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Evaluating a Collaborative iPad Game’s Impact on Social

Relationships for Children with Autism Spectrum Disorder

LOUANNE E. BOYD, University of California, Irvine

KATHRYN E. RINGLAND, University of California, Irvine
OLIVER L. HAIMSON, University of California, Irvine
HELEN FERNANDEZ, La Habra City Schools
MARIA BISTARKEY, La Habra City Schools
GILLIAN R. HAYES, University of California, Irvine

This paper describes how collaborative assistive technologies, housed on off-the-shelf low cost platforms
such as the iPad, can be used to facilitate social relationships in children with autism spectrum disorder
(ASD). Through an empirical study of the use of a collaborative iPad game, Zody, we explore how assistive
technologies can be used to support social relationships, even without intervention from adults. We discuss
how specific design choices can encourage three levels of social relationship: membership, partnership, and
friendship. This work contributes to research on both assistive technologies and collaborative gaming
through a framework that describes how specific in-game elements can foster social skill development for
children with ASD.
Categories and Subject Descriptors: H5.2 [Information interfaces and presentation (e.g. HCI)]: User
Interfaces---Evaluation/methodology, interaction styles; Group and Organization interfaces---Collaborative
computing, Computer-support-cooperative work, Synchronous interaction, Theory and methods, K.4.2
[[Social Issues]: Assistive technologies for persons with disabilities
General Terms: Design, Human Factors
Additional Key Words and Phrases: collaborative games, iPad, autism, ASD, social skills, cooperation,
social
ACM Reference Format:
Boyd, L. E., Ringland, K. E., Haimson, O. L., Fernandez, H., Bistarkey, M., and Hayes, G. R. 2014. ACM
Trans. Access Comput. 2015. Evaluating a collaborative iPad game’s impact on social relationships for
children with autism spectrum disorder.

1. INTRODUCTION AND BACKGROUND

Individuals with Autism Spectrum Disorder (ASD) 1 often experience difficulties
developing social relationships [Baron-Cohen 1988, Dawson et al. 2004, Kasari et al.

Author’s addresses: LouAnne E. Boyd, Department of Informatics, University of California, Irvine, CA

92697-3440; email: [email protected]; Kathryn E. Ringland, Department of Informatics, University of
California, Irvine; Oliver L. Haimson, Department of Informatics, University of California, Irvine; Gillian
R. Hayes, Department of Informatics, University of California, Irvine, Helen Fernandez and Maria
Bistarky, La Habra City School District.
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DOI:http://dx.doi.org/10.1145/0000000.0000000
1
Autism Spectrum DisorderDisorders is an umbrella term used in the Diagnostic and Statistical Manual
5th edition to describe a range of difficulties with social communication and repetitive behavior. In previous
editions of the DSM, symptoms were clustered into categories such as autism, Asperger’s syndrome, and
Pervasive Developmental Disorder Not Otherwise Specified.

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2001, Travis and Sigman 1998], leading to social isolation [Ghaziuddin et al. 2002,
White et al. 2007, Hurtig et al. 2009, Boyd and Ward 2013]. Rates of depression are
substantially higher (25% vs. 10%) for people with ASD compared to the general
population, potentially due to a lack of friends [Leyfer et al. 2006, Lieb 2011]. Of
adults with ASD, only 8% report interacting with a “friend” on a weekly basis
[Orsmond et al. 2004]. Social difficulties can be improved through intervention across
the lifespan [Gerhardt and Mayville 2010, Krasny et al. 2003, Reichow and Volkmar
2010]. To simplify thinking about social relationships and interventions to support
them, we developed a framework of social relationships. Informed by our analysis of
collaborative patterns among children with ASD when playing an iPad game, our
framework includes three categories of social relationships with increasing levels of
intimacy: membership, partnership, and friendship.
We define membership as being part of a group and participating, such as being
physically present and making a small action that contributes to the group’s activity.
For example, membership can include sitting with a group at a table and saying
‘hello’ to the others already seated. Interventions that aim to address membership
usually do so by focusing the training on a group of peers of which the child is
expected to already be a part (e.g, Circe of Friends [Kalyva and Avramidis, 2005],
peer-mediated social skills training [Laushey and Heflin 2000]).
Partnership, defined simply here as two people having specific responsibilities in
achieving their mutual endeavor, has likewise been supported through a variety of
interventions. For example, parent-assisted friendship training [Frankel et al. 2010]
aims at teaching social etiquette and social rules to the child with ASD that are used
by the child’s peer group. Relationship Development Intervention (RDI) [Gutstein
2002] supports adults in teaching the collaborative interactions of partnership by
systematically teaching synchronization and reciprocal responding as well as the
highly emotional interactions of friendship. In this case, friendship consists of having
mutual interests and an affinity for each other. Interventions designed to support
friendships tend to include creating enriched emotional experiences that can become
shared memories.
Across all of these types of social relationships, one substantial challenge remains.
Interventions that support them currently require intensive effort from parents,
therapists, and other mediators. Thus, in this work, we were interested in
understanding whether and how technology might be used to support the building of
social skills at all three of these levels with limited or no human mediation. To
address this research question, we evaluated the use of a collaborative tablet game
intended to teach social skills to children with ASD. Our results indicate that such
games can be designed to support teaching social skills at all three levels of intimacy
without a human mediator. However, the specific mechanisms by which such
instruction occurs must be adapted to the particular skills, strengths, and challenges
of the individuals using the game.
The remainder of this paper is structured as follows. First, we provide an
overview of related work in interactive and collaborative technologies to support
social skills development as well as gaming for socialization. We then detail our
methods for this empirical study. Finally, we present the results of our study in light
of these three levels of intimacy: membership, partnership, and friendship; closing
with a discussion of how future technologies might be designed to support these skills.

