A Survey of ICT Tools for Communication Development in Children
with ASD
Margarida Lucas da Silva
1,2
and Daniel Gonc¸alves
2
1
Instituto Superior T
´
ecnico, Av. Rovisco Pais, 49, 1050-001 Lisboa, Portugal
2
INESC-ID, Rua Alves Redol, 9, 1000-029 Lisboa, Portugal
Keywords:
Autism Spectrum Disorders, Information and Communication Technologies, Communication Development.
Abstract:
Several studies using Information and Communication Technologies (ICT) have been carried out over the
years, trying to solve problems related with multiple dimensions of the limitations faced by children with
Autism Spectrum Disorders (ASD). It is not yet possible to conclude that the use of ICT is more beneficial
than the use of alternative or traditional educational approaches for children with ASD. In this paper we are
going to look at several studies related with communication development in children with ASD, with the
purpose of understanding the approaches available and some of their possible results.
1 INTRODUCTION
The constant evolution in Information and Communi-
cation Technologies (ICT) brought a wide range of
new possibilities to help people with learning dis-
abilities access new opportunities for learning, enter-
tainment and personal development. Children with
Autism Spectrum Disorders (ASD) are included in
this group, and although many approaches have been
tested but, few have been adopted or successfully in-
tegrated in the daily life of the children, their tutors
or caregivers (Putnam and Chong, 2008). Due to the
difficulties faced by children with ASD in terms of
communication skills, a few studies have been devel-
oped throughout the years in order to find solutions
to minimize this issue. Several approaches have been
tested since there is no formula nor enough empiri-
cal evidence on how to develop for such a context.
Nowadays, the most commonly used tool with chil-
dren with ASD is the traditional Picture Exchange
Communication System (PECS). PECS is an augmen-
tative communication system, developed to help sub-
jects in quickly acquiring a functional means of com-
munication (Bondy and Frost, 2001). It is versatile
and inexpensive, since tutors can create and print the
pictures that the children needs. It is used with chil-
dren who need to communicate, but have some sort
of impairment that prevents them from using the nor-
mal communication channels, and it is sucessfull in
delivering clear messages. This tool is mostly used
by people with speech limitations, with the need to
communicate and understand actions in an effective
way. Although a simple approach, this is the general
base for most systems and tools aimed at supporting
children in communication.
In this chapter we are going to review some of
the most relevant studies in this area, focused on any
kind of approach for communication development,
and also look at commercially available tools, some of
which are not specifically designed for patients with
ASD, but are still used in some cases.
2 ICT STUDIES
We are going to describe 15 studies, all focused on
communication, but with some differences on the
targeted communication outcomes. Hailpern et al.
(2009) (Hailpern et al., 2009) and Simpson et al.
(2004) (Simpson et al., 2004) focus their studies in
developing the number of vocalizations, proposing
methodologies that force the use of speech. Bosseler
and Massaro (2003) (Bosseler and Massaro, 2003),
Coleman-Martin et al. (2005) (Coleman-Martin et al.,
2005), Hetzroni and Shalem (2005) (Hetzroni and
Shalem, 2005), Massaro and Bosseler (2006) (Mas-
saro and Bosseler, 2006) and Moore and Calvert
(2000) (Moore and Calvert, 2000) focused on de-
veloping the children vocabulary, proposing a set of
methodologies that tried to teach word to picture
matching. Woodcock and Woolner (2007) (Wood-
285
Lucas da Silva M. and Gonçalves D..
A Survey of ICT Tools for Communication Development in Children with ASD.
