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Systematic literature review: Games for social skills development in people

with Autism Spectrum Disorder (ASD)

Chapter · April 2023

DOI: 10.1201/9781003372486-75

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Systematic literature review: Games for social skills development in

people with Autism Spectrum Disorder (ASD)

O.D. Hutagaol, Y. Rahayu, P. Nova, M. Rafly & A. Sultani

Institut Komunikasi dan Bisnis LSPR, Jakarta, Indonesia

ABSTRACT: The use of technology, especially games in education, has recently increased,
including its use for social skills development in people with autistic spectrum disorder
(ASD). This study is designed to investigate existing and recommended evidence-based
digital games and strategies in social skills development for people with ASD through the
available published studies. This systematic literature review searched for peer-reviewed
articles published in the Sage Journal, Science Direct, and Emerald Insight databases in the
year 2018–2022 using specific keywords and phrases that covered games, ASD, and social
skills without age restriction. The end area is composed momentarily and briefly, without the
expansion of any new understandings. The consequence of the end area should answer the
goals of the issue, peculiarity, and all of the work on the exploration. The outcome ought to
sum up discoveries as opposed to giving information exhaustively.

Keywords: Systematic Review, Autism Spectrum Disorder, Games, Social Skills

1 INTRODUCTION

Autism spectrum disorder (ASD) is a complex neurological disorder with a wide range of
symptoms The DSM-5 defines a range of diagnoses that include Autistic Disorder,
Asperger’s Disorder, or Asperger Syndrome (AS). (Donald w. black & E. grant. 2013)
According to a global review of ASD prevalence, one out of every 160 children have ASD.
As of 2018, it was estimated that the global prevalence of ASD was 7.6 people per every 100-
population base (Autism, n.d.). People with ASD often have difficulty communicating,
behaving politely, making friends, and coping with conflicts. They may also struggle to
express their feelings, assertiveness, and coordinate groups. They may struggle to speak in
public. The majority of studies on autism have been focused on children who are younger
than 12 years. The general assumption is that when management and proper treatment
address ASD identified among children in this age category, disability-related challenges are
significantly reduced among the elderly. However, some of the limitations of this general
assumption are that delays in the diagnosis of ASD among children have become a major
global challenge, especially in emerging and developing countries. Current prevalence and
incidence studies among people with ASD show that the category of adolescents is a new and
emerging group that needs care and attention. In this research, although we are not limited
to the ages, we are more focused on how games could assist social skills development in
people with ASD recently and further research opportunities.

2 RESEARCH METHODS

This study uses a systematic literature review method with PRISMA flow as the search
method. Around June and July 2022, we searched Science Direct, Sage Publishing, and

DOI: 10.1201/9781003372486-75 405

Emerald Insight databases using computerized methods. In all three, searches were limited to
English-language articles published in peer-reviewed journals between the years 2018–2022
and using the following keywords: autism or ASD and games. We screened all reports,
studies, and reviews that were identified by reading the titles and abstracts. In addition, we
reviewed the reference list of studies that met the selection criteria to identify additional
inclusion studies (Bono et al. 2016).

Figure 1. PRISMA flow diagram of the searched method used in this study.

3 RESULTS AND DISCUSSION

Table 1 sums up the principal qualities of the seven games that target general interactive
abilities. The use of information correspondence progresses (ICTs) in treatment gives new
perspectives for treating individuals with synthetic unevenness range issues (ASD) because
they can be used in different ways and settings and they are charming to the patients. For
getting ready on intelligent capacities, serious games are very uplifting. They can be used to
plan different capacities and can lean toward correspondences in arranged settings and
conditions, some of which seem to be reality. In any case, the current open serious games
present a couple of cut-off points concerning the confirmation of their clinical benefits. It by
and by appears to be vital to check the ampleness of ICTs and the use of serious games for
remediation through extra generous assessments concerning method (immense models,
control social occasions, longer treatment periods, and follow-up to assess whether changes
stay stable). We in like manner need to zero in more diligently on blueprint and cultivate a
specific framework for this kind of serious game to propose games that test and interface
with the patients. Additionally, we really need to encourage more serious games that are
acclimated to LFASD individuals and that rely upon late advances in enrolling systems that
can normally answer client input. The current status of the workmanship has put a great deal
of emphasis on the specific capacities associated with feeling affirmation in faces. Later,
researchers should similarly progress various subsets of abilities that are critical for non-
verbal social correspondence like joining thoughts or movements. Features that depict
mental working in ASD should moreover be thought of. Taking into account that

