A tablet-based game for the assessment of visual motor skills in autistic children.

Abstract

Increasing evidence suggests that early motor impairments are a common feature of autism. Thus, scalable, quantitative methods for measuring motor behavior in young autistic children are needed. This work presents an engaging and scalable assessment of visual-motor abilities based on a bubble-popping game administered on a tablet. Participants are 233 children ranging from 1.5 to 10 years of age (147 neurotypical children and 86 children diagnosed with autism spectrum disorder [autistic], of which 32 are also diagnosed with co-occurring attention-deficit/hyperactivity disorder [autistic+ADHD]). Computer vision analyses are used to extract several game-based touch features, which are compared across autistic, autistic+ADHD, and neurotypical participants. Results show that younger (1.5-3 years) autistic children pop the bubbles at a lower rate, and their ability to touch the bubble's center is less accurate compared to neurotypical children. When they pop a bubble, their finger lingers for a longer period, and they show more variability in their performance. In older children (3-10-years), consistent with previous research, the presence of co-occurring ADHD is associated with greater motor impairment, reflected in lower accuracy and more variable performance. Several motor features are correlated with standardized assessments of fine motor and cognitive abilities, as evaluated by an independent clinical assessment. These results highlight the potential of touch-based games as an efficient and scalable approach for assessing children's visual-motor skills, which can be part of a broader screening tool for identifying early signs associated with autism.

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Citation

Published Version (Please cite this version)

10.1038/s41746-023-00762-6

Publication Info

Perochon, Sam, J Matias Di Martino, Kimberly LH Carpenter, Scott Compton, Naomi Davis, Steven Espinosa, Lauren Franz, Amber D Rieder, et al. (2023). A tablet-based game for the assessment of visual motor skills in autistic children. NPJ digital medicine, 6(1). p. 17. 10.1038/s41746-023-00762-6 Retrieved from https://hdl.handle.net/10161/27360.

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Scholars@Duke

Carpenter

Kimberly Carpenter

Associate Professor in Psychiatry and Behavioral Sciences

Dr. Kimberly Carpenter is a clinical neuroscientist specializing in understanding complex brain-behavior relationships in young children with autism and associated disorders. Her program of research includes four interrelated research themes: (1) Understanding the impact of comorbid disorders on clinical and behavioral outcomes of young autistic children; (2) Identification of early risk factors for the development of psychiatric and neurodevelopmental disorders; (3) Identification of brain-based biomarkers for group stratification and treatment response tracking in young children; and (4) Improving methods for screening, early identification, and treatment monitoring in autism and associated disorders. She currently leads an innovative research program exploring the shared and unique impacts that co-occurring anxiety and ADHD have on brain and behavioral biomarkers in young autistic children. She was the first to demonstrate that sensory over-responsivity, a symptom that has been described as part of a number of disorders including autism, anxiety, and ADHD, is a specific and unidirectional risk factor for the development of anxiety disorders in young children. She was also the first to demonstrate that, when accounting for comorbidity among individual anxiety disorders, specific anxiety disorders are associated with phenotypically meaningful differences in brain connectivity using MRI. Dr. Carpenter has also collaborated with experts in early childhood mental health, computer science, and engineering to develop novel technologies that utilize multi-modal methods via computer vision and machine learning to develop, refine, and test novel screening tools for early identification and treatment monitoring in young children with autism and related disorders.

Davis

Naomi O. Davis

Assistant Professor in Psychiatry and Behavioral Sciences
Franz

Lauren Franz

Associate Professor of Psychiatry and Behavioral Sciences

Dr Franz's research focuses on improving access to evidence-based services and support for neurodevelopmental disabilities, including autism, in diverse, low-resource, local and global communities.

Sapiro

Guillermo Sapiro

James B. Duke Distinguished Professor of Electrical and Computer Engineering

Guillermo Sapiro received his B.Sc. (summa cum laude), M.Sc., and Ph.D. from the Department of Electrical Engineering at the Technion, Israel Institute of Technology, in 1989, 1991, and 1993 respectively. After post-doctoral research at MIT, Dr. Sapiro became Member of Technical Staff at the research facilities of HP Labs in Palo Alto, California. He was with the Department of Electrical and Computer Engineering at the University of Minnesota, where he held the position of Distinguished McKnight University Professor and Vincentine Hermes-Luh Chair in Electrical and Computer Engineering. Currently he is the Edmund T. Pratt, Jr. School Professor with Duke University.

G. Sapiro works on theory and applications in computer vision, computer graphics, medical imaging, image analysis, and machine learning. He has authored and co-authored over 300 papers in these areas and has written a book published by Cambridge University Press, January 2001.

G. Sapiro was awarded the Gutwirth Scholarship for Special Excellence in Graduate Studies in 1991,  the Ollendorff Fellowship for Excellence in Vision and Image Understanding Work in 1992,  the Rothschild Fellowship for Post-Doctoral Studies in 1993, the Office of Naval Research Young Investigator Award in 1998,  the Presidential Early Career Awards for Scientist and Engineers (PECASE) in 1998, the National Science Foundation Career Award in 1999, and the National Security Science and Engineering Faculty Fellowship in 2010. He received the test of time award at ICCV 2011. He was elected to the American Academy of Arts and Sciences on 2018.

G. Sapiro is a Fellow of IEEE and SIAM.

G. Sapiro was the founding Editor-in-Chief of the SIAM Journal on Imaging Sciences.

Dawson

Geraldine Dawson

William Cleland Distinguished Professor

Geraldine Dawson is the William Cleland Distinguished Professor of Psychiatry and Behavioral Sciences at Duke University, where she also is a Professor of Pediatrics and Psychology & Neuroscience.  Dawson also is the Founding Director of the Duke Center for Autism and Brain Development, an NIH Autism Center of Excellence, which is an interdisciplinary research program and clinic, aimed to improve the lives of those diagnosed with autism through research, education, clinical services, and policy. Dawson received a Ph.D. in Developmental and Child Clinical Psychology from the University of Washington and completed a clinical internship at the UCLA Neuropsychiatric Institute.

Dawson's work focuses on improving methods for early detection and intervention for autism, understanding brain function in autism, and validation of autism EEG biomarkers. She co-developed the Early Start Denver Model, an empirically-validated early autism intervention that is used worldwide. She collaborates with colleagues in the departments of computer science and engineering, pediatrics, and biostatistics to develop novel digital health approaches to autism screening and outcome monitoring. 

Dawson previously served as Director of the Duke Institute for Brain Sciences, President of the International Society for Autism Research, and was appointed by the US Secretary of Health as a member of the NIH Interagency Autism Coordinating Committee (IACC) which develops the federal strategic plan for autism research, services, and policy. Dawson is a member of the American Academy of Arts and Sciences. She was Founding Director of the University of Washington (UW) Autism Center and the Duke Center for Autism and Brain Development. Dawson's awards include the American Psychological Association Distinguished Career Award (Div53); Association for Psychological Science Lifetime Achievement Award; Clarivate Top 1% Cited Researcher Across All Scientific Fields; among others. Dawson is a Fellow of the International Society for Autism Research, the American Psychological Society, and the American Psychological Association. 


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