Table 3.

“Ludography” detailing specific games tested on children with ASC and other conditions.

Game (Reference)	Summary of game	Application
Bingo (Baker, 2000)	Bingo involves children having a board that is delineated by rows and columns. A player wins Bingo by having a complete row/column that contains items announced by the Bingo caller. In this version, the Bingo game is modified to reflect an autistic child's restricted interests. For instance, a child who is interested in model cars, the bingo item is “called” by having the children launch cars off a track and note what car picture the model car lands upon following the jump. This picture must then match the picture on the Bingo card in order to be covered up.	Autistic children may be more receptive to learning games and playing with peers if games are centered around their preferred area of interest. To do this effectively, it is helpful for practitioners to learn about the child's interests from parents and create modifications to existing games for ease of access.
Recognition Game (Dell'Angela et al., 2020)	The Recognition Game is a variant of the game Mimtoo, a pantomime game in which children select at random a slip of paper with a sentence that they must act out for their team to guess. In this emotional competence version, the child who is set to pantomime will choose both a sentence and an emotion word which may or may not be congruent with the sentence (e.g., “My mother forgot my birthday” and one of the six emotions: happy, sad, frustrated, etc). Taking turns, each team will send a player to pantomime the sentence and act out the emotion. The goal is to guess as many correct emotions as possible in a given time.	This game could be a particularly engaging way to improve emotion recognition. The challenge is that the emotion may not match the sentence. However, it presents an interesting way about learning emotional context, as many sentences could be spoken in a different way to convey a different meaning. As children with ASC have difficulty interpreting emotions and understanding context in communication, it could be a particularly beneficial game to learn these two skills. Additionally, this game is played in a group setting that could improve peer relationships. Very little materials are needed to implement this game, making it very easy to adapt to various settings.
Differentiation Game (Dell'Angela et al., 2020)	The Differentiation Game is a variant of the game Codenames. Children in teams try to help their group guess a specific combination of word cards laid out on a grid based on a card identifying which words are safe and which are off limits. Players should only give clues that help identify certain words, and avoid clues leading to incorrect guesses. In this version, rather than choose any word as a clue, the player must use an emotional word.	In this version the skill being used is emotion recognition and the ability to perspective take. The team that is guessing the words must think about what the player likely feels about certain words on the board (i.e., “Do they get scared on roller coasters? Or maybe they find certain types of movies scary?”). This type of emotional reasoning is building on perspective-taking, while also encouraging children to think more broadly about emotions. This game allows for the adaptation of an existing game that is readily available, and refines it to target a specific emotional competency skill. It could also be used to help build relationships between team members, as they learn about one another by understanding what emotions a team member associates with certain words. This would be an excellent game to test on autistic children who are looking to build skills in this area.
Reappraisal Game (Dell'Angela et al., 2020)	The Reappraisal Game is a cooperative storytelling game in which children must incorporate randomly drawn story cards into a single narrative in sequential order. This game is based on the cooperative storytelling game Once Upon a Time. In this version of the game, there is an added layer to build emotional competencies. In this version, toward the end of the story one of the players draws a “complicator” card that introduces a negative element into the story. The player must then describe the emotions that the characters would experience following this complication. Another player designated to be the “optimist” must then roll a dice that matches a reappraisal strategy. They must then use that reappraisal strategy to see the complication's “bright side.” The other players then guess which reappraisal strategy had been used.	This game builds on several important cognitive skills. In line with the original version, the Reappraisal Game allows children to practice building a cohesive narrative and doing so with an audience in mind, a form of theory of mind. The Reappraisal game builds on this by requiring players to also focus on the story's emotional arc, first describing a complication and then a resolution. The children will be focusing on the resolution's emotional effects by identifying how the resolution was presented using cognitive reappraisal. This game may be beneficial for autistic children who experience difficulties in emotion recognition, narrative comprehension, and emotional regulation. Learning techniques for seeing the “bright side” of a negative event may be particularly helpful regarding this last skill. Like the last two games discussed in this study, this game would be easy to implement and suitable for many settings.
Linear Board Game (Satsangi and Bofferding, 2017)	In this game designed to build numerical competencies, the board, the children, played upon forms a number path, with 10 tiles numbered 1–10 displayed horizontally. The tiles alternated in color (red, blue, and green). To play the game, the children rolled a six-sided die, with half of the die faces numbered “1” and the other half “2.” The children then moved across the number line the number of spaces they had rolled, and verbally stated the numbers that they moved across on the board.	Children who played the game significantly improved in their numerical knowledge compared to those who had done a control condition using colors instead of numbers to advance across the board. This game is undoubtedly useful for children with autism who struggle with numerical understanding. However, it is rather rudimentary, and there doesn't appear to be a scoring system in place, which adds an element of competition or a reward for completion. If adopted by a professional it would be beneficial to add more complexities to the game, especially for older children. This is, however, an easy game to create and run for groups.
