Serious games are a form of digital medicine (a.k.a. digital therapeutics) which incorporates game-like elements (e.g., points, achievements, levelling-up) into Internet- or app-based treatments to increase interest, enjoyment, motivation, and adherence [Ref 1-3]. Within the past few years, the clinical effectiveness of serious games has been scientifically evaluated, particularly in relation to mental health and psychosocial outcomes, demonstrating small but consistently positive effects in line with many pharmaceutical treatments [Ref 1,2].

Likewise, a variety of serious games have been, and continue to be, developed for neurodiverse individuals [Ref 3-5]. For example, Carier and colleagues developed two mini-games (New Horizon and SpaceControl) for autistic children and their parents which incorporated relaxation techniques and found that these games significantly reduced autistic children’s stress and anxiety [Ref 5]. Serious games have also shown to have a positive impact on social interaction and competency skills for autistic youth [Ref 3-4], although the generalisability of such programs to autistic and neurodiverse adults remains to be investigated.

As such, serious games provide a fun and engaging alternative to mental health and psychosocial treatments that capitalise on performance-based rewards, challenges, and achievements that can be geared to each individual’s strengths and goals [Ref 6,7]. Furthermore, serious games also provide external motivators and (some) control over the degree of social interaction (e.g., increasing social interaction at higher game levels) which may be more appealing to some neurodiverse individuals who experience social anxiety and/or are more comfortable in indirect social situations.

Thus, serious games are a promising avenue for the future of digital therapeutics in mental health and neurodiverse populations and should continue to be investigated for evidence-based clinical efficacy in autistic youth and adults.

[You might like to read our other blog about Gaming As Therapy]

References

1 – Lau, H.M., Smit, J.H., Fleming, T.M., & Riper, H. (2017). Serious games for mental health: Are they accessible, feasible, and effective? A systematic review and meta-analysis. Frontiers in Psychiatry, 7(209). 1-13. http://dx.doi.org/10.3389/fpsyt.2016.00209

2 – Fleming, T.M., Bavin, L., Stasiak, K., Hermansson-Webb, E., Merry, S.N., Cheek, C., Lucassen, M., Pollmuller, B., & Hetrick, S. (2017). Serious games and gamification for mental health: Current status and promising directions. Frontiers in Psychiatry, 7(215). 1-7. http://dx.doi.org/fpsyt.2015.00215

3 – Grossard, C., Grynspan, O., Serret, S., Jouen, A.L., Bailly, K., & Cohen, D. (2017). Serious games to teach social interactions and emotions to individuals with autism spectrum disorders (ASD). Computers and Education, 113, 195-211. http://dx.doi.org/10.1016/j.compedu.2017.05.002

4 – Jiménez-Muñoz, L., Peñuelas-Calvo, I., Calvo-Rivera, P., Diaz-Oliván, I., Moreno, M., Baca-Garcia, E., & Porras-Segovia, A. (2021). Video games for the treatment of autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders. http://dx.doi.org/10.1007/s10803-021-04934-9

5 – Carlier, S., Van der Paelt, S., Ongenae, F., & De Backere F. (2020). Empowering children with ASD and their parents: Design of a serious game for anxiety and stress reduction. Sensors, 20, 996. 1-41. http://dx.doi.org/10.3390/s20040966

Video Gaming As Therapy?

A promising alternative for neurodiverse adults

Video games are a common pastime and special interest of neurodiverse individuals. In fact, autistic adults report playing video games and participating in collaborative gaming platforms to regulate their emotions (e.g., stress relief, distraction) and connect socially with peers who share common interests (ref below 1,2). It is essential to recognise, however, that autistic adults are at an increased risk for developing gaming and/or Internet addiction (ref 3,4) and some individuals report they are drawn to playing video games out of compulsion (ref 2). Therefore, as with any activity, it is important for neurodiverse individuals to remember to moderate their video and online game play time.