406
Table 1. Selected research articles related to games for social skills development in people with ASD.
No Article Details
1. Title: Online gaming, loneliness, and friend-
ships among adolescents and adults with ASD
(Sundberg 2018).
Participants: A total of 85 people with ASD
between 14 and 69 years old
Social Skills: Making & maintaining friends
Assessment Tools: (1) Motives for Online
gaming questionnaire (2) UCLA Loneliness
scale (3) Unidimensional Relationship
Closeness Scale
Game Type: Online game
2. Title: Dynamic difficulty adjustment
technique-based mobile vocabulary learning
game for children with an autism spectrum
disorder (Shohieb et al. 2022)
Participants: Seven children with ASD between
5 and 10 years old
Social Skills Communication & Assertiveness
Assessment Tools: (1) Pre-study & Post-Study
User Interviews (2) Engagement Assessment
and Usability Evaluation of Pickstar
Game Type: Pickstar, Mobile Game with
Dynamic Difficulty Adjustment (DDA)
3. Title: A pilot study on evaluating children with
autism spectrum disorder using computer
games. (Chen et al. 2019)
Participants: Ninety-one children (40 ASD &
51 TD was compared) between 2 and 6
years old
Social Skills: Communication
Assessment Tools: Analysis of differences using
t-tests
Game Type Computer-based game
4. Title: Does playing on a digital tablet impact
the social interactions of children with autism
spectrum disorder? (Paquet et al. 2022)
Participants Four children between 3 and 5
years old and four young people between 14
and 20 years old.
Social Skills: Social relations, communication,
and restricted behaviors
Assessment Tools: Behavioral observation with
nonparametric tests and Wilcoxon test
Game Type: Memory Card game & Snakes and
Ladders Digital & Physical game.
407
Outcome and Findings
Outcome Measures: Connection to friendships
and loneliness among teenagers and adults
with ASD
Findings: People with ASD who play online
games have a significant increase in the num-
ber of friends they have. Online games can
provide a platform for people with ASD to
make new friendships and maintain
existing ones.
Outcome Measures: A of educational and
therapeutic methods for ASD and to mitigate
caregivers’ problems in accessing educational
materials
Findings Pickstar with DDA can be used with
minimal guidance to improve the vocabulary
skills of individuals with ASD & can mitigate
caregiver problems in accessing good-quality,
engaging, and affordable education for their
children.
Outcome Measures: Children with ASD and
TD children in the development fields of joint
attention, ToM, visual search skills, fine motor
skills, cognitive understanding, and
classification
Findings: In general, most of the children with
ASD have lower development levels than the
TD children with significant differences. But
ASD group sometimes performed better than
the TD group (in terms of raw scores) on
several tasks.
Computer games have great potential as sup-
port, evaluation, or intervention tools in the
field of special education with appropriate
support.
Outcome Measures: Test the effect of tablets on
social interactions in a multiplayer game
situation involving children with ASD.
Findings: Tablets did not improve social inter-
action. However, sharing a game with others
seemed to contribute to the development of
interactive behaviors.
(continued )
Table 1. Continued

No Article Details Outcome and Findings

5. Title: Co-Op World: Adaptive computer game
for supporting child psychotherapy (Alkalay
et al. 2020)
Participants: Four cases with different age
groups of Children ranging in age from 7 to 10.
Social Skills: Social interaction and
communication
Assessment Tools: Evaluating each case at a
different type of level.
Game Type Virtual game players, and
Co-Op World
Outcome Measures: Evaluation of the Co-Op
World game during therapy for ASD children.
Findings: The game has great potential in
therapy. Reveal high acceptance of the game
by the users and demonstrate various beha-
vioral strategies adopted by the children. By
using the game, the therapists were able to hold
discussions with the children about their moti-
vations to expand their learning about their
real-life
social interactions.

