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Defining guidelines for designing effective interactive games for children with Autistic

Spectrum Disorder (ASD) in the UK

Chapter 1: Introduction

1.1 Background Information

Human is a technological being. As noted by Blischak & Schlosser (2003) technological
advancement constitutes the base in which human being depend on for survival and is
omnipresent in the modern day we live today. Human beings are set apart from other species
from the way he uses, invents, and continually improves utilities and tools. Generally, Blischak
& Schlosser (2003) have defined technology as a practical knowledge application in a specific
area. We employ technology to develop strategies that that enable us achieve some tasks like
prolonged submissions in water and flights that would have otherwise taken us long period to
accomplish. In the same vein, human beings have employed technology to extend his ability to
either regulate his environment or communicate and to improve food gathering process among
other many functions (Blischak & Schlosser, 2003).
The most fascinating use of technology is however, treating disability, illness and ailment. As
Bondy & Frost (2001) observe, man continually struggle to explore and seek new methods of
bringing sick individuals to life and try to help those with disability to live a life that is close to
normal as much as he can. To this end, noteworthy efforts have been undertaken in developing
technologies that are capable of helping children tormented by cognitive impairment in
developing language skills and learning social interactions. The more targeted have been those
with Autistic Spectrum Disorder (ASD) which encompasses various developmental disabilities
such as pervasive development disorder, Asperger and autism (Frith. 2009). Because of the
various implications imposed by ASD on children like immerse attention and communication
deficit, the implications emanating from the disorder are relatively strong. This calls for very
effective interventions aimed at the children. The most currently evolving arena in the context of
such interventions centres on game method implementation like serious games, off the shelf
video games and gamification. Nonetheless, despite such efforts, it is still surprising that a
significant percentage (35%) of these new technologies especially computer games are still not
effectively adopted with only a few tools targeting crucial factor in emotions and communication
((Dawe, 2006). This author has attributed the low rate of adoption to the inadequate
understanding of the requirement, needs, motivations and context of use for children with ASD.
For technology to be deployed successfully for children with ASD there is need to clearly
understand the technological needs of these population before an appropriate games can be
designed (Piper et al, 2006).

In light of these facts presented above, this current study endeavours to investigate the state of
research on these gaming technologies. By so doing, this current study focuses on: the extent of
the problem of Autism in the UK, and analyse how it has been addressed within the educational
system; how technology has been used to assist in the educational process for autistic children;
the educational concerns for children with Autism and methods that can be used to overcome
such concerns. Such knowledge are very useful in providing recommendations on how various
technologies can be incorporated in the development of interactive game design capable of
helping these people understand, generalise and recognise from mere facial expressions. The
model for designing interactive game takes into consideration the children with ASDs strong
systemising skills (Baron-Cohen, 2009) as well as Eckman and Friesen (1971)s six crosscultural and basic emotions: fear, surprise, disgust, anger, sadness and happiness. Specifically,
these authors are of the opinion that these six emotions can be systematically appraised. Thus, by
designing interactive games that facilitates learning through pattern recognition and a structured
process, children with Autistic Spectrum Disorder (ASD) might widen their understanding on
regularities and rules correlated to recognition of emotions via a systemised approach.
1.1 Rationale of the study
Various authors (Volkmar, 1998 and Michaud, Clavet, Lachiver & Lucas, 2000) are of the
consensus that of nearly all medical disabilities and disorders, ASD presents one of the most
challenging domains of technological application in the treatment, study and diagnosis of the
disease. Following Volkmar (1998) for instance, just as other illnesses which are psychological
in nature, autism condition is specifically multifaceted and intangible, offering no
straightforward and obvious method of carrying out research or employing technology to
improve the state of children with ASD. On the other hand, Michaud, Clavet, Lachiver & Lucas,
2000 argued that the profound social aspect of ASD does not allow for its treatment with simple
methods of treatment such as trivial clinical and physical apparatus methods. Nonetheless,
despite these studies on ASD, study into some of the guidelines for designing effective
interactive games for children with ASD are still not adequately explored in literature. These
challenges provide major motivations for conducting the current study.
Moreover, significant endeavours have been made by various researchers (MacArthur, 2000 and
Cheng, Kimberly & Orlich, 2003) to come up with the appropriate technology that can be very
helpful in the treatment and diagnosis of the disease. The result has been the influx of remarkable

methods and tools that are capable of improving the daily life of children with ASD and offer
response to most of the open questions regarding the nature of ASD. However, these researchers
have failed to show the shortcomings of these methods and tools with regards to how they can
effectively be modified. This forms the other rationale of conducting the current study.
Evidently, the current study is conducted in the context of children in the UK. The motivation
behind conducting the study in the context of children in the UK is two-fold; persistent influx of
people with ASD and an absence of definite cause attributed to the disease. According to various
reports (BBC, 2013 and The-Telegraph, 2012), UK has continued to witness substantial increase
in autism despite efforts different efforts by doctors to improve the way cases of autism is dealt
with. Following BBC (2013) for example, the major rise in autism took place in 1990s and
touched peak soon after 2000 when the number of children with autism spectrum disorder in the
UK has increased by 50% and remained at same level throughout 2010. As estimated by BBC
(2013), ASD was almost 3.7 in every 1000 boys and approximately 0.7 in every 1000 girls in
1990s. According to Gorski (2014), the increased awareness towards autism and early diagnosis
of autism has been the key contributor to the rise in the number of cases of autism in the UK.
Thus, it will be fascinating to conduct the study in the context of the UK to reveal some of the
reasons for the increased cases of autism despite the development of measures to curb the
The-National-Autistic-Society (2015) attribute the increasing cases of ASD in the UK to lack of
government commitment to designing effective initiatives for keeping a record of people
suffering from ASD. This report suggest that treating autism is not uniform for every gender and
age group and thus there is need for the government to keep records of children with ASD based
on gender, age and level of disorder. However, literature has not provided wholesome evidences
on various types of techniques that the UK government can employ to minimise cases of children
with ASD. More specifically, there is no study on how the UK government can minimise cases of
ASD using effective interactive games. This presents another gap that the current study
endeavours to fill by conducting the study in the context of the UK.
1.2 Personal Motivation for the study
The study into the topic under investigation in this study was motivated by personal interests.
The first motive behind the choice of this topic under investigation is that my nephew is autistic.

