Development and Evaluation of a Computer-Animated Tutor for Vocabulary and Language Learning in Children with Autism

Insights from user experience and evaluation of a mobile health nutrition intervention for children with autism: A qualitative study

BACKGROUND

Children with autism spectrum disorder (ASD) experience high rates of atypical eating behaviours, such as food neophobia. Mobile health (mHealth) interventions have been found to improve communication, behaviour and social skills for children with ASD. However, there is limited evidence examining mHealth nutrition interventions among children with ASD.

METHODS

The present study comprised a qualitative descriptive study that used qualitative content analysis to explore parent and child experiences with a novel mHealth nutrition intervention. Ten parent-child dyads provided user feedback and evaluation of the intervention. Data collection tools included a semistructured interview guide and a quantitative questionnaire with open-ended questions. Data analysis of the interview transcripts and open-ended questionnaire responses was an iterative process that continued until saturation was achieved. Descriptive statistics were used to analyse quantitative questionnaire data.

RESULTS

Analysis of the qualitative semistructured interviews led to emergence of three themes: (1) positive intervention outcomes; (2) parent suggestions for improvement; and (3) barriers to engagement. Each theme included subthemes. Questionnaire data revealed the ability to pick rewards and the virtual character that reinforced dietary goals ("Nutrition Ninja") were the most liked components of the application. Sending messages within the application and the Nutrition Ninja game were the least liked components of the application.

CONCLUSIONS

Collectively, findings indicated that the app served as an interactive tool prompting dietary change and conversations within families. Yet, for some families, the intervention design, resistance to change or child disinterest hindered use and implementation of the intervention.

Effects of a mobile health nutrition intervention on dietary intake in children who have autism spectrum disorder

Background

Children who have Autism Spectrum Disorder (ASD) show preferences for processed foods, such as salty and sugary snacks (SSS) and sugar-sweetened beverages (SSB), while healthier foods, such as fruits and vegetables (FV), are consumed less. Innovative tools are needed that can efficiently disseminate evidence-based interventions and engage autistic children to improve their diet.

Aim

The aim of this 3-month randomized trial was to test the initial efficacy of a mobile health (mHealth) nutrition intervention on changing consumption of targeted healthy (FV) and less healthy foods/beverages (SSS, SSB) in children who have ASD, ages 6-10, who were picky eaters.

Methods

Thirty-eight parent-child dyads were randomly assigned to either an intervention (technology) group or a wait list control (education) group. The intervention included behavioral skills training, a high level of personalization for dietary goals, and involved parents as "agents of change." Parents in the education group received general nutrition education and the dietary goals but did not receive skills training. Children's intake was assessed at baseline and at 3 months using 24-hour dietary recalls.

Results

While there were no significant group-by-time interactions (P > 0.25) for any of the primary outcomes, we found a significant main effect of time for FV intake (P = 0.04) indicating that both groups consumed more FV at 3 months (2.58 ± 0.30 servings/day) than at baseline (2.17 ± 0.28 servings/day; P = 0.03). Children in the intervention group who consumed few FV at baseline and showed high engagement with the technology increased their FV intake by 1.5 servings/day (P < 0.01). Children's taste/smell sensitivity significantly predicted their FV intake (P = 0.0446); for each unit of lower taste/smell sensitivity (indicating greater sensory processing abnormalities), FV intake increased by 0.13 ± 0.1 servings/day.

Discussion

This mHealth intervention did not yield significant between-group differences for changing consumption of targeted foods/beverages. Only children who consumed few FV at baseline and highly engaged with the technology increased their FV intake at 3 months. Future research should test additional strategies to expand the intervention's impact on a wider range of foods while also reaching a broader group of children who have ASD. This trial was registered at clinicaltrials.gov as NCT03424811.Clinical Trial Registration: This study was registered at clinicaltrials.gov as NCT03424811.

Evaluating the Acceptability and Social Validity of a Caregiver-Led Technology-Based Menstrual Hygiene Management Intervention for Youth on the Autism Spectrum

OBJECTIVES

Menstrual hygiene management (MHM) is a critical area of daily living skills for neurodiverse menstruators in which few evidence-based interventions exist. This study evaluated the acceptability and social validity of a caregiver-mediated intervention for youth on the autism spectrum utilizing behavior skills training, animated video modeling, task analysis, and telehealth services to improve changing a menstrual pad.

