Development of Immersive Gaze-Controlled Video Game Therapy for Children with Autism Spectrum Disorder

Poster Presentation
Friday, May 11, 2018: 11:30 AM-1:30 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
L. Cordero1, Z. M. Dravis1, B. Farber2, L. Robinson2, M. Farber3 and J. D. Herrington4, (1)Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, (2)BioStream Technologies, LLC, Boston, MA, (3)BioStream Technologies, LLC, Philadelphia, PA, (4)Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA

Existing interventions for children with autism spectrum disorder (ASD) require significant therapist or educator time, with an estimated annual cost of more than $11B. As such, there is a pressing need for affordable and accessible tools to evaluate and treat children with ASD. In collaboration with the University of Pennsylvania and the Children's Hospital of Philadelphia, BioStream Technologies, LLC (“BioStream”) is developing a commercial-quality immersive 3D video game to augment social skill training for children with ASD. BioStream’s game leverages behavioral and educational principles used in applied behavior analysis, such as discrete trial training and differential reinforcement, to shape behavior and drive positive outcomes. To inform game design, BioStream has developed a proprietary research platform (“BioStream Platform”), which uses state-of-the-art software to collect and interpolate synchronized biosensor data and enable programmatic adaptation of player experiences in real time.


1) To determine that the BioStream Platform can collect accurate synchronized physiological and behavioral metrics. 2) To qualitatively evaluate BioStream’s game that includes tasks designed to facilitate social abilities (eye contact and facial expression recognition).


This observational pilot study is actively recruiting children between the ages of 6 and 17 targeting 50 children with ASD and 20 typically developing children. To date, BioStream’s game has been administered 36 times over 13 children (10 ASD and 3 TDC) (mean age = 12.25 years, 83% Male). The wide age range aids in further identifying a target demographic of those who may benefit most from the game. Study visits include computer game play while wearing biosensors including ECG, EDA/GSR, EEG, and use of eye trackers (table-top and eyeglass-mounted depending on the task). Participants are also recorded with front facing cameras to analyze facial expressions. After a physiological baseline is obtained via a 3 minute long fractal video with no sound, participants engage in a three minute dyadic conversation. Next, they move on to play BioStream’s game, which includes repeatedly administered discrete trials that require participants to attend to specific contents on a computer screen (i.e., eyes within a face), and provides immediate, rewarding feedback upon success. The use of real-time eye tracking data is essential to truly evaluating eye contact and providing effective differential reinforcement.


To date, the BioStream Platform and BioStream’s game have proven to be safe and well tolerated by participants. The gaze-contingent eye tracking portion of the game has worked successfully for all children. Quality assurance and basic analyses are presently underway for the remaining biosensor data.


BioStream’s game and platform have been well received by participants and the platform effectively collects simultaneous biosensor and behavioral data among children with varying abilities. In addition to the value of the BioStream Platform in developing interventions, present data suggest that it provides a convenient method for researchers to simultaneously measure multiple data streams during dyadic communication, gameplay training and social skills assessments. By INSAR 2018 Annual Meeting we will have implemented analyses on data from each biosensor (including eye tracking), as well as on child ratings of the game.