Seeing the struggle my sister undergo in her efforts to educate her, gave me the idea of creating
an interactive game to help her. Unfortunately, I did not have enough time and expertise to do so
and instead I decided to do a research to find some parameters and principles for me to follow
when I, eventually get enough expertise and time start creating the game. Something that even
my supervisor became enthusiastic about. Moreover, another motivation for this study emanated
from my visit to the hospital where autistic children were undergoing therapy. Seeing their
struggle to use the games, I felt that the available games being used in the hospitals are not user
designed and thus leading to the difficulty in their use by the autistic children. Since I did not
have enough financial muscles to develop interactive games that best suit each and every autistic
children, I felt the need to conduct a study on the same and make the results of my findings
available to the relevant bodies with the capacity to suggest or develop more effective interactive
games to fit each and every autistic childs needs.
1.4 Research Aims and Objectives
The overall aim of this current study is to critically examine the defining guidelines for designing
effective interactive games for children with Autistic Spectrum Disorder (ASD). To realise this
aim, the following four objectives have been proposed to guide the study:

To evaluate the extent of the problem of Autism in the UK, and analyse how it has been

addressed within the educational system.

To evaluate how technology has been used to assist in the educational process for autistic

To analyse the educational concerns for children with Autism and methods that can be

used to overcome such concerns.

To evaluate how such methods can be incorporated in interactive game design and to
provide guidelines and recommendations

1.5 Disposition of the study

The current study is chronologically divided into five main sections: chapter 1-5. In the first
chapter of the study, the study background, the rationale, research aims and objectives as well as
disposition of the study have been delineated. The subsequent section is the literature review.
Under this second section, the various theoretical discourses on the phenomenon under
investigation are explored with relation to the four objectives set forth in this study. Moreover,
crucial definitions are also presented in this section to help for the understanding of the study.

The third chapter is the methodology where all the methodologies to be adopted in the study are
presented. These includes research philosophy, research strategy research approach, data
collection methods, sample and sampling methods, methods of data analysis, ethical
considerations, limitations of the study among others. The fourth section is the findings and
analysis section. Under this fourth section, the data collected from the sample populations are
tabulated and analysed. Lastly, is the conclusion and recommendation section where the
conclusions emanating from the whole study are presented and recommendations are offered?
Moreover, limitations of the study as well as suggestions for future researches are also presented
in the last chapter of the study.

Chapter 2: Literature Review

2.1 Introduction
The literature review section forms the second chapter of the current study. Under this chapter,
different theoretical discourses on the topic under research are analysed. The analysis is carried
out with close reference to the four objectives set forth in the first chapter. Moreover, to offer
guidelines and give better direction to readers towards better understanding the study, the chief
theme of the study; Autistic Spectrum Disorder (ASD) is defined from the perspective of various
researchers before exploration of other themes emanating from the four objectives are deeply
2.2 Autistic Spectrum Disorder (ASD) Defined
Autistic Spectrum Disorder (ASD) was first defined by Kanner (1943) after noticing that
children who were generally referred to as mentally retarded showed similar character of
reduced interest. Since Early Infantile Autism recognition by Kanner (1943), there has been a
dramatic change on how autism is viewed among various medical practitioners and scientists
(Koegel and Brown, 2007; Ferraro, 2014; Happ, F. & Frith, 1996; Camarata, 2013 and Richler,
Huerta, Bishop, & Lord, 2010), broadening to entail other forms of disorders. For instance,
Richler, Huerta, Bishop, & Lord (2010) view ASD as the neurodevelopment set of disorders
characterised by communication skills, social interactions and behavioural impairment that is
repetitive and restricted in nature. Similarly, Ferraro (2014) described ASD also commonly
referred to as Pervasive Development Disorder (PDD) as a general term used to describe a

complex group of brain disorders characterised by stereotyped interests and behaviours in

addition to other forms of impairment proposed by Richler, Huerta, Bishop, & Lord (2010). On
the same tenet, Happ & Frith (1996) added imagination impairment by defining ASD as a
developmental and life-long disability mainly characterised by imagination, communication and
social skills impairment.
Yet on the other hand, Camarata (2013) described ASD as multifaceted neurological disorders or
disability that affect development of a persons brain during the first three years of a childhood
impacting on a childs communication skills and social interaction development. Lastly, Koegel
and Brown (2007) have provided a more conclusive definition of ASD by presenting a minute
difference between the term and autism. According to Koegel and Brown (2007), ASD is a
broader term and majorly consists of five disorders: Autism, Aspergers syndrome, Pervasive
Developmental Disorder, Childhood Disintegrative Disorder and Rett syndrome. This indicates
that an affected individual who is suffering from ASD may also have Autism. But an individual
who is suffering from Autism may not have the range of syndromes, fall under ASD. Despite
these varying definitions of the term ASD, one thread that cut across all these definitions is social
and communication impairment that is associated with the disease.
2.3 The extent of Autism and how it has been addressed within the educational system in
the UK
2.3.1 The Extent of Autism in the UK
Various reports and researchers (BBC, 2013; The-National-Autistic-Society, 2015 and TheTelegraph, 2012) indicate that the number of people with autism in the UK has increased
substantially with the major rise being experienced in 1990s. According to BBC (2013) for
instance, estimated the cases of autism spectrum disorder to be around 3.7 in every 1000 boys
and approximately 0.7 in every 1000 girls in the UK in 1990s. As noted by Gorski (2014), the
figure remained relatively stable between 2004 and 2010. In a ddtion to BBC (2013) estimates,
earlier findings by The-Telegraph (2012) also revealed that one in every 100 people in the UK is
suffering from autism spectrum disorder. These rapid increase in autism in the UK has been
largely attributed to increased awareness towards autism and early diagnosis of autism (Gorski,
Moreover, recent findings by The-National-Autistic-Society (2015) also indicate that more than
61000 schoolchildren in the countrys state funded schools have some kind of ASD that is almost