METHODS

The consultant recruited three youth and caregiver dyads to test the intervention and collect acceptability and social validity assessments. Materials varied based on the phase of the study; however, a typical trial required data collection sheets, youth's underwear, a menstrual pad, and, during intervention, the video model and hardware technology. A multiple baseline design across participants and reversal design were used to demonstrate experimental effects. Due to the sensitive nature of the study, independence and accuracy data were collected by caregivers and analyzed later by the consultant through visual analysis.

RESULTS

Overall, youth participants improved their percentage of independent and accurate steps of changing a menstrual pad. Furthermore, caregivers reported moderate to high levels of acceptability of the telehealth service delivery and animated video modeling, as well as the overall MHM training program measured by the Technology Acceptability Model-Fast Form (FF-TAM) and the Behavior Intervention Rating Scale (BIRS), respectively. Youth reported high levels of acceptability of the MHM training program as measured by the Child Intervention Rating Profile (CIRP).

CONCLUSIONS

Results suggest that a technology-based, caregiver-mediated MHM intervention for neurodiverse youth would be considered acceptable and socially valid by caregiver and youth participants.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s41252-022-00261-x.

Virtual Reality Technology as an Educational and Intervention Tool for Children with Autism Spectrum Disorder: Current Perspectives and Future Directions

The worldwide rising trend of autism spectrum disorder (ASD) calls for innovative and efficacious techniques for assessment and treatment. Virtual reality (VR) technology gains theoretical support from rehabilitation and pedagogical theories and offers a variety of capabilities in educational and interventional contexts with affordable products. VR is attracting increasing attention in the medical and healthcare industry, as it provides fully interactive three-dimensional simulations of real-world settings and social situations, which are particularly suitable for cognitive and performance training, including social and interaction skills. This review article offers a summary of current perspectives and evidence-based VR applications for children with ASD, with a primary focus on social communication, including social functioning, emotion recognition, and speech and language. Technology- and design-related limitations, as well as disputes over the application of VR to autism research and therapy, are discussed, and future directions of this emerging field are highlighted with regards to application expansion and improvement, technology enhancement, linguistic diversity, and the development of theoretical models and brain-based research.

INC-Hg: An Intelligent Collaborative Haptic-Gripper Virtual Reality System

Collaborative Virtual Environments (CVE) have shown potential to be an effective social skill training platform for children with Autism Spectrum Disorders (ASD) to learn and practice collaborative and communication skills through peer interactions. However, most existing CVE systems require that appropriately matched partners be available at the same time to promote interaction, which limits their applicability to some community settings due to scheduling constraints. A second shortcoming of these more naturalistic peer-based designs is the intensive resources required to manually code the unrestricted conversations that occurred during the peer-based interactions. To preserve the benefits of CVE-based platforms and mitigate some of the resource limitations related to peer availability, we developed an Intelligent Collaborative Haptic-Gripper System (INC-Hg). This system provides an intelligent agent partner who can understand, communicate, and haptically interact with the user, without requiring the presence of another human peer. The INC-Hg operates in real time and thus is able to perform collaborative training tasks at any time and at the user's pace. INC-Hg can also record the real-time data regarding spoken language and task performance, thereby greatly reducing the resource burden of communication and interaction performance analysis. A preliminary usability study with 10 participants with ASD (ages 8–12 years) indicated that the system could classify the participant's utterances into five classes with an accuracy of 70.34%, which suggested the potential of INC-Hg to automatically recognize and analyze conversational content. The results also indicated high accuracies of the agent to initiate a conversation (97.56%) and respond to the participants (86.52%), suggesting the capability of the agent to conduct proper conversations with the participants. Compared to the results of human-to-human collaborative tasks, the human-to-agent mode achieved higher average collaborative operation ratio (61% compared to 40%) and comparable average frequencies for Initiations and Responses among the participants with ASD. These results offer preliminary support as well as areas of improvement regarding the agent's ability to respond to participants, work with participants to complete tasks, engage in back-and-forth conversations, and support the potential of the agent to be a useful partner for individuals with ASD completing CVE tasks.

