title: GOLIAH: A Gaming Platform for Home-Based Intervention in Autism - Principles and Design.
abstract: Children with Autism need intensive intervention and this is challenging in terms of manpower, costs, and time. Advances in Information Communication Technology and computer gaming may help in this respect by creating a nomadically deployable closed-loop intervention system involving the child and active participation of parents and therapists. An automated serious gaming platform enabling intensive intervention in nomadic settings has been developed by mapping two pivotal skills in autism spectrum disorder: Imitation and Joint Attention (JA). Eleven games - seven Imitations and four JA - were derived from the Early Start Denver Model. The games involved application of visual and audio stimuli with multiple difficulty levels and a wide variety of tasks and actions pertaining to the Imitation and JA. The platform runs on mobile devices and allows the therapist to (1) characterize the child's initial difficulties/strengths, ensuring tailored and adapted intervention by choosing appropriate games and (2) investigate and track the temporal evolution of the child's progress through a set of automatically extracted quantitative performance metrics. The platform allows the therapist to change the game or its difficulty levels during the intervention depending on the child's progress. Performance of the platform was assessed in a 3-month open trial with 10 children with autism (Trial ID: NCT02560415, Clinicaltrials.gov). The children and the parents participated in 80% of the sessions both at home (77.5%) and at the hospital (90%). All children went through all the games but, given the diversity of the games and the heterogeneity of children profiles and abilities, for a given game the number of sessions dedicated to the game varied and could be tailored through automatic scoring. Parents (N = 10) highlighted enhancement in the child's concentration, flexibility, and self-esteem in 78, 89, and 44% of the cases, respectively, and 56% observed an enhanced parents-child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial.
authors.affiliation: Electronics and Computer Science, University of Southampton , Southampton , UK.
authors.forename: Valentina
authors.initials: V
authors.lastname: Bono
authors.affiliation: Department of Developmental Neuroscience, IRCCS Stella Maris Foundation , Pisa , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Narzisi
authors.affiliation: Institute of Intelligent Systems and Robotics, University Pierre and Marie Curie , Paris , France.
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Jouen
authors.affiliation: Institute of Intelligent Systems and Robotics, University Pierre and Marie Curie, Paris, France; Department of Child and Adolescent Psychiatry, APHP, Groupe Hospitalier Pitié-Salpêtrière et University Pierre and Marie Curie, Paris, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Tilmont
authors.affiliation: Electronics and Computer Science, University of Southampton , Southampton , UK.
authors.forename: Stephane
authors.initials: S
authors.lastname: Hommel
authors.affiliation: Electronics and Computer Science, University of Southampton , Southampton , UK.
authors.forename: Wasifa
authors.initials: W
authors.lastname: Jamal
authors.affiliation: Department of Child and Adolescent Psychiatry, APHP, Groupe Hospitalier Pitié-Salpêtrière et University Pierre and Marie Curie , Paris , France.
authors.forename: Jean
authors.initials: J
authors.lastname: Xavier
authors.affiliation: Department of Developmental Neuroscience, IRCCS Stella Maris Foundation , Pisa , Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Billeci
authors.affiliation: Electronics and Computer Science, University of Southampton , Southampton , UK.
authors.forename: Koushik
authors.initials: K
authors.lastname: Maharatna
authors.affiliation: Electronics and Computer Science, University of Southampton , Southampton , UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Wald
authors.affiliation: Institute of Intelligent Systems and Robotics, University Pierre and Marie Curie , Paris , France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chetouani
authors.affiliation: Institute of Intelligent Systems and Robotics, University Pierre and Marie Curie, Paris, France; Department of Child and Adolescent Psychiatry, APHP, Groupe Hospitalier Pitié-Salpêtrière et University Pierre and Marie Curie, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Cohen
authors.affiliation: Department of Developmental Neuroscience, IRCCS Stella Maris Foundation , Pisa , Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Muratori
keywords: Early Start Denver Model; Imitation; Joint Attention; autism spectrum disorder; intensive intervention; nomadic settings; serious game