1% of the entire school population of the country. In 2007 the number of students with ASD in
the UK was only 39000 i.e. less than 1% of the countrys schoolchildren population. As per the
data provided by Department of Education, the ratio of autistic pupils to the students without
such disorder was 1:200 and the figure rose to 1:125, indicating a sharp rise in ASD among the
students in the UK (The-National-Autistic-Society, 2015).
These findings gains support from a survey conducted by Isaacs (2010) on male and female
adults in England. The findings of this survey revealed that 1.8% of the male survey had autism
spectrum disorder as compared to approximately 0.2% of their female counterparts. Although
there is no specific reason behind such difference, various experts such as Gorski (2014) believe
that girls are more efficient in hiding their difficulties as compared to boys and thus, their
behaviour might have got unnoticed by the researchers. However, these findings do not
accurately reveal the actual number of people with ASD currently as they are supported by a
survey on a sample population which are subject to biasness. Such views gain support from TheNational-Autistic-Society (2015) which acknowledges that despite having almost 700000 people
with ASD in the UK currently, there is no clear data in this context. This indicates that the UK
government which is considered the custodial of all medical records has not taken considerable
initiatives for keeping a record of people suffering from ASD. This could be a probable reason
behind increasing rate of autism in spite of undertaking actions for minimising the issue. Thus, it
is essential for the government to keep a track of people having autism spectrum disorder based
on different categories like female, male, children etc. This is because treating autism is not
uniform for every gender and age group and it varies based on the level of disorder. Thus, as
proposed by The-National-Autistic-Society (2015), identifying the number and type of people
having ASD would enable the UK government to have exact figure of those with ASD and to
take effective initiative for minimising the issue to a significant extent. However, wholesome
evidences on various types of techniques for minimising the level of ASD based on the gender
and age of the individuals is still lacking in theoretical discourses.
2.3.2 Addressing Autism in the UK Education System
More than half of the 5100 pupils having ASD are provided education in the mainstream schools
in the UK (Humphrey, 2008). This author further stated that, students with autism spectrum
disorder are 20 times more likely to be excluded from the schools as compared to the students
without such disorder. This has initiated the need for increasing focus on children with ASD and

their educational needs. To this end, various researchers and institutions (The-National-AutisticSociety, 2015 and Bell & Heitmueller, 2009) have explored how autism is being addressed in the
UK. Following Bell & Heitmueller (2009) for instance, one of the most common method that is
used by the UK government to address autism in the country is through legislation. According to
this author, the UK government has enacted the Disability Discrimination Act 1995 that has
provisions for students with ASD an obligation for the mainstream schools in the UK. This
enables the autistic children to gain equal opportunity for education. Nonetheless, despite these
legislations, adequate studies have not been conducted towards the effectiveness of such
legislations in addressing autism.
Other strategies that the UK has employed in addressing autism in the UK education system have
been pointed out by Guldberg (2010) to include The National Strategies. According to this
author, the National strategies developed the Inclusion Development Programme (IDP) in 2008
that involved a four year programme for professional development of the pupils with special
education need (SEN) and ASD in order to boost self-confidence and skills of the teachers
associated with teaching such students. This has enabled the teachers to identify the requirements
of the pupils with SEN and ASD and determine the most appropriate way to teach them while
applying formal as well as informal techniques. Despite developments in the provisions for the
students with ASD in the last decade, establishment of inclusive schools are still few and cannot
accommodate increasing number of cases of autism in the country. Thus, there is need for
empirical studies to establish whether inadequate inclusive schools have contributed to the
increasing cases of autism in the UK.
Lastly, other methods that have been implemented to address autism in the UK education system
as suggested by Day, Prunty, & Dupont (2012) is making selection of appropriate
accommodation for children with ASD and SEN mandatory in UK schools. As noted by TheNational-Autistic-Society (2015), strict monitoring system is required to be established to
analyse the effectiveness of the provisions in the mainstream schools as well as special schools
for the children with SEN and autism spectrum disorder. However, there is still dissatisfaction
among the parents of children with autism regarding the effectiveness of such initiatives.
Moreover, no theoretical discourse or report has explored the practical implication of the rules
developed by the UK government. This presents a big research gap that this study wish to fill

through a survey of children with autism through their mothers to find out if at all such strict
monitoring system exists in the mainstream schools.
2.4 Role of technology in facilitating educational process for autistic children
Children with autism have a lot of strength in processing visual images thus supporting the
application of technology to facilitate education of this population (Porayska-Pomsta, et al. 2012)
Moreover, other leaning features of autistic children that support the use of technology for their
education are their interest in inanimate things and desire for sameness. However, children with
autism also experience various difficulties that can be addressed by technology. These include
communication difficulties, complex cues and effective socialising difficulties. To this end, the
concept of the role of technology in facilitating educational process for autistic children is
paramount. Various authors (McGee & Lord, 2001 and Cafiero, 2005) have explored the role of
technology in education process of children with autism.
McGee & Lord (2001) for instance, look at the role of technology in solving communication
difficulties experienced by autistic children. Communication has been defined in this context by
McGee & Lord (2001) simply as what a person understands and generate to another person and it
is very crucial learning tool for children with ASD. As observed by this author, technology offers
effective tools for writing, reading using improved speech support and reading. For instance,
alternative and augmented communication which entails the application of technology to create
information system can act as a stimulant for speech development and communication generation
in children with ASD. The view point of McGee & Lord (2001) gains support from Hourcade,
Williams, Miller, Huebner, & Liang, 2013) who add that, communication constitute a partnership
and hence patners involved in communication must be very active. Using the case of alternative
and augmented communication, it is a requirement that partners in a communication should offer
verbal and visual input to the child with ASD. This forms the main feature in promotion of
communication in children with ASD (McGee & Lord, 2001). One example of such technology
is a Boardmaker which generate symbols to communicate pictures to enhance, augment,
develop and support current language as illustrated in figure 1 and 2 below.

Figure 1: The
Boardmaker (McGee &
Lord, 2001).

Figure 2: Interactive Communication Board

On the other hand, Cafiero (2005) have explored the role of technology in facilitating education
of children with ASD from the perspective of complex cues. According to Cafiero (2005)
children with ASD generally have trouble in processing global sensory, translating into
fragmented and localised stimuli around them. As further noted by this author, these processing
difficulties are usually connected to challenges experienced in processing complex and multiple
cues. To this end, Cafiero (2005) suggest that technology plays a very crucial role by offering
capability for developing various complex symbols from a single and simple symbol. The most
commonly used technologies in creating complex cues are tangible objects such as a cup to
express a desire to drink something as illustrated below.