DOI: 10.5220/0004641202850292
In Proceedings of the International Conference on Physiological Computing Systems (PhyCS-2014), pages 285-292
ISBN: 978-989-758-006-2
Copyright
c
2014 SCITEPRESS (Science and Technology Publications, Lda.)
cock and Woolner, 2007), Millen et al. (2011) (Millen
et al., 2011), Ohene-Djan (2010) (Ohene-Djan, 2010),
Hetzroni and Tannous (2004) (Hetzroni and Tannous,
2004), Hirano et al. (2010) (Hirano et al., 2010), De
Leo and Leroy (2008) (De Leo and Leroy, 2008) and
Cihak et al. (2012) (Cihak et al., 2012) proposed
methodologies to develop communication in a social
context, by providing tools to socialize by showing
social situations or means to send messages, or to
encourage spontaneous vocalizations. And finally,
Rodr
`
ıguez et al (2004) (Gea-Meg
´
ıas et al., 2004) used
an approach to teach the children communicating by
showing them casual situations, focusing on the de-
velopment of the cognitive component as a way of
increasing vocabulary and social imagination skills.
In summary, we address research studies and tools
according to the following taxonomy:
1. Number of Vocalizations: Studies targeted at
motivating the number of vocalizations produced
by the children, which is of upmost importance in
children that can’t speak.
2. Vocabulary Expansion: Authors that try to in-
crease the number of words that the children rec-
ognize and use. Communication in children with
ASD can be affected by their cognitive abilities,
which is a severe impairment that is usually found
in children with ASD.
3. Communication in a Social Context: Work that
tries to deliver some examples to children on how
to socialize, or engage them in some computer-
mediated situations, in order for the children to
learn how to react and feel more comfortable
when confronted in real life.
4. General Communication Learning: Authors
that try to develop cognitive abilities in order
to improve several communication impairments.
This can help the children to learn more vocabu-
lary, or to prepare them to face different situations.
5. Commercial Tools: Tools that are available for
purchase or free download for children with ASD
or other types of impairments, without having any
research associated, and having only the purpose
to answers the users’ needs.
2.1 Number of Vocalizations
Several studies are focused on developing the
children vocalization abilities, but each author has
followed a different approach. A simpler approach
came with the work by Trying a more social way to
motivate vocalizations, Simpson et al. (2004) (Simp-
son et al., 2004) studied a way to create spontaneous
verbal greetings to peers with examples and counter
examples of the social skill: sharing, following tutor
directions, and social greetings. The approach com-
bined video and computer based instructions using
HyperStudio 3.2. The software had several screens
that provided written instructions, synthetized speech
and video examples. The child was able to select
which content to watch and had to discriminate the
examples from the counter examples displayed in the
videos. Results showed an increase in targeted social
skills, and this study has an interesting approach since
it tries to develop social skills indirectly, through the
communication development. But it’s still a limited
approach, since it doesn’t give the possibility for
the children to get to know somehow other peers,
and directly exchange messages with them as a
safe method to communicate for them. It has a gap
between learning how to communicate, and how to
physically socialize with peers.
As a more comprehensive approach, which tried
to create a package of tools, was proposed by
Hailpern et al. (2009) (Hailpern et al., 2009) by pre-
senting the Spoken Impact Project Software (SIPS).
In their approach, the authors tried to understand how
the effect of audio and visual feedback can encour-
age vocalizations of children with ASD, with aspects
present in previous approaches and with positive re-
sults. The SIPS generates audio and visual feedback
directly related with the amount of external noise pro-
duced by the children and detected by the system, for
example, a square shape showed in the screen might
change to a round shape according to a sound it cap-
tured. The results give us strong indications that au-
dio and visual feedback does encourage spontaneous
speech-like vocalizations in low-functioning children
with ASD. While using the program, they found that
children also have distinct and specific preferences for
feedback, stating that in the future they might need in-
dividual customization.
2.2 Vocabulary Expansion
Another line of research has been concerned with the
increase of the vocabulary possessed by children, and
although some aspects are somehow similar to those
found in the previously described studies, there are
different views on how to motivate children, by using
other types of stimuli.
A similar study focused on stimulating children
with visual and auditory stimuli was developed by
Moore and Calvert (2000) (Moore and Calvert,
2000), which analyzed the impact of computers on
the extension of the vocabulary of the child, by devel-
oping a software program that builds upon behavioral
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learning principles to enhance the vocabulary skills
of children with autism. The software provides
animations and interesting sounds as a reinforcement
when correct responses to the given commands are
provided by the child. The results are positive as in
the previous study, showing that children pay more
attention when using the computer than with the tutor,
and that they felt more motivated to continue the
study using the computer. An important conclusion is
that the number of correct words identified increased.
