IEEE Trans Neural Syst Rehabil Eng. 2021;29:884-893. doi: 10.1109/TNSRE.2021.3077480. Epub 2021 May 18.
Autism Spectrum Disorder (ASD) affects 1 in 54 children in the United States. A core social communication skill negatively impacted by ASD is joint attention (JA), which influences the development of language, cognitive, and social skills from infancy onward. Although several technology-based JA studies have shown potential, they primarily focus on response to joint attention (RJA). The other important component of JA, the initiation of joint attention (IJA), has received less attention from a technology-based intervention perspective. In this work, we present an immersive Computer-mediated Caregiver-Child Interaction (C3I) system to help children with ASD practice IJA skills. C3I is a novel computerized intervention system that integrates a caregiver in the teaching loop, thereby preserving the advantages of both human and computer-administered intervention. A feasibility study with 6 dyads (caregiver-child with ASD) was conducted. A near significant increase with medium effect size on IJA performance was observed. Meanwhile, physiology-based stress analysis showed that C3I did not increase stress of the caregivers over the course of the study. To the best of our knowledge, this is the first autonomous system designed for teaching IJA skills to children with ASD incorporating caregivers within the loop to enhance the potential for generalization in real-world.
自闭症谱系障碍（ASD）影响美国每 54 名儿童中的 1 名。受 ASD 负面影响的核心社交沟通技能是共同注意力（JA），它会影响从婴儿期开始的语言、认知和社交技能的发展。尽管有几项基于技术的 JA 研究显示出了潜力，但它们主要集中在对共同注意力的反应（RJA）上。JA 的另一个重要组成部分，即共同注意力的发起（IJA），从基于技术的干预角度来看，受到的关注较少。在这项工作中，我们提出了一种沉浸式计算机介导的照顾者-儿童互动（C3I）系统，以帮助患有 ASD 的儿童练习 IJA 技能。C3I 是一种新颖的计算机化干预系统，它将照顾者纳入教学循环中，从而保留了人与计算机干预的优势。我们对 6 对（有 ASD 的照顾者-儿童）进行了一项可行性研究。观察到 IJA 表现有近显著增加，具有中等效果大小。同时，基于生理的应激分析表明，在研究过程中，C3I 并未增加照顾者的应激。据我们所知，这是第一个设计用于向患有 ASD 的儿童教授 IJA 技能的自主系统，将照顾者纳入循环中，以提高在现实世界中推广的潜力。