Power Card Games (Daubert et al., 2015)	Power Cards are behavioral reinforcement tools in which a child has a character related to their restricted interest model appropriate behaviors depicted on cards. These cards are then presented to the child during activities to remind the child of appropriate behaviors and to motivate them to emulate their favorite character. Power Cards were used to guide children through gameplay, specifically the games Topple, Operation, and Honey Bee Tree. All three of these games require players to use a similar motion, grasping, to reach a particular gaming goal. For instance, in the game Topple, players have to build the tallest structure they can without having the structure topple after placing a piece on the top. In these games, Power Cards were used to guide appropriate gameplay behavior, specifically initiating a turn, relinquishing a turn, and speaking encouragingly to other players.	Power Card techniques have been tested in other domains, and have improved behaviors in autistic children in a number of activities. This study suggests that they are particularly useful when introducing autistic children to gaming, and helping them play effectively with others. Power Cards are easy to adopt, as they require few materials, and are easy to adapt, as they follow a broad template designed to be customized to a child's favorite character. As autistic children may struggle with emotional regulation and reciprocity, they will likely need additional help when learning about good sportsmanship in gameplay. Using Power Cards within a gaming intervention may be particularly useful for those children who show particular difficulties with regard to these gaming skills.
Live Action Role Playing (LARPing) (Fein, 2015)	LARPing involves a group of participants create and enact a different story. In the LARPing activities discussed in the article below, the quest narratives were created by the Journeyfolk, who run a summer camp tailored for autistic adolescents in the United States. In LARPing the game is begun using a broad theme drawn from several different narratives. Each player then adds their own element to the story and their subsequent decisions within the game change the plot. Players develop characters that they embody within the game. These characters have backstories, personality traits, and customized costumes to fully realize their characters within the game.	In this qualitative study, the researcher found that autistic LARPers were empowered within the gaming event. They created meaning out of the quests that often appeared to express something about how they felt about themselves as an autistic person, including the challenges and the pride they felt in their autistic identity. Within the LARPing environment, campers had more structured social encounters that were made more clear by the constraints of the game. They were also able to engage with each other in creative ways by changing the narrative and personalizing their characters. Finally, campers formed a community with one another where they shared common interests and engaged with their autistic identity. Creating opportunities for LARPing among autistic adolescents may be a valuable endeavor. Such an intervention would be time consuming with regards to gaging interest and organizing the materials (i.e., scripts, costumes). However, if it stimulated excitement among participants it could lead to an autistic adolescent community where shared interests and acceptance of differences led to friendships and increased self-esteem.
Table Top Role Playing Games (Katō, 2019)	Interactive games in which a small group of players interact through a fictional story setting. Using pencils, paper, and dice, TRPG players explore their character's personality, background, and goals to construct the story with other players in the form of in-game role playing. Their choices within the game will affect the outcome of the group. TRPGs have been found to enhance creativity and divergent thinking and have been used therapeutically to build social skills and self-esteem in teens and young adults.	For autistic teens with typically developed verbal ability, training-based communication support, which teaches routine methods for conversation, may not provide naturalistic opportunities for communication. They also rely heavily on professional help rather than learning through everyday interactions with peers. Creating opportunities for autistic teens to interact with peers in an engaging environment may teach communication skills absent from stricter communication training programs. The games themselves may be intrinsically motivating as they allow for creativity, character development, and immersion in the game.
Speech Therapy Games Hoque et al. (2009)	Players are completing traditional speech therapy activities in the context of a computer game. For instance, in the game, a participant would be required to modulate the volume of their speech, or the rate of their speech, to control objects in the game. The authors provide limited information about this game, and therefore the description above is brief.	There is not enough information about the game to say whether it offers definitive improvements over traditional speech therapy with a speech and language specialist. However, the preliminary results suggested that this was more engaging to students than the traditional delivery. The program appears to be easy to implement as the only necessary equipment would be a computer and a microphone headset. However, it is unclear whether this program is readily available for use or purchase. Professionals who wish to explore this option can contact the authors for more information.
