Document Type : Original/Review Paper


Faculty of Computer Engineering, Shahrood University of Technology, Shahrood, Iran.



Autism spectrum disorder (ASD) is a collection of inconstant characteristics. Anomalies in reciprocal social communications and disabilities in perceiving communication patterns characterize These features. Also, exclusive repeated interests and actions identify ASD. Computer games have affirmative effects on autistic children. Serious games have been widely used to elevate the ability to communicate with other individuals in these children. In this paper, we propose an adaptive serious game to rate the social skills of autistic children. The proposed serious game employs a reinforcement learning mechanism to learn such ratings adaptively for the players. It uses fuzzy logic to estimate the communication skills of autistic children. The game adapts itself to the level of the child with autism. For that matter, it uses an intelligent agent to tune the challenges through playtime. To dynamically evaluate the communication skills of these children, the game challenges may grow harder based on the development of a child's skills through playtime. We also employ fuzzy logic to estimate the playing abilities of the player periodically. Fifteen autistic children participated in experiments to evaluate the presented serious game. The experimental results show that the proposed method is effective in the communication skill of autistic children.


Main Subjects

[1] F. Zeidán-Chuliá, J. L. Rybarczyk-Filho, A. B. Salmina, B. N. De Oliveira, M. Noda, and J. C. F. Moreira, “Exploring the multifactorial nature of autism through computational systems biology: calcium and the Rho GTPase RAC1 under the spotlight,” Neuromolecular Medicine, vol. 15, No. 2, pp. 364-383, 2013.
[2] V. Khullar, H.P. Singh, and M. Bala, “Meltdown/Tantrum Detection System for Individuals with Autism Spectrum Disorder,” Applied Artificial Intelligence, vol. 35. No. 15, pp.1708-1732, 2021.
[3] M. Elsabbagh, E. Mercure, K. Hudry, S. Chandler, G. Pasco, I. Charman, A. Pickles, S. Baron-Cohen, P. Bolton, and M. H. Johnson, “Infant neural sensitivity to dynamic eye gaze is associated with later emerging autism,” Current Biology, vol. 22, No. 4, pp. 338-342, 2012.
[4] D. L. Christensen, J. Baio, K. V. N. Braun, D. Bilder, J. Charles, J. N. Constantino, J. Daniels, M. S. Durkin, R. T. Fitzgerald, M. Kurzius-Spencer, Li-Ching Lee, S. Pettygrove, C. Robinson, E. Schulz, C. Wells, M. S. Wingate, W. Zahorodny, and M. Yeargin-Allsopp, “Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years,” Surveillance Summaries, vol. 65, No.3, pp. 1-28, 2016.
[5] J. A. Worley and J. L. Matson, “comparing symptoms of autism spectrum disorders using the current DSM-IV-TR diagnostic criteria and the proposed DSM-V diagnostic criteria,” Research in Autism Spectrum Disorders, vol. 6, No. 2, pp. 965-970, 2012.
[6] H. Sharif and R.A. Khan, “A novel machine learning based framework for detection of autism spectrum disorder (ASD),” Applied Artificial Intelligence, vol. 36, No.1, 2022.
[7] G. Mascheroni, S. Livingstone, M. Dreier, and S. Chaudron, “Learning versus play or learning through play? How parent’s imaginaries, discourses and practices around ICTs shape children’s (digital) literacy practices,” Media Education, vol. 7, No. 2, pp. 261-280, 2016.
[8] I. Giannopulu, T. Kazunori, and W. Tomio, “Communication using robots: a Perception-action scenario in moderate ASD,” Journal of Experimental & Theoretical Artificial Intelligence, vol. 30, No. 5 pp. 603-613, 2018.
[9] S. Cankaya and A. Kuzu, “Investigating the characteristics of educational computer games developed for children with autism: a project proposal,” Procedia-Social and Behavioral Sciences, vol. 9, pp. 825-830, 2010.
[10] S. M. Rao and B. Gagie, “Learning through seeing and doing visual supports for children with autism,” teaching Exceptional Children, vol. 38, No. 6, pp. 26-33, 2006.
[11] T.Y. Tang, M. Falzarano, and P.A. Morreale, “Assessment of the utility of gesture-based applications for the engagement of Chinese children with autism,” Universal Access in the Information Society, vol. 17, No. 2, pp.275-290, 2018.
[12] E. S. Kim, L. D. Berkovits, E. P. Bernier, D. Leyzberg, F. Shic, R. Paul, and B. Scassellati, “Social robots as embedded reinforcers of social behavior in children with autism,” Journal of autism and developmental disorders, vol. 43, No. 5, pp. 1038-1049, 2013.
[13] J. Lozano Martinez, F. 1. Ballesta Pagon, and S. Alcaraz Garcia, “software for teaching emotions to students with autism spectrum disorder,” Revista Comunicar, vol. 18, No. 36, pp. 139-148, 2011.
[14] Y. Ohtake, M. Wehmeyer, N. Uchida, A. Nakaya, and M. Yanagihara, “Enabling a Paralinguistic Communicator with Autism to Use Picture Card as a Strategy for Repairing Listener Misunderstandings: A Case Study,” Education and training in Autism and developmental disabilities, vol. 45, No. 3, pp. 410-421, 2010.
[15] B. H. Srensen and B. Meyer, “Serious games in language learning and teaching a theoretical perspective,” in Proceedings of the third International Conference of the Digital Games Research Association, 2007, pp. 559-566.
