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2. PREVIOUS WORK 3. SYSTEM OVERVIEW
2.1 AR-based Application for Children with 3.1 The Core Module of Offline Object
Autism to Enhance Social and Communication Recognition Powered in the TensorFlow
Skills Platform
The majority of AR-based applications had been developed The core part of the imagine recognition module had implemented
to enhance autistic children’s social and communication skills within Google’s TensorFlow 1 machine learning framework.
with reported increased engagement and positive emotion. For Without modifying the sample codes, we took advantage of
example, the overlay of digital contents on top of physical ones in around one hundred already-trained models to cold start our
[Escobedo et al 2014] revealed that autistic children demonstrated system so that it could function in an offline fashion to facilitate
increased sustained and selective attention; meanwhile, due to the especially outdoor, home and non-classroom use. At present, our
inherent fun and attractiveness of the AR-based outputs, positive system can recognize one hundred common daily objects without
emotion had been elicited, which thus promoted engagement connecting to the internet, which thus offers tremendous
during therapies. Increased engagement has also been reported in advantage especially for rural users who have much less access to
in [Chung and Chen 2016] where AR technologies overlaying therapists [Tang and Flatla 2016]. We also offered further testing
with corresponding virtual images in tangible markers for children scenarios and results with seven animal toys to demonstrated the
with high-functioning autism. [Brandão et al 2015] also adopted usefulness of the offline learning algorithm.
AR technology in an interactive game book where children can
play with one 3D AR avatar with different facial expressions and 3.2 System User Interfaces
choosing the correct one to the right scenario, with an aim to train Our system went through several design iterations, which aims at
autistic children emotion and cognitive skills. AR-based facilitating the ease of use for autistic children. Figure 1 showed
applications were also developed to train autistic children’s the latest user interface.
emotion expression and social skills [Chen et al 2015], and
cognitive and social skills [Cunha et al 2016]. Enhancing pretend
play had been the focus in both [Bai et al 2015] and [Dragomir et
al 2018], while the latter sets the training in the classroom which
might not fully exploit the advantages of the AR technologies.
AR-based Google Glass has been adopted in two recent
studies to teach children social and communication skills. In
particular, Liu et al [2017] first systematically explored the
feasibility of autism-focused AR-based smart-glasses for training
social communication and pointed out that the AR-based can
significantly increase children’s engagement and fun, which thus
might in turn enhance the respective skills during intervention.
The AR-based Google Glass was studied in [Daniels et al 2018]
for home-based social affective learning in children with autism
with greater social acuity and increased eye-contact.
Despite the increasing popularity of AR-based technology among Fig. 1. The system can recognize four objects in one scene.
children, parents and therapists, findings in the clinical aspect is In Figure 1, the colored border corresponding the colored buttons;
not conclusive. For example, a recent study on AR for social skills when a user presses a colored button, the Chinese word for the
intervention failed to find significant improvement between item corresponding to the colored button will be shown and
groups [Lorenzo et al 2018]. Thus, further ecological studies are spoken, as shown in Figure 2. Notice in Figure 2, the user targeted
necessary. Despise it, due to the unique opportunity an AR-based a photo in a browser, which shows that our system is capable of
system can offer, it would continue to be present in future systems. supporting learning anywhere and anytime for these children.
2.2 AR-based Application to Target Other
Skills of Children with Autism
A few studies address other deficits of the children and train the
corresponding skills accordingly, including speech [da Silva et al
2014] which allows parents and therapists to join in during the
intervention section to increase engagement, science vocabulary
[McMahon et al 2016] to promote authentic learning opportunities,
science knowledge understanding [Hung et al 2016],
Among these studies, [Hung et al 2016] systematically compared
three different teaching materials including a typical picture book,
physical interactions and an AR graphic book, and revealed that
AR-based book offers a practical and hands ‐ on channel for Fig. 2. A sample example of the word recognition where both
children to explore and learn about corresponding knowledge. Chinese and English words appear.
