Serius Games and Autism: an overview

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

• eol>ASD
• serious games
• autism
• systematic review
• education
• therapy
• 1

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 patt erns 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 inte ractive 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 mee t 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. [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 6 th 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.

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