GOLIAH (Gaming Open Library for Intervention in Autism at Home): a 6-month single blind matched controlled exploratory study

Abstract

BackgroundTo meet the required hours of intensive intervention for treating children with autism spectrum disorder (ASD), we developed an automated serious gaming platform (11 games) to deliver intervention at home (GOLIAH) by mapping the imitation and joint attention (JA) subset of age-adapted stimuli from the Early Start Denver Model (ESDM) intervention. Here, we report the results of a 6-month matched controlled exploratory study.MethodsFrom two specialized clinics, we included 14 children (age range 5–8 years) with ASD and 10 controls matched for gender, age, sites, and treatment as usual (TAU). Participants from the experimental group received in addition to TAU four 30-min sessions with GOLIAH per week at home and one at hospital for 6 months. Statistics were performed using Linear Mixed Models.ResultsChildren and parents participated in 40% of the planned sessions. They were able to use the 11 games, and participants trained with GOLIAH improved time to perform the task in most JA games and imitation scores in most imitation games. GOLIAH intervention did not affect Parental Stress Index scores. At end-point, we found in both groups a significant improvement for Autism Diagnostic Observation Schedule scores, Vineland socialization score, Parental Stress Index total score, and Child Behavior Checklist internalizing, externalizing and total problems. However, we found no significant change for by time × group interaction.ConclusionsDespite the lack of superiority of TAU + GOLIAH versus TAU, the results are interesting both in terms of changes by using the gaming platform and lack of parental stress increase. A large randomized controlled trial with younger participants (who are the core target of ESDM model) is now discussed. This should be facilitated by computing GOLIAH for a web platform. Trial registration Clinicaltrials.gov NCT02560415

Technology-Facilitated Diagnosis and Treatment of Individuals with Autism Spectrum Disorder: An Engineering Perspective

“…The visual content can be displayed on a laptop screen, a computer monitor, a TV screen, or a touch screen from a mobile device. An advantage of using a mobile device to deliver a game/program to a participant is the convenience [13][14][15][16][17]. A participant could play the game or engage in a program anytime he/she wants and virtually in any posture.…”

“…Hence, other forms of rewards such as video or audio effect should be provided to encourage and motivate participants. In [13], a smiley face is shown at the completion of each game regardless of the score. This is referred to as reward-based intervention.…”

“…The data were collected at the beginning and at the end of the six-month treatment plan. In [13], the game-associated parameters used for assessment include the game identifier and level of difficulty, when the game was played, the game score, and the reaction time for a participant to complete a task. The clinical measures include the Autism Diagnosis Observation Schedule, the Vineland Adaptive Behavior Scale II, Weschsler scales, the Child Behavior Checklist, and the Social Communication Questionnaire, and the Parenting Stress Index.…”

Rumo a um framework de ensino baseado em recursos audiovisuais para auxiliar o desenvolvimento de crianças autistas

“…Os estudos [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34] descrevem resultados na redução e aquisição (intensional) de habilidades e competências a partir do uso de artefatos de mídia. Estes trabalhos publicados entre 2015 a 2017 nas bases de dados ACM, IEEE, Springer e Scopus evidenciam a discussão sobre métodos de intervenção, habilidades sociais gerais, habilidades de mentalização, recreativas e acadêmicas em aspectos como conteúdo, tecnologia e contexto de utilização.…”

“…Por outro lado, no uso diário de sistemas ou aplicativos, a proporção é invertida, dando prioridade aos interesses do portador que faz usos incomuns, restritos e até repetitivos da mídia. Por exemplo, é recorrente entre as crianças com o TEA a reprodução repetitiva de vídeos musicais e desenhos infantis, por apresentarem simplesmente um determinado estímulo visual ou sonoro que as chamou atenção, mesmo que este não tenha função ou motivo com o contexto da atividade em andamento Dentre os estudos [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34] não foram identificados aspectos de modularidade ou adaptabilidade de conteúdo para atender essas duas linhas de motivação. Sendo assim, percebe-se a necessidade ou melhor, a potencialidade da criação de um aporte teórico para a criação de sistemas de áudio e vídeo interativos que atendam tanto as relações de utilidade e percepção de valor clínica, assim como os interesses lúdicos e potencialidades dos indivíduos.…”