Social Skills and Reciprocal Behavior with a Virtual Player Among Children With and Without SLD/ADHD.

The study aimed to compare reciprocal behavior during interaction with a virtual-player in a computer game between children with typical development (TD) and children with specific-learning-disabilities (SLD) and/or with attention-deficit/hyperactivity disorder (ADHD), and to examine its correlation with social skills. A total of 120 children (43 SLD/ADHD, 77 TD) aged 9-11 years participated. Participants completed self-reported questionnaires focusing on social skills and reciprocity and played a computer game in which such social situations arose. Results indicated no difference between the groups in self-reported social skills or reciprocity. However, the children's actual reciprocal behavior during gameplay revealed different results: the SLD/ADHD group exhibited higher levels of selfish (helping others for personal gain) and lower levels of altruistic reciprocity (helping others for their benefit) compared to the TD group. Furthermore, a correlation was found between self-reported social skills and reciprocity, as well as with the reciprocal-patterns observed in the gameplay.

Effectiveness of the mentalisation-based serious game 'You & I' for adults with mild to borderline intellectual disabilities: A randomised controlled trial.

BACKGROUND: Mentalising and stress regulation pose challenges for adults with mild to borderline intellectual disabilities (MBID), emphasising the importance of an intervention program. The study examined the effectiveness and social validity of the serious game 'You & I' in enhancing mentalising and stress regulation among adults with MBID. METHOD: A randomised controlled superiority trial with experimental and waitlist-control groups was conducted with 159 adults with MBID (Mage = 36) at baseline, post-test, and follow-up. Analyses investigated the effects on aspects of mentalising, stress regulation, and social validity. RESULTS: The experimental group showed decreased stress from negative interpersonal relations, while the control group experienced increased stress (d = 0.26). There were no significant effects on mentalising, but positive user expectations and experiences were reported. CONCLUSIONS: This initial study on 'You & I' provides limited evidence of its effectiveness for people with MBID, warranting further examination of the potential of serious games.

Features and effects of computer-based games on cognitive impairments in children with autism spectrum disorder: an evidence-based systematic literature review.

INTRODUCTION: Children with Autism Spectrum Disorder (ASD) have different cognitive and intelligence profiles than typical developing individuals. Some of these children need cognitive rehabilitation. This study's main purpose is to provide a systematic review about applying computerized cognitive games for autistic children and to determine the effectiveness of such interventions. MATERIAL AND METHODS: A thorough search of the ISI Web of Science, Medline (through PubMed), Scopus, IEEE Xplore, and APA PsycInfo databases was performed for articles published from inception to May 17, 2022. RESULTS: Of 1746 papers, 28 studies were found to be eligible in this systematic review. Fifteen studies (53.57%) compared a Control Group (CG) with Experimental Groups (EGs), while 13 papers (46.42%) evaluated only the impact of the applied intervention in an experimental group. Major domains of cognitive functions are divided into five main categories: 1. Executive functions, 2. Social cognition/emotions, 3. Attention/concentration, 4. Learning and memory, and 5. Language. In 42.85% (12 studies) of the screened papers, social cognition and emotions were assessed after cognitive rehabilitation. The highest rate of effects reported by studies were related to social cognition enhancement. Of the total number of included studies, 17 studies reported a positive effect at all scales, of which nine were quasi-experimental, and seven were fully experimental. CONCLUSION: Using suitable computerized game-based solutions could enhance cognition indexes in autistic children. Hence, further investigation is needed to determine the real effectiveness of these novel technologies.

A pilot study of game-based learning programs for childhood cancer survivors.

