Background
Children with autism can have difficulty attending to social information, such as looking at people or listening to their voices. Paying attention to social information is important for the developmental of cognitive abilities, such as the ability to learn from other people, or the ability to understand other people.
Why did we do this study?
Previous research has found many benefits in the use of technology to support learning for autistic people, such as improved focus, communication, and enthusiasm. It is possible that using video games may be particularly appropriate to help autistic children learn social attention. It is our hope that by learning and practising basic social and communication skills in a safe and fun way, children will start to show these skills in real life too.
What did we do?
The Click-East project was divided into two main stages. The first stage was about developing an educational iPad app for young children with autism, and the second stage tested whether it is a successful learning aid. This second stage was a rigorously-designed randomised controlled trial, registered on both the UK Clinical Research Network study portfolio and on the National Institute of Health clinical trials register.
Stage One: completed in March 2012
The first stage of the project involved a range of different people who contributed to the development of the game in different ways. At the University of Edinburgh the project received contributions from computer programmers and human-computer interaction specialists in the School of Informatics and from animators at the Edinburgh College of Art.
We collected a lot of feedback on the game from typically-developing children, parents of children with autism spectrum disorders, teachers and nursery nurses providing specialist provision for children with autism spectrum disorders, speech and language therapists and young adults with an autism spectrum diagnosis.
Stage Two: completed in June 2013
In Stage Two we tested whether the app we designed had a beneficial effect for children with autism. Using a computer game as a learning tool plays to the strengths of children with autism, who often show a strong preference for technology and a lot of ability in this area.
54 autistic children under the age of 6 took part in the study. The social and communication skills of all the children were assessed before at the very beginning of the study to know the children’s baseline abilities. After this baseline measure, half the children were given an iPad with the video game installed, and their parents were asked to let the child play with the app for about 5 or 10 minutes every day or so for 2 months. The other half of the group was used as a comparison group and follow their usual therapies without the iPad app. The social and communication skills of all the children were assessed again 2 months and 6 months after the first baseline assessment.
What did we find?
We found that the children enjoyed playing with the app, regardless of their developmental level and their overall abilities. However, the social and communication skills of the children were not improved by the game. This means that what was learned with the game did not transfer into real-world social communication skills. This goes against our hypothesis, but it is not all bad news. This result is very informative: only relying on apps and video games may not always be an appropriate to help young autistic children develop new skills. However, as both children and parents enjoyed this new way of receiving intervention, training and support, it is worth researching further the use of games as a learning tool.
Outputs
Commercial Partnership: Interface 3
Interface 3 was our commercial partner. To give the app a life beyond the research project (both in terms of lifetime and quality of life) we engaged in a partnership with this award-winning Edinburgh based company. For more about this decision, have a look at this post on the DART Blog. Alongside the research project detailed above, Interface 3 published the app, called FindMe, for worldwide consumption. We were fortunate to be able to make the app available on iTunes for about 4 years after the project, but unfortunately operating system updates since 2018 have meant that our app is no longer commercially available.
You can find more information about the entire project on this page. You can also find here 3 newsletters that were sent to the families that took part in the project. You can find here several articles, posters, and presentations created around the project, and there a talk given by Sue.
The results were also published in peer-reviewed journals:
Fletcher-Watson, S., Pain, H., Hammond, S., Humphry, A., & McConachie, H. (2016). Designing for young children with autism spectrum disorder in health and education: a case study of an iPad app. International Journal of Child-Computer Interaction. https://doi.org/10.1016/j.ijcci.2016.03.002
Fletcher-Watson, S., Petrou, A., Scott-Barrett, J., Dicks, P., Graham, C., O’Hare, A., Pain, H., & McConachie, H. (2015). A trial of an iPad intervention targeting social communication skills in children with autism. Autism. https://doi.org/10.1177/1362361315605624
Who conducted and funded the project?
This study was conducted by Sue Fletcher-Watson (more details on this page). The project was funded by the Nuffield Foundation.