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2. RELATED WORK
Research on using assistive technology to support social skills traditionally focuses
on an individual user engaging with a device to support the development of specific
skills [McCoy and Waller 2009]. For example, Tartaro and Cassell [2011]
demonstrated that a life-sized virtual peer could be used to teach social skills by
interacting with a child with ASD, sharing toys and responding to the child’s input.
Similarly, robots have been shown to be able to assist children with ASD in
collaborative play that required continual communication, coordination and
synchronization between the two participants [Wainer 2012]. Additionally,
collaborative virtual environments [Cheng and Ye 2010], consisting of a 3D
expressive avatar, an animated social situation, and verbal and text communication,
allowed children with ASD to improve their social interactions and understanding of
social interactions. Finally, in the ECHOS project, a technology that detects the
user’s eye gaze at objects on the screen and responds to the user based on where he is
looking on the screen facilitated joint attention (the shared focus of two people)
between the computer agent and the child with ASD [Porayska-Pomsta et al. 2012].
These projects demonstrate that technologies can be used to engage directly with
children individually to teach specific social skills.
Building on this work, a growing body of research addresses social relationship
skills by developing tools for multiple children with social skills deficits to collaborate
using the same device [e.g., Gal et al. 2009, Hourcade et al. 2012, Piper et al. 2006].
Touchscreens and other shared interactive surfaces “allow face-to-face interaction
and multiple simultaneous inputs from individuals acting independently or as part of
a group” [Morris et al. 2006 as cited in Kientz et al. 2013], making them particularly
compelling as platforms for developing collaborative applications and games for
children with ASD. Because of their inherently collaborative features, touchscreens
have been used in research studies to teach a variety of social skills.
In particular, the high levels of structure that can be imparted using touchscreens
have been shown to improve student performance in joint activities [Bullock-Rest
and Hansen 2007, Gal and Goren-Bar 2007, Hourcade et al., 2012]. For example,
Piper et al. (2006) developed and evaluated a tabletop system to support the teaching
of turn taking, called SIDES. By using a system that contained prescribed and
limited choices, clear visual directions, and consistent feedback, SIDES not only
encouraged turn taking during the game but improved social skills overall for
participants. Likewise, as part of the Serious Games for PDD-NOS 2 project,
researchers found that by playing a collaborative game for approximately 20 minutes
per day, students improved in their abilities to collaborate within the game. However,
these skills did not generalize to other classroom skills [van Veen et al. 2009].
Although these projects are promising, they all use very large touchscreens, which
are not cost effective for most schools and clinics and are too bulky for use in many
situations.
With the advent of tablets and other mobile shared surfaces, smaller scale
collaborative systems are much more likely to be used outside of the research setting.
For instance, the Open Autism Project focused on the use of multi-touch tablets for
encouraging social interactions “through creative, expressive, and collaborative
activities” [Hourcade et al. 2013]. Hiniker et al. (2013) found that using game

2
PDD-NOS stands for “Pervasive Developmental Disorder-Not Otherwise Specified”, and was a diagnostic
category used when social, communication and cognitive deficits that did not meet full criteria for autism
while also not meeting criteria for another developmental disorder per the DSM-IV IV [APA 2000]

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elements in a suite of cognitive tasks on the tablet could support extended

engagement in therapeutic activities.
Outside of the specific ASD technology community, multiplayer games have been
shown to encourage sociability and communication among players [Seay et al. 2003]
to accomplish shared goals [Brown and Gutwin 2003, Wendel et al. 2013]. Despite the
concern that some video games may promote violence or other “anti-social” behaviors
[The Harris Poll 2013], recent empirical research indicates that the rate of violence
has actually decreased at the same time that sales of violent games have increased
[Cunningham et al. 2011]. Even players of first person shooter games have been
found to seek out social relationships with other players [Xu et al. 2011].
Collaborative virtual environments, including games, successfully encourage
partnership by requiring users to use offline skills to carry out activities within a
virtual environment [Bowers et al. 1996]. In fact, much of the “fun” of games may
actually come from the relationships among players as they navigate game activities
[Hughes et al. 1983, Nardi and Harris 2006].
The related research in ASD technologies demonstrates the feasibility of games
and other collaborative technological systems to teach a variety of skills, including
social skills, to individuals with ASD. At the same time, the more general field of
collaborative gaming indicates that games are—perhaps unsurprisingly—inherently
motivating and social in many cases. Playing with others can both provide some of
the motivation needed to engage in a therapy and increase social interactions
[McGrenere 1996]. Thus, in this work, we were interested in unpacking the
relationship between specific game elements and levels of intimacy in social
relationships for children with social skill challenges.

