Simone Kirst1, Robert Diehm2, Katharina Bögl3, Sabine Wilde-Etzold4, Christiane Bach5, Michele Noterdaeme6, Luise Poustka7, Matthias Ziegler8, Isabel Dziobek9. 1. Clinical Psychology of Social Interaction, Berlin School of Mind and Brain, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: simone.kirst@hu-berlin.de. 2. Department of Child and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. Electronic address: robert.diehm@meduniwien.ac.at. 3. Clinical Psychology of Social Interaction, Berlin School of Mind and Brain, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: katharina.boegl@hu-berlin.de. 4. Department of Child and Adolescent Psychiatry and Psychotherapy, Josefinum Augsburg, Augsburg, Germany. Electronic address: WildeE.Sabine@josefinum.de. 5. Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany. Electronic address: christiane.bach@medizin.uni-leipzig.de. 6. Department of Child and Adolescent Psychiatry and Psychotherapy, Josefinum Augsburg, Augsburg, Germany. Electronic address: Noterdaeme.Michele@josefinum.de. 7. Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine, Georg-August Universität Göttingen, Göttingen, Germany. Electronic address: luise.poustka@med.uni-goettingen.de. 8. Psychological Diagnostics, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: zieglema@hu-berlin.de. 9. Clinical Psychology of Social Interaction, Berlin School of Mind and Brain, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: isabel-dziobek@hu-berlin.de.
Abstract
OBJECTIVE: Serious games are a promising means of fostering socio-emotional skills in children on the autism spectrum (AS). However, empathy and related constructs have not yet been addressed comprehensively and together with emotion recognition, and there is a lack of randomized controlled trials (RCT) to investigate skill maintenance and the transfer to functional behavior. METHOD: The manualized, parent-assisted serious game Zirkus Empathico (ZE) was tested against an active control group, in a six-week multicenter RCT. Eighty-two children aged 5-10 years on the AS were assessed at baseline, post-treatment, and three-month follow-up. Empathy and emotion recognition skills were defined as the primary outcomes. The secondary outcomes included measures of emotional awareness, emotion regulation, autism social symptomatology (Social Responsiveness Scale), and subjective therapy goals. RESULTS: Training effects were observed after the intervention for empathy (d = 0.71) and emotion recognition (d = 0.50), but not at follow-up. Moderate effects on emotional awareness, emotion regulation, and autism social symptomatology were indicated by the short and mid-term assessments. Parents reported treatment goal attainment and positive training transfer. CONCLUSION: While a six-week training with ZE failed to induce lasting changes in empathy and emotion recognition, it may be effective for improving emotional awareness and emotion regulation, and mitigate general autism symptomatology. CLINICAL TRIAL REGISTRATION INFORMATION: Zirkus Empathico - Promoting socioemotional competencies in 5- to 10-year-old children with autism spectrum conditions using a computer-based training program; https://www.drks.de/; DRKS-ID: DRKS00009337; Universal Trial Number (UTN): U1111-1175-5451.
OBJECTIVE: Serious games are a promising means of fostering socio-emotional skills in children on the autism spectrum (AS). However, empathy and related constructs have not yet been addressed comprehensively and together with emotion recognition, and there is a lack of randomized controlled trials (RCT) to investigate skill maintenance and the transfer to functional behavior. METHOD: The manualized, parent-assisted serious game Zirkus Empathico (ZE) was tested against an active control group, in a six-week multicenter RCT. Eighty-two children aged 5-10 years on the AS were assessed at baseline, post-treatment, and three-month follow-up. Empathy and emotion recognition skills were defined as the primary outcomes. The secondary outcomes included measures of emotional awareness, emotion regulation, autism social symptomatology (Social Responsiveness Scale), and subjective therapy goals. RESULTS: Training effects were observed after the intervention for empathy (d = 0.71) and emotion recognition (d = 0.50), but not at follow-up. Moderate effects on emotional awareness, emotion regulation, and autism social symptomatology were indicated by the short and mid-term assessments. Parents reported treatment goal attainment and positive training transfer. CONCLUSION: While a six-week training with ZE failed to induce lasting changes in empathy and emotion recognition, it may be effective for improving emotional awareness and emotion regulation, and mitigate general autism symptomatology. CLINICAL TRIAL REGISTRATION INFORMATION: Zirkus Empathico - Promoting socioemotional competencies in 5- to 10-year-old children with autism spectrum conditions using a computer-based training program; https://www.drks.de/; DRKS-ID: DRKS00009337; Universal Trial Number (UTN): U1111-1175-5451.
Authors: Ana Xavier; Paula Vagos; Lara Palmeira; Paulo Menezes; Bruno Patrão; Sónia Pereira; Vanessa Rocha; Sofia Mendes; Marta Tavares Journal: Int J Environ Res Public Health Date: 2022-08-04 Impact factor: 4.614