Hello. My name is Adrian Schneider, and I’m going to be discussing game design
for children with Fetal Alcohol Spectrum Disorder (FASD for short).
If you’re not familiar with FASD: As the name says, it’s caused by prenatal alcohol exposure,
and is a spectrum disorder: it has many possible symptoms.
In North America, where we performed our research, FASD is estimated to affect 2-5% of the population.
So, it’s no small matter. As a spectrum disorder, there are many deficit that can be associated with FASD.
But, for this talk, there are two to keep in mind:
First, executive function, particularly emotional regulation, and impulse control and deferred gratification;
plus, some forms of social skill, like social adjustment, appropriateness, and consideration of others,
that I will collectively refer to as “social adaptation.”
That’s the what. Moving on to why: Why is this important to research?
Well, first is the social equity argument. Playing games is part of the social fabric of being a kid these days.
If it’s hard for you to play games, then you can’t talk about games,
or play games with the other kids, which can exacerbate social isolation.
This is in a population that can already have trouble with social interaction.
Second reason: games are often used as the delivery mechanism for clinical interventions
intended to improve the symptoms of FASD. If you’re going to do that, it should be a good game!
But… the publications for these clinical interventions usually emphasize the clinical effectiveness of the intervention,
not the quality of the game’s design.
there are guidelines for players with cognitive disabilities in general,
but few of these address FASD specifically.
This leaves us with limited understanding of what specific challenges might exist
for designing enjoyable games for kids with FASD. To find out, you really need to run trials,
with kids with FASD, looking for game design considerations. So, that’s what we did.
A brief overview of our study:
It was an in-school study with 11 elementary school participants,
split into two cohorts. They played over the course of 10 weeks,
with a total of 18 sessions, roughly 40 minutes long each.
The game they played was called Liberi, which is a multiplayer cycling-based exergame.
Players pedal a stationary exercise bike to move, and use a wireless game controller for other inputs.
The game ran on tablet computers mounted on stands, giving each player their own screen.
Also: each player had a “buddy.”
Buddies were volunteers from the University of the Fraser Valley,
and were there to offer personal support to their assigned player as needed.
Buddy duties included answering questions from their participants,
or being the first to offer help in case of emotional upset.
Another key duty of the buddies was to write the “passports,”
which were a standardized information-gathering checklist for observing and recording player experiences:
both what they said directly, and the buddies’ own observations based on players’ behaviour.
Here is an example, this is a fairly typical, representative passport.
The passport was divided into two section. The first section holds questions asked to the participants
at the end of each session. These were simple questions:
what was your favourite game and why, what did you like and what didn’t you like.
These questions were mostly meant to prompt player feedback about the session.
The other section is for the buddy’s own observations during the course of the session:
what went well, what didn’t go well, and anything else they noticed.
Continuing with examples, I have some example videos up next.
This first video shows players pedaling, and we can see that it’s not a very big room,
and the bikes are quite close. This allowed the players to talk to each other easily.
We can also see a buddy making notes on a passport, during play.
Buddies were not needed every moment, and could note down observations as they observed them them.
Our final example is a screen capture of the game itself.
Liberi follows a minigame format, with individual short games
accessible from portals on a central island.
This one is a racing game, in which you race against the other players
(in this case, computer-controlled bots.)
The objective is to be the first to reach the finish line at the top.
When the race ends, players are given coins according to how far they made it.
Every minigame has some way to earn coins while playing.
What are the coins used for? Well,
Well, when we return to the central island, we have access to the minigame portals.
But we also have access to the shops.
At the shops, players can spend their coins on a variety of reward items,
like costume pieces for their avatar. Items vary in price,
from buyable after a couple games to needing days of saving for the fanciest ones.
Alongside the gameplay itself, the shops are one of the main reward systems in Liberi.
So, that’s the background information. Moving on to the outcomes:
For analyzing the study, we performed thematic analysis on the observations within the passports.
From these observations, we constructed three themes.
I’m going to go over those theme in detail, but briefly:
The first theme was Frustration: sometimes players got frustrated.
But, how frustrated, and what by?
Second theme: Rewards. was “saving up coins to buy items”
an effective reward system for these players?
And the third theme was Social Interaction: how well were the players able to play together,
and how much did they want to?
Theme 1: frustration. Some frustration was fairly common while playing;
about 5-6 times a day on average. This isn’t extraordinary on its own:
when you play a game and something goes wrong, sometimes you get frustrated.
But what was noteworthy were “emotional outbursts:”
when a player became so frustrated that it disrupted the entire session.
In one memorable example, a player got so frustrated that he shouted loudly and long enough
for the school’s principal to intervene.
These emotional outbursts happened about once a day on average,
and were not seen in previous populations playing the same game.
This suggests that they are related to FASD, and specifically to difficulty with emotional regulation.
This theme contains two subthemes, which I will discuss separately:
design causes, aspects of the game or the play sessions that were under the control of the designers;
and non-design causes, that were not under our control.
