Novel and Surprising Touchscreen Game Elements Can Motivate Spontaneous Communication from Children with Autism

Background: A core characteristic of autism is difficulty with social communication and interaction, particularly initiating new communications. This research uses touch-screen computer games as a means to motivate practice of spontaneous initiations. The current games deliberately try create situations that children will perceive as subjectively novel or surprising (i.e. discrepant, differing from their current knowledge and expectations), and that are “worth communicating about” to others. In a previous project (the ECHOES virtual environment), autistic children were observed to frequently and spontaneously initiate about events of this type. ECHOES deliberately included novelty (e.g. new digital objects), however, software errors also caused unintentional surprises, such as the character making “mistakes” in an activity he had previously demonstrated correctly. The new designs deliberately alter a game environment and introduce new elements, trying to re-create and extend the type of spontaneous initiations fortuitously present in ECHOES.

Objectives: Evaluate a new set of games to determine whether deliberate inclusion of novel and surprising elements can motivate spontaneous, positive initiations about game content, similar to the interactions seen in ECHOES.

Methods: Three new games were developed, based on the simple, exploratory, cause-and-effect play in the original ECHOES environment. In one, children sorted apples by colour; two centred on growing flowers or carrots by shaking a magic cloud. Each game had a “baseline” and a “discrepant” version. After the baseline versions were familiar to children (session 1), additional objects and properties were introduced to create “discrepant” versions, with novel and surprising elements (sessions 2-3). Surprises included altered object appearances, sound effects, and timings between events. A character also made occasional “mistakes” with his actions and utterances. These things were predicted to interest children and pose opportunities for them to spontaneously initiate communication. A proof-of-concept scale school study in the UK (10 autistic children age 5-11 years, 2 female, phrase language use) evaluated the new games’ effectiveness at motivating communication with an adult social partner. Children played the games individually, over 3 short sessions (mean 48 minutes total play /child).

Results: In 580 min of gameplay video, there were 409 spontaneous initiations to the adult researcher or game character, related to discrepancies (range 11-79 initiations, mean= 40.9/child). In an additional 241 instances, children reacted to discrepancies in a non-socially-directed way. 46% of these initiations were about game elements deliberately included to create discrepant (novel or surprising) situtations. Children also initiated about “non-designed” discrepancies: genuine system errors, and subjectively perceived changes or differences. Across all children, there were very few instances of negative affect. The games appeared both motivating, and emotionally manageable.

Conclusions: The current strategy of including novel and surprising game elements appears to have been successful in motivating spontaneous social communication for a diverse group of autistic children. It merits further investigation with a wider age/ability range, and with other types of technology. These findings are an early step towards determining whether this strategy may contribute to a future technology-based intervention for autism, capable of changing children’s initiation behaviour outside of a game context.