This study doesn’t disclose many details about the
software, making it somehow suggestive and difficult
to evaluate in terms of the adopted methodology.
Still focusing on vocabulary development, but
using a different approach, Bosseler and Massaro
(2003) (Bosseler and Massaro, 2003) used a software
called Baldi which is a 3D language tutor, qualified to
help in learning speech and reading through the asso-
ciation between pictures and spoken words. Accord-
ing to the authors, Baldi has been successful in teach-
ing vocabulary and grammar to children with ASD
and to children with hearing problems also they tried
to understand if using the tutors face helped increas-
ing the success in the learning process, so they per-
formed experimental evaluation with and without the
tutors face. They asked children to take pictures of
objects and surroundings at home, which were then
incorpored in the lessons. In the results, the number
of vocabulary words increased, and the authors con-
cluded that the positive results were due to the lessons
with Baldi. Using an embodied agent might be a pos-
itive reinforcement since can more easily relate with
a non-human character. But with time, based on Put-
nam’s findings (Putnam and Chong, 2008), children
may get bored with the agent itself, leading to loss of
interest. This could mean that over time the lessons
may be increasingly strained, which ultimately leads
to decreased motivation and possibly to the reduction
of visible results.
Later, Massaro and Bosseler (2006) (Massaro
and Bosseler, 2006) also used Baldi as software to
conduct tests to teach vocabulary and grammar by
identifying pictures. Here the program provided
exercises in every lesson with a unique set of items
appropriate for the children’s vocabulary, knowledge,
and abilities. In each lesson they could use the
Baldi agent or only the spoken word. During the
exercises the child had to choose the correct image
given the word that was said, or to choose certain
areas of the image according to what was asked. In
some exercises they had positive reinforcements with
a happy face, or a sad face for incorrect answers.
At some point, the child was asked to vocalize the
name of the item or its function. Results showed that
there were more correct answers with Baldi, than
with the audio alone and in the overall the correct
answers increased. Although this approach using
Baldi it is different from the Bosseler and Massaro
(2003) (Bosseler and Massaro, 2003) study, the two
show that is possible to test several approaches with
the same tool, but the problems listed above of the
possible decrease in motivation still apply here, and
the results are clear in stating that using the agent is
more beneficial than without it.
A suggestive test using rich slides created in
Power Point was developed by Coleman-Martin
et al. (2005) (Coleman-Martin et al., 2005). In
their work, the authors focused on developing the
capacity to identify vocabulary words, by starting to
show a first slide with the target word written and
with the corresponding audio vocalization. Then
the subsequent slides presented words by phonemes,
for the child to repeat, which was then followed
by a positive reinforcement picture, and a sonorous
”Excellent”. The last slide presented the whole word
again. The results showed an increase in vocabulary
words, but they tested under three conditions: a) tutor
only, (b) tutor plus computer-aided protocol, and
(c) computer-aided protocol only. Although using
Power Point gives the possibility to easily change
all contents and structure, regularly creating and
updating slideshows fin-tuned to the childrens needs
can involve a considerably large and time consuming
effort. Another possibility is that they always use
the same document, but that raises the question
previously highlighted in another study about the
potential loss of interest due to habituation by the
child.
Finally, Hetzroni and Shalem (2005) (Hetzroni
and Shalem, 2005) tried a more simple approach fo-
cused on the vocabulary development, after a study
targeted at the development of communication skills
in social context (we will detail this study in the next
section). The authors developed a tool to implement a
7-step gradual fading protocol, where at first it shows
the picture of a food item with the name on it, and
then the pictures fade out until only the name is vis-
ible. They also used emoticons as a reinforcement.
Later, in the classroom setting, children were asked
to point out the food items that were written. Results
show that correct matches between the text and the
food items improved for all participants, but the soft-
ware shows limited resources and lacks any kind of
engaging contents for children.