3. METHODS
To understand how a tablet based collaborative game might support the development
of social skills, we conducted a quasi-controlled study in a school using a single-
subject design using an iPad game, Zody, and Lego play sets. Playing Legos together
is a current best practice to support collaborative play in the school that served as
the site for this study. Naturalistic approaches are considered most likely to produce
generalization of such social skills [Delprato 2001, Krasny, 2003]. A natural,
motivating real-life activity, such as Lego therapy [LeGoff, 2004 & 2006], can produce
improvement in indirect measures of autism-specific social interaction scores when
compared to a direct teaching approach guided by a therapist [Owen 2008]. We
conducted a within subjects ABAB study to observe how technology might augment
social skill development when alternated with current practice. In this section, we
provide details about the participants, the study design, and the Zody game used in
the study.

3.1 Participants
Four dyads (eight children, including one female) aged 8 to 11 (M=9.6; SD=0.7)
participated in the study. Participants were recruited from a twelve-person special
day class for students with ASD in the third through fifth grades (US). Nine students
expressed interest in the study, and eight were randomly selected from among those
nine to ensure even numbers. The students were taught to use Zody, before
beginning the study. All participants had educational and parent-reported medical
diagnoses of ASD. Each student was a member of a self-contained special education
classroom at an elementary school district in Southern California (see Table 1).

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Participant
Dyad Pseudonym Age Gender Ethnicity IQ (Standard Score)*
A Juan 9 Male Hispanic 113

A Tasha 9 Female Hispanic 87

B Anthony 8 Male Caucasian 98

B Robert 10 Male Caucasian 91

C Jesus 10 Male Caucasian 95

C Ignacio 10 Male Hispanic 72

D Andrew 11 Male Asian/Hispanic 93

D Max 10 Male Hispanic 89

* IQ scores were derived from various cognitive assessments: Woodcock-Johnson Cognitive
Assessment, Wechsler Intelligence Scale for Children (WISC-IV), Universal Nonverbal Intelligence
test (UNIT), etc. The most current school records indicated IQ scores ranging from 72-113 (with 90-
110 being average intelligence).

Table 1: Participant demographics.

The Autism Social Skills Profile (ASSP) [Bellini and Hopf 2007] was completed
by their parents and indicated they had moderate social skill deficits consistent with
a diagnosis of ASD. Two of the three concerns noted most frequently in this
instrument were engaged in the study design: considering multiple viewpoints and
compromising during disagreements. The third major concern, introducing self to
others, was not explored, because all of the students already knew each other
through the class from which they were recruited. Participants were randomly
assigned to dyads and remained with that partner for all study sessions.

3.2 Study Design

The study included an ABAB design [Kazdin 2011], to maximize the impact of the
results across the eight participants [Sears and Hanson 2012]. The dyads played
three times a week with a 401-piece Lego set in weeks one and three, and Zody
during weeks two and four. Each dyad shared one iPad or one Lego set, enforcing
some measure of engagement with one another. Three researchers observed each
session, taking detailed notes about participant behaviors. The observations
conducted during the intervention informed questions asked during short interviews
conducted with each participant at the end of the study. Interviews were structured
to collect maximal data in five to twenty minutes, which was all the time available
given the constraints of conducting this research in a school setting. Additionally, the
student participants often struggled to concentrate and maintain the social
interaction necessary for an interview for longer than 20 minutes. Two researchers
conducted each interview with one student at a time. All interviews were audio-
recorded and transcribed for detailed analysis alongside observational data.

3.3 Zody: A Collaborative Game for Teaching Social Skills

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DIR Social Engagement Strategies Zody Features

Develop joint attention Tutorials
Visual feedback
Parallel game controllers
Play starts automatically
Tablet form
Multiple mini-games
Facilitate experience of mutual joy Mutual goals
Visual feedback
Rewards for success
Mirror affect Visual feedback
Sound effects
Exaggerate your expression Visual feedback (highlights affect)
Turn action into interaction Cooperative gestures
Promote child’s agenda Rewards for success
Be necessary means to an end Cooperative gestures
Use anticipation to increase mutual attention Mystery game after gopher defeat

Table 2: Features of DIR therapy aligned with Zody component.

