Training Attention and Eye Movement in ASD
Condition: Autistic Disorder; Autism Spectrum Disorder
MeSH terms: Autism Spectrum Disorder; Autistic Disorder
Study type: Interventional

Summary: 
      Current therapies for autism target social and language behaviors, but due to the high-level
      nature of these skills any improvement rarely extends beyond the targeted behavior. This
      project uses new technology to implement a novel concept for behavioral intervention to
      improve basic attention and eye movement skills in ASD. Because these basic skills form the
      foundation for good social communication, training these abilities has the potential to
      improve a broad spectrum of clinical symptoms, and in young children may affect the course of
      development.
    

Detailed description: 
      Autism Spectrum Disorder (ASD) is a lifelong disorder that severely affects the ability to
      learn and function in a social environment. In typical function, higher level social,
      language and communication skills develop over the first few years of life and depend upon
      the critical building blocks of sensory-motor and attention abilities. Similarly in autism,
      higher level problems with social communication develop over the first two post-natal years
      and are preceded by subtle but abnormal visual attention and motor skills. Trainings to
      improve social interaction and communication are the most common of behavioral interventions
      in ASD. These therapies may improve the specific behaviors that are targets of the training,
      but rarely do they generalize to broader function or other clinical symptoms. The
      investigators propose that interventions aimed instead at the early deficits that support
      social and language skills would be more broadly effective. Because disruption of attention
      is one of the earliest and most persistent symptoms in autism, and because attention is
      highly subject to improvement with training, it is an important target for intervention.

      This a novel intervention to train the speed and accuracy of attention orienting and eye
      movement. The training is designed to target attentional behaviors that have been shown to be
      impaired in autism, including attention orienting, disengagement and shifting, and a
      restricted attentional field. Because eye movement and attention are tightly linked, eye
      movement deficits in ASD parallel those found in spatial attention. Eye movements provide a
      marker for attention and the proposed training is designed to improve speed, accuracy and
      flexibility of eye movement and attention simultaneously. Training uses a series of
      entertaining video games to gradually shape behavior using visual and auditory feedback
      provided in real time. The investigators plan three levels of outcome measures for pre- and
      post-training to test the effectiveness of the intervention (direct tests of attention and
      eye movement; tests of improvement in attentional and visual monitoring and speed and
      accuracy of response in a simulated environment; tests of behavior in an actual social
      environment). The investigators will conduct clinical trials with control conditions (e.g.,
      standard video games without training elements) with a small sample of ASD children aged
      9-15. If this initial work is successful, the long term goal is to develop a readily
      available inexpensive eyetracker-based system for home use that is suitable for a broad age
      range of ASD children and adults.
    

Intervention name(s): Cognitive Training; Eye Motor Training; Hand Motor Training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): A collection of video games that rely on various aspects of visual behavior (i.e. sustained attention, vigilance, rapid discrimination, etc) for successful play.; Game play will be controlled by the player's eye movements (via an eye tracking device); Game play will be controlled by the player's hand movements (via a joystick).
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: This project develops the intervention and includes a small clinical (behavioral) trial for ASD participants. A small number of ASD participants will be randomly assigned to intervention 'games' played by mouse response--the others to gaze-driven response.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Video Games