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2.3 Communication in a Social Context
With a more social approach, Hetzroni and Tannous
(2004) (Hetzroni and Tannous, 2004) investigated the
possibility of enhancing communication functions of
children with autism, using software developed by
them. They focused on delayed echolalia, immediate
echolalia, irrelevant speech, relevant speech, and
communicative initiations. The software showed
animations of daily routines, and in each one an
animation of an adult asking a question related
with the current routine. After the child selects the
response from a given list, an animation is shown
with the results of the selected answer. The results
were positive, evidencing a decrease in delayed
echolalia, in immediate echolalia, and in irrelevant
speech, together with an increase in relevant speech
communication initiations. Also, this study showed
that children were able to transfer the knowledge
from the experimental settings to their real world rou-
tines. Over time, children train all possible situations,
repeating already trained scenarios, which may lead
to a decline in their interest and communication skills.
Woodcock and Woolner (2007) (Woodcock and
Woolner, 2007) describe a low cost and user-tuned
polysensory environment developed for children with
ASD; their work, called inserted in Project Spectrum,
which tries to engage children with ASD in using
digital technologies. This project has several modules
that try to address the whole triad of impairments, by
providing a set of predefined interactive activities that
are considered to be engaging for children with ASD.
It has the concern of including fun and engaging
content, leading children to actively seek the use of
the software. Using interactive activities, the authors
want to provide children with opportunities to com-
municate and encourage spontaneous vocalizations.
One of the drawbacks of this project is the fact that
it requires a demanding experimental setup: video
cameras for motion tracking, a microphone, lights,
a projector, speakers, and a computer. This setup
can be very expensive, it requires tutors to learn an
extensive set of skills to use it, and it doesn’t provides
implified modules for message exchange between
users.
Devised as a more practical approach, De Leo and
Leroy (2008) (De Leo and Leroy, 2008) use a
smartphone as a mean to enhancing communication
and social skills. They developed a tool called
PixTalk
1
, which gives the possibility of choosing
from any image placed in the program (that can be
customized according to the user’ interests), write
1
http://www.communicationautism.com
a message, and send it to another user. This is a
conceptually approach when compared to ours, since
they try to meet the interests and preferences of
the users and let them communicate in the way in
which they feel more comfortable with. This project
evolved to a commercial tool called I Click I Talk
2
and currently has more features than the one used
in the study. We were not able to have access to the
results of this study, but since a similar approach was
followed, we thought that was important to make a
reference. Despite the message functionality being
similar, it still lacks all the other functionalities and
ease of content access and customization, like videos
or images to help motivate tool usage and sharing
preferences.
Thinking more specifically in a classroom envi-
ronment and its requirements, often forgotten in these
studies, Hirano et al. (2010) (Hirano et al., 2010)
developed vSked, an interactive and collaborative
visual scheduling system, designed for elementary
school classrooms. They define a visual schedule
as a set of pictures or words that cues someone to
engage in a sequence of activities. They tested it as a
timetable with all the children’s activities during the
day, and each entry on the timetable had an animation
associated with that activity. Each student received
a notification in their personal devices indicating a
location of that activity, or a set of choices for the
child to choose the right location. It also provided
help when the child chose the wrong answer, or just
didn’t answer. When the answers were correct, chil-
dren were rewarded with animations of their liking.
The acceptance in the classroom was good both by
the children and staff, which reported reductions
in the effort required to use visual supports. The
results were also positive, showing that the children
have interest in using the system, and reached an
increase in communication and social interactions
in the classroom. But despite proving to be a useful
tool, it has a different purpose, and doesn’t enable the
children to communicate directly with their peers, or
visualize their favorite content.
Ohene-Djan (2010) (Ohene-Djan, 2010) de-
veloped Winkball, a new Internet-based video
messaging and broadcasting technology, designed to
support the teaching of oral and visual communica-
tion skills in schools. Despite not targetting children
with ASD, the author believes that the technology
can also be beneficial for this population, since
the use of media is usually perceived as interest-
ing and motivating. The author doesn’t show any
2
http://www.iclickitalk.com
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tests or results related with the tool, and therefore it
is difficult to draw conclusions about its effectiveness.