The Effect of the ‘Touch Screen-Based Cognitive Training’ for Children with Severe Cognitive Impairment in Special Education

Traditional education in special schools have some limitations. We aimed to investigate if the ‘touch screen-based cognitive training’ is feasible and effective for children with severe cognitive impairment (developmental age 18–36 months) in special education. In this case, 29 children were randomly allocated to intervention (n = 17, ‘touch screen-based cognitive training’, 30 min/session, 3 times/week, 12 weeks) and control (n = 12, traditional education) groups. Psychoeducational Profile-Revised (PEP-R), Early Childhood Behavior Questionnaire (ECBQ), Sequenced Language Scale for Infants (SELSI), Pediatric Evaluation of Disability Inventory (PEDI), and Goal Attainment Scale (GAS) were measured before and after 12 weeks of education. The ‘touch screen-based cognitive training’ was applicable in special education. When repeated measures analysis of variance (ANOVA) was used, significant groupⅹtime effect was found for GAS, and significant group effect was found for ECBQ (attentional shifting) and GAS. When adjusting for pre-education measurements, the intervention had a significant effect on the post-education measurements of ECBQ (attentional shifting) and GAS (p < 0.05). No relationship existed between the degree of improvements and the severeness of developmental delay in the measurements. ‘Touch screen-based cognitive training’ in special school was feasible and it improved cognition in children with severe cognitive impairment (developmental age 18–36 months), irrespective of the severeness of the developmental delay.

Mobile application based early educational intervention for children with autism - a pilot trial

PURPOSE

To design and develop a mobile application for pre-school readiness of children with autism and also to identify their learning pattern.

METHODOLOGY

Based on strong foundation of functional academics, we have developed a mobile application for providing an early educational intervention program to the children with autism. Three successive software trials have been conducted among 31 children with autism of age group of three to 10 years. The mobile app has been provided to educators and parents and they have been allowed to supervise the children during their learning phase for eight to 10 weeks. The imprint of learning pattern is recorded and learning progress profile is generated for individual child.

RESULTS

Data analysis of learning progress profile shows that 90% of the participants preferred drag and drop or simple touch approach over conventional methods practised during classroom teachings. More than 84% of the children are found to adapt pre-requisite skills for writing like scribbling, tracing, dots joining, copying, etc. after using the app on their tablet who are reluctant to hold pencil and paper otherwise. Twenty-five percent of the participants are reported to reciprocate the greeting etiquettes in class such as greeting teachers and their peers.

CONCLUSIONS

The mobile application made a valuable contribution to early intervention program for children with autism by imparting appropriate learning opportunities readily available to them. Performance metrics underlying each activity form a strong base of identification of learning patterns and formulation of revised individualized education plan (IEP).Implications for RehabilitationChildren with autism need the mobile application as an educational intervention program for it is readily available and user friendly.Educators need the mobile application to quantify the performance parameters and there by monitor/evaluate the progress of the child.Overall, the present research has aimed to develop an easy reach app by which educating as well as handling challenging behaviour of the children with autism would be easier.

A map of assistive technology educative instruments in neurodevelopmental disorders

PURPOSE

The use of assistive technology in mental health has gained an increased interest over the last decades. A growing number of studies have investigated diverse applications of technological interventions for rehabilitation of children with neurodevelopmental disorders. This article presents a map of the technological devises applied as therapeutic instruments.

METHODS

The research question of this review was which technological applications could be referred as an educational instrument for the management of children with autism spectrum disorders (ASDs), intellectual disability and attention deficit disorder. The articles included in this review were collected after a structured literature search in electronic databases using keywords such as "Assistive Technology", "technology devices", "robots", "Autism Disorder", "Intellectual Disabilities" and "Mental Retardation".

RESULTS

Assistive technology with the most up-to-date devices and applications helps children with intellectual disability and ASDs enhance cognitive skills and improve challenging behaviour, social communication and academic performance. Different technological tools are used to foster attention span and improve time management skills in children with attention deficit syndrome.

