUR Workshop Proceedings (CEUR-WS.org)
CEUR
ceur-ws.org
Workshop ISSN 1613-0073
Proceedings
2. 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]. For instance, Zelai et al.
(2011) introduced an education-oriented serious game for first aid, targeting individuals with
autism, utilizing Android mobile devices. Another example is Arshia et al. (2011), who introduced a
custom computer game based on digital narration aimed at facilitating understanding of money
usage for children with autism aged 9 to 14. This game was designed to teach appropriate social
behaviors during shopping. Another study by Barakova et al. (2007) presented an innovative
interactive toy designed to express emerging behaviors and used in behavioral training for children
with autism. This toy engages children by leveraging their natural interest in regular patterns and
order, consisting of cubes that interact and change color based on player placement. User tests
demonstrated prolonged engagement of children with the toy, indicating pronounced exploratory
behavior and positive outcomes with improvements in interaction during the game. Among other
approaches, cMotion stands out for using virtual humans to teach emotion recognition and
programming concepts to children. The goal is to engage users in contextualizing emotions,
promoting learning of emotional nuances in a cultural context and fundamental principles of
computer programming [18].Other serious games aim to develop narrative understanding, such as
TouchStory [22]. Examples of linguistic skill development include games developed by Anika
Anwar et al. (2011) and MaiteFrutos et al. (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].
3. 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.
References
[1] Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.
[2] D. V. Keen, F. D. Reid & D. Armone. (2010). “Autism, Ethnicity and Maternal Immigration”. The
British Journal of Psychiatry, 196:274-281.
[3] Center for Disease Control. Prevalence of autism spectrum disorders: autism and
developmental disabilities monitoring network [Online].Available:
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5810a1.htm.
[4] Dolah, J., Yahaya, W. A. J. W. & Chong, T. S. (2011).“Potential of interactive multimedia
learning awareness (IMLA) in enhancing awareness of autistic characteristics among parents
and society in Malaysia”. Electronic Journal of Computer Science and Information Technology
(eJCSIT), 3(1).
[5] C. M. (2004). “The REACH way to transformation. Pulau Pinang: Association of Resource and
Education for Autistic Children.”[Online]. Available: http://lionsreach.net/resources.htm
[6] Seigel B. (2003). Helping children with autism learn. New York: Oxford University Press.
[7] Belanich, J., Mullin, L. N. and Dressel, J. D. (2004). Symposium on PC-based simulations and
gaming for military training. Arlington, Virginia: US Army Research Institute for the
Behavioural and Social Sciences.
[8] Abt, C. (1970). Serious Games. New York: The Viking Press.
[9] CDC “Autism spectrum disorder”. (2010) [Online]. Available:
http://www.cdc.gov/ncbddd/autism/index.html
[10] Billstedt E, Gillberg C. (2005). “Autism After Adolescense: Population-Based 13–22-Year
Follow-Up Study Of 120 Individuals With Autism Diagnosed In Childhood”. Journal of Autism
and Developmental Disorders 35(3):351–360.
[11] Eaves LC, Ho HH. (2008). “Young Adult Outcome Of Autism Spectrum Disorders”. Journal of
Autism and Developmental Disorders 38(4):739–747.
[12] Howlin P, Goode S, Hutton J, Rutter M. (2004).“Adult Outcome For Children With Autism”.
Journal of Child Psychology and Psychiatry 45(2):212–229.
[13] Sorensen, b.H. & Meyer, b. “Serious games in language learning and teaching-a theoretical
perspective”, in Proceedings of the 2007 Digital Games research Association Conference. pp.
559-566.
[14] Felicia, P. (2009). “Digital games in schools: A handbook for teachers”, European Schoolnet,
euN Partnership AiSbl: Belgium. [Online]. Available:
http://games.eun.org/upload/GIS_HANDBOOK_EN.PDF.
[15] Noor, H. A. M., Shahbodin, F., & Pee, N. C. (2012). Serious game for autism children: review of
literature. International Journal of Psychological and Behavioral Sciences, 6(4), 554-559.