Candy Land (Jung and Sainato, 2015)	Candy Land is a board game in which players draw cards with either colors or characters. Players then move their game pieces along the Candy Land board using the cards as guidance. Various challenges within the game allow some players to advance a greater distance at specific points, or get stuck. Players win when they reach the end of the board. There are special editions of Candy Land. In this study, a young autistic girl who was interested in princesses played the Candy Land: Disney Princesses version of the game.	Candy Land was supplemented by a video modeling program in which instructors recorded videos of themselves playing the game dressed as a princess. The child then dressed up as the princess to play the game. This was done to encourage the child to model their behavior after the video, and to maintain interest in the game theme. The behaviors targeted related to engagement, social reciprocity, and reducing inappropriate behavior. Results suggested that not only did behaviors improve in the game, but they generalized to a new game without the embedded character. This intervention would be somewhat lengthy to implement as it would involve video recording behaviors as certain characters. However, this may be necessary for children with ASC who would not otherwise be motivated to participate. That this technique led to some generalization to novel games is encouraging. Though the process of recording the videos for each child may be time consuming, it is something that would be readily accessible i.e., no specialist tools are required.
Make n Break (Jung and Sainato, 2015)	Make n Break is a game in which players must follow a blueprint to build a certain structure using 10 colorful wooden blocks. Players must complete as many of the 60 structures as they can in the allotted time indicated on the dice, which they roll prior to beginning construction. In this study cited below, Make N Break was combined with the video modeling approach described in the above game.	Similar to the previous discussion of the game Candy Land and how it is combined with video modeling, this seems to be a valuable tool to increase engagement and appropriate gaming behavior in autistic children. While it is not a ready-made intervention, meaning a professional will need to create customized videos demonstrating gaming behavior in line with the child's interests, it significantly increases motivation to play games. Professionals may want to explore this option to improve social functioning in autistic children.
Pico's Adventure (Malinverni et al., 2017)	Pico's Adventure is a Kinect based game in which children played a whole-body video game over four sessions. In the game, children go on a series of adventures to help Pico, an alien, complete different missions (i.e., fixing his spaceship). In the four sessions, the children work on basic social initiation, cooperation, joint attention, and turn-taking. In the first session, the child meets the character and familiarizes themselves with the environment. In the subsequent sessions the child plays in tandem with a parent/professional and another autistic child. While the intervention's effects were not formally tested with regards to improvements on the target behaviors, an exploratory study found that the children readily engaged in the task and were eager to explore the digital environment.	Pico's Adventure could be a fun addition to a social skills curriculum for ASC children, either at school or at home. Kinect equipment is needed, but this is readily available for purchase. One of Pico's Adventure's strengths is that it was designed with the help of ASC professionals and children, making it particularly appealing to its target demographic. As it encourages whole-body movement and encourages social interaction between two players, it could be a stimulating way to improve reciprocal interactions between peers, though this needs more formal testing. Pico's Adventure also includes a narrative, in that children are learning about Pico throughout the game and helping him return to his planet after accidentally landing on earth. It would be interesting to explore whether narrative comprehension is also positively affected following the intervention. Professionals or parents looking to engage children with ASC in a social intervention that may also improve narrative comprehension may want to include this game in a curriculum.
• Consoles Wii (i.e., baseball/wiffle/sports) • Kinect (Ferguson et al., 2013) • Edwards et al. (2017)	• Nintendo Wii is a video game console that allows for motion-controlled gaming. Wii has motion sensing technologies and a Wii remote, which can be used as a pointing device or as a means to detect whole body or arm motion. The Wii console is readily available and has games suitable for all ages. • Xbox Kinect is also a motion-sensing video game console. Unlike the Wii which uses a handheld remote, the Kinect uses cameras and microphones to allow the device to recognize speech and detect the bodies of up to four players. The Kinect camera sits at the top of the user's display and operates like a webcam. • Both consoles allow users to play games that allow the user to interact within the gaming environment using whole-body motion to mimic real-life gameplay (i.e., hitting a virtual tennis ball by swinging the arm in real-time).	• In the two papers listed, Wii and Kinect were used to encourage autistic children to play virtual sports games and, in the process, improve their sportsmanship or their object control abilities. Both interventions showed an improvement, either in certain sportsmanship behaviors or in perceived sports abilities. This suggests that both gaming platforms can teach new behaviors and improve self-perceptions of physical competence. Both platforms allow for autistic children to interact with other players through an engaging virtual environment. As both platforms allow for multiple users, they would be a useful addition to curriculums aiming to improve social skills and/or physical activity as they encourage whole-body movement and social interaction, either competitively or cooperatively. • Both consoles are similarly priced. However, Wii games require an additional remote for each player, and motion tracking is only done through the handheld remote. The Kinect can track whole-body movement (i.e., arms legs head) and has voice recognition. As it does not require a remote, up to four players can be involved without any additional equipment. The Kinect, however, requires the Xbox console in addition to the Kinect, so it is more expensive. However, if it is possible, the Kinect may be more suitable for autistic children who have more significant needs as it does not require holding a remote and is more sensitive with regards to movement tracking. For interventions in which practitioners want to understand motor differences in autistic children, the Kinect will offer a more fine-grained analysis. The Kinect can also project the user's image into the game, particularly engaging players.