CONCLUSION

It is important that therapists choose the instrument that will offer the best approach towards the goal that is set. Future research could provide evidence based data, evaluating each specific methodology and tailoring each therapeutic approach specifically to a case.IMPLICATIONS FOR REHABILITATIONTechnology creates environments in which children could practice and learn in a safer, more predictable and pleasant manner.Assistive Technologies provide the opportunity for better acquisition of selfhelp skills and the power of social interaction for individuals with disabilities.By mapping out the wide array of Assistive Technology that is available today, future applications for rehabilitation of children with neurodevelopmental disorders could help extend therapeutic strategies out of the clinical and school settings and into the home, thereby incorporating the family and emphasizing personalization.Future studies could develop a model for the choice and use of each tool, tailoring each therapeutic approach specifically to each case.

The effectiveness of using colors in L1 and L2 vocabulary development of autistic children

Purpose

The purpose of this paper is to examine the effectiveness of using colors and learner’s intelligence quotient (IQ) in teaching new vocabulary in Arabic (L1) and English (L2) to children with autism spectrum disorder (henceforth, ASD).

Design/methodology/approach

To this end, 12 autistic children whose ages ranged between 7 and 12 were observed while they were being taught ten new words. The children were divided into two groups based on their IQ: Low (70–74) and High (76–79). The children were also divided into two groups: Group 1 studied the words written in a black font, whereas Group 2 studied the same words, but written in colors (each letter in the word in a different color), and an illustrative picture was provided with each word for both groups. The pictures were also different in color in the former group, while the picture was in black and white in the latter. The children involved in the study have a relatively slight ability to read letters based on an annual language assessment conducted by the center, and they learn a new word by learning its shape and by repetition. The experiment took place over a two-week period that involved teaching, revising and testing.

Findings

The results of the study showed that the children’s IQ played a crucial role in learning L1 and L2 vocabulary. The results also demonstrated that using colors had no significant impact on the children’s performance in the test. Finally, the results showed that teaching new words to children with ASD through repetition and drilling could be regarded as a useful technique. The study concludes with some recommendations for further studies.

Originality/value

The study shows that using pictures is a very useful tool in teaching L1 and L2 vocabulary to children with ASD.

Do Children with Autism Spectrum Disorder Understand Their Academic Competencies?

Research suggests that individuals with autism spectrum disorder (ASD) are unaware of their competencies in many domains. The current study examines whether self-perception of academic competency differs in children with ASD compared to typically-developing (TD) controls and whether estimations change after providing feedback. Sixty participants, 10-15 years of age, completed academic tasks and were asked to predict their performance before and after each task. The ASD group overestimated their performance compared to the TD group except when provided with feedback. The ASD group was significantly more accurate with their perceptions when receiving feedback, which suggests that they are able to process concrete feedback. Future research should attempt to understand the underlying mechanisms and functions of this bias.

An Evaluation of a Mobile Application Designed to Teach Receptive Language Skills to Children with Autism Spectrum Disorder

The current study evaluated the effectiveness of a mobile application, Camp Discovery, designed to teach receptive language skills to children with autism spectrum disorder based on the principles of applied behavior analysis. Participants (N = 28) were randomly assigned to an immediate-treatment or a delayed-treatment control group. The treatment group made significant gains, p < .001, M = 58.1, SE = 7.54, following 4 weeks of interaction with the application as compared to the control group, M = 8.4, SE = 2.13. Secondary analyses revealed significant gains in the control group after using the application and maintenance of acquired skills in the treatment group after application usage was discontinued. Findings suggest that the application effectively teaches the targeted skills.

Development and evaluation of a 3-D virtual pronunciation tutor for children with autism spectrum disorders