[16] Arshia Zernab Hassan, Bushra TasnimZahed, Fatema TuzZohora, Johra Muhammad Moosa,
Tasmiha Salam, Md. Mustafizur Rahman, Hasan Shahid Ferdous, Syed Ishtiaque Ahmed,
“Developing the concept of money by interactive computer games for autistic children,” in
Conf. Rec. 2011 IEEE Int. Symposium on Multimedia, pp. 559–564.
[17] Emilia Barakova, Gilles van Wanrooij, Ruben van Limpt, MarnickMenting. (2007). “Using an
emergent system concept in designing interactive games for autistic children (Published
Conference Proceedings style),” in International Conference on Interaction Design and
Children Proceedings: Creativity and Learning, Aalborg, Denmark, 73-76.
[18] Samantha L. Finkelstein, Andrea Nickel, Lane Harrison, Evan A. Suma, Tiffany Barnes,
“cMotion: A new game design to teach emotion recognition and programming logic to children
using virtual humans,” in Conf. Rec. 2009 IEEE Virtual Reality, pp. 249-250.
[19] Anika Anwar, Md. Mustafizur Rahman, S. M. Ferdous, SamiulAlamAnik, Syed Ishtiaque
Ahmed, “A computer game based approach for increasing fluency in the speech of the autistic
children,” in Conf. Rec. 2011 11th IEEE Int. Conf. on Advanced Learning Technologies, 17-18.
[20] MaiteFrutos, Itxaso Bustos, Begoña García Zapirain, Amaia Mendez Zorrilla, “Computer game
to learn and enhance speech problems for children with autism,” in Conf. Rec. 2011 The 16 the
International Conference on Computer Games, pp. 209-216.
[21] Zelai Sáenz de Urturi, Amaia Méndez Zorrilla, Begoña García Zapirain. (2011). “serious game
based on first aid education for individuals with autism spectrum disorder (ASD) using android
mobile devices,” in Conf. Rec. 2011 The 16 the International Conference on Computer Games,
223-227.
[22] Megan Davis, Nuno Otero, Kerstin Dautenhahn, Chrystopher L. Nehaniv, Stuart D. Powell,
“Creating a software to promote understanding about narrative in children with autism:
reflecting on the design of feedback and opportunities to reason,” in Conf. Rec. 2007 6th IEEE
Int. Conf. on Development and Learning, pp. 64-69.
[23] Mohammed E. Hoque, Joseph K. Lane, Rana elKaliouby, Matthew Goodwin, “Exploring speech
therapy games with children on the autism spectrum,” in Conf. Rec. 2009 10th Annual
Conference of the International Speech Communication Association. [Online]. Available:
http://dspace.mit.edu/handle/1721.1/56580.
[24] Md. Mustafizur Rahman, S. M. Ferdous, Syed Ishtiaque Ahmed, (2010)“Increasing intelligibility
in the speech of the autistic children by an interactive computer game,” in Conf. Rec. 2010 IEEE
Int. Symposium on Multimedia, pp. 383-387.
[25] Alberto Battocchi, Fabio Pianesi, Paola Venuti, Ayelet Ben-Sasson, EynatGal. (2009).
“Collaborative puzzle game: Fostering collaboration in children with autistic spectrum disorder
(ASD) and with typical development,” in Proc. International Conference on Interactive
Tabletops and Surfaces, 197-204.
[26] Qiang Wang, Olga Sourina, Minh Khoa Nguyen, “EEG-based serious games design for medical
applications,” in Proc. 2010 Int. Conf. on Cyberworlds, pp. 270-276.
[27] Frolli, A., Ciotola, S., Esposito, C., Fraschetti, S., Ricci, M. C., Cerciello, F., & Russo, M. G. (2022).
AAC and Autism: Manual Signs and Pecs, a Comparison. Behavioral sciences (Basel,
Switzerland), 12(10), 359. https://doi.org/10.3390/bs12100359.
[28] Rega, A., Castellano, L., & Vita, S. (2021). Develop educational technology tailored for people
with autism: a children’s observation grid to build better tools. In Proceedings of the First
Workshop on Technology Enhanced Learning Environments for Blended Education
(teleXbe2021), January 21–22, 2021, Foggia, Italy.