BACKGROUND: Childhood cancer survivors lacking awareness on their potential risks of late effects often fail to seek adequate follow-up care. Patient education matching their preference is of great importance to improve their adherence to survivorship care. In this study, we developed two age-dependent game-based learning programs, which enable continuous approaches for childhood cancer survivors along their intellectual maturation. Then, we assessed the effectiveness of the programs. METHODS: Childhood cancer survivors over 10 years of age who regularly visited a long-term follow-up clinic were enrolled in this study. They were requested to play either of two different types of game tools, one for school children and another for adolescents and young adults, for one month at home. To evaluate the educational effects of the programs, they were examined for health management awareness, self-esteem, and knowledge on cancer-related late effects before and after the intervention with age-based questionnaires and knowledge tests. RESULTS: Among 83 participants, 49 (59.0%) completed the assessments over the period of 12 months. The health management awareness and knowledge levels increased significantly at 1-month after the intervention as compared to the baseline in both school children and adolescents/young adults (for health management awareness, p = 0.011 in elementary school children; p = 0.007 in junior high school children; p < 0.001 in adolescents/young adults; for knowledge levels, p < 0.001 in school children; p < 0.001 in adolescents/young adults). The effect was maintained for 12 months in school children while it decreased in adolescents and young adults with time. Self-esteem significantly increased at 1-month (p = 0.002 in school children; p = 0.020 in adolescents/young adults) and was maintained for 12 months in both age groups. CONCLUSION: The game-based learning programs enhanced health locus of control and self-esteem in childhood cancer survivors. The game-based learning programs could be applied effectively to survivorship care as a new modality of patient education. TRIAL REGISTRATION: This study was retrospectively registered in UMIN-CTR ( UMIN000043603 ) on March 12, 2021.

Computer Game-Based Telerehabilitation Platform Targeting Manual Dexterity: Exercise Is Fun. "You Are Kidding-Right?"

There is a need for innovation to improve the engagement and accessibility of rehabilitation programs for children and adults with upper extremity motor impairments due to neurodevelopmental disorders, acquired brain injuries, or spinal cord injuries. For this purpose, a computer game-based telerehabilitation platform (GTP) was developed to address this need. Through the application of a miniature inertial-based computer mouse and the wide variety of commercial computer games, the developed GTP can provide engaging task-specific exercises for the rehabilitation of manual dexterity (object handling and manipulation). A purpose-built repetitive task practice software (RTP) was also developed to gather event data and synchronize it with patient movements during gameplays. This provides automated monitoring and quantification of patients' motor skills, while they practice a range of game-based exercises with their hand and/or arm. The GTP would initially be used in a supervised clinical setting followed by a transition to function at home and be monitored by clinician specialists. Clinical support for home and rural communities, with protocols that can be easily updated, will help increase accessibility to targeted and personalized solutions for patients and achieve the desired training effect.

Using an augmented reality game to teach three junior high school students with intellectual disabilities to improve ATM use.

BACKGROUND: Individuals with intellectual disabilities (ID) may have difficulties in performing daily living tasks. Among other daily living tasks, independent automated teller machine (ATM) skills are an essential life skill for people with intellectual disabilities. MATERIALS AND METHODS: Three junior high school students in a special education class participated in the experiment. We employed the augmented reality (AR) technology to gamify ATM skill training. Specifically, a multiple baseline design was adopted to demonstrate the relation between game-based intervention and using an ATM independently. RESULTS: Data showed that the percentage of correct task steps increased among all three participants. Social validity results showed the teachers considered the AR game was very useful and it had helped their students learn the ATM skills effectively. CONCLUSIONS: The proposed AR game can be used for effective training of students with intellectual disabilities using an ATM independently.

The effect of interactive computer play on balance and functional abilities in children with moderate cerebral palsy: a pilot randomized study.

OBJECTIVES:: To investigate the feasibility and potential efficacy of a six-week interactive computer play training on balance and gross motor function in children with moderate cerebral palsy. DESIGN:: A pilot single-blinded matched randomized controlled study. SETTING:: Community. PARTICIPANTS:: In total, 18 children with moderate cerebral palsy were recruited, paired according to age and severity of cerebral palsy and randomized into intervention group or control group. INTERVENTION:: The intervention group received additional trunk control training using the interactive computer play in sitting four times per week, 20 minutes per session for six weeks. All study children continued their usual physiotherapy programme. MEASUREMENTS:: All study children were assessed at baseline, week 3, week 6 (completion of intervention) and week 12 using the Pediatric Reach Test, Gross Motor Function Measure-66-Item Set and 2-Minute Walk Test. RESULTS:: All intervention children completed and enjoyed the training with no reported adverse event. All children were assessed at all time points. No significant difference was found between the two groups in all assessments. In both groups of children, significant improvements were found in the Gross Motor Function Measure-66-Item Set between week 3 (intervention group: mean 53.41, SD 5.34; control group: mean 52.86, SD 8.33) and week 6 (intervention group: mean 55.00, SD 6.32; control group: mean 54.20, SD 8.35). CONCLUSION:: The intervention protocol of a six-week interactive computer play training was feasible and safe for children with moderate cerebral palsy in special school settings. Future studies with larger sample sizes or using single-subject designs are recommended.