Millen et al. (2011) (Millen et al., 2011) tried
to find ways of supporting communication and
collaboration skills for children with autism in the
scope of the COSPATIAL project (Communication
and social participation: collaborative technologies
for interaction and learning)
3
. This project de-
veloped a suite of applications composed by two
Collaborative Virtual Environments (CVE) to support
the enhancement of social skills in children with
autism, and two educational technologies in the
form of Shared Active Surfaces (SAS). This suite
is composed by Block Party CVE (a collaborative
puzzle-style game that requires users to communicate
and collaborate in order to build a specific tower of
blocks in a given pattern), TalkAbout CVE (an avatar
with which children must train a social conversation),
Join-In Suite SAS (a set of short problematic stories
presented to children, that have different solutions
either given by the program or suggested by the chil-
dren, which the child can experience later in a game),
and No-Problem! (an activity in which children
can explore stages of a social conversation, explore
alternatives solutions or suggest new ones). To date,
only descriptive information about the project and its
goals is available, meaning that there are no results
available. Still, we considered important to make a
reference to such a project.
Finally, Cihak et al. (2012) (Cihak et al., 2012)
tried a simple approach consisting on the evaluation
of PECS used in conjunction with Video Modeling
(VM) as a technique to increase independent commu-
nicative interactions in children with limited to no ver-
bal communication skills. In this study, the authors
use video to teach what would normally be taught
with PECS. Tests show that as a result of using VM in
conjunction with PECS, all students increased inde-
pendent communication interactions, and the students
rate of learning was quicker when using VM. Still,
this technique is very limited in giving the children a
comprehensive set of tools to enable learning of com-
munication skills, and communicating with others.
2.4 General Communication Learning
Rodr
`
ıguez et al (2004) (Gea-Meg
´
ıas et al., 2004)
propose the Sc@ut Communicator, an Augmenta-
tive and Alternative Communication (AAC) designed
to help people with communication problems, such
3
http://cospatial.fbk.eu
as subjects with ASD dysphasia and brain paraly-
sis. The communicator runs in several portable de-
vices (pocket PCs, mobile phones, video game con-
soles and computers), and uses hypermedia templates
with sounds and pictures to improve learning. Sc@ut
shows a structure of templates with images, simi-
lar to PECS. Images can be pictograms, photos or
drawings, which represent objects that the user can
ask for, or actions that can be carried out. When
an image is selected, an associated sound previously
stored is played. This sound, which can be a word
or a sentence, represents a reinforcement for the user
and allows tutors to know what the user wants. It
also provides links between templates, when a spe-
cific image is selected in it. This interaction allows
the construction of structured sentences, or the clas-
sification of actions and elements. They also have
a separate tool called Sc@ut Generator (Gea-Meg
´
ıas
et al., 2004), which allows the Communicator to be
customized “ad-hoc”, while the child is progressing
in his learning activities, thus adapting dynamically
to the progress of the child, unlike other more rigid
AAC systems. This way tutors can change content
and interaction, adapting them to specific educational
contexts, so that the software can be used as a sup-
port in learning process. This tool tries to adapt to the
children’ needs and give them a way to easily learn
context-specific situations, but it doesn’t allow them
communicate directly with other people.
2.5 Commercial Tools
There are a few applications in the market that despite
not being the matter of a study for which we can
assess experimental results, are still important to look
and evaluate. Some of them have been specifically
developed for people with ASD, trying to help with
the cognitive and communication impariments. Other
tools are broad spectrum and aimed at populations
with very distinct needs, although they are also
applicable to people with ASD. As in the previous
section we are going to analyze and describe these
tools.