Zody, short for Zody’s World: The Clock Catastrophe3, is a commercially available
collaborative iPad game designed by SymPlay. The SymPlay website states that
“each game includes a cooperative mode and helps you show how it’s good to work
together with other people and pay attention to what they're doing.”4 The game
includes four mini-games connected to a primary home scenario. Players return to
the home scenario between the mini-games. The overall goal of the game is to collect
several pieces to assemble a clock that has been stolen at the beginning of the game.
In interviews with the game’s designers, they indicated that the game was inspired
by the DIR “Floor Time” model [Davis et al. 2014] (see Table 2).
In the home scenario, which is also another mini-game, one player’s character
carries the other player’s character piggyback, avoiding hazards and incoming fruit

Figure 1: (left): The dual controls at the bottom of the screen allows one player to move
while the other throws fruit at the gophers. (right): Screen text encourages celebration
when “leveling up”.
3
Zody was developed by SymPlay at http://www.SymPlay.com
4
Zody is retrievable at https://itunes.apple.com/us/app/zodys-world-clock-catastrophe/id821791253?mt=8

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Figure 2: Players choose where to dig for treasure by first communicating about their
choices, then each picking their respective coordinate (vertical or horizontal) and
simultaneously placing their thumbs on the color-coded fingerprint icons to initiate
digging.

thrown by gophers while that second character throws fruit at the gophers (See
Figure 1).
The goal of the Treasure Chase mini-game is to dig for buried treasure in pairs by
simultaneously pressing fingerprints to engage the digging action (see Figure 2). In
the Dragon Blast mini-game, players each use an individual paddle to throw ice balls
and break down the walls protecting a dragon that is in turn shooting fireballs at
them. This mini-game provides each player their own side to play in a parallel
fashion, and one side can help the other side by returning their partner’s ice ball if it
passes through the center of the screen (see Figure 3).

Figure 3: Each player has a controller from which they can throw ice balls at the dragon.

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Figure 4: The color-coded arrows show the feature that requires cooperative gestures.
The color-coding is designed to encourage each player to collaborate by controlling two
of the four directions.
The Garden Maze has two modes: Tilt Maze and Arrow Maze. In Tilt Maze,
players each hold a side of the iPad and turn synchronously to move their character
through the maze. In Arrow Maze, each player controls two buttons, which each
correspond to one direction (i.e., up, down, left, right) (see Figure 4).
Finally, in the Talk it Over mini-game, the players decide which characters (i.e.,
the strong, gentle character or the small, assertive character) will try a particular
strategy (i.e., action, reasoning, empathy) to persuade the dragon to allow the
characters to remove a painful thorn from the dragon’s foot.

3.4 Analysis
Throughout data collection and analysis, the research team met regularly to
discuss trends in the data collected from observations. Dominant topics included any
usability or technical challenges the children were having as well as of social
behaviors participants exhibited when using specific features of the game. All
members of the research team read the interview transcripts from all participants.
Our overall analysis was a mix of inductive and deductive approaches. We
examined the interview transcripts and field notes for data related to our initial
hypotheses surrounding the potential feasibility of collaborative computer games to
support a variety of social relationships and teach multiple social skills to students
with ASD. Additionally, we looked for explanatory interview data to help understand
the trends we saw in direct observations. We use “cooperative gestures” [Morris et al.
2006] as a means for explaining the ways in which the Zody game executes actions by
multiple users. Specifically, Morris et al. (2006) describe six design axes that make
up cooperative gestures:
• Symmetry: similarity in actions
• Parallelism: the temporal pattern of the interaction (simultaneous or serial)
• Proxemics distance: the physical distance of users during the interaction
• Additivity: the amplification of effect when more than one user makes a given
gesture simultaneously
• Identity-Awareness: focus that comes from designated roles
• Number of Users and Number of Devices: complexity in learning and
executing the actions

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Building on the concept of roles and collaborative actions and aligning with the
tenants of Cognitive Behavioral Therapy, Giusti et al. (2011) developed a set of
collaborative patterns (“choosing together”, “constraints on object”, “different role”,
and “ownership”). Taken together, these works describe the spectrum of involvement
required or elicited from each player within a set of patterns and provide a
framework by which we analyze interactions with Zody.
Our inductive analysis process included coding, memoing, and affinity
diagramming throughout the data collection and analysis process [Charmaz and
Belgrave 2002]. During the first round of open coding, codes focused on orientation
and reactions to the game, as well as the concepts of negotiating play, friendship and
partnership, and goal completion.
The first author drafted multiple memos describing her analysis of the interview
data to serve as the basis for discussion with the rest of the research team.
Additional rounds of coding and analysis examined the connection between specific
game features and particular social skills, with an emphasis on known social skills
lists from the ASD literature [Krasny 2003 et al. 2006, Wilcynzki et al. 2007]. Finally,
to simplify understanding of the highly varied and complex social relationships
observed, a set of memos were drafted using the framework of three levels of
intimacy in the observed social relationships: membership, partnership, and
friendship. Using these memos as the basis for discussion, we examined how the
collaborative patterns differed between the two conditions. In particular, a
framework of cooperative gestures [Morris et al. 2006, Giusti et al. 2011] game
elements present in Zody impacted social skills during experimental sessions. We
reduced the codes into categories of membership, partnership, and friendship by
collapsing axial codes. We developed our framework using these categories by
comparing behavior observed across both conditions. What we present here then are
empirical results in light of the connection between features of collaborative play and
the learning and practicing of social skills specifically in terms of membership,
partnership, and friendship.

