Treatment of Autism Spectrum Disorder (ASD): Cognitive Intervention in Children with ASD

In this article, occupational therapist and University of Burgos professor Olalla Saiz, together with her student Victoria Gómez, explains the treatment of autism spectrum disorder (ASD), specifically how to carry out a cognitive intervention in children with ASD using NeuronUP.

What is autism spectrum disorder (ASD)?

Autism spectrum disorder is defined as a neurodevelopmental disorder of neurobiological origin that presents a wide variety of clinical expressions as a result of multifactorial dysfunctions in the development of the central nervous system.

Symptoms of autism spectrum disorder

All cases of autism spectrum disorder present symptoms in the following three areas:

• Impaired development of reciprocal social interaction
• Impaired verbal and nonverbal communication
• Restricted repertoire of interests and behaviors

Areas of difficulty

ASD involves difficulties in the following areas:

• Reciprocal social interaction
• Communication and language
• Repetitive behaviors and mental inflexibility
• Psychiatric conditions
• Cognitive and learning dysfunctions
• Medical conditions

What causes autism spectrum disorder?

The etiology of ASD is considered multifactorial: there is no single cause that explains why it develops. However, genetic inheritance is a very important factor.

Cognitive intervention in children with autism spectrum disorder using NeuronUP

Below, we explain the goals of the intervention session, the methodology, the schedule, the duration, and the activities chosen.

Goals of the cognitive intervention in children with ASD

The main goal of the cognitive intervention in children with autism spectrum disorder using NeuronUP is to improve the cognitive function of attention. To do so, a cognitive session will be carried out with the NeuronUP program.

There are also a number of specific goals:

• Improve sustained attention when doing activities
• Strengthen focused attention on the activity
• Minimize hyperactive or impulsive behaviors
• Increase concentration when carrying out a specific task

Methodology

• The group consists of about 15 children with ASD.
• The rooms can be set up in a U shape.
• Depending on the children’s characteristics, some activities, such as activity 1, will be done as a group, or each child will work individually on their own computer. If the work is done individually, the therapists will need to keep an eye on the children in case they need help.
• The activities will be done using the NeuronUP platform (2).

Schedule

The NeuronUP session will follow this schedule:

Schedule	Activity
10:00 – 10:30	Opening activity
10:30 – 10: 40	Activity 1: Shape Sorter
10:40 – 10:50	Activity 2: Search and you will find!
10:50 – 11:00	Activity 3: Hidden Code
11:00 – 11:30	Break
11:30 – 11:40	Activity 4: Monster Escape! (if time allows).
11:40 – 12:00	Closing activity

The schedule includes an opening activity as a first point of contact. The goal is to build trust, both among the children and between us and the children.

Duration of the intervention

Each NeuronUP activity lasts 10 minutes, making a NeuronUP session of about 40 minutes, plus 20 or 30 minutes for the opening and closing activities. These last two are longer because we need to explain clearly what we want to do with the children and to evaluate how the session went.

If the session runs longer than planned because the children need more time to complete the activities, activity number 4 would be kept in reserve in case any of the activities didn’t appeal to them.

Materials needed

The materials needed for this intervention for the treatment of autism spectrum disorder (ASD) are:

• Computer,
• NeuronUP.

NeuronUP activities for a cognitive intervention in children with ASD

Below, we explain in detail the activities chosen for the NeuronUP session:

1. Shape Sorter

What does it involve?

The therapist will start the game for the children and explain it. The game involves putting each piece in its place.

The game shows the shape to be placed in one color and the gray space where it should go, so children learn to match the shape with its shadow.

When the child gets it right, the character looks happy, and when they make a mistake, it looks sad.

What does this activity work on?

The main function this activity for children with ASD works on is visual gnosis, and its secondary function is selective attention.

Play by levels

The game is divided into 6 phases, with phase 1 being the easiest and phase 6 the hardest.

The user moves up or down a level automatically based on their correct answers and mistakes, with three lives per phase.

2. Search and you will find!

What does it involve?

This exercise involves looking for a series of items within a group. Here’s an example in the following video:

What does this activity work on?

This exercise works on selective attention.

Play by levels

The game is divided into 12 phases, with phase 1 being the easiest and phase 12 the hardest.

The child moves up or down a level automatically based on their correct answers and mistakes.

In the easiest phase, phase 1, the game tells us, for example, which animal to look for among four animals and put in the farm.

As the levels increase, there are more animals to look for among many more animals, as shown in the following image:

3. Hidden Code

What does it involve?

It involves finding, as quickly as possible, the numbers that stay still among a group of numbers that keep changing.

What does this activity work on?

This activity works on:

• selective attention,
• visual gnosis,
• sustained attention.

Play by levels

The game has 9 phases, with phase 1 being the easiest and phase 9 the hardest.

In phase 1, there are 25 numbers, and all of them move except six. The goal is to find these six numbers that don’t move and tap them.

As you move through the phases, it gets harder. In phase 9, the hard one, there are 256 numbers and only 1 moves. This phase will only be done once we see that the children can do the previous ones easily (hard phase).

4. Monster Escape!

What does it involve?

The therapist will explain the game, which involves selecting, as quickly as possible, the squares to move forward and avoid being caught by the monster.

What does this activity work on?

The main function this activity for children with ASD works on is processing speed, and its secondary function is selective attention.

Play by levels

The game is divided into 12 phases, with phase 1 being the easiest and phase 12 the hardest.

The user moves up or down a level automatically based on their correct answers and mistakes.

In phase 1, they only have to choose the shape, a circle or a square, and follow the sequence. The user moves up or down a level automatically based on their correct answers and mistakes, with three lives per phase.

In the last phase, phase 12, they have to choose the background color, the color of the shape, the outline, and the shape itself. In other words, the game requires more and more attention and concentration from the child with autism spectrum disorder.

Conclusion

Working on attention with children can be very beneficial for them.

Challenges

• Problems such as a lack of initiative may come up, although with such dynamic games, I don’t think this would affect the whole group, but rather individual children.
• Other problems that may arise are that the explanations aren’t clear enough and the children don’t understand what they have to do. To prevent this, clear, simple, and brief instructions should be given.
• Finally, frustration could be a problem, since, depending on each child’s abilities, they will be able to complete one phase or another. For this reason, I think it’s important to work by phases, since each child can progress at their own pace and improve little by little.

NeuronUP, a versatile platform

To conclude, I think NeuronUP is a very good platform, since it offers many resources and activities for working on different cognitive functions. It’s also a very versatile platform, since it can be used with both children and adults, or in certain cognitive areas that may be more difficult and harder to reach.

References

1.     American Psychiatric Association, editor. Guía de consulta de los criterios diagnósticos del DSM-5. Arlington, VA: American Psychiatric Publishing; 2014. 438 p.

2.     Digital activities [Internet].  [cited  November 19, 2022].  Available at www.neuronup.com

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“This article has been translated. Link to the original article in Spanish:”
Tratamiento del trastorno del espectro autista (ASD): Intervención cognitiva en niños con TEA