Comparison between Concentration and Immersion Based on EEG Analysis.

Concentration and immersion belong to a similar mental state in which a person is preoccupied with a particular task. In this study, we investigated a possibility of diagnosing two mental states with a subtle difference. Concentration and immersion states were induced to analyze the electroencephalography (EEG) changes during these states. Thirty-two college students in their 20s participated in the study. For concentration, subjects were asked to focus on a red dot at the center of a white screen, and for immersion they were asked to focus on playing a computer game. Relative to rest, Alpha waves decreased during concentration and immersion. Relative to rest, Theta waves decreased at almost all channels during concentration and, on the other hand, increased at all channels during immersion. Beta waves increased during concentration and immersion in the frontal and occipital lobes, with a higher increase in immersion. In the temporal lobe, Beta waves decreased during concentration and increased during immersion. In the central region, Beta waves decreased during concentration and immersion, and the decrease during immersion was larger. Such evident differences between the EEG results for concentration and immersion can imply diagnostic capabilities of various other mental states.

Dual-task training of children with neuromotor disorders during robot-assisted gait therapy: prerequisites of patients and influence on leg muscle activity.

BACKGROUND: Walking in daily life is complex entailing various prerequisites such as leg strength, trunk stability or cognitive and motor dual task (DT) activities. Conventional physiotherapy can be complemented with robot-assisted gait therapy (RAGT) and exergames to enhance the number of step repetitions, feedback, motivation, and additional simultaneously performed tasks besides walking (e.g., dual-task (DT) activities). Although DT gait training leads to improvements in daily ambulation in adult patient groups, no study has evaluated RAGT with a DT exergame in children with neurological gait disorders. Therefore, we investigated children's functional and cognitive prerequisites to walk physiologically during RAGT with a DT exergame and analysed the influence of DT on leg muscle activity. METHODS: Children and adolescents (6-18 years) with neurological gait disorders completed RAGT with and without a DT exergame in this quasi-experimental study. We assessed several measures on the body function and activity domains (according to the International Classification of Functioning, Disability, and Health (ICF)) and determined whether these measures could distinguish well between children who walked physiologically during the DT RAGT or not. We measured leg muscle activity with surface electrodes to identify changes in EMG-amplitudes and -patterns. RESULTS: Twenty-one children participated (7 females, 6.5-17.3 years, Gross Motor Function Classification System (GMFCS) levels I-IV). Most activity measures distinguished significantly between participants performing the DT exergame physiologically or not with moderate to good sensitivity (0.8 ≤ sensitivity≤1.0) and specificity (0.5 ≤ specificity≤0.9). Body function measures differentiated less well. Despite that the EMG-amplitudes of key stance muscles were significantly lower during DT versus no DT exergaming, the mean activation patterns of all muscles correlated high (ρ > 0.75) between the conditions. CONCLUSION: This study is the first that investigated effects of a DT exergame during RAGT in children with neurological gait disorders. Several performance measures could differentiate well between patients who walked with physiological versus compensatory movements while performing the DT exergame. While the DT exergame affected the leg muscle activity amplitudes, it did not largely affect the activity patterns of the muscles.

Acute Effect of Intermittent Exercise and Action-Based Video Game Breaks on Math Performance in Preadolescent Children.

PURPOSE: The purpose of this study was to compare the acute effects of video game breaks and intermittent exercise breaks, performed at varying intensities, on math performance in preadolescent children. METHODS: A total of 39 children (18 males and 21 females; aged 7-11 y) completed 4 experimental conditions in random order: 8 hours of sitting interrupted with 20 two-minute low-, moderate-, or high-intensity exercise breaks or 20 two-minute sedentary computer game breaks. The intensity of exercise breaks for the low-, moderate-, and high-intensity conditions corresponded with 25%, 50%, and 75% of heart rate reserve, respectively. Math performance was assessed 3 times throughout each condition day using a 90-second math test consisting of 40 single-digit addition and subtraction questions. RESULTS: There were no significant differences in percent change in math scores (correct answers out of attempted) by condition [low: -1.3 (0.8), moderate: 0.1 (1.3), high: -1.8 (0.7), and computer: -2.5 (0.8); P > .05]. There were significant differences in percent change in math scores over the course of the condition days with lower math scores reported at end-of-day test compared with midday test [-2.4 (0.5) vs -0.4 (0.3); P = .01]. There were no significant condition × time, time × age, condition × age, or condition × time × age interactions (all Ps > .05). CONCLUSION: Action-based video game and exercise breaks elicit the same level of math performance in children; however, time of day may impact this relationship. These findings may have important implications for instructional time in elementary classrooms.