The deficit in speech sound production in some children with autism spectrum disorder (ASD) adds to their communication barriers. The 3-D virtual environments have been implemented to improve their communication abilities. However, there were no previous studies on the use of a 3-D virtual pronunciation tutor designed specifically to train pronunciation for children with ASD. To fill this research gap, the current study developed and evaluated a 3-D virtual tutor which served as a multimodal and real-data-driven speech production tutor to present both places and manners of Mandarin articulation. Using an eye-tracking technique (RED 5 Eye Tracker), Experiment 1 objectively investigated children’s gauged attention distribution online while learning with our computer-assisted 3-D virtual tutor in comparison to a real human face (HF) tutor. Eye-tracking results indicated most participants showed more interests in the visual speech cues of the 3-D tutor, and paid some degree of absolute attention to the additional visual speech information of both articulatory movements and airflow changes. To further compare treatment outcomes, training performance was evaluated in Experiment 2 with the ASD learners divided into two groups, with one group learning from the HF tutor and the other from the 3-D tutor (HF group vs. 3-D group). Both groups showed improvement with the help of computer-based training in the post-intervention test based on the calculation of a 5-point Likert scale. However, the 3-D group showed much higher gains in producing Mandarin stop and affricate consonants, and apical vowels. We conclude that our 3-D virtual imitation intervention system provides an effective approach of audiovisual pronunciation training for children with ASD.

Mothers Consistently Alter Their Unique Vocal Fingerprints When Communicating with Infants

The voice is the most direct link we have to others' minds, allowing us to communicate using a rich variety of speech cues [1, 2]. This link is particularly critical early in life as parents draw infants into the structure of their environment using infant-directed speech (IDS), a communicative code with unique pitch and rhythmic characteristics relative to adult-directed speech (ADS) [3, 4]. To begin breaking into language, infants must discern subtle statistical differences about people and voices in order to direct their attention toward the most relevant signals. Here, we uncover a new defining feature of IDS: mothers significantly alter statistical properties of vocal timbre when speaking to their infants. Timbre, the tone color or unique quality of a sound, is a spectral fingerprint that helps us instantly identify and classify sound sources, such as individual people and musical instruments [5-7]. We recorded 24 mothers' naturalistic speech while they interacted with their infants and with adult experimenters in their native language. Half of the participants were English speakers, and half were not. Using a support vector machine classifier, we found that mothers consistently shifted their timbre between ADS and IDS. Importantly, this shift was similar across languages, suggesting that such alterations of timbre may be universal. These findings have theoretical implications for understanding how infants tune in to their local communicative environments. Moreover, our classification algorithm for identifying infant-directed timbre has direct translational implications for speech recognition technology.

Designing Serious Game Interventions for Individuals with Autism

The design of "Serious games" that use game components (e.g., storyline, long-term goals, rewards) to create engaging learning experiences has increased in recent years. We examine of the core principles of serious game design and examine the current use of these principles in computer-based interventions for individuals with autism. Participants who undergo these computer-based interventions often show little evidence of the ability to generalize such learning to novel, everyday social communicative interactions. This lack of generalized learning may result, in part, from the limited use of fundamental elements of serious game design that are known to maximize learning. We suggest that future computer-based interventions should consider the full range of serious game design principles that promote generalization of learning.

Read my lips

A computer-animated tutor, Baldi, has been successful in teaching vocabulary and grammar to children with autism and those with hearing problems. The present study assessed to what extent the face facilitated this learning process relative to the voice alone. Baldi was implemented in a Language Wizard/Tutor, which allows easy creation and presentation of a vocabulary lesson involving the association of pictures and spoken words. The lesson plan included both the receptive identification of pictures and the production of spoken words. A within-subject design with five children with autism followed an alternating treatment in which each child continuously learned to criterion sets of words with and without the face. The rate of learning was significantly faster and the retention was better with the face. The research indicates that at least some children with autism benefit from the face in learning new language within an automated program.

Assessing Early Receptive Language Skills in Children With ASD

Language assessments play a large role in the diagnosis and treatment of autism spectrum disorders (ASD) because language impairments are often part of an ASD diagnosis and language status is a fundamental prognostic indicator for individuals with ASD. Receptive language forms the foundation for competent expressive language including literacy skills. Information from language assessments is also used to create therapy goals and monitor progress on these goals. Therefore, valid and accurate assessment of receptive language for individuals with ASD is paramount. Current assessments include tasks that are particularly difficult for individuals with ASD and often assess higher-level language skills and not emerging language skills, resulting in floor effects for individuals with ASD. Developing better receptive language measures is an important area for future research. Assessing and treating receptive language impairments will lead to improved expressive communication, including social communication, and literacy skills for individuals with ASD.