However, although the new technology increased learning
motivation, the overall learning outcomes does not seem to
particularly favor this type of learning materials. 1
https://www.tensorflow.org/tutorials/images/image_recognition
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3.3 System Testing with Animal Toys and a few children who were demonstrated the application show
In order to further examine the accuracy and feasibility of the high interest in trying it after several rounds. Parents are
lightweight, offline deep-learning algorithm, we further tested the particularly satisfied with the audio module of the application.
algorithm with seven animal toys, with very satisfying results. However, due to the limited training sets, the accuracy of the
Figures 3 shows the two testing moments. Of note, our algorithm, application is not overall satisfying. Despite it, we argued that
although cold-started with a small-scale of data, performs with such lightweight applications are very desirable and crucial
satisfying results; it can also recognize multiple items (see the especially for non-classroom use to integrate with the classroom-
right photo in Figure 3). based intervention for infants and younger children with autism
[Virnes et al 2015].
In summary, our feasibility and usability studies are aligned with
those in previous ones, particularly in [Liu et al 2017, Dragomir et
al 2018] that the application greatly attracts children’s attention,
which thus might promote learning at their own pace outside the
classroom.
7. REFERENCES
[1] Almeida, C., Ramires, A., & Grohman, A. (2015). STAR:
Speech Theragy with augmented reality for children with
autism Spectrum disorders. In E. I. Systems (Ed.), J.
Cordeiro, S., Hammoudi, L. Maciaszek, O. Camp, J. Filipe
(pp. 379–396). Germany: Springer.
[2] Bai, Z., Blackwell, A.F. and Coulouris, G., (2015). Using
augmented reality to elicit pretend play for children with
autism. IEEE transactions on visualization and computer
graphics, 21(5), pp.598--610.
[3] Brandão, J., Cunha, P., Vasconcelos, J., Carvalho, V., Soares,
F. 2015. An Augmented Reality GameBook for Children
with Autism Spectrum Disorders. In Proc. of ICELW 2015.
[4] Cunha, P., Brandao, J., Vasconcelos, J., Soares, F., Carvalho,
V. (2016). Augmented reality for cognitive and social skills
Fig. 4. A child is shown of the application recognizing an object improvement in children with ASD. In Remote Engineering
by the researcher. and Virtual Instrumentation (REV), 2016 13th International
Conference on (pp. 334-335). IEEE computer society:
Consistent with our speculations that the acceptability of the Whashington: USA.
application is surprisingly high, particularly for parents who
claimed that such AR-based applications are very rare in China;
67
[5] Charman, T. and Swettenham, J. (2001). Repetitive [14] Hung, Y., Chen, C., & Huang, S. (2016). Applying
behaviors and social-communicative impairments in autism: augmented reality to enhance learning: A study of different
Implications for developmental theory and diagnosis. In J.A. teaching materials. Journal of Computer Assisted Learning,
Burack, T. Charman, N. Yirmiya, & P.R. Zelazo (Eds.), The [15] Liu, R., Salisbury, J. P., Vahabzadeh, A., and Sahin, N. T.
development of autism: Perspectives from theory and (2017). Feasibility of an Autism-Focused Augmented Reality
research. Mahwah, New Jersey. Lawerence Eribaum Smartglasses System for Social Communication and
Associates. Behavioral Coaching. Frontiers in Pediatrics. 5: 145.
[6] Chen, C., Lee, I., Lin, L. (2015). Augmented reality-based [16] McMahon, D. D., Cihak, D. F., Wright, R. E., and Bell, S. M.
self-facial modeling to promote the emotional expression and (2016). Augmented Reality for Teaching Science Vocabulary
social skills of adolescents with autism spectrum disorders. to Postsecondary Education Students with Intellectual
Res. Dev. Disabil. 36, 396–403. Disabilities and Autism. Journal of Research on Technology
[7] Chi-Hsuan Chung, Chien-Hsu Chen. (2016). Augmented in Education, 48(1):38-56.
