Abstract
Autism Spectrum Disorder (ASD) affects 1 in 54 children in the United States. A core social communication skill negatively impacted by ASD is joint attention (JA), which influences the development of language, cognitive, and social skills from infancy onward. Although several technology-based JA studies have shown potential, they primarily focus on response to joint attention (RJA). The other important component of JA, the initiation of joint attention (IJA), has received less attention from a technology-based intervention perspective. In this work, we present an immersive Computer-mediated Caregiver-Child Interaction (C3I) system to help children with ASD practice IJA skills. C3I is a novel computerized intervention system that integrates a caregiver in the teaching loop, thereby preserving the advantages of both human and computer-administered intervention. A feasibility study with 6 dyads (caregiver-child with ASD) was conducted. A near significant increase with medium effect size on IJA performance was observed. Meanwhile, physiology-based stress analysis showed that C3I did not increase stress of the caregivers over the course of the study. To the best of our knowledge, this is the first autonomous system designed for teaching IJA skills to children with ASD incorporating caregivers within the loop to enhance the potential for generalization in real-world.
Highlights
Autism Spectrum Disorders (ASD) are characterized by difficulties in social communication and repetitive or restricted behaviors and interests [1]
A core social communication symptom of early childhood that is commonly targeted during treatment is deficits in joint attention (JA), which is defined as shared attention with others through pointing [5][6], showing, and coordinated looks between objects and people [7]
Eye-tracking studies have shown that Initiation of joint attention (IJA) contains more discriminative information to distinguish ASD from typically developing (TD) children, as their gaze patterns are different when they are expected to initiate joint attention and not when they respond to joint attention [10]
Summary
Autism Spectrum Disorders (ASD) are characterized by difficulties in social communication and repetitive or restricted behaviors and interests [1]. Collaborative virtual environments [38], [39] have been explored, where children with ASD learn skills though cooperating with other children to accomplish tasks These systems were not designed for caregiver-child interaction. We present an immersive computer-mediated system designed for caregiver-child interaction, with an explicit interaction protocol, aiming to improve IJA skill for young children with ASD. We anticipated that within this immersive system environment, an explicitly defined interaction protocol, an intuitive system assistance to evoke, guide and reinforce children’s social behaviors, and an consistent, quantitative tracking of IJA performance would promote children’s social skills and would not increase the stress of caregivers during interaction. The remainder of this paper is organized as follows: system design details are presented in Section II; a feasibility study is presented in Section III; Section IV presents and discusses the experimental results, and Section V summarizes the contributions and discusses future work
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