CircusInMotion

Autism spectrum disorder (ASD) is a neurological disorder associated with cognitive impairments in attention, social interaction, restricted, and repetitive behavior. Around 80% of the children with ASD exhibit significant sensory processing disorders. Likewise, they lack appropriate sensory integration capabilities, i.e., “the unconscious process of the brain to organize information detected by one’s senses and allow them to respond to the situation in a purposeful manner”. Given the sensory processing disorders exhibited by children with ASD, the vestibular system is one of the most affected. As a result, children with ASD often exhibit balance problems and atypical postures.

Current, vestibular therapies, using techniques from motor therapeutic interventions, aim at creating situations where patients could improve their balance and posture. Motor therapeutic interventions comprise a set of repeated movements that stimulate the vestibular system to help patients develop abilities for self-regulation and interpretation of sensory stimuli. Vestibular therapy sessions include an exercise routine consisting in the repetition of non-locomotor movements with changes in the patient’s base of support. For example, during a session, therapists could ask patients to keep their arms steady while jumping on one foot.

Therapists determine the difficulty of the exercise routine based on each patients’ motor capabilities. Most of the time, therapists need to adjust the difficulty level to challenge their patients and ask them to perform more complex movements while keeping them engaged during the therapy. This dynamic game fine-tuning is a complex and time-consuming task for therapists.

To cope with issues related to engagement and frustration, some specialists have incorporated exergames into their motor therapeutic interventions. Then, in this project, we describe the design, development, and evaluation of Circus in Motion, an adaptive exergame to support the practice of non-locomotor exercises during vestibular therapies. A deployment study with 12 children with ASD showed Circus in Motion could potentially support traditional vestibular therapies in increasing physical activation and the number of completed repetitions of non-locomotor movements.

We also use data from real-time usage of Circus in Motion could be used to design a fuzzy system that automatically adjusts the difficulty level according to each child’s motor performance.