First, design causes. There were four types:
Players often felt that the AI-controlled bots were being mean, or picking on them.
As one of the developers of the game, I can promise you that they don’t do that;
if the same bot hits you four times in a row, that’s just unlucky.
But nonetheless, players felt really unhappy with these bots.
Also, not all game portals were open at the same time; they rotated.
The idea is, when a new game appears, it’s fresh and exciting!
But when an old game disappears, that turns out to be very frustrating.
Players were sometime frustrated when they lost to another player in a competitive game.
And finally, a small oversight in the shop interface: if a player bought a reward item by accident,
there was no refund option; the coins were just wasted.
Again, all these factors were present in previous trials,
but it was only now, in this population, that they became problematic.
So, what does this tell us about game design? First, ensure a low cost of failure.
The common factor between these four causes is a feeling of unfairness:
something bad happened, and the players felt like there was nothing they could have done to stop it.
Note that none of these were intended to be costs. But, it seems that you need to be very careful,
for this population, to avoid even accidental negative feedback.
More specifically, as seen with the game rotation: avoid retracting options.
If something has become available, don’t take it away.
Next, non-design causes. These fall under two categories:
First, glitches. If there was a programming error in the game,
or if the network was having problems, then players could often get frustrated.
You remove as many of these as you can, but no software is perfect.
And sometimes, players were frustrated by something completely out of our control.
For example, one kid had to choose between attending the game session, or going on a field trip.
That is a difficult choice, and there was nothing we could do to help.
What can we do about causes of frustration outside our control? Account for breaks.
If some amount of frustration will happen, have a plan to mitigate it.
For our sessions, taking a break and leaving the room allowed players to cool down from an outburst,
and come back when they were ready. Two factors made this feasible:
first, the buddies were there to suggest when it may be time to take a break.
Also, the fact that it’s minigames: you can leave the minigame and come back later,
and you didn’t miss much.
Theme 2: rewards. We wanted to know if the rewards appealed to the players.
The short answer was, yes. Responses from players were overwhelming positive.
Players enjoyed going to the shops, either to buy items, or even just to window-shop the options.
Players bought cheap items, they bought expensive items,
with no evidence that they had trouble putting off impulse purchases in order to save up.
While the shops were intended to be the main reward,
players were often interesting in the coins themselves.
I’m going to zoom in on that and discuss it in detail.
Players frequently did not specify why they wanted the coins.
As far as we know, they just wanted them.
Other time, players did tell us why they wanted coins.
Sometimes they were saving up to buy a specific item them wanted.
But other times, we know they really did just want coins for their own sake.
One player managed to get over 7,000 coins at once, which took weeks.
So what does that say? Well, that says to us that you should show progression in rewards.
Players mentioned wanting coins more frequently than they mentioned the shops. Why?
Because the coins themselves were more frequent.
Getting coins acts as an immediate and frequent reward, helping keep motivation high.
And our final theme: social interaction.
Interpersonal conflict was quite rare; it was observed only three times in total,
in the form of some unfriendly competitions.
Occasionally, players wanted to play alone, rather than socially.
This is fine; certainly an improvement over conflict.
But, most of the time, they wanted to play with other players.
They were deliberately playing socially, about 6x as common as the others combined.
So, like before, the simple answer is,
yes: players were eager to play together if given the opportunity.
Zooming in on the engagement subtheme, there are a couple specifics I want to point out.
First, cooperative play was more popular than competitive play; it was about a 3-to-1 ratio.
And, second: players were so keen to play socially that they invented their own ways of doing so.
I’m going to play a simple video example, of a sort of improvised jousting game.
So, in this video, our protagonist jumps over the head (Whoop!)
of the player with the green box head (Whoop!) each time the box head passes. (Olé!)
As I said, this is quite a simple example. I show this to you, not because it’s especially exciting,
but because we happened to have it on video, by complete coincidence.
There were other times players would improvise their own social games.
Out on the island, between minigames, they would play games like tag, or hide-and-seek.
Players would also team up against the bots.
This was especially interesting to us, since it meant the players were creating
their own techniques for dealing with the frustration of losing to bots.
The players were effectively able to team up and all win together by working cooperatively.
Combined, these observations suggest that it should be a design goal
to favour cooperation over competition.
Players being able to work together to reduce frustration is very valuable!
This is not intended behaviour, but we suggest that this ability to team up
in a game meant to be competitive is more of a feature than a bug.
Now, we’re not suggesting getting rid of competitive games entirely.
Players enjoyed them. However, if it’s possible to work together,
then players can help each other, and themselves, avoid frustrating aspects of the game.
So, in summary: Game design for children with FASD,
specifically, making games effective as games, is a neglected area, but important.
We conducted an observational study with 11 children with FASD across 10 weeks
From those observations, we constructed three themes:
Frustration, Rewards, and Social Interaction
And, our findings suggest the following as implications for game design for this population:
Ensure low cost of failure; Avoid retracting options;
Account for breaks; Show progression in rewards;
and Favour cooperation over competition.
Thank you for your time.