GOLIAH (Gaming Open Library for Intervention in Autism at Home): a 6-month single blind matched controlled exploratory study

Anne-Lise Jouen, Antonio Narzisi, Jean Xavier, Elodie Tilmont, Nicolas Bodeau, Valentina Bono, Nabila Ketem-Premel, Salvatore Anzalone, Koushik Maharatna, Mohamed Chetouani, Filippo Muratori, David Cohen, MICHELANGELO Study Group, Silvio Bonfiglio, Fabio Apicella, Federico Sicca, Lucia Billeci, Giovanni Pioggia, Federico Cruciani, Cristiano Paggetti, Angele Giuliano, Maryrose Francisa, Saptarshi Das, Wasifa Jamal, Leo Galway, Mark Donnelly, Anne-Lise Jouen, Antonio Narzisi, Jean Xavier, Elodie Tilmont, Nicolas Bodeau, Valentina Bono, Nabila Ketem-Premel, Salvatore Anzalone, Koushik Maharatna, Mohamed Chetouani, Filippo Muratori, David Cohen, MICHELANGELO Study Group, Silvio Bonfiglio, Fabio Apicella, Federico Sicca, Lucia Billeci, Giovanni Pioggia, Federico Cruciani, Cristiano Paggetti, Angele Giuliano, Maryrose Francisa, Saptarshi Das, Wasifa Jamal, Leo Galway, Mark Donnelly

Abstract

Background: To meet the required hours of intensive intervention for treating children with autism spectrum disorder (ASD), we developed an automated serious gaming platform (11 games) to deliver intervention at home (GOLIAH) by mapping the imitation and joint attention (JA) subset of age-adapted stimuli from the Early Start Denver Model (ESDM) intervention. Here, we report the results of a 6-month matched controlled exploratory study.

Methods: From two specialized clinics, we included 14 children (age range 5-8 years) with ASD and 10 controls matched for gender, age, sites, and treatment as usual (TAU). Participants from the experimental group received in addition to TAU four 30-min sessions with GOLIAH per week at home and one at hospital for 6 months. Statistics were performed using Linear Mixed Models.

Results: Children and parents participated in 40% of the planned sessions. They were able to use the 11 games, and participants trained with GOLIAH improved time to perform the task in most JA games and imitation scores in most imitation games. GOLIAH intervention did not affect Parental Stress Index scores. At end-point, we found in both groups a significant improvement for Autism Diagnostic Observation Schedule scores, Vineland socialization score, Parental Stress Index total score, and Child Behavior Checklist internalizing, externalizing and total problems. However, we found no significant change for by time × group interaction.

Conclusions: Despite the lack of superiority of TAU + GOLIAH versus TAU, the results are interesting both in terms of changes by using the gaming platform and lack of parental stress increase. A large randomized controlled trial with younger participants (who are the core target of ESDM model) is now discussed. This should be facilitated by computing GOLIAH for a web platform. Trial registration Clinicaltrials.gov NCT02560415.

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