4. RESULTS
Our results indicate that cooperative assistive technologies, including video games,
can support developing social skills at varying levels of intimacy between players. In
particular, specific game features can support membership, partnership, and
friendship without a human mediator. As described in the introduction, membership
behaviors include physical proximity to other players and initiating participation
through an interaction with the game. Partnership behaviors are collaboration
through turn-taking and coordinating simultaneous actions. Friendship behaviors
are sharing joy and demonstrating empathy.
In this section, we describe the ways in which the pairs in our study played
together, with particular attention paid to the ways in which both traditional (Lego)
and digital (Zody) supports facilitated these social relationships, noting features
appropriate for the design and development of social games for children with ASD.

4.1 Membership
As noted in the introduction, membership can be defined as being part of a group and
participating, such as being physically present and making a small action toward
participation in the group’s activity. Importantly, membership potentially results in
the inclusion of people who are often socially isolated and have difficulty interacting

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with others. Membership behaviors signify that a person is part of the group. In our
study, membership was supported in the Zody condition by the use of a small form
factor, a somewhat unexpected benefit of the iPad platform, and by the assignment of
roles. In the Lego condition, membership was supported by the use of one, relatively
small booklet with instructions. The dyads all spontaneously organized themselves
into one child reading the instructions and directing the other.

4.1.1 Maintaining Physical Proximity through Small Form Factor

Zody uses “social” cooperative gestures [Morris et al. 2006], meaning that
participants touch the same device but not the same button within the game. The
small size of an iPad requires students playing it together to sit or stand in close
physical proximity to one another, which is in and of itself a goal of social skills
therapy for many students. Specifically, close proximity can “encourage chance
encounters and opportunities for interaction, which can lead to the formation of new
relationships and the maintenance of existing ones” [Rivera et al. 2010]. Given that
maintaining proximity tends to be listed by social skills experts as an explicit goal
that students may not achieve naturally, it is perhaps unsurprising that the students
in our study did not particularly like the size of the form factor used. For example,
Robert5 conveyed his discomfort related to sharing the small space:

“The only problem is that sometimes it would get very crowded… The
thing that would have made it better was if there was a full table for
the iPad, like a full giant table, that like we can move. That would be
easier for Zody…I mean, make it, make the iPad a bit bigger, the size
of a table…It would make it a less frustrating for example if you have
an iPad, a regular iPad and you have to share it with another guy.
It's really hard because, you know, it isn't full roam. And, a table, a
giant table, it would that would look like an iPad and would actually
work… So it would make it less frustrating to control sometimes.”

The very discomfort expressed is an indication that the form factor may help
students to overcome their challenges with maintaining close proximity to others.
In turn, this close proximity can then lend itself to opportunities for other pro-
social behaviors [Rivera et al. 2010]. In particular, once engaged in a shared physical
space, students in this study became jointly engaged, leading them to describe
themselves and act as members of a team or pair. For example, Juan stated that he
and his partner “joined forces to get the dragon.” and that he and Tasha “just played
together. We played. And we just played together.”
Our results indicate that the specific form factor chosen can help students to
develop particular social skills. Given that children use physical proximity as a
strategy to enter a social group [Bakeman and Brownlee 1980], the use of a small
form factor to require increasing tolerance for sitting in close proximity with a peer
can support learning these membership strategies. Of course, something larger (e.g.,
a tabletop) or more distant (e.g., online interactions) might be more appropriate for
teaching other types of skills or for children for whom close physical proximity goes
beyond simply challenging to extremely anxiety producing or even painful.
Additionally, requiring extended coordination in such close proximity could cause

5
Participants are referred to by pseudonyms.

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frustration. Those designing social skills interventions must understand the ways in
which a digital intervention’s physical form factor can impact the acceptance of the
technology and possibly serve as an intervention itself.

4.1.2 Participation through assigned roles

Membership can also be facilitated by providing players with designated roles during
gameplay. For example, Piper et al. (2006) prescribed identifiable roles for the
players of a tabletop game and found that participants’ roles influenced how the
children played the tabletop game, with students performing particularly well when
therapists assigned them the role of leader. In our study, participants negotiated
these roles dynamically in both conditions. When initiating play, one or both would
reach for the manual or the iPad. Notably, once a partner took a passive role in Lego
play by being the builder for their partner instruction reader, it did not change
within that session; whereas in Zody, roles changed throughout the play session as
described below.
In Zody, roles were designated by the device (e.g., one player was the thrower and
the other controlled character movement) or by the students themselves (e.g., one
player clicked the character and strategy buttons in the Talk it Over mini-game),
with no therapist intervention. The roles in each mini-game tend to be similar, if not
equal, in terms of the impact on meeting the goal. For example, in the Garden Maze
game, color-coding indicates that each participant has control of two directions, and
all four are needed to navigate. In the Treasure Chase game, the two digger roles are
equivalent in that each player can move in one of two directions and press one of two
fingerprints. The Dragon Blast game allows players to blast the dragon from
separate directions. The Gopher game has the most dissimilar roles in that one
player is the “runner” and one the “thrower.” Most players accepted the role of the
character whose inputs were physically closest.
Although all of the games involve two players on screen, it is physically possible
for a single player to play both roles. Thus, there were occasions when a participant
attempted to take exclusive control of the iPad. For example, Ignacio struggled with
securing his role in the mini-games, and stated that his partner played both roles
and exited out of the mini-games without Ignacio’s input. Ignacio stated that he
wished players would share the roles and take turns picking the next game.