Zac Browser
The Zone for Autistic Children Browser (Zac
Browser)
4
, is a multimedia software developed for
children with ASD. This tool was inspired in an
autistic child named Zachary, which was unable to
use his computer using regular computer software
tools (e.g. Internet Explorer, Windows Messenger,
etc.). Faced with these difficulties, his grandfather
decided to develop the Zac Browser as a software
4
http://zacbrowser.com
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289
completely adapted to Zachary’s needs with a more
visual navigation, and safer to use due to parental
control. This software is especially designed for
recreational and entertainment use, and as such, it
does not explore the interpersonal communication
specificities. Furthermore, tutors are limited in terms
of content adaptation and software configuration,
given that they are bound to the pre-defined contents.
Furthermore, the tool depends on Internet connection
to access most contents, which may not available in
every school.
Boardmaker
Boardmaker
5
is a suite of applications that enables
the adaptation of learning materials to the needs of
each child. The program has a large database of
symbols they call Picture Communication Symbols
(PCS)
TM
, and allows the users to create any kind
of customized material, such as schedules, manual
communication boards, books, teaching materials,
etc. The material can be used in the computer or
printed, making this tool usefull to create materials
for teaching, however, this software is designed
for the tutor and was not conceived to be used by
children.
TeachTown
TeachTown
6
is a Computer-Assisted Instructional
(CAI) program designed for developmental ages
between 2-6 years, specifically to meet needs of ASD
population. The program includes a comprehensive
curriculum that aligns to standardized measures,
which integrated the following learning domains: 1)
Language Development; 2) Social and Emotional
Skills; 3) Adaptive Skills; 4) Cognitive Skills; 5)
Language Arts; and 6) Mathematics. The curricu-
lumdepends on the performance and is adjusted for
each student. Tutors can customize the curriculum
to meet Individual Educational Plan (IEP) goals.
TeachTown also collects data from the children usage
and produces reports, to track the student progress.
This tool is one of the most complete applications for
children with ASD currently available, and extensive
research has proven that an ICT tool like TeachTown
has beneficial results. However, this tool is not
completely customizable, and it is not targetting all
the children preferences, which can have poor effects
in their attention and engagement. Furthermore,
this tool was devised for individual use, and lacks
features that can promote communication and social
interaction skills.
5
http://www.mayer-johnson.com/boardmaker-software
6
http://web.teachtown.com/
Tablet Applications
With the advent of the iPad, several new applica-
tions have been created for children to use in tablet
devices, motivated by the ease-of-use of the touch-
screen. In fact, touchscreens brought new possibil-
ities, since users with cognitive and motor impair-
ments have an easier way to interact with the com-
puter. Instead of using the usual keyboard and mouse,
which requires a higher coordination or a greater un-
derstanding of its operation that the child sometimes
does not have, tablets enable a more natural interac-
tion.
There are some applications that became a ref-
erence in the autism area such as Proloquo2Go
7
,
MyTalk
8
, Grace
9
and iCommunicate
10
. Despite be-
ing different applications, all of them use the PECS
format to communicate; the child can choose the pic-
ture that best translates what he/she is trying to say,
or combine several pictures to write a phrase or story.
Some applications also have voice speech that reads
what the children write. Most of them are paid, which
means that these applications are developed with a
commercial purpose in mind, and they only allow a
local and physical interaction using the tablet with
their peers.
3 CONCLUSIONS
In the overall, existing approaches and methodolo-
gies proposed to date focus on self-development and
don’t show much concern towards enabling children
to communicate with each other, to adapt the tool to
the user, or deliver any kind of courseware. Most of
the work found to data is inspired in PECS, which is
a simple system that children understand, and is sim-
ple to use. After a closer look at the studies focused
on communication, we can understand the different
concerns and tactics used. In vocalizations studies
we see that audio is the most important feature to be
used, as these approaches try to resort to imitation as
a way to increase the user confidence in using speech.
