International Meeting for Autism Research: Results of An RCT of FaceSay In Public Elementary Schools

Results of An RCT of FaceSay In Public Elementary Schools

Friday, May 13, 2011
Elizabeth Ballroom E-F and Lirenta Foyer Level 2 (Manchester Grand Hyatt)
9:00 AM
C. Wimsatt, Symbionica, LLC, San Jose, CA
Background:  

A 2007 RCt of FaceSay (N=49, submitted), showed promising outcomes, particularly in naturalistic playground observation measures.  While the 2007 study was done in private school settings for special needs students, this 2010 study (N=31) evaluated FaceSay in a more typical community setting, public elementary schools. To address the more challenging environment, a higher dose of FaceSay was planned.  In practice, a lower dose of FaceSay was all that was feasible.  The results were a mix of expected - no in-vivo, but good in-vitro - and a surprisingly strong results on a standardzied Theory of Mind measure.

Objectives:  

Aim 1: The primary aim was to evaluate whether FaceSay could improve student performance on standardized neuropsychological assessments of ER and theory of mind in a community setting.  It was predicted that the intervention group would have significantly higher mean pre-to-post intervention scores on ER (hypothesis 1) and ToM (hypothesis 2) after the intervention, as compared to the control group.
Aim 2: The secondary aim was to evaluate if FaceSay could improve social skills including the generalization of those skills to natural settings, such as the classroom and the playground in a community setting.  It was predicted that the intervention group would show a greater improvement in classroom (hypothesis 3) and playground observations (hypothesis 4 and 5) after the intervention, as compared to the control group.

Methods:  

31 children met the inclusion criteria of being a K-5th student in the district eligible for special education services under the educationally based handicapping condition of autism high functioning.  Participants were randomized to either treatment (FaceSay) or control (SuccessMaker).  Participants met once per week for 10 weeks as part of their regularly scheduled computer lab time.

Measures:

Emotion Recognition:  Nepsy II Affect Recognition subscale
Theory of Mind: Nepsy II ToM subscale
Classroom Observations:  SRS (completed by teachers blind to the assignments)
Playground Observations: Hauck (completed by research assistants blind to assignments)

Results:  

Analyses used an independent samples t-test, with group as the independent variable, the post test score as the dependent variable and the pre-test score as the covariate.

Hypothesis 1:  Improved Emotion Recognition on standardized neuropsych assessment.  Significant.  (p < .001)
Hypothesis 2:  Improved Theory of Mind on standardized neuropsych assessment.  Significant.  (p < .001)
Hypothesis 3:  Improved Social Interactions in the Classroom.  Not significant. 
Hypothesis 4:  Increased Positive Interactions on the Playground.  Not significant. 
Hypothesis 5:  Decreased Negative Interactions on the Playground.  Not significant.

Conclusions:  

The results from this RCT provide interesting new data about FaceSay. In a public school setting, lower doses of FaceSay are probably not sufficient for a measured impact in naturalistic settings.  The strong results on Theory of Mind are encouraging and provide additional support for the notion that awareness of the face is central to social learning.  The ToM results also suggest an interesting meta-question about states of mind.   If you assumed that all communication is explicit, would you be inclined to wonder about others' states of mind?

Acknowledgements:

This study was designed and conducted by Linda Rice in fulfillment of her PhD in School Psychology.

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