Collaborative Puzzle Game (Battocchi et al., 2009)	The Collaborative Puzzle Game (CPG) is a two-player puzzle game played on a touch screen tabletop. In the game, players must complete jigsaw puzzles in tandem. Specifically, to have a piece move, both players must be dragging it together simultaneously with their fingertips. During the puzzle completion phase and after completing a puzzle, the users are given visual and auditory feedback that alerts them if a mistake is made and gives them praise for having finished the puzzle. The equipment needed for the game is an interactive touch screen tabletop.	• Research on the CPG showed that while the interactions with players who had to move the puzzle pieces in tandem with one another were more complex and completion time was longer, collaboration was higher than if the puzzle was completed independently. Players were also more coordinated with one another in the collaborative condition. Thus, it appears that the CPG is a useful tool for encouraging social interactions between children with ASC and may even lead to higher degrees of problem-solving as the puzzle was more difficult and communication more nuanced. • The CPG and its delivery using a touch screen table offer several benefits due to its unique format. The touch screen allows for a more naturalistic and intuitive way to complete a puzzle, in line with real-life jigsaw puzzle motions. The fact that it is delivered on a tabletop rather than a tablet, for instance, means that players have to coordinate with their bodies (i.e., leaning over the table, moving around the table), which could help autistic children who have motor difficulties. As this is a digitized puzzle, it can be programmed to deliver prompting and reinforcement, and can change the level of difficulty and the requirements for success (not allowing puzzle piece movement unless two children are touching the piece). This offers advantages over non-computerized tasks of a similar nature. However, purchasing a digital tabletop will not be feasible for everyone. It may, however, be a useful addition to a school or larger facility with more resources. However, unlike more popular consoles like the Kinect or Wii it is not clear how many programs are available on the digital touch table. Activities for the device may be more limited.
Lets Face It (Tanaka et al., 2010)	Lets Face It (LFI) is a computer game intervention in which children practice various face recognition skills. Specifically, LFI comprises seven games that target facial identification aspects, including holistic face processing, memory for faces, facial expression, and face dimensions. The intervention takes 20 h to complete, with a recommended time of 100 min spent playing LFI per week. LFI has built-in rewards and incentives, including a high score table and animated graphics. Children are also able to select the mode and level of gameplay. The LFI also has a face recognition battery test delivered over the computer, allowing for an understanding of baseline and post-treatment face recognition abilities. This program only requires a computer, as the program is available for free.	Results from the study listed below showed that LFI improved some aspects of face recognition in children with ASC, including recognition of the eyes and the mouth. However, most subtests did not see substantial improvement following the intervention. Additionally, this program did not assess whether real-life improvements in face recognition occurred following the intervention. As this program is available free of charge and requires little equipment, it may be a viable option for parents or professionals interested in targeting facial recognition skills in autistic children. However, this intervention only allows for independent gameplay. As many of the other games target specific skills while also allowing for peer-directed play, LFI may not be as effective in simultaneously teaching children about reciprocal social interactions or help with relationships development with peers. It may be that LFI is most useful in conjunction with a real-life peer activity (i.e., a role-playing game or a board game) where children can practice the facial recognition skills they learned in the game in real-life situations.
TeachTown (Whalen et al., 2010)	TeachTown is a computer-delivered intervention targeting academic and social skills. Specifically, the program targets receptive language, social understanding, life skills and cognition/academics. TeachTown is delivered through 20-min sessions over the computer and with an educator every day for 3 months. The program uses the basic principles of ABA. Specifically, children are encouraged to supply correct responses by receiving the opportunity to play games after they correctly complete a task. Children progress through at their own pace. After they master a lesson they move onto new material; if they do not progress on a pre-test then they are given training on the material until they master the content. In the in-person lessons provided by their instructor to the whole class, the teacher implements activities that target skills not included in the TeachTown curriculum (i.e., imaginative play, daily living skills).	Children who completed Teach Town showed significant improvement on the program's lessons. Though not significant, they had higher scores than waitlisted children on standardized assessments of the four TeachTown skill categories. This curriculum may be of interest to special educators interested in incorporating a computer-based intervention. TeachTown uses ABA principles, it may be particularly effective for classrooms that already use these techniques. More research is needed on the real life effects of TeachTown and the long term effects of the intervention. As this is delivered to young children, it may be that improvements following Teach Town are more obvious in following years, though this has yet to be tested. As the intervention must be completed daily, it may be most feasible for schools with multiple available computers so that several children can complete the tasks simultaneously. This may not be suitable for all children as it requires the ability to use a mouse and attend to the computer for 20 min.
