Feasibility of Mobile Game System for Potential Treatment of Developmental Delays

Study investigators will preliminarily measure change in the Vineland Adaptive Behavior Scales, 2d edition (VABS-2) Socialization subscale of the Parent/Caregiver Comprehensive form. This will allow study team to understand if use of the mobile app as treatment is feasible. Scores from the socialization domain of the VABS-2 reflects one's functioning in social situations. The socialization subscale is up to 113 items, where raw scores are converted to Intelligence Quotient (IQ) type standard scores--v-scale scores (M=15, SD=3) where scores range from 1 to 24, and factor in age equivalents, growth scale values, and higher scores indicate better adaptive functioning.

Time (in seconds) of app use across the 12 weeks.

The Social Responsiveness Scale-2 is a 65-item measure where parents/caregivers rate their child selecting responses on a Likert Scale. This measure will be used to measure and identify social impairment associated with Autism Spectrum Disorder (ASD) and to quantify its severitySocial Responsiveness Scale (SRS) raw scores measure social abilities with lower scores indicating better social skills. (Raw Score Range: 0 - 195 and T-Score Range: 37- above 90).

a level 2 screening tool that has been validated in several studies and that uses a brief parent/caregiver questionnaire with a 2 minute home video to generate a classification score that indicates severity of the autism phenotype (ranging from no autistic symptoms to severe autism) as well as confidence in the classification.

Shared videos will be evaluated for proper game play and enjoyment with the game across the 12 week period of the intervention.

Two 5 item questions regarding parent/caregiver confidence in their ability to manage their child's behaviors and adequacy of resources to manage their child's behaviors.

The PSI-SF is a 36-item parent report scale that evaluates the extent and source of parent stress in the form of three subscales: Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child. Total scores range from 36-180 with lower scores representing less parent stress.

The Fun ToolKit and Child Engagement Scale will be adapted and combined to assess children's engagement and enjoyment while playing the app.

Study team will use an image based emotion recognition task where participants will select the emotion that corresponds to an emotional facial image in the form of a GIF (Graphics Interchange Format) image. Participants will select 1 of 8 available Ekman emotion labels for 21 emotional face image stimuli presented in random order. Correct responses will be measured against a predetermined majority rules consensus of the emotional content of the GIFs.

Parents/caregivers will rate their child's socially motivated eye contact and joint attention skills pre and post. This will be a 10 item measure.

The NIH toolbox for emotion was developed to create a standardized, comprehensive, and concise battery of tests that can recognize the full spectrum of emotional experiences and their impacts on health and wellbeing. The NIH Toolbox for emotion includes 3 subdomains: negative affect, psychological well-being, and social relationships for children 3-7 years old. For the age range of 8-12 proxy measures are available for the same subdomains.