[Spanish validation of Game Addiction Scale for Adolescents (GASA)]. / Validación española de la Escala de Adicción a Videojuegos para Adolescentes (GASA).

OBJECTIVE: The aim of this study is to adapt and validate the Game Addiction Scale for Adolescents (GASA) to the Spanish youth population. DESIGN: Cultural adaptation and validation study. SETTING: Secondary Education centres. PARTICIPANTS: Two independent studies were conducted on a group of 466 young people with a mean age of 15.27 years (13-18, SD: 1.83) and 48.7% ♀ and on another group of 566, with a mean age of 21.24 years (19-26; SD: 1.86) 44.1% ♀. MEASUREMENTS: Addiction to video games (GASA); Game behavior (Game habits usage questionnaire), Impulsiveness (Plutchik Impulsiveness Scale) and Group Pressure (Ad hoc questionnaire). RESULTS: The Spanish version of GASA has shown good reliability and true to the original scale factor structure. As regards criterion validity, GASA scores are significantly different according to four criteria related to problem gambling: Game intensity and frequency, impulsiveness, and peer pressure. CONCLUSIONS: The results show that the adapted version GASA is adequate and a valid tool for assessing problematic gaming behaviour.

Analysis of Biosignals During Immersion in Computer Games.

The number of computer game users is increasing as computers and various IT devices in connection with the Internet are commonplace in all ages. In this research, in order to find the relevance of behavioral activity and its associated biosignal, biosignal changes before and after as well as during computer games were measured and analyzed for 31 subjects. For this purpose, a device to measure electrocardiogram, photoplethysmogram and skin temperature was developed such that the effect of motion artifacts could be minimized. The device was made wearable for convenient measurement. The game selected for the experiments was League of Legends™. Analysis on the pulse transit time, heart rate variability and skin temperature showed increased sympathetic nerve activities during computer game, while the parasympathetic nerves became less active. Interestingly, the sympathetic predominance group showed less change in the heart rate variability as compared to the normal group. The results can be valuable for studying internet gaming disorder.

[Refuge in Digital Worlds - the Association of Critical Life Events with Pathological Internet Use in Adolescence]. / Zuflucht in digitalen Welten - zum Zusammenhang von kritischen Lebensereignissen mit pathologischem Internetgebrauch im Jugendalter.

Refuge in Digital Worlds - the Association of Critical Life Events with Pathological Internet Use in Adolescence The present study sought to clarify the potential relationship between critical life events and pathological internet use in adolescents. A cross-sectional survey was conducted within the framework of a European school-based study (SEYLE) which included a representative sample of 1,444 students from the Rhein-Neckar catchment area. The Young Diagnostic Questionnaire (YDQ) was used to assess pathological internet use, whereas a combination of the List of Threatening Experiences (LTE) and Life Events Checklist (LCE) was administered to assess critical life events over the period of the last six months. Statistical models were adjusted for the presence of psychopathological distress using the Strengths and Difficulties Questionnaire (SDQ). 4.8 % of the participating students reported pathological internet use, 14.5 % met criteria for risky Internet use. Overall, adolescents with risky or pathological internet use recalled more critical life events, particularly within the context of interpersonal relationships and academic performance. After adjusting for sociodemographic variables and psychopathological distress, results showed that an unexpected decrease in academic performance as well as the termination of a romantic relationship, both were significantly associated with pathological internet use. Adolescents with pathological internet use reported significantly more frequent interpersonal problems and an unexpected decrease of academic performance. Based on the cross-sectional nature of the investigation, causality of the association cannot be established. However, results point towards potential risk factors (academic performance, termination of relationships) which may guide the identification of adolescents with risky or pathological internet use in child- and adolescent psychiatry.