We can see that only two use images, and only one
uses video, from which we can infer that using this
kind of media to motivate speech imitation might be
intentionally avoided, in order to prevent any stress
caused by the people present or interacting with peo-
ple (even if it is through the computer). In general at
the end of the tasks, all experimental setups present
animations to the user as a positive feedback reward
7
http://www.assistiveware.com/product/proloquo2go
8
http://www.mytalktools.com
9
http://www.graceapp.com
10
http://www.grembe.com/icommunicate
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for their efforts, motivating them. As previously de-
scribed, in this type of tests, direct human interactions
are not used, and so there are no social components
involved. Furthermore, except for one of the stud-
ies (Simpson et al. (2004) (Simpson et al., 2004)),
none of the proposed approaches gives the possibil-
ity to change any aspect of the tool. It is also im-
portant to highlight that most of the platforms used
in the presented studies are not developed specifically
for the study; most of the features addressed by our
work are not be present because the researchers sim-
ply were not able to experiment with them or just
haven’t felt the need to use it. In the vocabulary
expansion field, where most studies are found, most
of the conclusions stated for vocalizations also ap-
ply. We see that social communication continues to be
missing, also probably to avoid stressing the children.
Media support is found to be very important; most of
the studies support mainly images, audio and anima-
tions, although videos still don’t seem to have much
importance, since most of the studies don’t support
or use them in the tests. The main difference is that
most of the tools enable the possibility to change con-
tent (Heimann et al., 1995; Moore and Calvert, 2000;
Bosseler and Massaro, 2003; Coleman-Martin et al.,
2005; Hetzroni and Shalem, 2005), which might show
that researchers realized the importance of adapting
the tool to the user, in order to achieve better out-
comes. These results also apply to the studies that
focus on developing communication in a social con-
text, and where the only obvious difference is the in-
clusion of message exchange in three of the studies
(De Leo and Leroy, 2008; Ohene-Djan, 2010; Millen
et al., 2011). Other commercial tools include more
functionalities supporting most media formats, mes-
sages and the possibility to change a few aspects of
the content and some functionalities of the tool itself
(a feature not found in any of the other studies). How-
ever, these features are motivated by the need to ad-
dress the requirements of a broader spectrum of tar-
get user groups (e.g. people with motor impairments),
which in most cases does not account for aspects that
are core to the ASD population, such as having en-
gaging and fun contents and interfaces. But they don’t
show much concern about being able to put the chil-
dren to communicate with each other, to adapt the tool
to the user, or deliver any kind of courseware. All
of the studies explore the use of multimedia, which
shows us that this is the most effective way of cap-
turing the attention of the children and help in the de-
velopment of new communication skills. In general,
we see that two of the main lines of research, the en-
hancement of the children’s vocalizations and vocab-
ulary, are using a more mechanic approach supported
by imitation combined with a visual and audio pos-
itive reinforcement. This kind of approach, despite
helping children to talk, doesn’t help them to com-
municate with other people or offers ways to do it in
a comfortable way for them. These tools also have
a high probability of leading to lack of interest over
time, since the contents and interface are always the
same, not giving the possibility for tutors to change
anything in order to stimulate a more constant mo-
tivation. This same reason makes the tool less fun
for the children, which is an important factor that is
pointed out in Putnam’s study (Putnam and Chong,
2008) as one of the main causes of abandonment in
computer-based interventions. These issues arise due
to the fact that little power is given to the tutors, to
change either contents, or the tool interface, easily
becoming outdated. None of the studies focuses on
the tutors’ or parents’ deep knowledge of their child’s
interests and needs, which should be one of the best
ways to get through to the child and prepare user-
tuned contents in a way that is more engaging and
positive for their personal development. New possi-
bilities have emerged with touchscreen technologies
(e.g. smartphones and tablets), bringing new oppor-
tunities to users (usually paid), and mostly designed
to help parents in the interaction with their children.
Typically, most applications arising nowadays show
concerns about enabling the children to compose sto-
ries or phrases to communicate, using custom key-
boards or touchscreen, to facilitate the handling of the
and to enhance self-communication through and mes-
sage composition.
ACKNOWLEDGEMENTS
This work has been partially funded by Fundac¸
˜
ao Por-
tugal Telecom, ASUSTeK Computer Inc., and by the
Fundac¸
˜
ao para a Ci
ˆ
encia e Tecnologia (FCT) under
project PEst-OE/EEI/LA0021/2013.
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