Using Serious Game Technology to Improve Sensitivity to Eye Gaze in Autism

项目摘要 社交行为障碍是自闭症的主要症状。最受影响的两种行为 包括对面部视觉注意力和理解眼睛凝视如何提供重要信息的能力 关于他人的行为和意图。一种理论认为，面部处理的神经系统是 从根本上妥协了。然而，我们最近的脑成像发现表明，在 这些神经系统对动物面部的正常反应，表明它们没有受到损害，但 在自闭症中可能会有不同的调谐。因此，我们假设在学习过程中存在早期中断 导致这种调谐模式改变的环境，这种干扰反映在注意力的减少上 面对面孔，更多地关注非社会刺激。长期的后果是自闭症患者 可能从来没有了解过面部社交信号的功能意义，比如眼睛凝视的暗示。 我们假设有可能重新调整面部处理系统和社交表情行为 通过使用有效的方法鼓励个人将视觉注意力集中在面孔和 发现眼睛凝视暗示的功能意义。反过来，这可能会开始治疗自闭症的症状和 改善社会功能。我们建议开发和测试一种针对自闭症青少年的干预措施 采用基于证据的“严肃游戏”原则(例如，故事情节、长期目标、攀登难度)。 “严肃游戏”是一种独特的干预工具，可以促进学习困难技能，目标是提高技能。 现实世界的结果。我们的干预游戏旨在帮助人们在学习集中注意力的同时 在叙事故事情节的背景下，解读动画人物的眼睛凝视暗示。参与者 必须发现，眼睛凝视的暗示对引导自己的目标导向行为解决问题很有用 在比赛中。这模拟了社交信息线索在现实世界中被发现和使用的方式， 因此，更有可能对现实世界的行为一概而论。 我们提出了一项分两个阶段的探索性研究来测试这种干预。在R61阶段，我们将利用行为 以及眼球跟踪方法，以检查测试前后目标机制的变化(关注人脸 玩干预游戏的青少年对眼睛注视暗示的敏感性)。在R33阶段，我们将 进行小规模随机对照试验，将干预游戏与主动控制游戏进行比较，以评估结果 多个时间点(前、后、6个月跟踪)，并评估在广泛范围内的改善 行为，从受控的基于实验室的任务到不受控制的真实世界社交互动。我们的目标是 评估1)目标机制的变化，2)改善面孔处理行为和真实世界的社交 沟通行为；3)目标机制参与与症状的关系 结果。这些目标代表了基于计算机的RCT设计的重大创新 对自闭症的干预，并为广泛和廉价的传播带来了巨大的希望。

Project Summary Impairments in social communicative behaviors are primary in autism. Two of the most affected behaviors include visual attention to faces and the ability to understand how eye gaze provides important information about the actions and intentions of others. One theory is that the neural systems for face processing are fundamentally compromised. However, our recent brain imaging findings suggest that there are contexts in which these neural systems respond normally to animal faces, indicating that they are not compromised, but likely tuned differently in autism. As a result, we hypothesize that there is an early disruption in the learning environment that leads to this altered pattern of tuning and that this disruption is reflected by reduced attention to faces and more attention to non-social stimuli. The long-term consequence is that individuals with autism may never have learned about the functional significance of social signals from the face, like eye gaze cues. We hypothesize that it may be possible to re-tune the face processing system and social looking behaviors in autism by employing effective methods for encouraging individuals to focus visual attention on faces and discover the functional significance of eye gaze cues. In turn, this may begin to treat symptoms of autism and improve social functioning. We propose to develop and test an intervention for adolescents with autism that employs evidence-based “serious game” principles (e.g., storylines, long-term goals, scaling difficulty). “Serious games” are unique intervention tools that foster learning of difficult skills, with the goal of improving real-world outcomes. Our intervention game is designed to scaffold learning to focus attention on faces while interpreting eye gaze cues from animated human characters in the context of a narrative storyline. Participants have to discover that eye gaze cues are useful for guiding their own goal-directed behavior to solve problems in the game. This simulates the way social information cues are discovered and used in the real world and, therefore, is more likely to generalize to real-world behavior. We propose a two-stage exploratory study to test this intervention. In the R61 phase, we will utilize behavioral and eye-tracking methods to examine pre- to post-test changes on our target mechanisms (attention to faces and sensitivity to eye gaze cues) in adolescents who play the intervention game. In the R33 phase, we will conduct a small-scale RCT comparing the intervention game to an active control game to assess outcomes at multiple time points (pre-, post-, 6-month follow-up), and to evaluate improvements in a wide range of behaviors, from controlled lab-based tasks to uncontrolled, real-world social interactions. Our aims are evaluating 1) changes in the target mechanisms, 2) improved face-processing behaviors and real-world social communication behaviors, and 3) the relation between engagement of the target mechanisms and symptom outcomes. These goals represent significant innovation in the design of RCTs for computer-based interventions for autism, and hold tremendous promise for widespread and inexpensive dissemination.