4.1.3 Summary of Membership

These results indicate that membership can be supported through careful design
of an appropriately sized form factor and dedicated roles for each of the participants.
The small form of the iPad prompted participants’ close physical proximity, and
having a role for both players encouraged participation. However, the lack of role
enforcement and the small form factor sometimes worked against specific individual.
The impact on game play of the lack of role enforcement indicates that designers
should consider ways to enforce players’ roles, potentially through player
identification and explicit control mechanisms. Tradeoffs must be considered between
the importance of teaching children to negotiate roles with one another dynamically
and the structure of controlling those roles automatically. Likewise, a sufficiently
large form factor would prevent individual children from taking too much control—
their arms would simply not reach—but would also mean less practice at sitting and
acting appropriately when in close quarters as described above.

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4.2 Partnership
Partnership involves two people having specific responsibilities in achieving their
mutual endeavor. Partnership differs from membership in that each person is
dependent on the other’s play, as it impacts the shared outcome. In this section, we
describe first the serial behavior observed in Lego play and then how the cooperative
gestures of serial, synchronized, and symmetrical actions all encouraged pairs to
think and act like partners when playing with Zody.

4.2.1 Collaborating through Turn-Taking Gestures

Turn taking, a basic social skill, is frequently the target of intervention (e.g., Brok
and Barakova 2010, Goodrich et al. 2011, Koegel and Koegel 1987, Mundy et al. 1986,
Mundy et al. 1994, Scassellati et al. 2012, Schegloff 2000). Legos do not benefit from
these gestures, and turn-taking in the Legos condition tended to involve one player
issuing an order (one turn) and the other implementing it (another turn). In Zody,
pairs took turns touching the arrows in the maze mini-game due to the assignment of
two arrows per player and the need to travel in all four directions. Turns must be
taken rapidly in this game—a slow playing pair will find their treasure “moved” by a
capricious cat—which can challenge one’s ability to wait for their partner to take a
turn. For example, in dyad B, one partner regularly held the other’s hand during the
maze game, exerting a small amount of control even during the other player’s turn.
As a more traditional—and slower moving—example, most dyads took turns
choosing the next mini-game once one was completed. This behavior is not enforced,
however, and so one player could dominate all choices, as seen in dyad C. These
results indicate that games can facilitate turn taking behavior at multiple timescales.
However, roles and design features in the technology or an outside human mediator
are required to enforce the turn taking behaviors desired. An open question for
designers then is how to facilitate these kinds of interactions without overly
prescribing them.

4.2.2 Coordinating trough Simultaneous Gestures

“Simultaneous gestures” [Morris et al. 2006], which are cooperative gestures that
occur at the same time, support partnership by enforcing coordination among
members of a dyad. For example, in the Treasure Chase game, the players must
synchronize their actions, because the game only accepts both fingerprints being
pressed at once as appropriate input. To complete the synchronized finger-press
gesture, students often spoke with one another, sometimes counting aloud to
coordinate the time they would touch the screen “One-two-three-go!” In our
observations, counting could occur out loud together or with one partner counting
and the other listening. As pairs became more familiar with one another and with the
game, explicit verbal interaction was often no longer necessary. A glance at each
other, demonstrating eye contact (an important social skill in and of itself [Phillips et
al. 1992]) or touching the partner on the arm, could convey the message that it is
time to press the screen.
“Symmetrical actions” [Morris et al. 2006], (i.e., the same action by both players
with each using their own controller), support partnership by setting up situations in
which players help each other complete a mutual task through different roles. For
example, Andrew described his partner as someone helping him with tasks: “Mhm,
he helped me. Helped me find the pieces and helped me try to defeat, help me…He
would help me try to throw these ice balls at the dragon.”

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 Collaborative iPad Game L. Boyd et al. 39:13

Cooperative gestures provide a level of coordinated engagement that extends a

social interaction beyond a simple single turn taking activity. When each player can
depend on the other to meet goals over the course of the mini-game and possibly all
the games during the session, participants experience being needed by the other, and
depending on the other, partnership.
In Zody, collaboration and coordination occurred without a mechanism for
determining who was touching the interface (e.g., the Diamond Touch [Dietz and
Leigh 2001]) or a human mediator to manage turn taking. Additional opportunities
to practice partnership occurred each time a mini game ended and the pair needed to
make a decision. Most pairs made decisions by engaging in a brief discussion during
which they stated their preferences and reached consensus through compromise. For
example, in the first Zody session for Dyad A, the pair used both verbal and non-
verbal communication cues to determine what to do:

The teacher places the iPad in front of Tasha. Tasha says to Juan,
“Don’t touch it, she say don’t touch it.” The teacher says, “Okay guys,
play together.” Tasha says, “Okay” and releases the iPad. Juan pulls
the iPad close to him to a point midway between them on the desk.
He begins to scroll through comic-book style instructions. Leaning
into the iPad space, Tasha says to him, “Let me read.” Then they
alternate touching the screen to advance the directions. Once at the
end of the tutorial, Juan, with very brief glance at her says, “Okay (to)
do this?” Tasha reads aloud the first word of the home screen script,
says, “ready” and puts her thumb up. Juan says, “Okay, you walk this
and get the vegetables.” She points at him (see Figure 5) and says,
“And you,” as he continues saying, “And I get gophers.” Then they
begin to use the related controller button on their side of the screen.
- Field Notes from December 17, 2013

Figure 5: The pair negotiate roles in the gopher game by stating who will do which in-game
task (throw fruit or run after gophers).

4.2.3 Summary of Partnership

Our results indicate that partnership can be supported by thoughtfully employing

cooperative gestures of various dimensions. “Serial gestures” [Morris et al. 2006]
provided the structure for pairs to take turns, supporting the use of “simultaneous
gestures” [Morris et al. 2006] required of players to coordinate their actions in time.

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39:14 Collaborative iPad Game L. Boyd et al.

Figure 6: (left): Dyad B celebrates by smiling and making fist pumps. (right): A “win”
creates the opportunity to celebrate together as they engage in a “high five” gesture.
Over time, each pair’s coordination expanded beyond the cooperative gesture to
include counting down together or looking at each other to be in sync. However, some
pairs had difficulty coordinating their actions at the precise moment in time required
to effectively play the game, leading to frustration when using cooperative gestures
did not quickly result in finishing the task (e.g., finding the treasure in the dig game)
and repeated cooperative gestures were required. Therefore, the potential for
frustration created by cooperative gestures indicates that designers should consider
the level of difficulty required by the pair to execute the coordinating movements, as
it impacts their motivation to sustain play. The balance between the effort of working
together and the challenge of an activity is an area for future research.

4.3 Friendship
Friendships are typically built on mutual interests, affinity for each other, and often
involve having fun together, a developmental step in lasting relationships
[Greenspan 2000]. Building friendships is a top priority in the development of early
social engagement [Davis et al. 2014] as well as coping together and developing
empathy for one another during less fun times.

4.3.1 Experiencing Shared Joy through “Wins”

The DIR/Floortime™ model, which inspired the creation of the Zody iPad game,
argues for the importance of making therapeutic activities fun to motivate students
to practice and learn social skills [Davis et al. 2014]. In particular, in this work, we
found that rewards for winning a game can be powerful incentives for continued
participation. Additionally, winning provides opportunities for shared joy, a
foundational step towards friendship. In the Zody game, players receive visual and
auditory praise, earn points, and “level up” after each mini-game is won. During our
study, despite having been paired by random assignment with a classmate with
whom they were not necessarily friends prior to the study, one or both partners
typically made positive comments to each other in response to a victory. For example,
players would regularly cheer for one another (e.g., “Yes we did it! Whoa!”), “high
five,” and demonstrate other expressions of shared joy with their wins (see Figure 6).
Furthermore, during interviews, the students described forming friendships over the
course of the study:

“It was fun actually. Usually um, usually me and Ignacio don’t really
get along, but since we started playing together, we actually started
getting along, we started being friends.” - Jesus

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 Collaborative iPad Game L. Boyd et al. 39:15

These results indicate that the kind of acts of kindness and mutual celebration
seen in the general population playing massively multiplayer online games [Nardi
and Harris 2006] can be reproduced through smaller therapeutic games for children
with ASD. These positive interactions can in turn create shared experiences from
which a friendship can form beyond the session, thereby reinforcing social skills
outside of structured treatments. Designers can leverage this momentum toward
friendship formation by saving a pair’s progress in the game, memorializing their
interaction, and potentially reminding them of their play together. At the same time,
by enabling small quick wins within a larger game structure, game play can serve to
motivate and reinforce the therapeutic goals immediately.

4.3.2 Demonstrating Empathy through “Losses”

Empathy, a major part of friendship, is challenging for those with ASD [Baron-Cohen
et al. 1988] but can be built and demonstrated by commiserating about an
unfortunate event. The high frequency of opportunities to lose a round of play in
most games in Zody allowed for ample opportunity to commiserate with one another.
Specifically, the visual and auditory feedback provided by Zody supported expression
of grief over joint losses, one’s own loss, or that of a partner by encouraging players to
make a commiserating statement such as “Almost got ‘em”. This in-game script
supported players in accepting the loss, commenting to their partner on the loss, and
moving on with play. Furthermore, having some mini-games set up as parallel play
(e.g., Dragon Blast) permitted participants’ to observe their partner’s play and
comment on it thus making a connection to each other. Increasing the frequency of
these high-emotional states is an important goal for technologies designed to teach
and support social skills development because of the ease with which technology can
provide fun experiences. The more practice with these emotional skills, the better the
outcome for people learning social skills [Donnellan 1983].
These results indicate that games can support friendship by occasioning
celebration and commiseration through the opportunity to observe the other’s play
and the use of wins and losses reinforced with visual and auditory feedback. When
wins or losses occurred for one player, such as in Dragon Blast, or both, as in Gopher,
pairs interacted by glancing at each other, commenting, or coordinating gestures
such as giving a high five. In reference to the other player they might sigh or both
spontaneously express their reaction by saying, “Oh no!” Thus, single and joint wins
and losses were critical moments that provided an opportunity for the pairs to
communicate their feelings about playing together.