According to Cafiero (2005) providing static and limited cues might be very helpful in enabling
children with ASD to respond and understand the environment they live in. Earlier, Cafiero
(2001) suggested the use of visual cues as focused and simple stimuli to promote transitions and
instructions as one of the most common and validated ASD practice. Nonetheless, despite the
theoretical discourses on the role of technology in facilitating education of children with ASD,
empirical studies on the effectiveness of these technologies still remain inadequately explored in
literature. Thus, this is a gap that this current study wishes to fill through an interview survey
2.5 Educational concerns for children with Autism and strategies for addressing them

2.5.1 Educational concerns for children with Autism

Various theoretical discourses (Humphrey, 2008; Azad and Mandell, 2015 and Isaacs (2010)
have explored some of the educational concerns for children with autism. Taking Humphrey
(2008) for instance, the main problem with imparting education to the autistic students is that
they are unable to vocalise their needs like that of a typical child. This makes it very challenging
their teachers to understand their thoughts because they must identify the underlying problem. As
further added by this author, children with autism get disturbed easily due to a certain smell, a
phrase or word, colour, thus it creates problem for the teacher and the other students to deal with
the students. As a result, affected individuals are 20 times more liable to be separated from
schools compare to their developing peers (Humphrey, 2008). This has given rise to increased
concern regarding educational needs of ASD affected individuals and thus a research gap that
this current study wish to fill.
Contrarily, Azad and Mandell (2015) have taken issues with the UK education authorities by
arguing that their policies, practices and cultures as one of the educational concerns for children
with autism. According to this author, these policies, practices and cultures do not accomplish an
inclusive educational environment that also accommodates children with autism. As argued by
Humphrey (2008), The Disability Discrimination Act (1995) for instance necessitates schools
to arrange for reasonable adjustments in order to ensure that ASD affected children are not
deprived than their peers. It is vital for the teachers to adopt processes and attitudes, which make
sure that all students have equal access to curriculum. To add to the views of Humphrey (2008),
Sallows (2000) have argued that simply placing a child on autistic spectrum in not inclusion
rather locational integration. Yet on the other hand, Isaacs (2010) states poor understanding as
one of the major educational concerns for children with autism. According to this author,
different teaching methods are based on the understanding of social behaviours and language in
the classroom. Therefore, poor understanding could be a risk for the affected children. Autistic
individuals differ in terms of profile and learning style, hence no single intervention is proper for
all affected individuals.
2.5.2 Strategies for addressing educational concerns of children with autism
Various authors (Benson et al. 2008 and and Huang, et al, 2010) have explored strategies for
addressing educational concerns of children with autism. Benson et al. (2008) suggest education
as one of the effective treatment for Autism that enables early diagnosis and intervention. As

stressed by this author, education also supports the development of intellectual skills, which
could further help the affected individuals to incorporate their abilities and skills into real life
situations. To add to Benson et al. (2008) opinion, Pratt (2005) argued that deficits in
psychological and social skills development separate a normal individual from that of an Autistic
individual. This separation presents various complications in the context of education. It is
frequently seen that the Autistic children are bullied often by their peers, which is referred to as
profound public health problem. Consequently, it could lead to behavioural problems, low
grades, depression, stress and physical illnesses. Due to the bullied students may also restrict
themselves from visiting regular schools and as a result affect their daily required education
(Szalavitz & Szalavitz, 2012). To this end, Huang, et al. (2010) suggested that intlectual skills
(knowledge, ability to comprehend, application, analysis, synthesis and evaluation) as a few
basic requirements that could help to develop and strengthen the educational backbone of an
individual with autism.
On the other hand, authors such as Huang, Jia, & Wheeler (2012) have a diferent view. Globally
the number of Autistic children is gradually increasing (1 out of 68 children is currently
diagnosed with ASD, where the prior rate was 1 in 88 or 1 in 110 individuals (Ivey, 2004).
Therefore, children with ASD are progressively being placed in mainstream schools. It is seen
that teachers are encountering various challenges while including these children as full
participants in classrooms. The teachers have frequently reported about challenges like sociostructural problems (lack of resources, training, and school policies), understanding and
managing behaviour, making inclusive environment (lack of clear communication between
students, parents and other guardians) (Matson, Nebel-Schwalm, & Matson, 2007). From prior
survey by Huang, Jia, & Wheeler (2012), it is seen that teachers have frequently recommended
for support, training and more resources in order to enhance the level of education and inclusion
of ASD children. Nonetheless, these findings are very inclusive since they only represents the
view points of teachers and not the children with autism or their parents. Thus, this current study
endeavours to get the view point of children with autism together with their mothers through an
interview survey of children with autism through their mothers to fill this theoretical gap.
2.6 Interactive Games for Autistic Children
2.6.1 LIFEis GAME

Over the last decade, various theoretical discourses (Alves, et al, 2013) have highlighted and
evaluated different kinds of interactive games for children with ASD. Alves, et al (2013) for
instance evaluated LIFEis GAME; a serious and prototype-Ipad like game that purports to
improve emotional and facial skill recognition in autistic children. In his study, Alves, et al
(2013) surveyed 11 children with autism with varying ages of 5-15 from Autistic Association in
Portugal through their mothers. In a quite setting with less light and noise, the prototype game
was presented to the children with autism on an Ipad. During the play, a video was recorded for
each and every child during the play which lasted for 15 minutes and thereafter, an analysis of
the footage was conducted with regards to the motivation of the children to play as well as
usability of the game. To improve the accuracy of research findings, specific instructions to start
playing was not given to the participants and in an effort to promote friendly play session and
reduce stress, a child centred method was used. Moreover, though a limit of 15 minutes was
imposed, the children were given opportunity to play longer if they needed. Further, to reduce
degree of anxiety brought about by novelty, the researcher previously informed all the children
with autism who took [part in the study through therapists and their mothers. The mothers of the
children with autism who took part in the survey were asked to fill a parental consent form and a
questionnaire sheet about the usage of the game and emotional understanding of the game by
their children.
For the analysis of the game motivation which is one of the primary aim of this study conducted
by Alves, et al (2013), various points were taken into consideration: if the child laughed, smiled
or showed any sign of content, if all game modes were explored by the child, if the autistic child
showed motor behaviour or stayed in the room and if the autistic child played for more or 15
minutes. After the game session, the researcher sough answers from the autistic children who
took part in the game with regards to their likes and dislikes about the game, their general views
about the game as well as the game mode they favourite to them.
On the other hand, with regards to the game usability which the Alves, et al (2013) also sought to
find out, a number of points were taken into consideration. These included finding out if the
autistic children who took part in the survey was in a position to navigate the game, finish or
start game mode, finish or start the game, follow the set visual guidelines to gain insight on how
each game mode is played, to accurately use option button available in each game to realise the
objective of the game and to require for any assistance in order to go on with the game.