[16] Z. Urturi, A. Zorrilla, and B. Zapirain, “A serious game for android devices to help educate individuals with autism on basic first aid,” in The 16th International Conference on Computer Games., Louisville., KY., 2012, pp. 609-616.
[17] Fakhoury M, “Autistic spectrum disorders: A review of clinical features, theories and diagnosis,” International Journal of Developmental Neuroscience, vol. 43, pp. 70-77, 2015.
[18] M.S. Zubair, D.J. Brown, T. Hughes-Roberts, and M. Bates, “Designing accessible visual programming tools for children with autism spectrum condition,” Universal Access in the Information Society, vol 22, pp.277-296, 2023.
[19] B. Roehr, “American psychiatric association explains dsm-5,” BMJ, vol. 346, 2013.
[20] D. V. Keen, F. D. Reid, and D. Arnone, “Autism, ethnicity and maternal immigration,” The British Journal of Psychiatry, vol. 196, No. 4, pp. 274-281, 2010.
[21] H. A. M. Noor, F. Shahbodin, and N. C. Pee, “Serious game for autism children: Review of literature,” World Academy of Science, Engineering and Technology, vol. 6, No. 4, pp. 588-593, 2012.
[22] D. Arellano, R. Rauh, B. Krautheim, M. Spicker, U.M. Schaller, V. Helzle, and O. Deussen, “Interactive testbed for research in autism—the SARA project,” Universal Access in the Information Society, vol. 17, No. 1, pp. 21-36, 2018.
[23] G. Khayat, T. Mabrouk, and A. Elmaghraby, “Intelligent serious games system for children with learning disabilities,” in The 17th International Conference on Computer Games (CGAMES)., 2012, pp. 30–34.
[24] A. Elmaghraby, A. Mendez, B. Garcia Zapirain, W. Sheta, and S. el Shehaby, “Serious games and health informatics: A unified framework,” in The 17th International Conference on Computer Games (CGAMES)., 2012, pp. 35–38.
[25] N. A. Bartolome, A. M. Zorrilla, and B. G. Zapirain, “Autism Spectrum Disorder children interaction skills measurement using computer games,” in The 18th International Conference on Computer Games., Louisville., KY., 2013.
[26] Yi Li and A. S. Elmaghraby, “A Framework for using Games for Behavioral Analysis of Autistic Children,” in The 19th International Conference on Computer Games., Louisville., KY., 2014.
[27] E. T. Bekele, U. Lahiri, A. R. Swanson, J. A. Crittendon, Z. E. Warren, and N. Sarkar, “A step towards developing adaptive robot-mediated intervention architecture (aria) for children with autism,” IEEE transactions on neural systems and rehabilitation engineering: a publication of the IEEE Engineering in Medicine and Biology Society, vol. 21, No. 2, pp. 289-299 , 2013.
[28] A. Wojciechowski and R. Al-Musawi, “Assistive technology application for enhancing social and language skills of young children with autism,” Multimedia Tools and Applications, vol. 76, pp. 5419–5439, 2017.
[29] G. F. M. Silva-Calpa, A. B. Raposo, and M. Suplino, “CoASD: A tabletop game to support the collaborative work of users with autism spectrum disorder,” in 2018 IEEE 6th International Conference on Serious Games and Applications for Health (SeGAH)., Vienna., 2018, pp. 1-8.
[30] M. Sundberg, “Online gaming, loneliness and friendships among adolescents and adults with ASD,” Computers in Human Behavior, vol. 79, No. 1, pp. 105-110, 2018. 
[31] A. Covaci, G. Ghinea, C. Lin et al., ”Multisensory games-based learning - lessons learnt from olfactory enhancement of a digital board game,” Multimedia Tools and Applications, vol. 77, pp. 21245–21263, 2018.
[32] J. Mercado, I. Espinosa-Curiel, and L. Escobedo et al.,”Developing and evaluating a BCI video game for neurofeedback training: the case of autism,” Multimedia Tools and Applications, vol. 78, pp. 13675–13712, 2019.
[33] J. S.Y. Tang, N.T.M. Chen, M. Falkmer, S. Bӧlte, and S.  Girdler “A systematic review and meta-analysis of social emotional computer-based interventions for autistic individuals using the serious game framework,” Research in Autism Spectrum Disorders, vol. 66, No. 1, pp. 1-32, 2019. 
[34] K. Caro, A.I Martínez-García, and S. Kurniawan, “A performance comparison between exergames designed for individuals with autism spectrum disorder and commercially-available exergames,” Multimedia Tools and Applications, vol. 79, pp. 33623–33655, 2020.
[35] S. K. Jarraya, M. Masmoudi, and M. Hammami, “A comparative study of Autistic Children emotion recognition based on patio-Temporal and Deep analysis of facial expressions features during a Meltdown Crisis,” Multimedia Tools and Applications, vol. 80, pp. 83–125, 2021.
[36] Y. A. Sekhavat and H. Zarei: “Dynamic Difficulty Adjustment of Rehabilitation Games using Reinforcement Learning,” Tabriz Journal of Electrical Engineering, vol. 48, No. 1, pp. 61-70, 2018.
[37] A. H. Khabbaz, A. A. Pouyan, M. Fateh, and V. Abolghasemi, “An adaptive RL-based fuzzy game for autistic children,” in 2017 Artificial Intelligence and Signal Processing Conference (AISP)., Shiraz., 2017, pp. 47-52.
[38] A. H. Khabbaz, A. A. Pouyan, M. Fateh, and V. Abolghasemi, “An Adaptive Learning Game for Autistic Children using Reinforcement Learning and Fuzzy Logic,” Journal of AI and Data Mining, vol.7, No. 2, pp. 321-329, 2019. 
[39] P. Massoudi and A. H. Fassihi: “Achieving Dynamic AI Difficulty by Using Reinforcement Learning and Fuzzy Logic Skill Metering,” in 2013 IEEE International Games Innovation Conference (IGIC)., 2013, pp. 163-168.
[40] R. S. Sutton, A. G. Barto, Reinforcement learning: an introduction, MIT Press, 1998.