Videogame Based on Full-Body Interaction Used As a Tool to Foster Social Conducts in Children with Autism Spectrum Disorders: A Feasibility Study on Pico's Adventure

Background: Game-based interventions have shown to facilitate motivation and learning processes in Autism Spectrum Disorders (ASD). Moreover, interventions that use Information and Communication Technologies are attractive for children with ASD and have demonstrated to be useful to increase social behaviors.

Objectives: The main purpose of this project was to conduct a feasibility study to compare the amount of social initiation conducts performed during a full-body interaction videogame versus the amount of social initiation conducts occurred during a free-play activity in children with ASD. We hypothesized that the videogame could elicit a higher number of these conducts and therefore could be proposed as a tool to promote social initiation skills.

Methods: A total of 15 children (ages 4 to 6) were recruited. Diagnoses were confirmed using the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). In order to be included in the study, subjects had to obtain cognitive capacity above 70. Children participated in four consecutive weekly sessions with two sections: a section where they played with the videogame Pico’s Adventure (a Kinect-based game developed for high functioning children with ASD) and a section that just involved free play time. Sessions involved different conditions; playing alone, with a parent, and with a peer the subject did not know before. Social skills conducts were codified according to an observational scale.

Results: Results show that the videogame elicited more social initiation conducts than free play in children with ASD when playing alone [t(11)= 2,438, p= 0,033] or playing with a peer [t(13)= 3,60, p=0,003]. Furthermore, it showed to be as effective as free play in promoting social initiation while playing with parents. In addition, results indicate that repetitive behaviors were less frequent during the videogame (Mdn = 0) than during free play (Mdn = 2), Z = 2.05, p = 0.040. Along with social initiation we calculated the number of spontaneous gestures performed by the children in both Pico’s Adventure and free play. Results show significant differences in emotional gestures during the two situations where the child was playing with a parent [t (12) = 2,420; p = ,032; t (12) = 2,360; p = ,036] and during a situation where the child was playing with the peer [t (13) = 2,879; p = ,013]. In the three aforementioned cases more emotional gestures were reported in Pico’s Adventure than in free play. Similarly, a significant difference in the amount of pointing gestures was found between the videogame and free play.

Conclusions: The videogame Pico's Adventure elicited more social initiation behaviors than free play in children with ASD when they were playing alone or playing with a peer. The videogame was also effective in reducing repetitive behaviors and increasing both emotional and pointing gestures. Therefore, the game could be useful as a tool to increase social behaviors. Future work is needed to obtain further data that supports this hypothesis.