Effects of a 2-player computer-assisted learning game on visual and joint attention in the adults with autism spectrum disorder and intellectual disabilities

Abstract

Autism spectrum disorder (ASD) is a condition which cannot be cured medically. Education has been regarded as a hope for children with ASD (Wong & Hui, 2008). Although a few studies exist on the theory of mind (ToM) of high-functioning individuals with ASD, adult-based research on joint attention (JA) remains scarce (Fletcher-Watson, Leekam, Findlay, & Stanton, 2008). The focus of the research reported in this thesis was visual attention (VA) and JA and it involved two studies with adults.

Study One examined four learning functions and their relationships to ASD. Five measurements were carried out on forty-eight adults who had been diagnosed with ASD during childhood and forty-three adults without the diagnosis of ASD, in order to examine the levels of A. ASD characteristics by the Gilliam Autism Rating Scale - 2nd edition (GARS-2) (Gilliam, 2006). B. Theory of mind (ToM) by the Sally-Anne Test (Frith, 2003, 2008). C. Span of visual attention (VA) (Naber, Bakermans-Kranenburg, Van Ijzendoorn, Dietz, Van Daalen, Swinkels, Buitelaar, & Van Engeland, 2008). D. Initiation of joint attention (IJA) (Murray, Creaghead, Manning-Courtney, Shear, Bean, & Prendeville, 2008). E. Response to joint attention (RJA) (Warreyn, Roeyers, Oelbrandt, & De Groote, 2005).

The results of Study One revealed the following: 1. Sixteen adults who were diagnosed with ASD during childhood did not display extreme ASD characteristics by the time of this study. 2. The adults who displayed extreme ASD characteristics tended to display deficits in ToM, VA, and IJA. 3. The levels of VA tended to be associated with the levels of IJA in the adults without extreme ASD characteristics.

Study Two, conducted with five adults who had been diagnosed with ASD, investigated the effects of a 2-player computer game during the treatment phases (phases B) of the ABAB withdrawal single-subject multiple-cases experiment to stimulate the participant into active collaboration learning. In Study Two, four participants demonstrated IJA episodes during at least one session in phases B but none in the non-treatment phases (phases A). Concurrently, the four participants maintained high VA levels in phases B.

The results of Study Two revealed the following: 1. The 2-player computer game in general enhanced VA and potentially stimulated IJA in the participants. 2. The function of IJA is situational rather than developmental in the adults. 3. VA and IJA are two associated functions in the adults but not in all situations.

The results from Study Two demonstrated that enhanced interactions with the computer promoted overall performances in the participants and hence supported the situated learning theory as advocated by Clancey (1997), Kaptelinin and Nardi (2006), and Kirsh (2009). The results also supported the proposal of Blakemore and Frith (2005) that adults with ASD have the potential to learn, the proposal of Tomasello, Carpenta, Call, Behne, and Moll (2005) that “collaborative engagement” may facilitate JA (p. 682), and Frith’s (2003) observation that persons with ASD tend to learn through “real-life” experiences (p. 141). Further research will substantiate application of the aforementioned concepts to the adult learning.