Moreover, since theoretical discourse (Golan et al., 2008) observe that autistic children posses
different functioning level, Alves, et al (2013) also carried out an interview on the participants of
the survey through their mothers to collect data on the facial expression abilities, recognition of
facial emotions as well as usage of technology.
The result of the interview survey by Alves, et al (2013) was as follows: Regarding game
motivation, most parents of the autistic children who took part in the play indicated that their
children enjoyed the game and played for the either 15 minutes of the game session or more.
Moreover, all the parents who took part in the survey indicated that their children explored the
game modes; however, the Memory Game was the most favourite game mode among the
children and was played for comparatively longer period of the session. Furthermore, Sketch Me
was identified by the mothers of the autistic children who took part in the survey as the game
promoting laughter, smile and enjoyment among the autistic children. On the other hand, with
regards to attractiveness of the game, the mothers of the autistic children interviewed stated that
their children found the game very attractive and fun playing (a boy with features of a cartoon
like a small nose, big eyes, round face and big eyes). Additionally, the parents stated that their
children enjoyed the design of the button and the interface of the game which was made of bright
The result of the study indicated that though the autistic children who took part in the study
enjoyed the game, there is still need for simplification of the game (Alves, et al, 2013). In this
study, surprise, emotions and disgust emerged as the most difficult emotions to recognise.
Consequently, parents of autistic children who took part in the study suggested addition of
musical stimuli in the form of sound effects especially when losing or winning points to motivate
autistic children (Alves, et al, 2013). Other parents also suggested that the reward for the game
should be in the form of visual effects like toys and stars and feedback should be positive to
reduce the level of frustration of the autistic children. These findings gain support from Baron et
al (2013) who argued that autistic children are often easily frustrated by negative feedback.
On the other hand, the findings of the survey of mothers of autistic children by Alves, et al
(2013) indicated that game usability showed that even autistic children who have never been in a
position to use Ipad, starting or navigating the game very intuitive to them. Most mothers who
took part in the survey further indicated that the game play was facilitated especially by the
childrens previous computer game experience and they were conversant with the re- start button

design of the game, close and restart design as well as the delete and pause. The findings of the
survey by Alves, et al (2013) also showed that all the autistic children were in a position to restart or start and end the game mode and the game, change the mode of the game and select
distinct and difficult game levels. With regards to assistance required, the survey found out that
nearly all the autistic children who took part in the survey requested some assistance to go on
with the game especially for the Recon Mee Free game mode. These findings gain support from
theory of the mind studies (Baron et al., 2013) where it is argued that ability to understand
instructions from the main difficulty experienced by autistic children.
However, these studies are conducted in the context of Portugal which makes the applications of
it findings very difficult to generalise in the context of the UK. This presents a research gap that
this study endavours to fill by specifically carrying out the interview survey in the UK context to
address the main aim of the current study. Moreover, the survey by Alves, et al (2013) was
conducted in 2013 which is a long time ago and thus its findings might not be used to fairly
represent the current autism situation in the UK and thus presents a research gap that this current
study endavours to fill. Finally, though the survey has addressed some of the problems faced by
autistic children when using the current games as well as some suggestions on how the games
can be improved, no insights have been provided in the study as to how the UK government is
addressing such issues in its educational system. This presents a gap that this current studies
endavours to fill through the first objective set forth in this study.
2.6.2 Computer animated tutor
Away from Alves, et al (2013), Monjurul, Abdullah & Priyam Biswas (2013) evaluated how
interactive computer games has been utilised to improve ability of autistic children to speak
effectively. In their study, Monjurul, Abdullah & Priyam Biswas (2013) evaluated computer
animated tutor and evaluated its effectiveness in improving grammar and vocabulary of autistic
children in the UK. This was facilitated through a preliminary assessment test on 8 autistic
children and reassessed them after a month on their ability to master vocabulary. The result of
this study indicated that a significant number of students (85%) were in a position to identify and
recall various newly learned vocabulary after the expiry of the one month. These findings gain
support from Moore and Calvert (2014) who argued that acquisition of knowledge and
vocabulary are essential apparatus of competency in language in autistic children constituting
reading comprehension and oral communication proficiency. According to this author, depth and

breadth of vocabulary not only affect the success of reading of the autistic children but also the
overall success of autistic children in school. Accordingly, there is growing need of strengthening
and developing vocabulary to act as a critical component of intervention programs for autistic
children. This would reduce the gap of the population who are at risk of autism. Nonetheless, as
Moore and Calvert (2014) laments, many obstacles must be overcome by the motivational
environment required in the development of language skills. To this end, the author explored the
use of computerised based intervention (Computer animated tutor) by stating that computer
animated tutor has specifically helped the development and training of autistic children on
vocabulary for both second language and native English learners as well as for autistic children.
According to the findings by Moore and Calvert (2014), one of the crucial incentives of
computer animated tutor is ease at which programming of feedback, automated practice and
branching is done. Secondly, is the potentiality of the game to present multiple information
sources like images, texts and sound in parallel? By incorporating visual images and texts of
vocabulary for children to learn alongside actual sound and definitions of vocabulary improves
memory and assist learning for the vocabulary targeted. To this end, Moore and Calvert (2014)
conducted a study on 7 autistic children in the UK. In his study, this author observed the ability
of the autistic children to recall a different and second language during a training which was
composed of combined presentation constituting texts, written words, images and spoken words.
The findings of this study indicated a significant increase in recalling the vocabulary of second
language by the 7 autistic children who took part in the study.
Though effective than other previously developed interactive games for children with ASD,
computer animated tutor was found to lack some basic elements that can be used to improve
speech recognition further in autistic children. The mothers of autistic children who took part in
the survey expressed concerns that the main problem they experienced was that the pictures,
grammar and file in the game were not dynamically updated from the environment. Moreover,
despite the growing use of smartphones, the game is still not integrated in mobile platforms and
this makes its use among the lower and middle class very limited due to the high costs of schools
which offers these sophisticated devices. Therefore, this presents a huge theoretical research gap
that this study endavours to fill through its third objective; to analyse educational concerns of
children with autism and methods that can be implemented to overcome such concerns.
2.6.3 Computerised Games (Lets Face It)

Apart from Alves, et al (2013) and Monjurul, Abdullah & Priyam Biswas (2013), James et al
(2010) also explored how interactive games have been utilised by the government to educate
autistic children. In their study, James et al (2010) explored how computerised games (Lets Face
It computer base intervention program) have been utilised in the UK educational system to
educate autistic children on skills necessary for face recognition. To achieve the aim of the study,
James et al (2010) prescreened 42 autistic children with subsets of batteries in a clinical trial in a
bid to examine the ability of autistic children to process objects and face. The findings of the
study showed that majority of the participants (37) demonstrated significant improvement in
their ability to analytically recognise the features of their mouth and holistically recognise their
face on the basis of features of their eyes (James et al, 2010). Though the findings of this study
shows that the current interactive game; Lets Face It in particular has played a huge role in
education of autistic children on face recognition skills, the observation method used in the study
presents the limitation of biasness emanating from the researcher thus presenting a need to
conduct other studies using other methodologies to as to substantiate these findings. To this end,
this current study endavours to fill this gap by carrying out the study using interview survey.
Moreover, the study conducted by James et al (2010) does not show how the UK government has
particularly incorporated Lets Face It games into the education system. This presents another
research gap that this current studies endavours to fill through its first objective.
2.7 Conclusion
Autism is a neuro-developmental disorder which includes unusual repetitive and restricted
behaviours and inadequacies in communication and social reciprocity. The UK government have
often put in place measures to curb or to reduce cases of autism in the country. For instance,
through the Disability Discrimination Act 1995, the UK government has made developing
provisions for ASD affected students to be adhered to in the UK mainstream schools.
Additionally, the UK government makes selection of appropriate accommodation for children
with ASD and SEN compulsory in the UK schools. Lastly, various Teaching technology and
communicating technology have also been implemented by the UK government as assistive
technology to enhance the education system for Autistic students in the country. From above
theoretical discourses, some of the interactive games that have been implemented by the UK
government to drive autistic children towards skill learning includes computerised games like

