Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition that affects 1% of the population. Individuals with this condition can exhibit difficulties with social interaction, and can also exhibit other restricted or repetitious behaviours.
In terms of treatments, lost earnings, care and support, ASD has been estimated to cost the UK as much as £32 billion/year. Developing interventions at a young age - ideally school-based - that could maximise educational, social and mental health outcomes is therefore a research and public health priority.
Emotional training
One of the main features of ASD is impaired social function, including recognition of emotional expressions, which likely plays a key role in the social interaction issues that people with ASD experience. Giving these individuals help with emotional processing has been shown to lead to improvements in social functioning abilities, social emotional skills, and contextual adaptive behaviour, which in turn improves the individual’s quality of life.
Dr Angela Attwood and her team developed, in conjunction with teachers and caregivers, an app called “AboutFace”, which trains ASD individuals to recognise emotions and interpret them appropriately.
Attention and memory
“Our app includes a range of activities to teach children to use emotional words and to match emotions to different faces”, Dr Attwood explained. “These activities engage different cognitive domains, including attention and memory, to provide an engaging and holistic approach to emotional processing development.”
The app, which is iPad based to maximise flexibility of use, also has a range of user-chosen options to tailor the tasks (e.g. a slider to dynamically increase/decrease emotional intensity), and it provides concrete examples of emotional expressions using different age and ethnicity faces.
Dr Attwood continued, “AboutFace was co-produced with teachers, parents and ASD students, which is a crucial omission in existing interventions. It displays life-like stimuli by morphing photographs of individuals to create “prototype” facial images. These provide a large stimulus set comprising a range of emotions and emotional intensities. Therefore, we can include low intensity emotions that enable the intervention to be tailored to individual abilities.”
Confidence in Concept
Dr Attwood’s group used a Confidence in Concept award from the Elizabeth Blackwell Institute and the MRC to take the app to focus groups at schools, and to conduct user experience sessions with both staff and students. The team also conducted a proof-of-concept study, where children across different types of schools engaged with the app, and in so doing, they were able to expand the network of schools that the team was able to contact to take part in the research.
As well as demonstrating that the app could work in the classroom setting with good training fidelity, the study also identified key areas in which improvements could be made, as Dr Attwood explains.
Meets the need
“Our results showed us that emotional processing was identified as a problem with a lack of needed resources, and that our AboutFace app had the potential to meet this need across a variety of different school types - from mainstream schools to those with Special Educational Needs (SEN). We were also able to identify several important ways in which the app could be improved, principally by including supplementary classroom materials, and reconfiguring it to a multi-modal intervention.”