Using Multitouch Collaboration Technology to Enhance Social Interaction of Children with High-Functioning Autism

AIMS

Children with high-functioning Autism Spectrum Disorder (HFASD) have major difficulties in social communication skills, which may impact their performance and participation in everyday life. The goal of this study was to examine whether the StoryTable, an intervention paradigm based on a collaborative narrative, multitouch tabletop interface, enhanced social interaction for children with HFASD, and to determine whether the acquired abilities were transferred to behaviors during other tasks.

METHODS

Fourteen boys with HFASD, aged 7-12 years, participated in a 3-week, 11-session intervention. Social interactions during two nonintervention tasks were videotaped at three points in time, one prior to the intervention (pre), a second immediately following the intervention (post) and a third three weeks after the intervention (follow-up). The video-recorded files were coded using the Friendship Observation Scale to ascertain the frequencies of positive and negative social interactions and collaborative play. Differences in these behaviors were tested for significance using nonparametric statistical tests.

RESULTS

There were significantly higher rates of positive social interactions and collaborative play, and lower rates of negative social interactions following the intervention suggesting generalization of the social skills learned during the intervention. Improvement was maintained when tested three weeks later.

CONCLUSION

These findings provide support for the use of collaborative technology-based interventions within educational settings to enhance social interaction of children with HFASD.

A psychometric analysis of the reading the mind in the eyes test: toward a brief form for research and applied settings

The Reading the Mind in the Eyes Test is a popular measure of individual differences in Theory of Mind that is often applied in the assessment of particular clinical populations (primarily, individuals on the autism spectrum). However, little is known about the test's psychometric properties, including factor structure, internal consistency, and convergent validity evidence. We present a psychometric analysis of the test followed by an evaluation of other empirically proposed and statistically identified structures. We identified, and cross-validated in a second sample, an adequate short-form solution that is homogeneous with adequate internal consistency, and is moderately related to Cognitive Empathy, Emotion Perception, and strongly related to Vocabulary. We recommend the use of this short-form solution in normal adults as a more precise measure over the original version. Future revisions of the test should seek to reduce the test's reliance on one's vocabulary and evaluate the short-form structure in clinical populations.

Are children with autism more responsive to animated characters? A study of interactions with humans and human-controlled avatars

Few direct comparisons have been made between the responsiveness of children with autism to computer-generated or animated characters and their responsiveness to humans. Twelve 4- to 8-year-old children with autism interacted with a human therapist; a human-controlled, interactive avatar in a theme park; a human actor speaking like the avatar; and cartoon characters who sought social responses. We found superior gestural and verbal responses to the therapist; intermediate response levels to the avatar and the actor; and poorest responses to the cartoon characters, although attention was equivalent across conditions. These results suggest that even avatars that provide live, responsive interactions are not superior to human therapists in eliciting verbal and non-verbal communication from children with autism in this age range.

Accessing Peer Social Interaction

Autism spectrum and related communication and social disorders can severely affect some children's ability to engage in peer social interaction. In this article, we describe and evaluate an Authorable Virtual Peer (AVP), technology designed to help children access peer interactions by supporting them in developing critical social skills. Children interact with the AVP in three ways: (1) engaging in face-to-face interaction with a life-sized, computer-animated child; (2) creating new social behaviors for the AVP; and (3) controlling the AVP using a graphical user interface to select appropriate responses while the AVP interacts with another person. Our evaluation suggests that when an AVP is used as an activity during a social group intervention, a common intervention approach used with children with social and communication difficulties, that children's use of specific social behaviors critical to successful social interaction increases during role-play of common social situations with another child.

Visuospatial processing in children with autism: no evidence for (training-resistant) abnormalities

Individuals with autism spectrum disorders (ASDs) have been assumed to show evidence of abnormal visuospatial processing, which has been attributed to a failure to integrate local features into coherent global Gestalts and/or to a bias towards local processing. As the available data are based on baseline performance only, which does not provide insight into cognitive/neural plasticity and actual cognitive potential, we investigated how training-resistant possible visuospatial processing differences between children with and without ASD are. In particular, we studied the effect of computerized versus face-to-face visuospatial training in a group of normally intelligent children with ASD and typically developing children as control. Findings show that (a) children with and without ASD do not differ much in visuospatial processing (as assessed by a tangram-like task) and the few differences we observed were all eliminated by training; (b) training can improve visuospatial processing (equally) in both children with ASD and normally developing children; and (c) computer-based and face-to-face training was equally effective.

