The 3^rd Autism plan gives priority for reinforcement of school inclusion and school accompaniment of children and youths with Autism Spectrum Disorders (ASD) and consultations about the 4^th Autism plan may renew this critical issue. Indeed, mainstream school inclusion of students with ASD is often compromised because of their socio-adaptive difficulties, which notably occur during first-time mainstream inclusion. For this reason, children/youths with ASD are often included into mainstream schools, but in specialized classrooms, called ULIS (Unité Localisée pour l’Inclusion Scolaire – Located Unit for School Inclusion) in middle school.

Since 2012, Phoenix team is working closely with French National Education Ministry, Bordeaux Academy and Rectorship, as well as the Autism Ressources Center in Aquitaine, for developing a study aiming to design and evaluate the efficacy of a school digital assistant on tablets for students in specialized classrooms. This school digital assistant, named School+ and composed with several tools for students in ULIS, have been designed for supporting educational and communication activities in order to facilitate school inclusion in mainstream settings for core lessons (French, history, geography, etc.)

A multidisciplinary approach was necessary to cover the whole range of activities of this project (from people needs’ analysis to the deployment and the evaluation of the school assistant, and along with software development). Then, the project gathers researchers in computers sciences (Charles Consel, Phoenix team, INRIA Bordeaux Sud-Ouest), in cognitive sciences (Hélène Sauzéon, Lab. “Handicap, Activité, Cognition, Santé” EA-4136, SFR Neurosciences, University of Bordeaux), and in child psychiatry (Kattalin Etchegoyhen, Anouck Amestoy, Manuel Bouvard, Autism Ressources Center of Aquitaine, Charles Perrens hospital center).

Project’s overview (2012-2016)

School+ is a digital assistant which target cognitive and behavioral areas that are known to underpin difficulties that encounter students with ASD : verbal and non-verbal communication, socio-adaptive behaviors, emotion regulation. Designed through a centered-user approach, this tool’s development was driven by needs analysis with all stakeholders: students with ASD and their families, specialized clinicians, teachers and school accompanying for students with special needs. This iterative and user-centered design approach allows providing a tool that respond to the specific needs, expectations and abilities of students as well as those of school inclusion’s stakeholders.

School+ assistant is composed with a set of applications, divided in two modules: 1) a school life’s assistant module, and 2) a sociocognitive training/rehabilitation module with serious games. Also, School+ provide personalization’s features by isolating contents from interface: elements such as pictures and text can be modified without modifying the interface. This allows to customize School+ for the student which use it.

Assistance module

The Assistance module gathers three applications: two applications assist activities’ achievement (verbal and educational ones), and one application assists the emotional regulation.

The assistance for activities’ achievement provide a decomposition of the activity into several steps, in order to guide the person in performing one task. The user selects an activity and accesses to a viewer displaying one by one the required steps for the selected activity. Each step is displayed with a text and a picture depicting the expected action. The user can self-placed come and go through the steps. Two version of this application are provided: 1) assistance to school routines (e.g., take notes, do homeworks, enter in class), and 2) assistance to verbal routines (e.g., ask the teacher, answer to classmates).

The third assistance application aims to support emotional self-regulation in order to avoid emotional overflow during class courses. When application opens, the user is invited to identify the emotion that he is experiencing among four basic emotions (happiness, fear, sadness, anger). Then, the user is invited to indicate the intensity level through the use of a visual thermometer, ranged from 1 (low) to 4 (high intensity). According to the selected level, the application will provide different contents: at level 1, there are relaxation advices, at level 2 and 3, there are respectively photos and videos depending on student’s interests, and at level 4, the application propose to go rest in the specialized classroom.

These three assistive applications are fully customizable. For instance, in school and verbal routines applications, pictures and text may be replaced with user’s photo.

Training module

The training module gathers three applications, designed as serious games for training sociocognitive processes in students with ASD.

The first application has been designed for training the gaze orientation. The application displays a picture depicting a face (1^st level) or a social school scene (2^nd level), and asks the user to look in the eyes of the main character. Few seconds after, a symbol briefly appears in the character’s eyes (for a face) or on the main character’s face (for a scene). Then, the user is asked to retrieve the depicted symbol among 6 possible answers. Difficulty levels are determined by the symbol’s presentation time, which decreases with the difficulty.