Reality Based Social Stories Training System for Promoting [17] G-Jen Hwang, Po-Han Wu, Chi-Chang Chen and Nien-Ting
the Social Skills of Children with Autism. In: Soares M., Tu. (2016). Effects of an augmented reality-based
Falcão C., Ahram T. (eds) Advances in Ergonomics educational game on students' learning achievements and
Modeling, Usability & Special Populations. Advances in attitudes in real-world observations. Interactive Learning
Intelligent Systems and Computing, vol 486. Springer, Cham. Environments, 24(8):1895-1906.
[8] Daniels, J., Schwartz, J. N., Voss, C., Haber, N., Fazel, A., [18] Su, Maw S and Haga C. (2018). Effectiveness of cognitive,
Kline, A., Washington, P., Feinstein, C., Winograd, T. & developmental, and behavioural interventions for Autism
Wall, D. P. (2018). Exploratory study examining the at-home Spectrum Disorder in preschool-aged children: A systematic
feasibility of a wearable tool for social-affective learning in review and meta-analysis. Heliyon. 4(9): e00763.
children with autism. npj Digital Medicine, volume 1, Article
number: 32. [19] Szatmari P., Bryson S.E, Boyle M.H, Streiner D.L, Duku E.
(2003). Predictors of outcome among high functioning
[9] Geraldine Dawson, Sally Rogers, Jeffrey Munson, Milani children with autism and Asperger syndrome. J Child
Smith, Jamie Winter, Jessica Greenson, Amy Donaldson, Psychol Psychiatry. 44(4):520-528.
Jennifer Varley (2010). Randomized controlled trial of the
Early Start Denver Model: A developmental behavioral [20] Tang, T. Y., and D. R, Flatla, D. R. (2016). Autism
intervention for toddlers with autism: Effects on IQ, adaptive Awareness and Technology- Based Intervention Research in
behavior, and autism diagnosis. Pediatrics. 2010. 125(1): China: the Good, the Bad, and the Challenging. Proceedings
e17-23. of Workshop on Autism and Technology - Beyond Assistance
& Intervention, in Conjunction with the CHI 2016.
[10] Dragomir, M., Manches, A., Fletcher-Watson, S. and Helen
Pain, H. (2018). Facilitating Pretend Play in Autistic [21] Virnes, M., Kärnä, E., Vellonen, V. (2015). Review of
Children: Results from an Augmented Reality App Research on Children with Autism Spectrum Disorder and
Evaluation. In Proc. of the 20th International ACM the Use of Technology. J. of Special Education Technology,
SIGACCESS Conference on Computers and Accessibility 30(1):13-27.
(ASSETS '18), Pages 407-409. [22] Lonnie Zwaigenbaum, Margaret L. Bauman, Roula Choueiri,
[11] Escobedo, L., Tentori, M., Quintana, E., Favela, J., and Connie Kasari, Alice Carter, Doreen Granpeesheh, Zoe
Garcia-Rosas, D. (2014). Using Augmented Reality to Help Mailloux, Susanne Smith Roley, Sheldon Wagner, Deborah
Children with Autism Stay Focused. IEEE Pervasive Fein, Karen Pierce, Timothy Buie, Patricia A. Davis, Craig
Computing, 13(1):38 - 46. Newschaffer, Diana Robins, Amy Wetherby, Wendy L.
Stone, Nurit Yirmiya, Annette Estes, Robin L. Hansen,
[12] French L., Kennedy E.M.M. (2018). Annual Research James C. McPartland, Marvin R. Natowicz. (2015). Early
Review: Early intervention for infants and young children intervention for children with autism spectrum disorder
with, or at-risk of, autism spectrum disorder: a systematic under 3 years of age: recommendations for practice and
review. J Child Psychol Psychiatry.59(4):444-456. research. Pediatrics, 136, S60-81. doi:10.1542/peds.2014-
[13] Gonzalo Lorenzo, Marcos Gómez-Puerta, Graciela Arráez- 3667E.
Vera, Alejandro Lorenzo-Lledó. (2018). Preliminary study of
augmented reality as an instrument for improvement of social
skills in children with autism spectrum disorder. Education
and Information Technologies (2018).
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