A review of technology-based interventions to teach academic skills to students with autism spectrum disorder

A comprehensive review of the literature was conducted for articles published between 1993 and 2012 to determine the degree to which technology-based interventions can be considered an evidence-based practice to teach academic skills to individuals with Autism Spectrum Disorder (ASD). Criteria developed by Horner et al. (Except Child 71:165-178, 2005) and Gersten et al. (Except Child 71:149-164, 2005) were used to determine the quality of single-subject research studies and group experimental research studies respectively. A total of 29 [Corrected] studies met inclusion criteria. Of these studies, only three single-subject studies and no group studies met criteria for quality or acceptable studies. Taken together, the results suggest that practitioners should use caution when teaching academic skills to individuals with ASD using technology-based interventions. Limitations and directions for future research are discussed.

Innovative technology-based interventions for autism spectrum disorders: a meta-analysis

This article reports the results of a meta-analysis of technology-based intervention studies for children with autism spectrum disorders. We conducted a systematic review of research that used a pre-post design to assess innovative technology interventions, including computer programs, virtual reality, and robotics. The selected studies provided interventions via a desktop computer, interactive DVD, shared active surface, and virtual reality. None employed robotics. The results provide evidence for the overall effectiveness of technology-based training. The overall mean effect size for posttests of controlled studies of children with autism spectrum disorders who received technology-based interventions was significantly different from zero and approached the medium magnitude, d = 0.47 (confidence interval: 0.08-0.86). The influence of age and IQ was not significant. Differences in training procedures are discussed in the light of the negative correlation that was found between the intervention durations and the studies' effect sizes. The results of this meta-analysis provide support for the continuing development, evaluation, and clinical usage of technology-based intervention for individuals with autism spectrum disorders.

The development of a multimedia online language assessment tool for young children with autism

This study aimed to provide early childhood special education professionals with a standardized and comprehensive language assessment tool for the early identification of language learning characteristics (e.g., hyperlexia) of young children with autism. In this study, we used computer technology to develop a multi-media online language assessment tool that presents auditory or visual stimuli. This online comprehensive language assessment consists of six subtests: decoding, homographs, auditory vocabulary comprehension, visual vocabulary comprehension, auditory sentence comprehension, and visual sentence comprehension. Three hundred typically developing children and 35 children with autism from Tao-Yuan County in Taiwan aged 4-6 participated in this study. The Cronbach α values of the six subtests ranged from .64 to .97. The variance explained by the six subtests ranged from 14% to 56%, the current validity of each subtest with the Peabody Picture Vocabulary Test-Revised ranged from .21 to .45, and the predictive validity of each subtest with WISC-III ranged from .47 to .75. This assessment tool was also found to be able to accurately differentiate children with autism up to 92%. These results indicate that this assessment tool has both adequate reliability and validity. Additionally, 35 children with autism have completed the entire assessment in this study without exhibiting any extremely troubling behaviors. However, future research is needed to increase the sample size of both typically developing children and young children with autism and to overcome the technical challenges associated with internet issues.

Audiovisual speech perception in children with developmental language disorder in degraded listening conditions

PURPOSE

The effect of the signal-to-noise ratio (SNR) on the perception of audiovisual speech in children with and without developmental language disorder (DLD) was investigated by varying the noise level and the sound intensity of acoustic speech. The main hypotheses were that the McGurk effect (in which incongruent visual speech alters the auditory speech percept) would be weaker for children with DLD than for controls and that it would get stronger with decreasing SNR in both groups.

METHOD

The participants were 8-year-old children with DLD and a sample of children with normal language development. In the McGurk stimuli, the consonant uttered by the voice differed from that articulated by the face. Three sound intensities (24, 36, and 48 dB) and noise levels (-12, 0, and +6 dB) were used. Perception of unisensory visual speech was also measured.