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39:16 Collaborative iPad Game L. Boyd et al.

Cooperative Social
Mini-game Activity gestures Social skill(s) relationship(s)
Maze Players work Serial, Turn-taking Membership
together to move Asymmetric
character in four
directions
Treasure Players push icons Parallel, Coordination, Partnership
Hunt simultaneously for Symmetric, Collaboration,
character to dig for Additive Compromise
treasure

Dragon Player tosses Parallel, Empathy Friendship

Blast iceballs at the Symmetric
dragon from
opposite sides
Gopher A player runs, Parallel, Joint Attention, Membership,
other rides on his Asymmetric Communication, Partnership,
back and throws Shared Joy Friendship
fruit at gophers

Table 3: Sample of Zody mini-game activities with cooperative gestures aligned with related
social skill(s) and social relationship(s).

4.4 A summary of the cooperative gestures

Zody presented a variety of ways for pairs to perform collaborative actions. Unlike
the dominant pattern in the Lego set play, that in this brief study, mostly promoted a
serial, asymmetric pattern of interaction, Zody offered variety of combinations. Table
3 describes four of the mini games, presents examples of in-game activities, and
identifies the related cooperative gesture, the social skill that it supported, and the
type of social relationships that it engendered.

5. DISCUSSION AND CONCLUSION

The majority of research on social skills interventions for individuals with ASD
focuses on the development of specific social skills, (such as initiating greetings, turn-
taking, making eye contact, smiling, or waving goodbye [Ozonoff 2002, Krasny 2003,
Wilczynski 2007]) or one type of social relationship (such as social inclusion/
membership [Kalyva and Avramidis 2005]). However, in examining the impact of a
collaborative iPad game on social skills, we found that one technology can support
multiple skills and relationships. Designers can support development and
engagement in a variety of social relationships by using joining in features to support
membership, coordinating actions to support partnership, and commenting on the
shared experience to support friendship.
These distinct social events can be designed to occur within a single play session.
The ability to incorporate these multiple interaction styles can also help maintain
engagement and attention to the game or therapy [Ringland et al. 2014]. Overall,
designers must balance the therapeutic benefit of certain interactions with the fun of
others. Games have great potential as an intervention, due to the ability to

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 Collaborative iPad Game L. Boyd et al. 39:17

interweave thoughtfully applied design elements with the naturally occurring

contingencies (i.e., having fun together).
These insights leave us with the following questions: would more intimate pro-
social behaviors, such as collaborating and sharing wins and losses, lead to sustained
outcomes beyond game play? What role do other game elements have in supporting
pro-social behaviors in a maintainable way? How can technology intermingle social
skill interventions within video games to achieve the greatest impact? Indeed, it may
be impossible to truly tease apart all the active components when considering a
holistic gaming experience. Nonetheless, further examination is warranted, because
children with ASD who play video games have been reported to spend roughly twice
as much time playing as typically-developing peers who also play video games
[Mazurek et al. 2011]. In summary, collaborative games on tablets provide an
effective and efficient platform for sustainable social skills intervention in that they
are portable, low cost, fun, require no human mediator. Moreover, the framework of
three types of social relationships—membership, partnership, and friendship—can
inform the design of new social skill interventions for children with ASD.

ACKNOWLEDGMENTS
We thank all of the students, parents, teachers, paraprofessionals who participated in this study,
specifically Sara Cabel, Wendy Miller, Teri Louer. We also thank Kelly McKinnon and Dr. Joe Donnelly at
the Center for Autism and Neurodevelopmental Disorders. This research was approved by human subjects
protocol 2013-9842 through UC Irvine and funded by a generous gift from Robert A. and Barbara L. Kleist.
The Zody game was provided free of charge by SymPlay, and we thank Bill Fisher, Bruce Brownstein, and
Josh Feder for their insight into the game and to support our research. We thank Jed Brubaker, Lynn
Dombrowski, Sen Hirano, and members of the STAR research group at UC Irvine for their valuable input
on drafts of this paper.

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Statement of Contribution:
This paper contributes to the discussion around collaborative gestures for children with ASD by evaluating
the impact of an iPad game designed to support social skills. Additionally, the context of this
work raises particular concerns for sustainability as previous works are not easily translated into
everyday practice beyond a research setting due to portability, cost, and need for a mediator.
Findings suggest a process through which to developers can support social relationships
through collaboration. The results of the pilot deployment with school-aged children with ASD
have not been published elsewhere and make possible an empirical validation of design
guidelines produced in earlier work.

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