6. Title: Supporting Youth With Autism
Learning Social
Competence: A Comparison of Game- and
Nongame-Based Activities in 3D Virtual
World. (Wang & Xing 2021)
Participants: Eleven adolescents with ASD
between 10 and 13 years old
Social Skills: Social interaction
Assessment Tools: (1) A learning analytics
approach—association rule mining, (2) Autism
Diagnostic Interview-Revised, (3) Autism
Diagnostic Observation Schedule Game Type:
Game-Based Learning in 3D Collaborative
Virtual World
Outcome Measures: Compared the social
interactions of 11 adolescents with ASD in
game-and non-game-based 3D collaborative
learning activities in the same social compe-
tence training curriculum.
Findings: Co-occurrence of verbal and non-
verbal behaviors is much stronger in game-
based learning activities. The game activities
also yielded more diverse social interaction
behavior patterns. the affordance of serious
game-based collaborative virtual learning
activities has a significant influence on lear-
ners’ social interactions.

7. Title MEDIUS: A Serious Game for Autistic
Children Based on Decision System (Daouadji
Amina & Fatima 2018)
Participants: Ten children with ASD between 5
and 13 years old
Social Skills: Consistency make decision &
facial expression
Assessment Tools: Picture Exchange
Communication System “PECS” and Applied
Behavior Analysis “ABA”
Game Type: Medius. PECS Game-Based
Outcome Measures: Realize a serious game
called “Medius” based on criteria of decision
support to present a new mean of commu-
nication between the tutor and the autistic
child in the form of a playful serious game, and
in a purely educational frame.
Findings: This work is very useful for a targeted
apprenticeship and personalized to each player
(autistic child) and also represents a mean of
communication between the tutor and the
autistic child seeing the difficulty of the
exchanges of information and the commu-
nication which reign in the world of the chil-
dren affected by the pervasive developmental
disorders “PDD”

individuals with ASD are every now and again paid all due respects to be visual driving
forces, future assessments ought to seek full advantage of the entryways dealing with the
expense of visual depictions intrinsic to serious games. The general hunt system yielded a
sum of 868 articles. These were every one of the articles that were caught utilizing the dif-
ferent watchwords and expressions listed in the procedure area.

408
 4 CONCLUSIONS

We found a total of seven research articles related to games for social skills development in
people with ASD as shown in Table 1. The end area is composed momentarily and briefly,
without the expansion of any new understandings. The consequence of the end area should
obviously answer the goals of the issue, peculiarity, and all of the work on the exploration.
The outcome ought, to sum up (logical) discoveries as opposed to giving information
exhaustively. Talk about the discoveries according to the hypothesis or the aftereffects of
past examinations, so science can keep on creating. This part can likewise record the curi-
osity of the examination, the benefits and hindrances of the exploration, as well as proposals
for additional examination. Technology, especially games, can help improve social skills in
people with autism, although its significance still needs to be investigated further. The types
of devices, features, interactions, and stimuli used need to be considered and adapted to the
characteristics of people with ASD such as the use of dynamic difficulty adjustment and
virtual characters. Technology or games in specific, can help improve social skills in people
with autism although its significance needs to be investigated further. The types of devices,
features, interactions, and stimuli used need to be considered and adapted to the character-
istics of people with ASD such as the use of Dynamic difficulty adjustment and virtual
characters. Further research related to the same research in adults and focusing on the types
of devices, features, interactions, and stimuli is highly recommended.

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