Autistic and neurotypical adults also report that they are drawn to video and/or online games for a general sense of achievement and immersion into another world (where deficits or challenges may be less emphasized) (ref 1,2). Along these lines, performance and reward-based attributes (e.g., XP, in-game currency, medals, achievements) play an important role in motivating and engaging players and can provide external motivational supports for individuals who may not have a high intrinsic motivation for engaging with others (ref 1,2). Therefore, participating in co-operative online and/or video gaming platforms has significant potential to be a digital therapy alternative for individuals on the spectrum, although there is currently no scientific evidence to support the clinical efficacy of these activities.

The general principles of video games do, however, serve as the basis for many modern “serious game” solutions (for more detail see What are Serious Games?), including those available for autistic youth (ref 5,6,7). Collectively, serious games show promise for improving mental health (e.g., anxiety, depression) and social skills in neurodiverse children (ref 5,8,9) although further scientific evidence is needed to concretely affirm the clinical effectiveness of such therapeutic solutions across the lifespan. All in all, participation in co-operative video and/or online games shows tremendous promise as a digital therapeutic alternative for neurodiverse adults – especially when conducted in a safe, inclusive, and positive environment (ref 1,2) but remains to be scientifically evaluated.

References

1 – Finke, E., Hickerson, B., & Kremkow, J. (2018). “To be quite honest, if it wasn’t for video games I wouldn’t have a social life at all”: Motivations of young adults with autism spectrum disorder for playing video games as leisure. American Journal of Speech-Language Pathology, 27(2), 672-689. http://dx.doi.org/10.1044/2017_AJSLP-17-0073

2 – Mazurek, M.O., Engelhardt, C.R., & Clark, K.E. (2015). Video games from the perspective of adults with autism spectrum disorder. Computers in Human Behavior, 51, 122-130. http://dx.doi.org/10.1016/j.chb.2015.04.062

3 – Coutelle, R., Weiner, L., Paasche, C., Pottelette, J., Bertschy, G., Schröder, C.M., & Lalanne, L. (2021). Autism spectrum disorder and video games: Restricted interests or addiction? International Journal of Mental Health and Addiction. http://dx.doi.org/10.1007/s11469-021-00511-4

4 – Normand, C.L., Fisher, M.H., Fecteau, S.M., Tremblay, K., Roy, E., & Poulin, M.H. (2021). Exploring problematic internet use and gaming in young adults with autism spectrum disorder. Poster presentation at the 2021 International Meeting for Autism Research. Virtual Conference.

5 – Grossard, C., Grynspan, O., Serret, S., Jouen, A.L., Bailly, K., & Cohen, D. (2017). Serious games to teach social interactions and emotions to individuals with autism spectrum disorders (ASD). Computers and Education, 113, 195-211. http://dx.doi.org/10.1016/j.compedu.2017.05.002

6 – Banskota, A. & Ng, Y.K. (2020). Recommending video games to adults with autism spectrum disorder for social-skill enhancement. UMAP Conference Proceeding in Genoa, Italy. 14-22. http://dx.doi.org/10.1145/3340631.3394867

7 – Ng, Y.K. & Pera, M.S. (2018). Recommending social-interactive games for adults with autism spectrum disorders (ASD). UMAP Conference Proceeding in Vancouver, Canada. 209-213. http://dx.doi.org/10.1145/3240323.3240405

8 – Jiménez-Muñoz, L., Peñuelas-Calvo, I., Calvo-Rivera, P., Diaz-Oliván, I., Moreno, M., Baca-Garcia, E., & Porras-Segovia, A. (2021). Video games for the treatment of autism spectrum disorder: A systematic review. Journal of Autism and Developmental Disorders. http://dx.doi.org/10.1007/s10803-021-04934-9

9 – Carlier, S., Van der Paelt, S., Ongenae, F., & De Backere F. (2020). Empowering children with ASD and their parents: Design of a serious game for anxiety and stress reduction. Sensors, 20, 996. 1-41. http://dx.doi.org/10.3390/s20040966

References

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