RESULTS

The children with DLD experienced a weak McGurk effect, that is, a weak influence of visual speech on audiovisual speech perception, which remained rather constant across SNR levels. The children with DLD were inaccurate at lipreading.

CONCLUSIONS

Children with DLD have problems in perceiving spoken consonants presented audiovisually and visually. The weaker McGurk effect could be accounted for by the poorer lipreading ability of children with DLD.

Single-case experimental designs: a systematic review of published research and current standards

This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support among those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design, and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods.

To enforce or not to enforce? The use of collaborative interfaces to promote social skills in children with high functioning autism spectrum disorder

The goal of this stud was to examine whether a technological touch activated Collaborative Puzzle Game (CPG) increased positive social behaviors in children with high functioning autism spectrum disorder (HFASD). The CPG involved construction of a virtual puzzle by selecting and dragging pieces into the solution area on a touch screen table. The target picture was presented on the top of the screen. Six dyads of children with HFASD (aged 8-11 years) engaged in the CPG in a Free Play (FP) mode in which partners could independently move puzzle pieces versus in an Enforced Collaboration (EC) mode in which partners could only move puzzle pieces together. Videos of the dames were coded for the frequencies of positive and negative social interaction, affect, play, and autistic behaviors. Parents completed the Social Responsiveness Scale (SRS). Wilcoxon Signed-ranks tests indicated that children with HFASD showed significantly higher frequencies of positive social interaction and collaborative play in the EC versus FP modes but there were no differences in negative social behaviors. Differences in social behaviors between partners during the puzzle games were not significant; however there were differences within pair in the severity of social deficits as assessed by the SRS questionnaire. The CPG in an EC mode was effective in promoting positive social interaction by requiring children to work together towards a mutual goal. However, the increased challenge in this mode, particularly for children with lower social-communication skills, suggests the need for establishing selection criteria and mediation steps for such interventions.

Computer-based interventions to improve social and emotional skills in individuals with autism spectrum disorders: a systematic review

OBJECTIVE

To review studies involving the use of computer-based interventions (CBI) to improve the social and emotional skills (e.g. emotional recognition) of individuals with autism spectrum disorders (ASD).

METHODS

The use of computer-based intervention (CBI) in the treatment of autism spectrum disorders (ASD) may offer some advantages to traditional one-to-one or group instruction including easier differentiation of instruction, decreased distractions and the incorporation of an individual's relative visual learning strengths. However, the results of past research suggest varying outcomes for CBI with individuals with ASD. This review provides a systematic analysis of studies investigating CBI to improve social and emotional skills (e.g. emotion recognition) of individuals with ASD. Electronic database searches and ancestral searches were used to identify studies that met pre-determined inclusion criteria. The included studies were then summarized in terms of: (a) participant characteristics, (b) social and emotional skills targeted, (c) details of the CBI, (d) results, and (e) certainty of evidence.

RESULTS

The results of these studies indicated that CBI's effect on social and emotional skills was mixed, with the majority of studies reporting unacceptable outcomes following intervention.

CONCLUSIONS

Overall, this review suggests that the use of CBI to improve the social and emotional skills of individuals with ASD is a promising practice. A comparison of CBI plus tutoring and face-to-face social skills training suggests that CBI can be as effective as face-to-face instruction. Practitioners should carefully consider the preferences and existing abilities of individuals with ASD and the customizability of the software when deciding to use CBI and selecting a software program.

Avatar assistant: improving social skills in students with an ASD through a computer-based intervention

This study assessed the efficacy of FaceSay, a computer-based social skills training program for children with Autism Spectrum Disorders (ASD). This randomized controlled study (N = 49) indicates that providing children with low-functioning autism (LFA) and high functioning autism (HFA) opportunities to practice attending to eye gaze, discriminating facial expressions and recognizing faces and emotions in FaceSay's structured environment with interactive, realistic avatar assistants improved their social skills abilities. The children with LFA demonstrated improvements in two areas of the intervention: emotion recognition and social interactions. The children with HFA demonstrated improvements in all three areas: facial recognition, emotion recognition, and social interactions. These findings, particularly the measured improvements to social interactions in a natural environment, are encouraging.