Development and testing of a game-based digital intervention for working memory training in autism spectrum disorder

Abstract

Autism spectrum disorder (ASD) is prevalent globally, yet it lacks cost-effective treatment approaches. Deficits in executive functions occur frequently in autism spectrum disorder and present a target for intervention. Here we report the design and development of five smartphone-based games for training working memory in children with ASD. These open-source games, available free of cost to the community, were designed to match the behavioral preferences and sensorimotor abilities of children with ASD. We then conducted a preliminary trial to test the effectiveness of a month-long intervention using these games. Although we did not see a significant change in the working memory of all children with a month-long training, children who performed better on the games also showed more improvement in their working memory, suggesting that a longer intervention with the games might be useful in improving working memory. Using a Hindi translation of the autism treatment evaluation checklist, we also tested the collateral gains of the training in reducing autistic symptoms. We found no significant change in the autistic symptoms after the intervention. Further, there was no correlation between the change in the working memory and the change in the autistic symptoms.

Scoping Review on Play-Based Interventions in Autism Spectrum Disorder

“…The included articles were conducted in the following countries: Australia ( n = 6) [ 29 , 30 , 31 , 32 , 33 , 34 ], the USA ( n = 3) [ 35 , 36 , 37 ], France ( n = 1) [ 38 ], Italy ( n = 1) [ 39 ], Spain ( n = 1) [ 40 ], China ( n = 1) [ 41 ], Canada ( n = 1) [ 42 ] and India ( n = 1) [ 43 ] ( Table 2 ). The sample size of the included studies ranged from 10 [ 31 ] to 76 participants [ 33 ].…”

“…In all the included studies the study population consisted of children and adolescents with ASD, but in two of them the diagnoses were specifically Rett syndrome [ 39 ] and Asperger syndrome [ 33 ]. In some studies, in addition to ASD, the study population was made up of typically developing children and adolescents ( n = 4) [ 30 , 32 , 33 , 36 ] or by children and adolescents with other disorders, such as Down’s syndrome ( n = 1) [ 43 ] ( Table 2 ).…”

“…The included studies were randomized controlled trials ( n = 7) [ 29 , 32 , 33 , 34 , 35 , 39 , 40 ], non-randomized controlled trials ( n = 7) [ 30 , 31 , 36 , 37 , 38 , 41 , 43 ] and a pilot study ( n = 1) [ 42 ] ( Table 2 ). Eight of the studies did not have a control group ( n = 8) [ 29 , 31 , 32 , 36 , 37 , 40 , 41 , 43 ], while seven did ( n = 7) [ 30 , 33 , 34 , 35 , 38 , 39 , 42 ]).…”

Functionality of Apps for People with Autism: Comparison between Educators from Florence and Granada

“…), and many studies have focused on their potential and the benefits that they provide. One example of this is the research—with encouraging results—on the use of apps focusing on the executive functions for people with autism [ 1 , 2 , 3 , 4 , 5 , 6 ], on the basic instrumental skills [ 7 , 8 , 9 ], or on the Theory of Mind [ 10 , 11 , 12 , 13 , 14 ].…”

Design of serious games based on cognitive bias modification and learned helplessness paradigms for treatment of depression.

“…A game serves as an interactive medium that gives the game designers significant control in creating engaging experiences and can reduce the attrition rate in online interventions (Fleming et al, 2016). Serious games have been evaluated for multiple mental health disorders including post-traumatic stress disorder (Holmes et al, 2010;Holmes, James, et al, 2009), autism spectrum disorder (Beaumont & Sofronoff, 2008;Tanaka et al, 2010;Wagle et al, 2021), attention deficit hyperactivity disorder (Dovis et al, 2015), cognitive functioning (Ballesteros et al, 2014;Rezaiyan et al, 2007), alcohol use disorder (Boendermaker et al, 2016;Verduin et al, 2013), trait anxiety (Dennis & O'Toole, 2014;Dennis-Tiwary et al, 2016), etc. A meta-analysis of serious games demonstrated a moderate effect size compared to a no-intervention control (Lau et al, 2017).…”