Computer Game Play Reduces Intrusive Memories of Experimental Trauma via Reconsolidation-Update Mechanisms.

Memory of a traumatic event becomes consolidated within hours. Intrusive memories can then flash back repeatedly into the mind's eye and cause distress. We investigated whether reconsolidation-the process during which memories become malleable when recalled-can be blocked using a cognitive task and whether such an approach can reduce these unbidden intrusions. We predicted that reconsolidation of a reactivated visual memory of experimental trauma could be disrupted by engaging in a visuospatial task that would compete for visual working memory resources. We showed that intrusive memories were virtually abolished by playing the computer game Tetris following a memory-reactivation task 24 hr after initial exposure to experimental trauma. Furthermore, both memory reactivation and playing Tetris were required to reduce subsequent intrusions (Experiment 2), consistent with reconsolidation-update mechanisms. A simple, noninvasive cognitive-task procedure administered after emotional memory has already consolidated (i.e., > 24 hours after exposure to experimental trauma) may prevent the recurrence of intrusive memories of those emotional events.

mRNA expression of dopamine receptors in peripheral blood lymphocytes of computer game addicts.

Excessive playing of computer games like some other behaviors could lead to addiction. Addictive behaviors may induce their reinforcing effects through stimulation of the brain dopaminergic mesolimbic pathway. The status of dopamine receptors in the brain may be parallel to their homologous receptors in peripheral blood lymphocytes (PBLs). Here, we have investigated the mRNA expression of dopamine D3, D4 and D5 receptors in PBLs of computer game addicts (n = 20) in comparison to normal subjects (n = 20), using a real-time PCR method. The results showed that the expression level of D3 and D4 dopamine receptors in computer game addicts were not statistically different from the control group. However, the expression of the mRNA of D5 dopamine receptor was significantly down-regulated in PBLs of computer game addicts and reached 0.42 the amount of the control group. It is concluded that unlike with drug addiction, the expression levels of the D3 and D4 dopamine receptors in computer game addicts are not altered compared to the control group. However, reduced level of the D5 dopamine receptor in computer game addicts may serve as a peripheral marker in studies where the confounding effects of abused drugs are unwanted.

A metacognitive strategy for reducing disruptive behavior in children with fetal alcohol spectrum disorders: GoFAR pilot.

BACKGROUND: Fetal alcohol spectrum disorders (FASD) are often characterized by disruptive behavior problems and there are few effective interventions available. GoFAR is a novel, 3-part intervention designed to improve self-regulation and adaptive living skills of children with FASD by improving metacognitive control of emotions and arousal. METHODS: The intervention has 3 components: (i) GoFAR: a "serious game" designed to teach a metacognitive control strategy in a computer game environment; (ii) parent training on child behavioral regulation; and (iii) Behavior Analog Therapy (BAT) sessions, a practical application of the metacognitive learning methodology by parent and child in the context of learning adaptive skills. The learning strategy (FAR) teaches the child to Focus and make a plan, Act out the plan, and Reflect back on the plan. Thirty families were randomized to 3 groups: (i) GoFAR (n = 10); (ii) FACELAND (n = 10); or (iii) CONTROL (n = 10). The 2 intervention groups, GoFAR and FACELAND, used computer games to instruct children. Both groups also received 5 sessions of parent training followed by 5 sessions of joint parent/child therapy (BAT). Assessment of disruptive behavior, including frequency of temper tantrums, frustration tolerance, impulsivity, destructiveness, aggression, and maintaining attention were carried out before enrollment at Mid-Treatment, when game play and parent training were completed, and finally, after completing the BAT sessions. RESULTS: Parental report of disruptive behavior overall was significantly reduced in the GoFAR group after the first components, game play and parent training, and after the BAT sessions in the FACELAND group with no changes in the CONTROL group over time. CONCLUSIONS: The GoFAR(®) game was well received by children and effective in teaching the required skills. Mastering the FAR metacognitive strategy was associated with a reduction in disruptive behaviors in children with FASD suggesting that effective interventions can improve outcomes for this high-risk group.

["What I don't Appreciate in Real Life": Online Role Playing Game Addiction of an Adolescent--Case Study]. / ¼Was ich am richtigen Leben nicht so schätze« Online-Rollenspielsucht eines Jugendlichen--Fallstudie.

