Vallefuoco, Ersilia (2020) A personalised serious game to improve daily living skills in people with Autism Spectrum Disorder. [Tesi di dottorato]

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Item Type: Tesi di dottorato
Lingua: English
Title: A personalised serious game to improve daily living skills in people with Autism Spectrum Disorder
Creators:
CreatorsEmail
Vallefuoco, Ersiliaersilia.vallefuoco@unina.it
Date: 11 March 2020
Number of Pages: 147
Institution: Università degli Studi di Napoli Federico II
Department: Ingegneria Elettrica e delle Tecnologie dell'Informazione
Dottorato: Information technology and electrical engineering
Ciclo di dottorato: 32
Coordinatore del Corso di dottorato:
nomeemail
Riccio, Danieledaniele.riccio@unina.it
Tutor:
nomeemail
Pepino, AlessandroUNSPECIFIED
Date: 11 March 2020
Number of Pages: 147
Uncontrolled Keywords: serious game; autism;simulation;rehabilitation engineering
Settori scientifico-disciplinari del MIUR: Area 09 - Ingegneria industriale e dell'informazione > ING-INF/06 - Bioingegneria elettronica e informatica
Date Deposited: 05 Apr 2020 14:46
Last Modified: 10 Nov 2021 10:00
URI: http://www.fedoa.unina.it/id/eprint/13068

Abstract

Autism Spectrum Disorder (ASD) includes a set of neurodevelopmental chronic disorders characterised by two main categories of symptoms: deficits in social communication and social interaction; restricted patterns of behaviours. The degree of impairment in these two domains can change radically among individuals and ASD is often associated with intellectual disability, psychiatric impairments, and other kinds of comorbidities, hence the high heterogeneity in the clinical presentation of ASD. ASD symptoms appear in early childhood but generally persist throughout life, so ASD is considered a lifelong disorder. As shown in several studies, technology-based interventions such as serious games (SGs) represent an innovative tool to support children and adults with ASD. Serious games motivate the player and facilitate the learning of skills and the training of actions and behaviours that can then be transferred to real life. However, SGs aimed at people with ASD show several limits; in particular, SGs often fail to consider the heterogeneity of the disorder and the different functioning profiles of individuals with ASD, they present a restricted range of topics and genres, and above all, their assessment proves little evidence of skill generalisation from the virtual world to real-life contexts. These limitations do not aid the spread of serious games in rehabilitation contexts and increase the gap between research and practice. The aim of the present thesis is to investigate new methodologies and techniques to improve autonomy in people with ASD through a personalised serious game. More specifically, a rehabilitation SG-based intervention for people with ASD was carried out for enhancing skills related to a specific daily living activity: shopping in a supermarket. The underlying hypothesis of this study is that training with an individualised serious game can improve the learning and generalisation of trained skills in a real-life environment. In order to prove this hypothesis, a sample of ten subjects with ASD, aged between 8 and 16 years, played with a personalised serious game, ShopAut, for ten sessions, one per week, for no more than 30 minutes. Before the training with ShopAut, a real-life experience was observed to evaluate the participants’ performance in a real supermarket. After the training with ShopAut, a second real-life experience was carried out to assess the improvements achieved by the participants. This study involved a multidisciplinary team, namely a biomedical engineer, a neuropsychiatrist, a psychologist, neuro and psychomotor therapists, speech therapists, and occupational therapists. The team planned and coordinated the rehabilitation intervention, designed the SG analyzing the personalized elements that had to be implemented in the game, and assessed and validated the effectiveness of the intervention. The serious game ShopAut was developed integrating an individualised design that provides both the personalisation of the game’s scenario, contents, difficulty, and user interface; and the customisation of game modes, player perspectives, and input devices. It is a three-dimensional game conceptually based on classic 3D life simulation games and provides a realistic shopping experience where the player can practice and engage with, above all, shopping activities, experiment their problem-solving skills, and take on unexpected events. For the assessment of pre- and post-training, an ad hoc form based on the International Classification of Functioning, Disability and Health: children and youth version (ICF-CY) was used to evaluate the participants’ functioning in the supermarket, and a clinical standardised scale, Vineland Adaptive Behavior Scale II (VABS-II), was adopted to measure the ability of the participants to perform daily activities. Moreover, the game performances of the participants were analysed over the game sessions. The personalised design allowed us to individualise the game experience, improving gameplay, playability, and usability, and consequently the learning outcome. Participants found our SG enjoyable and engaging. The results from the real-life experiences show a significant improvement in the real-life performance of the participants, especially in the main skills trained with ShopAut. More specifically, the training helped the participants to maintain their attention on specific actions, to improve problem-solving and orientation skills, and above all to enhance their ability in the shopping activity. Improvements were also proved by positive scores on the VABS-II scales, especially in daily living skills. Overall, the current study provides good evidence for the use of personalised SGs in interventions for children and teens with ASD. In particular, the results suggest that personalised SGs can effectively support rehabilitation interventions for people with ASD to improve generalisation process and autonomy.

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