Lets Face it, computer animated tutor and LIFEis GAME; a serious and prototype-Ipad like
game. These interactive games help in teaching the children the social, motor and language skills
in particular. Nonetheless, despite all these efforts by the UK government, case of autism are still
on the rise in the country leading to the question as to the effectiveness of these government
interventions. To this end, the current study is carried out to find out the defining guidelines that
can be used to design more effective interactive games for children with ASD in the UK.

Chapter 3: Methodology
3.1 Introduction
The methodology forms the third chapter of this study and it is where various research methods
adopted in the data collection process are explored. These methods includes research approach,
research strategy, research philosophy, data collection methods, sample and sampling methods as
well as techniques of data analysis are discussed. Moreover, ethical concerns that are likely to
arise in the course of this study are also addressed under this chapter of the study.
3.2 Research Philosophy
There are two most commonly used research philosophies in a study; positivism and
interpretivism research philosophy (Bell, 2014). However, for this study, interpretivism research
philosophy is adopted. Bell (2014) has defined interpretivism as a research method used in the
identification of social science methods having similar specific assumptions. The motivation
behind the use of interpretivism in this study is because the phenomenon under investigation in
this study requires an in-depth investigation since the defining will enable for an in-depth study
of the phenomenon under investigation (Crowther and Lancaster, 2012). Moreover, a
comparatively higher validity level is likely to be achieved in this study when interpretivism is
adopted in this current study. This as noted by Crowther and Lancaster (2012) is as a results of
the fact that data gathered through interpretivism research philosophy tend to be honest and
trustworthy. On the other hand, the use of positivism was ruled out in this study because the
phenomenon under investigation in this study does not aim to ascertain the correlation between
two variables.
3.3 Research approach

As Ritchie et al (2013) note, inductive and deductive are the two most commonly used research
approaches in a research study. To differentiate the two approaches, Pickard (2007), described
deductive research approach as a valid reasons commencing from a general conclusions and ends
in specific conclusions. Contrarily, inductive research approach is rational premise applied by
researchers to gather information viewed as true in a research study. In this current study
deductive research which entails development of knowledge and reasoning from a more general
standpoint to a more specific knowledge is utilised. The motivation behind the use of deductive
research approach is that it enables the researcher in this study to a rationale process with
information developed from explanations and scientific laws (Ritchie et al, 2013). The
application of deductive research approach in this current study ensured the researcher was in a
position to inform the study on the defining guidelines for designing effective interactive games
for children with ASD in the UK.
3.4 Research Strategy
Different research strategies that can be utilised in a research study exist. However, the most
widely applied research strategies in a study include case studies, ethnography and surveys and
observation (Crowther and Lancaster, 2012). It is worth noting that the selected strategy should
be that which is capable of defining all the research approaches that can be used by the UK
government in designing effective interactive games for children with ASD in the country. Out of
the four research strategies mentioned above, a mix method of survey which entails gathering
quantitative data from a population sample and observation were selected as the best research
strategies in this current study. The choice of the survey in this study is because, autistic children
who are the major focus in this study often show some general characteristics and behaviours.
Thus, the use of survey method by selecting a small population sample would not only saves the
researcher on time, but also offers a conclusive and accurate findings that can be used to
generalise the whole population of autistic children in the UK. On the other hand, the choice of
observation in this study was driven by the fact that it allows the researcher to get first hand
information through seeing and monitoring the autistic children as they play the game.
3.5 Data collection method and procedure
In any study collection of data plays a very significant role (Hox and Boeije, 2005). In this
current study, interview survey was selected as the best survey method of collecting data from

the sample population. Though very time consuming, interview was selected due to the fact that
it facilitate collection of very honest responses from the study respondents. Moreover, as noted
by Hox and Boeije (2005) qualitative interviews enable the researcher in a study to diverge from
the ancient ways of asking questions from the respondents. As a result, appropriate and correct
responses that are relevant to the study are stimulated. Additionally, qualitative interviews enable
the researcher in this study to have expansive responses thus minimising assumptions made in
case of vague responses by the respondents. Moreover, another reason for the choice of survey in
this study is because of its capability to allow for the direct engagement of the researcher with
the respondents (Hox and Boeije, 2005). The direct contact with the respondents enabled the
researcher in this study to have a feeling of the issues affecting children with autism thus
increasing the reliability of the study findings. To this effect, 8 children with ASD selected from
4 different schools for children with autism: Breckenbrough School, Freemantles, Chrysalis
School and Quest School for Autistic Children are chosen as suitable case that offers better and
fair representation of children with autism in the whole UK population. The mothers of the eight
children were picked equally from the four schools with two being picked from each school.
Since most of the children with autism were either young or could not communicate, the
interview was carried out through their mothers in the month of December 2015 at the homes of
8 children with autism during therapy seasons with prototype interactive games. The mothers
were chosen since they have very close contacts with the children as opposed to the fathers. The
interview questions were designed in a way that is very easily understood by the parents of
children with ASD who took part in the interview. The interview was designed to cover all the
issues that have been raised in the literature review to ensure all the objectives of the study are
met. The questions in the interview entailed both closed and open end questions organised in
three major sections.
The interview commenced by stating the study purposes and explaining the right of the
respondent in the study to gain their full consent. Thereafter, questions touching on the
demographic profile of the respondents excluding identifier data like name of the respondents.
These information included gender, age and the number of years their children have taken with
ASD. The fourth section of the interviews entailed the main questions touching on the four
objectives of the study and included both open and closed end questions. The open questions
required the respondents to give their views with either a Yes or NO while the closed end