The present article aims to provide an insight into the life story of a computer-game addicted adolescent. Here, the relationship between the symptom game addiction, the family as a reference framework, the game's characteristics, as well as the subjective emotional state of the adolescent are of particular interest. An emphasis is also laid on the psychodynamically approached question of the impact of infantile and current relationship experiences (both within a family environment as well as with peers) on personal development. Last, still within a psychodynamic framework, we hope to provide a better understanding of the role of online computer-game addiction in the process of experiences potentially dominated by conflicts.

[Association of peer victimization, coping, and pathological internet use among adolescents]. / Der Zusammenhang von Mobbingerfahrungen, Copingstilen und pathologischem Internetgebrauch bei Jugendlichen.

OBJECTIVE: To investigate the association of pathological internet use, peer victimization, and coping styles among German adolescents who reported experiences of peer victimization. METHOD: A cross-sectional survey was conducted within the framework of a European school-based study (SEYLE) which included 1357 representative students (female/male: 710/647; mean age: 14.7; SD = 0.80) from Germany. Pathological internet use was assessed by the Young Diagnostic Questionnaire. Peer victimization was classified into verbal, physical, and relational. Coping style was divided into active, avoidance, help-seeking, and other. Psychological symptoms were assessed as covariate by the Strengths and Difficulties Questionnaire. RESULTS: 4.8 % of the students showed pathological internet use, 14.4 % presented with problematic internet use. 52.3 % of the adolescents reported peer victimization (38.7 % verbal victimization, 19.8 % physical victimization, 34.1 % relational victimization). There was a significant association of peer victimization with pathological internet use, which could partly be explained by psychological symptoms. Normal, problematic, und pathological internet users did not differ with regard to their coping styles in relation to victimization. CONCLUSIONS: There is an association between peer victimization, psychological symptoms, and pathological internet use. School- and family-based prevention programs and evaluated therapies are needed.

[Primary prevention of computer game addiction in students of educational institutions]. / Pervichnaya profilaktika komp'yuternoi igrovoi zavisimosti u uchashchikhsya obshcheobrazovatel'nykh uchrezhdenii.

OBJECTIVE: To conduct the primary prevention of computer game addiction (PPCGA) in students of General education institutions (GEI), aimed at preventing the formation of CGA. MATERIAL AND METHODS: The study included 488 students in grades 7-10 of GEI aged 12-17 years (14.6±2.4 years), of which 393 adolescents, who made up the main group, received PPCGA and 95 - control, without PPCGA. RESULTS: Preventive measures were carried out without interrupting the educational process; they were carried out by addiction psychiatrists and medical psychologists. PPCGA was aimed at teaching students a healthy lifestyle, the development of their personal resources, the formation of skills to overcome problem situations, a change in the value attitude to computer games and the formation of alternative interests. In the main group, a decrease in the time interval spent by students at the computer was found (p<0.05). There was a decrease in the number of students (p<0.05), experiencing affective disorders when abstaining from the computer, including mild depression and subclinically expressed anxiety/depression, for whom computer games could lead to problems and negative consequences. An increase in the interval of time spent by students at the computer (p<0.05); an increase in the number of students experiencing affective disorders when abstaining from the computer (p<0.05); a trend towards the increase in the frequency of problems and delayed meetings and personal matters related to spending time at the computer; an increase in clearly uncommunicative (p<0.05) were found in the control group. CONCLUSIONS: Primary prevention of computer gaming increase the number of students who prefer a healthy lifestyle (physical education and sports, rational nutrition, sex education, family relationships) and reduce the number of people who prefer computer games as a form of leisure.

Evaluating the efficacy of computer games-based learning intervention in enhancing English speaking proficiency.

The use of learning games in education, particularly for second language (L2) acquisition, has gained significant traction recently, establishing game-based learning as a notable academic discipline. This study examines how computer game-based learning influences ESL undergraduates' speaking abilities, comparing traditional teaching methods with game-based teaching techniques. The study employed action research utilizing a control-experimental groups technique with a sample of 60 learners. Data were collected through observation sessions, interviews, as well as pre-tests and post-tests on English speaking skills. Upon comparing the scores of the control and experimental groups, the experimental group showed greater improvement in speaking skills. This study provides significant insights into the area of game-based learning using computers, particularly among international students in ESL contexts.