Children with autism demonstrate social skill deficits that often include difficulty recognizing emotions. Differences in recognizing faces can be observed in infants as young as 3 months old, and infants typically begin to recognize emotional expressions at 6 months old. Recognizing emotions is important for responding to social cues and also for recognizing and regulating one’s own emotions. Hence, a common aspect of early behavioral therapy for children with autism includes practicing emotion recognition.
While early behavioral therapy has shown to drastically improve outcomes for children with autism, many families experience difficulty getting access to therapy due to long wait times after a diagnosis and/or living far away from a site or clinician that provides these interventions. In an effort to make aspects of therapy more accessible, our team at Stanford developed a smartphone app that incorporates common elements of therapy. Our app was designed to deliver a fun game-based intervention while collecting data useful for measuring progress and outcomes from the comfort of home. To see if this app can help children improve emotion recognition and social skills, we are conducting a randomized controlled trial among children with autism 3-12 years old. Read more about the app and study below!
The app we designed is for Android and iPhone smartphone users. To play, the parent/guardian holds the phone on their forehead with the phone screen facing the child and displaying an image based prompt ( i.e. Dinosaur, Happy face, Skier, etc.) for the child to act out and for the parent to guess (similar to the game Heads Up! or HedBanz).
The entire charades play session is audio and video recorded by the phone’s front camera and at the end of a single 90 second session, users (parents) are asked to share or delete the video. Sharing the video sends the encrypted video securely to Stanford servers so that it can be analyzed by our research team.
What is involved in the study and what we expect to find: Parents who enroll in the study will be asked to complete 2 questionnaires online. At the end of the questionnaires, parent and child will complete a task where the child is asked to label different animated GIFs with an emotional label (happy, sad, angry, etc.).
After completing these tasks, the study team will randomly assign families to one of two groups. This means that half of participating families will be asked to download and play the app for 4 weeks, and the other half of families will wait to download the app until week 8. Both groups will repeat additional questionnaires at week 4 and week 8.
All participants will receive a $50 gift card for participating in the study for 4 weeks and an additional $20 for completing the additional questionnaires after 8 weeks of being in the study.
We expect to see greater improvements in social skills as measured by the Vineland Adaptive Behavior Scale, among participants who use the app for the 4 weeks compared to those who are waiting to use the app.
We hope the study will show that (1) this smartphone, game based intervention delivered by a parent can be just as effective as traditional therapy, and that (2) the smartphone game system can produce data for measuring progress and speed up traditional assessment procedures for diagnosis and service eligibility screening.
What can happen if the study works – will it be available commercially? In schools? If the study works, we plan to find ways to make the app available commercially. This could be accomplished by seeking FDA approval of the app so it can become an insurance reimbursed product or service, licensing the app to schools so they can use the app during daily programming, and/or make the app available on the Apple or Google Play store!
Interested in joining?
Start by completing the initial questionnaire at: guesswhatstudy.stanford.edu
ClinicalTrials.gov Registration: NCT04739982
Lab Website: https://wall-lab.stanford.edu