Fostering socio-emotional competencies in children on the autism spectrum using a parent-assisted serious game: A multicenter randomized controlled trial.

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 460 words

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Keywords Empathy; Emotion recognition; Autism; Children; Intervention; Technology; Serious game Highlights * Parent-assisted serious game for children on the autism spectrum tested in 6-week multicenter RCT. * Training effects post-treatment for empathy and emotion recognition. * Moderate effects on emotional awareness and emotion regulation also at 3-months follow-up. * Autism social symptomatology improved in short- and mid-term assessment. * High treatment satisfaction, acceptance, and training transfer in parental report. Abstract Objective Serious games are a promising means of fostering socio-emotional skills in children on the autism spectrum (AS). However, empathy and related constructs have not yet been addressed comprehensively and together with emotion recognition, and there is a lack of randomized controlled trials (RCT) to investigate skill maintenance and the transfer to functional behavior. Method The manualized, parent-assisted serious game Zirkus Empathico (ZE) was tested against an active control group, in a six-week multicenter RCT. Eighty-two children aged 5--10 years on the AS were assessed at baseline, post-treatment, and three-month follow-up. Empathy and emotion recognition skills were defined as the primary outcomes. The secondary outcomes included measures of emotional awareness, emotion regulation, autism social symptomatology (Social Responsiveness Scale), and subjective therapy goals. Results Training effects were observed after the intervention for empathy (d = 0.71) and emotion recognition (d = 0.50), but not at follow-up. Moderate effects on emotional awareness, emotion regulation, and autism social symptomatology were indicated by the short and mid-term assessments. Parents reported treatment goal attainment and positive training transfer. Conclusion While a six-week training with ZE failed to induce lasting changes in empathy and emotion recognition, it may be effective for improving emotional awareness and emotion regulation, and mitigate general autism symptomatology. Clinical trial registration information Zirkus Empathico -- Promoting socioemotional competencies in 5- to 10-year-old children with autism spectrum conditions using a computer-based training program;; DRKS-ID: DRKS00009337; Universal Trial Number (UTN): U1111-1175-5451. Abbreviations AS, autism spectrum; RCT, randomized controlled trial; ZE, Zirkus Empathico Author Affiliation: (a) Clinical Psychology of Social Interaction, Berlin School of Mind and Brain, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany (b) Department of Child and Adolescent Medicine, Medical University of Vienna, Vienna, Austria (c) Department of Child and Adolescent Psychiatry and Psychotherapy, Josefinum Augsburg, Augsburg, Germany (d) Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany (e) Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine, Georg-August Universität Göttingen, Göttingen, Germany (f) Psychological Diagnostics, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany * Corresponding author. Article History: Received 8 October 2020; Revised 9 February 2022; Accepted 24 February 2022 Byline: Simone Kirst [] (a,*), Robert Diehm [] (b), Katharina Bögl [] (a), Sabine Wilde-Etzold [] (c), Christiane Bach [] (d), Michele Noterdaeme [] (c), Luise Poustka [] (e), Matthias Ziegler [] (f), Isabel Dziobek [] (a)

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Gale Document Number: GALE|A699667854