Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let’s Face It! program
Open accessAbstract
Background: An emerging body of evidence indicates that relative to typically developing children, children with autism are selectively impaired in their ability to recognize facial identity. A critical question is whether face recognition skills can be enhanced through a direct training intervention. Methods: In a randomized clinical trial, children diagnosed with autism spectrum disorder were pre‐screened with a battery of subtests (the Let’s Face It! Skills battery) examining face and object processing abilities. Participants who were significantly impaired in their face processing abilities were assigned to either a treatment or a waitlist group. Children in the treatment group ( N = 42) received 20 hours of face training with the Let’s Face It! ( LFI! ) computer‐based intervention. The LFI! program is comprised of seven interactive computer games that target the specific face impairments associated with autism, including the recognition of identity across image changes in expression, viewpoint and features, analytic and holistic face processing strategies and attention to information in the eye region. Time 1 and Time 2 performance for the treatment and waitlist groups was assessed with the Let’s Face It! Skills battery. Results: The main finding was that relative to the control group ( N = 37), children in the face training group demonstrated reliable improvements in their analytic recognition of mouth features and holistic recognition of a face based on its eyes features. Conclusion: These results indicate that a relatively short‐term intervention program can produce measurable improvements in the face recognition skills of children with autism. As a treatment for face processing deficits, the Let’s Face It! program has advantages of being cost‐free, adaptable to the specific learning needs of the individual child and suitable for home and school applications.
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Six studies used serious games in the cognition training genre.
“Six studies used serious games in the cognition training genre (48, 58, 59, 61, 63, 65).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Beaumont and Sofronoff and Tanaka et al. had facial expression as a common primary outcome measure.
“Beaumont and Sofronoff (35) and Tanaka et al. (63) had facial expression as common primary outcome measure.”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The cognition training game Let's Face It! was used in order to reduce ASD-related symptoms such as poor facial recognition skills.
“The cognition training game Let’s Face It! was used in order to reduce ASD-related symptoms such as poor facial recognition skills (63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The intervention in Tanaka et al. had a duration of 19.1 weeks on average.
“The intervention had a duration of 19.1 weeks average (63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Two studies used serious games to address symptoms of ASD.
“Two studies used serious games to address symptoms of ASD (35, 63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Let's Face It! used face subtests and object subtests.
“Let’s Face It! used face subtests (face dimensions, immediate memory for faces, matching identity, masked features, expression, and parts/whole identity) and object subtests (house dimensions and immediate memory for cars) (63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Eight studies used serious games that were designed as such, and two studies used an existing entertainment game for a serious purpose (purpose-shifted).
“Eight studies used serious games that were designed as such (34, 35, 58–63). Two studies used an existing entertainment game for a serious purpose (purpose-shifted) (48, 64).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The games of Tanaka et al. are based on the theory of enhancement of recognition skills.
“The games of Tanaka et al. (63) are based on the theory of enhancement of recognition skills (63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
ASD was the focus of two studies.
“ASD was the focus of two studies (35, 63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Four studies had a high likelihood of incomplete outcome data.
“Four studies had a high likelihood of incomplete outcome data (35, 58, 60, 63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Five studies reported adequate random sequence generation.
“Five studies reported adequate random sequence generation (34, 59, 60, 62, 63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
Excluding the study with the highest and lowest effect size showed similar results.
“Excluding the study with the highest (34) and lowest (63) effect size showed similar results (see Table 3).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The group that aimed at ASD-related symptoms was shown to have a moderate non-significant effect size [g = 0.46 (95% CI 0.10-0.81, NNT = 3.91)].
“The group that aimed at ASD-related symptoms such as lowered ability of recognition skills (35, 63) was shown to have a moderate non-significant (P > 0.05) effect size [g = 0.46 (95% CI 0.10–0.81, NNT = 3.91)].”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The group targeting youth (≤18) was shown to have a moderate effect size [g = 0.70 (95% CI 0.32-1.07, NNT = 2.63)].
“The group targeting youth (≤18) (34, 35, 59–61, 63) was shown to have a moderate effect size [g = 0.70 (95% CI 0.32–1.07, NNT = 2.63)]”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The group targeting clinical participants showed a moderate effect size of [g = 0.59 (95% CI 0.18-0.99, NNT = 3.09)].
“The group targeting clinical participants (with diagnosed mental disorder) (35, 59, 61, 63) showed a moderate effect size of [g = 0.59 (95% CI 0.18–0.99, NNT = 3.09)]”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
The majority of studies focused on youth and young adults especially for ASD, ADHD, and depression.
“The majority of studies focused on youth and young adults especially for ASD, ADHD, and depression (34, 35, 59–61, 63).”
From Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis (2017) · cites this paper as [63]
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- Authors
- Tanaka, J. W., Wolf, J. M., Klaiman, C., Koenig, K., Cockburn, J., Herlihy, L., Brown, C., Stahl, S., Kaiser, M. D., & Schultz, R. T.
- Affiliations
- University of Victoria (CA)
- Yale University (US)
- Rutgers, The State University of New Jersey (US)
- University of Pennsylvania (US)
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2010-07-09
- Volume
- 51
- Issue
- 8
- Pages
- 944-952
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2109068575
- Cited by
- 318
- References
- 40
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 13 · 2023: 15 · 2022: 15 · 2021: 26 · 2020: 17 · 2019: 22 · 2018: 28 · 2017: 23 · 2016: 29 · 2015: 25 · 2014: 37 · 2013: 22 · 2012: 17
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation (0542013)
- James S. McDonnell Foundation
- University of Victoria
- National Institutes of Health (SBE-0542013)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD046526)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Keywords
- autism spectrum disorder, face recognition (cognition), computer-based intervention, interactive computer games, facial expression recognition, children
- MeSH terms
- Attention, Child, Child Development Disorders, Pervasive, Discrimination Learning, Face, Facial Expression, Female, Follow-Up Studies, Humans, Male, Memory, Short-Term, Pattern Recognition, Visual, Perceptual Masking, Retention, Psychology, Therapy, Computer-Assisted, Video Games, Asperger Syndrome
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