questions required the respondents to describe and elaborate on their views. The fourth section
was composed of questions with regards to the ability of the child to learn facial expressions and
emotions. Moreover, questions on the intervention materials and tools that have been used in the
past as well as their effectiveness. The use of closed end interview questions enabled the
researcher to capture additional information that is very relevant for the study but that which
might not have initially included in the interview and seek more clarifications on the
phenomenon under investigation. Each and every participant in the study was interviewed for 1540 minutes.
3.6 Data Analysis method
Every interview of the children with ASD together with their mothers after the games was
presented and analysed using qualitative content analysis. Each and every interview responses
were examined independently by the researcher and thereafter open coded to show emerging
themes from the data. Fast forward, the contextualisation of the emergent themes into a larger
game mode picture took place to allow for the understanding of the motivations, needs,
requirement and use context of children with ASD, more so in relation to the future game mode
Different methods of analysing qualitative data exist. However, thematic analysis is the most
widely applied method. According to Humphrey and Lee (2008) the aim of thematic analysis is
that of identifying patterns of meanings from a set of data gathered from the field so as to offers
responses to the objectives set forth in the study. Thematic analysis as noted by Humphrey and
Lee (2008) is very flexibility; it can be applied in various models to achieve the objectives of the
study. Thus, the application of thematic analysis in this current study is motivated by the fact that
the interview questions in the current study is related to the views, experience and perception of
people like what do you feel like educating your autistic child. Secondly, thematic analysis is
also suited to interview questions that are related to representation and understanding like how
does the government cater for children with autism. Since this current study has utilised
deductive research approach, a deductive way thematic analysis is used. This according to
Humphrey and Lee (2008) involves data coding and development of themes directed by current
ideas and concepts.
3.6 Ethical consideration

In any research study, ethical considerations plays a very significant role as far as protection of
the respondents rights and freedoms is concerned (Arbnor and Bjerke, 2009). To this end,
various ethical issues were taken into consideration in this study. Firstly, to ensure the
respondents privacy, the researcher ensured the respondents that their responses would only be
used for academic purposes and not any other purpose beyond the study. To this effect, a parental
consent form was sent to the parents of autistic children to fill as an indication that their
participation in the study is on voluntary basis and that they possess a right to withdraw from the
study at any time of the study before the interview could be conducted. Lastly, the full consent
of the respondents was only considered when they have given full responses to the questions in
the interview.

the "Interactive Games for Autistic Children" and the conclusion need more elaboration.
i.e., what were the findings? and how are they relevant to research aims?. The research
gap needs to be directly related to the research aims.

Chapter 4: Data analysis

4.1 Introduction
In this section of the study, data emanating from observation and interview was carried out.
Under this section of the study, analysis of various features of the game play is carried out
including specific selection by the user, game play total duration, common errors or difficulties
committed by the participants. The aim of these selections was to enable the researcher to
observe differences and commonalities between autistic children as well as their activities during
the game play. The results of the interview were organised under the three main themes as below
to ensure all the objectives set forth in chapter one of this study are realised.
4.2.1 Evaluation of the extent of the problem of Autism and how it has been addressed
within the educational system in the UK
Experience with Computer Games

According to the parents, computer-based games have been used for both learning and
entertaining purposes at home and school. During the interviews, most interviewees indicated

that video games, including computer games, strongly attract children with ASDs in a positive
way. Although, parents also noted that their children) become immersed in the gameplay. Several
children were identified as being so focused when playing video and computer games that
parents described having to intervene or redirect, especially when a child would play the same
thing repeatedly. Parents noted many age-appropriate online games that center around virtual
worlds, such as Disneys Club Penguin and Poptropica as well as educational tools. Children
were also described as being skilled in playing games, both computer-based and console-based
games, especially Nintendo Wii games. Children were described as quickly understanding
appropriate game interactions and actions as well as how to use input devices, including
keyboard, mouse, and controller inputs. Two parents discussed how their children had a strong
desire to win and at times become angry or distressed when they get something wrong within a
game or lose, while another discussed her sons desire to master games
4.2.2 Evaluation of how technology has been used to assist in the educational process for
autistic children in the UK
Current Approaches for Teaching Emotions
Teaching emotions did not seem to be a focus for many parents and most reported no specific
strategies targeted at emotion comprehension skills. Yet, parents did indicate that teaching
emotions was an integral part of their interventions. Based on the interviews, two main
approaches were identified: using existing tools and using improvising strategies. Existing tools
are the materials and intervention systems designed by professionals for special populations with
a particular learning outcome in mind. Whereas, the improvising strategies refer to methods
parents adopted to suit the specific learning needs and goals of their child in a particular situation
or context.
The most commonly adopted existing tool identified by parents was visual-based communication
systems (e.g., PECS). Other tools identified included Superflex and the Transporters DVD.
Examples of improvising strategies included reading books and discussing the attitudes and
emotions of the characters in the book. The most common improvised strategy discussed was to
engage in step-by-step discussions of social situations. Parents described using a system of
storytelling to explain particular social interactions their children) encountered and explain
appropriate emotional responses. For example, parents recounted stories involving an
inappropriate outburst or response from the child, a situation of the child struggling to interact

with peers, or a scenario where the child was being bullied. For example, Participant 2s mother
described a situation where her son was nervous about the school bus being late and that his
reactions angered some of the other students waiting for the bus, The mother described how it is
important to talk to her son about situations like this, including what happened and his feelings in
a very concrete step-by-step manner. Other parents also explained that this was one of the most
effective tools in facilitating their childs understanding of complex social situations and the
related emotional responses.
4.2.3 Analysis of educational concerns for children with Autism and methods that can be
used to overcome such concerns.
Emotion Related Skills Not the Focus
While the importance of recognizing, understanding, and responding appropriately to different
emotions, especially in social situations, was discussed by many of the parents during the
interviews, several noted that this skill was not the focus of any current intervention efforts. Four
of the seven parents interviewed specifically stated that the concentration of their intervention
strategies was on skills that seemed to be more fundamental than emotion recognition skills.
Participant 7s mother noted that her childs behavior problems were a more pressing issue. She
stated: His problem behaviors were much more of a big deal. We werent necessarily so
concerned with how can we catch him up, but how can we make him more livable. Other
parents similarly noted that there were behavior problems that had to be addressed before
emotion recognition skills. The mother of Participant 1 noted that interventions did not focus on
recognizing facial expressions of emotions until her son was four years old. This was because of
her sons delayed language development, which was the primary concern during the early
childhood interventions. The mother of Participant 4 discussed her concerns for her sons anxiety
and how addressing that issue was a priority. She said: We are dealing with something pretty
fundamental right now, with the anxiety issues. So, learning expressions and emotions has not
been a priority. Once [her son] is more stable we can attack that. The theme throughout many of
the parent interviews was just getting though the day.
Levels of Need
Several levels of need related to emotion recognition skills were revealed through the analysis of
parent interview data. The different levels identified were the need for 1) Recognition of basic
emotions, 2) Recognition of more complex emotions, and 3) Understanding the reasons behind