KASPAR (Wainer et al., 2014)	In this intervention, two children interact with a humanoid robot, KASPAR, while playing an imitation game. KASPAR appears similar to a baby doll, with realistic skin and hair, and has an animated face and free moving arms. KASPAR is able to speak and change his facial expressions. In the game, two children use Nintendo Wii controllers to complete a mimicry challenge similar to the game Simon Says. Specifically, one child would pose in a specific way by following a screen in front of them showing a specific pose depicted by a stick figure. The child would then strike that pose and communicate to their partner how to copy the pose. KASPAR's role in the game was to provide verbal encouragement, reminders and to be a third player in the imitation game. The equipment needed for this intervention is an animated robot doll and a digitized version of Simon Says.	Children who played together alongside KASPAR were more animated and showed more positive affect toward one another. At the same time, when playing with KASPAR, participants were less successful at the imitation task. Nonetheless, it appears that KASPAR improves social interactions between children with ASC and is an engaging addition to game play. KASPAR is not readily available for purchase, so this intervention's usability is limited. Additionally, though Wii remotes were used in the imitation game tested in this project, the imitation game is also not readily available. Specialists wishing to include a robot intervention may want to explore other more readily available options. For instance, many games have on-screen avatars which provide reinforcement similar to KASPAR. Researchers may want to test whether the inclusion of an avatar and the creation of an imitation game on a console like Wii or Kinect can produce similar effects.
ADDventourous Rhythmic Planet (Giannaraki et al., 2019)	In this virtual reality (VR) game, players use a drum to create a rhythm. This drumming is then turned into a gaming action that is visually represented in the VR space. In the game, the hero is an alien who only progresses if a player reproduces a rhythm correctly, allowing the alien to continue its journey into the game's next stage. The levels become increasingly difficult. The game comes with two modes, single and multi-user. The game plot encourages children to play with one another and move from single to multiplayer mode. When playing in multiplayer mode, the rhythm is created collaboratively. This game requires VR headsets, a drum that can transmit to the VR system, and computing systems that are able to run the VR platform Unity.	This game offers an engaging, multi-sensory digital environment in which children are encouraged to create music with one another and, in doing so, receive in-game rewards and complete a narrative quest. This program uses state of the art VR technology to create a 3-d visual game, thus providing a highly immersive gaming experience. Though originally designed with children with ADHD in mind, this would likely be beneficial to autistic children as well, as it encourages joint action between peers and helps build rhythmic competencies, which are often found to be disrupted. One of the limitations to this program is the feasibility and lack of formal testing. VR systems are expensive and highly technical. They require training with regards to set-up and testing, and may not be suitable for professionals, educators or parents. Additionally, while the VR systems are available for purchase, the intervention's drum to guide gameplay is not. Those wishing to use this intervention would have to create a similar instrument on their own. Researchers may want to investigate ways to recreate this game using less expensive, more readily available equipment and perhaps use an alternative to the physical drum (i.e., using a remote that simulates a drumstick to provide a similar movement). Finally, the effects of the intervention were not tested. More research is needed to determine how this improves skills in children with disabilities.
Magic Mat (Politopoulos et al., 2021)	In this video game, users stand on a mat that can track movement and thus guide on screen actions. Magic Mat is analogous to a large keyboard on the floor; it has arrows that the user steps on that guide the on-screen movements. For instance, in the game Tetris a user must guide falling blocks to angle them into gaps with a similar shape on the bottom of the screen. Using Magic Mat, the user does this by stepping on the appropriate arrow rather than sitting on a computer and doing this on the keyboard. This format encourages the user to use whole body movement to play traditional computer games. This requires a Magic Mat and compatible games in order to be used.	Though this was not designed specifically for ASC, it is relevant in that autistic children show an interest in computer games and struggle with coordination. The Magic Mat approach to video games may encourage more whole body movement, improved spatial awareness and even collaboration between multiple players. Magic Mat is a gaming prototype and is thus not readily available. However, it is a rather simplistic device that could likely be created by individuals with computer programming ability. It would be interesting for future research to test the effects of Magic Mat on autistic children with regards to physical coordination and peer collaboration. At present, however, it needs more testing and development in order to be used by professionals and families.