Interview: Casey Wimsatt, Symbionica on how games help the Autistic.

Again, this was research for a feature I did for PC Gamer on disabled gaming. Casey Wimsatt makes games proven to improve the social skills of children with Autism.

To the tune of: Tim Buckley – I Know I’d Recognize Your Face

Again, this was research for a feature I did for PC Gamer on disabled gaming. Casey Wimsatt of Facesay makes games proven to improve the social skills of children with Autism.

Can you back up your claims that your technology helps autistic children?
A peer reviewed paper was just published last week might be of interest. The paper is about a randomized controlled study (N=49) showing how my silly FaceSay computer games help kids with autism – both high and low functioning – improve their social interactions on the playground. This is a first, after a decade of brilliant attempts with other tech-based interventions.


The heavy-weights in the autism research field have provided nice quotes. As your story suggests, the broader question of can computer games make a difference is of interest.

How does the technology help the children? Do you think it’s merely shaping their behaviour along Pavlovian lines, or is it helping them actually understand better other people’s feelings?
The games do use some Skinnerish elements of classical Applied Behavioral Analysis, such as errorless learning, but I concocted the games, ala a stranger on a new planet, by synthesizing a “stew” of dozens of ideas. Since there are so many elements, we can’t officially say what contributes what, but I do have some hypotheses and pending patents. Broadly speaking, the games are designed to help the kids become aware of social value of the movements and features of the face, particularly in the area around the eyes. Attention to the eyes is important for a number of “upstream” skills, such as emotion recognition, joint attention and imitation.

As indirect evidence that the learning/acquisition is not just through conditioning and mastery, FaceSay never mentions emotion labels such as “happy”, “sad”, “etc”, but in two RCTs, the FaceSay participants have performed better on standard emotion recognition tests (I think because they are attending more to the clues in the area around the eyes). In the most recent RCT in 2010 (n=31) at a California School District, the FaceSay participants also improved on a standardized neuropsych assessment for Theory of Mind (Nepsy II), even though there is no explicit conditioning/training for the questions in the test.

Do you think there’s a large market for games that are therapeutic like this?
The “serious games” market has promise, but is far from booming. In an era where services funding are on the chopping block, inherently high fidelity interventions like this should provide a big savings and be adopted. Resistance to using computers in a social domain is one challenge (ranging from an ongoing debate whether computers are just more screen time away from people, to some job insecurity in the service provider sector).

Another challenge is getting scientific recognition of the therapeutic value. Posit Science’s games may be are current poster child. They are planning to apply for an FDA approval – something I admire and would like to attempt for FaceSay. In the field of Autism, there have been so many failures, so few successes, whether computer based or not, that ABA therapy is the only accepted form. As data continues to grow for FaceSay, I hope that it will become accepted by insurers, more of whom are being asked to cover autism intervention services.

If you were making a mainstream game, would you make it with the disabled in mind?
Sure. Broadly speaking, I think designing for a wide audience can enhance your creative process.

What tips would you give to mainstream developers who are looking to make games for autistic children?
This is a tough one. There are several dozens of things to consider and the kids, as a group, are very diverse. There’s a cliche “if you’ve met one autistic person, you’ve met one autistic person”. Thinking about sensory processing is one key, though. Talking with parents and autistic adults and piloting with autistic kids is another.