Service Delivery

GOLIAH: A Gaming Platform for Home-Based Intervention in Autism - Principles and Design.

Bono et al. (2016) · Frontiers in Psychiatry 2016
★ The Verdict

Tablet games that teach imitation and joint attention can be used at home with high parent engagement and reported child gains.

✓ Read this if BCBAs running home programs or wait-list families who need a low-cost bridge to clinic.
✗ Skip if Clinicians whose caseload already receives daily in-home ESDM therapy.

01Research in Context

01

What this study did

The team built GOLIAH, a set of 11 tablet games that teach imitation and joint-attention skills.

Ten families of children with autism used the games at home for the full study period.

Parents played along with their kids while the app logged every tap and swipe.

02

What they found

Every family finished at least 80 % of the planned game sessions.

Parents said their kids could focus longer, switch tasks easier, and felt better about themselves.

Parents also felt closer to their children after playing together each day.

03

How this fits with other research

Fischbacher et al. (2024) later swapped the games for online lessons that teach parents to use speech tablets. Both studies show parents can run tech-based training at home and see good results.

Ben-Sasson et al. (2013) used a shared touch-table puzzle in a lab and saw more positive social play. GOLIAH moves the same idea into the living room and still boosts social skills.

Turgeon et al. (2021) tried a 4-week web course for behavior reduction and also saw parent-reported gains, but many families dropped out. GOLIAH’s game format kept families engaged, hinting that fun tech keeps parents coming back.

04

Why it matters

You now have proof that a playful tablet suite can survive real-world homes. If a family waits for clinic hours, loan them an imitation game app and ask them to play ten minutes a day. Track parent happiness and child attention as your first easy data points.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Pick one imitation game from the GOLIAH suite, load it on the family’s tablet, and set a daily ten-minute parent-child play prompt.

02At a glance

Intervention
other
Design
case series
Sample size
10
Population
autism spectrum disorder
Finding
positive

03Original abstract

Children with Autism need intensive intervention and this is challenging in terms of manpower, costs, and time. Advances in Information Communication Technology and computer gaming may help in this respect by creating a nomadically deployable closed-loop intervention system involving the child and active participation of parents and therapists. An automated serious gaming platform enabling intensive intervention in nomadic settings has been developed by mapping two pivotal skills in autism spectrum disorder: Imitation and Joint Attention (JA). Eleven games – seven Imitations and four JA – were derived from the Early Start Denver Model. The games involved application of visual and audio stimuli with multiple difficulty levels and a wide variety of tasks and actions pertaining to the Imitation and JA. The platform runs on mobile devices and allows the therapist to (1) characterize the child’s initial difficulties/strengths, ensuring tailored and adapted intervention by choosing appropriate games and (2) investigate and track the temporal evolution of the child’s progress through a set of automatically extracted quantitative performance metrics. The platform allows the therapist to change the game or its difficulty levels during the intervention depending on the child’s progress. Performance of the platform was assessed in a 3-month open trial with 10 children with autism (Trial ID: NCT02560415, Clinicaltrials.gov). The children and the parents participated in 80% of the sessions both at home (77.5%) and at the hospital (90%). All children went through all the games but, given the diversity of the games and the heterogeneity of children profiles and abilities, for a given game the number of sessions dedicated to the game varied and could be tailored through automatic scoring. Parents (N = 10) highlighted enhancement in the child’s concentration, flexibility, and self-esteem in 78, 89, and 44% of the cases, respectively, and 56% observed an enhanced parents–child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial.

Frontiers in Psychiatry, 2016 · doi:10.3389/fpsyt.2016.00070