emotional responses. When discussing the recognition of basic emotions, many of the parents
identified that although this was not a current need, it had been difficult for their child at an
earlier developmental stage. The mother of Participant 1 said that her son was unable to
recognized most basic emotions until he was about 4 years old. Participant 7s mother said that
when [her son] was younger he would not even have tried to recognize facial expressions.
While, the mother of Participant 4 explained that in order for her son to recognize even basic
emotions the emotional response and expression needed to be exaggerated. She explained that
he recognizes more dramatic emotions; he can recognize sad, but he doesnt know when you
are sad, unless you are crying.
Many of the parents described their childs current ability to recognize basic facial expressions of
emotions but said that the ability to recognize more complex emotions and moreover understand
the context for those emotions was very difficult. The mother of Participant 4 explained,
sometimes the more subtle things are difficult. I wish [sons name] would know more of the
subtle expressions. While Participants 5 and 6 were described as being able to recognize basic
emotions such as happy and scared, their mother explained that they would not understand a
more complex emotion like embarrassed.
Many of the children were described as being visual learners who are able to quickly learn game
rules and objectives as well as memorizing processes or tasks; however, the participants were
also described as having difficulties understanding the more complex issues of why particular
actions or emotions are appropriate within a given context. With regard to emotion expressions
or responses, one parent discussed how her son is skilled in learning or imitating an appropriate
response to a specific situation but does not understand the underlying meaning or need for that
action. Participant 1s mother said that although her sons ability to recognize emotions improved
over time, he still unable to express the reason for his emotional state. The parents of Participants
8 and 9 expressed a similar sentiment. They described the girls as both being able to understand
basic emotions and recognize those emotions on others but would not associate those emotions to
a specific event. They described the girls abilities related to emotion recognition:
Their ability to recognize emotions is very basic, but we have never quizzed them on more subtle
nonverbal gestures. But it would probably go right past them. Their ability to recognize emotions
through facial expressions is pretty basic...they might not understand the context

Chapter 5: Conclusions and Recommendations

5.1 Introduction
The study aimed at investigating the defining guidelines for children with ASD. To this end, the
overall conclusions emerging from the study as well as recommendations are suggested in this
section as below.
5.2 Recommendations
Allow Customization
Morris et al. (2010) suggest that the customization of software is best way to increase the
accessibility of computer-based interventions to a wide range of users. Additionally, Hailpern et
al. (2009) conclude that individual customization for children with ASDs are necessary to
effectively enabling preferred feedback styles of end-users (e.g., parent, clinician, or child). The
results of this study support these claims. The wide varieties in childrens characteristics, ways of
processing information, and preferences to different visual and acoustic feedback that we
observed in this study suggest that future games should also allow children, parents, or therapists
to customize 1) agents that the children interact with (e.g., Avatars, real human faces, game
guide, etc.), 2) feedback and rewards, 3) the combination of text, audio, and video options, 4)
visual elements of the game (e.g., photos, illustrations, videos, lighting etc.), and 5) context of
the game environment (e.g., home, school, bus stop, or real environment etc.).
Incorporate Context
The second implication is to integrate context into the game. Parents indicated that providing a
storyline with real-life scenarios would help their children understand social interactions. Being
able to understand how certain emotional responses result in a particular outcome should be a
primary goal of an intervention tool, as put by one of the parents it is important to show how
when someone acts this way there is a negative outcome [and] when they act that way there is a
positive outcome. After observing the gameplay, many parents discussed the need for context in
the game. The mother of Participant 7 explained: Short stories are important to learning and
understanding cause and effect. That is something he really needs help with that actions make
people happy or sad. By providing context, children with ASDs may be better able to apply the
skills learned within the game and generalize that knowledge to real-world situations. Both

Bernad-Ripoll (2007) and Tseng and Do (2010) have suggested embedding narratives and social
scenarios to provide context.
Enable Adaptability
The third design implication is to make the game adaptive. Adaptability means enabling the
game to adapt to the behavior of each child. For example, the game could help the player make
eye contact by modifying the level of eye contact made by the computer agent and slowly
increasing eye contact in order to encourage this behavior without upsetting the player.
Additionally, if a player demonstrates repetitive behaviors, the game could alter the players
attention to the next stage by providing visual or sound effects. Adaptability could also be
integrated into the game using speech recognition and interactive scenarios. Speech recognition
could allow the game to react to the childs simple conversation or simple verbal command, such
as yes/no answers to a predefined question. Another example is interactive (reflective) scenarios
that could provide children with ASDs a safe environment to explore different responses to their
actions in social contexts. The inclusion of interactive environments to facilitate learning is
supported by previous studies, including interactive computer-based educational approaches
(Davis et al. 2006, Heinmann et al. 1995, Sehaba, Estraillier, and Lambert 2005).
Technology Platforms
Different technology platforms allow children to interact with computer-based games in a variety
of ways. Recently, computer games have been adapted for different interfaces, such as multitouch wall panels and movement-based game systems (e.g. Nintendo Wii and Xbox Kinect
games). In this study, parents noted that their children show delight and enjoyment while playing
Wii and Ipad. Future development on these platforms has a great potential to capture the inherent
enjoyment and interactivity of these interfaces for teaching children with ASDs.
In addition to the four major implications, several parents also noted a need for a more integrated
game flow. Currently, the game modes are played as very distinct exercises. In order to immerse
the player into the game, the modes need to be incorporated into a larger more complex game.
This game might include a virtual world in which the games are played and a include series of
rewards for completing levels.
5.3 Conclusions
Parents of children with ASDs recognize the importance of teaching children emotions, but lack
effective means. An interactive game targeted at teaching children emotions by recognizing

facial expressions can help fill this gap. Our research results suggest that in order to develop an
effective game designed to be an intervention tool that aids children with ASDs in enhancing
emotion recognition and comprehension skills needs to be not only interactive, but also adaptive
to individual childs characteristics and needs. At the same time, the game should
Incorporate meaningful social context to encourage generalization to other settings. The game
should also be
customizable in the sense that parents or children can choose characters, sounds, and context that
suit their needs. Our results also suggest that it is desirable to make the game available on multitouch platforms.