The two last applications aim to train the emotion recognition in both static and dynamical contexts. The first one asks the user to find an emotion depicted among 4 pictures of people expressing an emotion (happiness, sadness, fear, disgust, anger, surprise). The first level is composed with pictures of familiar people, and the 2^nd level with pictures of unfamiliar people. Another difficulty is driven by the possible answers, which may depict the same emotion (error minimization) or not.

The second application provide short videos, that are stopped after an emotionally connoted scene. The user is asked to recognize the emotion felt by the character among several possible answers. Three difficulty levels are proposed: 1) animated cartoons with one characters, 2) animated cartoons with several characters, and 3) movies with actors. Also, for an increasing difficulty, first trials provides slow-motion videos, which is “re-normalize” depending on user’s successes.

The user’s statistics were available to consultation through a meta-application, with a visualization of user’s successes.

In-situ evaluation of School+

For assessing the effects of School+, an in-situ evaluation was conducted with three public colleges from the Academy of Bordeaux, which have a specialized classroom. Fifty students from specialized classrooms were included in this study, including 29 students with ASD, and 21 with an intellectual or a learning disability (Non-ASD). The 50 students were divided into three groups: 1) students with TSA and equipped with School+, 2) students with TSA but not equipped with School+, and 3) Non-TSA students, equipped with School+. By this way, we were able to: 1) determine the effects of School+ on students with TSA, by comparing equipped vs. non-equipped students and 2) differentiate global effects of School+ from TSA-specific effects, by comparing two groups of equipped participants with different medical conditions.

School+ intervention’s assessment was undertaken before and after a 3-month period, during which students used School+. There were different psychological tests for assessing several cognitive and functional areas related to school handicap of students with ASD. The comparison between pre- and post-intervention’s results allows to evaluate the impact of School+ on socio-cognitive skills (e.g., emotion recognition, emotional awareness) and on school-related socio-adaptive functioning (e.g., socio-adaptive behaviors, school routines acquisition, social responsiveness, quality of life). Also, an ergonomic inspection was conducted with dedicated questionnaires (usability, autonomy of use, satisfaction) and data collection from School+ apps (e.g., frequency and duration of use, information on interactions with the tablet).

The results of this evaluation showed significant benefits in socio-cognitive skills, in socioadaptive functioning and in social responsiveness for the two equipped groups. Furthermore, the benefits were more important in the equipped ASD group than in the equipped non-ASD group. This result leads to believe that School+ is relevant with students with ASD. Concerning usability, students with TSA were able to learn the use of School+, thus validating its ergonomics. Another interesting point is that students with ASD were able to learn school routines from the assistant, which resulted in a decrease of the use of routine assistant at the end of the intervention.

This project was funded by the French National Education Ministry

Project continuation

With the financial support of French Orange Foundation, Phoenix team have renewed the project School+. First, School+ application was aesthetically and functionally redesigned for providing a more coherent and harmonious tool. These enhancements have already permit to publish the application School+ on the AppStore, and is now available for free.

Click here for online access to School+ on the AppStore.

The project continuation also planned to enhance and enrich the School+ assistant, as well as to conduct a new validation study on a longer period and with a larger number of participants.

The assistant for activity’s achievement will be consolidated and improved with new functionalities, designed for fostering the learning of students with ASD. Moreover, the content of this application will be enriched, on the one hand, by providing a lager set of core contents (i.e., assisted activities’ library), and on the other, by inviting the user to design new contents for this application. For this latter, we planned to provide a web platform for allowing users to share these contents. This will foster collaboration between school inclusion’s stakeholders and will permit to build a set of contents that are relevant for the daily lives of students with ASD.

A needs analysis was conducted with parents, teachers and health practitioners, and have revealed a strong demand for collaboration and for communication between them about the student with ASD. Thus, we planned to design a monitoring and communication module, which will provide a common knowledge base and sharing opportunities in the best interest of the student with ASD. All stakeholders will have access to general information about the student, to his/her profile and to elements relevant for individualizing the School+ intervention. Moreover, communication between stakeholders will be facilitated through an digital liaison diary for a more individualized monitoring of the student. This module will be secured and integrated in a web platform in order to be easily available for all stakeholders.

The project continuation and the development of School+ 2^nd version are funded by the French Orange Foundation.

Contributors

• Charles Fage
• Hélène Sauzéon
• Charles Consel
• Cécile Mazon
  

• Équipe “Handicap, Activité, Cognition, Santé” (EA 4136), Bordeaux University
• CRA Aquitaine,
• Centre PsyCLÉ (EA 3273), Provence, Aix-Marseille University
• French National Education Ministry
• French Orange Foundation