TYLES: A feasibility study for an application to teach autistic children to better understand facial expressions

Autism is a neurodevelopmental condition that impacts individuals' communication and social interaction skills. Technology-based interventions have been developed to teach autistic children how to recognise facial expressions, but the results have exhibited considerable variability across studies. Few studies have comprehensively explored the feasibility of technology-based interventions for autistic children. This project aimed to assess the feasibility of a tile-matrix task designed to help autistic children interpret facial expressions more accurately by focusing on the eye and mouth regions. The project included a usability and acceptability study, and used event-related potential recordings, eye-tracking, and neuropsychology assessments to determine the effectiveness of the task. The findings revealed that the app was usable in its current form. However, there were challenges related to user engagement. The children demonstrated high accuracy in guessing emotions, suggesting a pre-existing proficiency in recognising basic facial expressions. Parents reported that their children found the task redundant and expressed reluctance to continue using it. There were differences between the autistic and non-autistic groups across measures, including event-related potentials, eye-tracking, and social communication. However, the autistic group exhibited comparable proficiency to the non-autistic group in recognising facial expressions. Following the intervention, some changes were observed in facial feature scanning among autistic participants, characterised by increased time spent on the face and decreased fixations. The task failed to improve eye region scanning, facial feature encoding, or social communication skills for the autistic group. Overall, the study's results indicated that the current form of the task may not be feasible for autistic children who have already mastered basic facial expressions. The results offer insights for researchers and practitioners involved in designing and selecting technology-based interventions to support social skill development in autistic children.