Christopher R. Engelhardt

Video Game Use in Boys With Autism Spectrum Disorder, ADHD, or Typical Development

OBJECTIVES: The study objectives were to examine video game use in boys with autism spectrum disorder (ASD) compared with those with ADHD or typical development (TD) and to examine how specific symptoms and game features relate to problematic video game use across groups. METHODS: Participants included parents of boys (aged 8–18) with ASD (n = 56), ADHD (n = 44), or TD (n = 41). Questionnaires assessed daily hours of video game use, in-room video game access, video game genres, problematic video game use, ASD symptoms, and ADHD symptoms. RESULTS: Boys with ASD spent more time than did boys with TD playing video games (2.1 vs 1.2 h/d). Both the ASD and ADHD groups had greater in-room video game access and greater problematic video game use than the TD group. Multivariate models showed that inattentive symptoms predicted problematic game use for both the ASD and ADHD groups; and preferences for role-playing games predicted problematic game use in the ASD group only. CONCLUSIONS: Boys with ASD spend much more time playing video games than do boys with TD, and boys with ASD and ADHD are at greater risk for problematic video game use than are boys with TD. Inattentive symptoms, in particular, were strongly associated with problematic video game use for both groups, and role-playing game preferences may be an additional risk factor for problematic video game use among children with ASD. These findings suggest a need for longitudinal research to better understand predictors and outcomes of video game use in children with ASD and ADHD.

Age at first autism spectrum disorder diagnosis: the role of birth cohort, demographic factors, and clinical features.

Objective: This study sought to identify factors that may be associated with delays in autism spectrum disorder (ASD) diagnosis, including birth cohort, sociodemographic characteristics, and clinical features. Methods: Participants included 1716 children and adolescents with ASD enrolled in the Autism Speaks Autism Treatment Network (AS-ATN) between the years 2008 and 2011. Data were collected at enrollment using AS-ATN parent- and clinician-report forms and standardized measures of I.Q., ASD symptoms, adaptive function, and psychiatric symptoms. Results: Age at first ASD diagnosis was positively correlated with current age, suggesting a birth cohort effect. Sociodemographic and clinical features were also associated with age at diagnosis, even after controlling for current age. Hierarchical linear regression results showed that older current age, lower socioeconomic status (SES), higher I.Q. score, and lower levels of autism symptoms were associated with later age at initial diagnosis. There was also a significant interaction between current age and I.Q., with higher functioning children being diagnosed at younger ages than in previous years. Conclusions: Early diagnosis of ASD is critically important for improving access to interventions; however, many children experience diagnostic delays. In this sample, children from the most recent birth cohorts were diagnosed earlier, suggesting that early signs of ASD are being increasingly recognized. However, socioeconomic barriers to diagnosis still seem to exist. Children with less severe ASD symptoms and with higher I.Q. are also diagnosed at later ages. Efforts are still needed to reduce diagnostic disparities for families of low SES and to improve early recognition of more subtle symptoms.

Violent and nonviolent video games differentially affect physical aggression for individuals high vs. low in dispositional anger

Although numerous experiments have shown that exposure to violent video games (VVG) causes increases in aggression, relatively few studies have investigated the extent to which this effect differs as a function of theoretically relevant individual difference factors. This study investigated whether video game content differentially influences aggression as a function of individual differences in trait anger. Participants were randomly assigned to play a violent or nonviolent video game before completing a task in which they could behave aggressively. Results showed that participants high in trait anger were the most aggressive, but only if they first played a VVG. This relationship held while statistically controlling for dimensions other than violent content on which game conditions differed (e.g. frustration, arousal). Implications of these findings for models explaining the effects of video games on behavior are discussed.

Effects of Violent-Video-Game Exposure on Aggressive Behavior, Aggressive-Thought Accessibility, and Aggressive Affect Among Adults With and Without Autism Spectrum Disorder

Recent mass shootings have prompted the idea among some members of the public that exposure to violent video games can have a pronounced effect on individuals with autism spectrum disorder (ASD). Empirical evidence for or against this claim has been missing, however. To address this issue, we assigned adults with and without ASD to play a violent or nonviolent version of a customized first-person shooter video game. After they played the game, we assessed three aggression-related outcome variables (aggressive behavior, aggressive-thought accessibility, and aggressive affect). Results showed strong evidence that adults with ASD, compared with typically developing adults, are not differentially affected by acute exposure to violent video games. Moreover, model comparisons provided modest evidence against any effect of violent game content whatsoever. Findings from this experiment suggest that societal concerns that exposure to violent games may have a unique effect on adults with autism are not supported by evidence.

Video game access, parental rules, and problem behavior: A study of boys with autism spectrum disorder

Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to 18 years of age). Parents of these children reported on (1) whether they had specific rules regulating their child’s video game use, (2) whether their child had in-room access to a variety of screen-based media devices (television, computer, and video game console), and (3) their child’s oppositional behaviors. Multivariate regression models showed that in-room access to a video game console predicted oppositional behavior while controlling for in-room access to other media devices (computer and television) and relevant variables (e.g. average number of video game hours played per day). Additionally, the association between in-room access to a video game console and oppositional behavior was particularly large when parents reported no rules on their child’s video game use. The current findings indicate that both access and parental rules regarding video games warrant future experimental and longitudinal research as they relate to problem behavior in boys with autism spectrum disorder.

Overstated evidence for short-term effects of violent games on affect and behavior: A reanalysis of Anderson et al. (2010).

Violent video games are theorized to be a significant cause of aggressive thoughts, feelings, and behaviors. Important evidence for this claim comes from a large meta-analysis by Anderson and colleagues (2010), who found effects of violent games in experimental, cross-sectional, and longitudinal research. In that meta-analysis, the authors argued that there is little publication or analytic bias in the literature, an argument supported by their use of the trim-and-fill procedure. In the present manuscript, we reexamine their meta-analysis using a wider array of techniques for detecting bias and adjusting effect sizes. Our conclusions differ from those of Anderson and colleagues in 3 salient ways. First, we detect substantial publication bias in experimental research on the effects of violent games on aggressive affect and aggressive behavior. Second, after adjustment for bias, the effects of violent games on aggressive behavior in experimental research are estimated as being very small, and estimates of effects on aggressive affect are much reduced. In contrast, the cross-sectional literature finds correlations that appear largely unbiased. Third, experiments meeting the original authors’ criteria for methodological quality do not yield larger adjusted effects than other experiments, but instead yield larger indications of bias, indicating that perhaps they were selected for significance. We outline future directions for stronger experimental research. The results indicate the need for an open, transparent, and preregistered research process to test the existence of the basic phenomenon.

Video games from the perspective of adults with autism spectrum disorder

Video game preferences of 58 adults with autism spectrum disorder were examined.Game play motives included stress relief, immersion, time use, and social connection.Participants reported enjoying achievement, creativity, story, and game graphics.Addiction and negative social interactions were identified as negative game aspects.Many participants disliked game violence, sexual content, and game design problems. Individuals with autism spectrum disorder (ASD) experience significant challenges in community engagement and social activities, yet they have strong interests in video games. Thus, there has been increasing interest in understanding potentially positive and negative effects of video games in this population. However, research has not yet examined the perspectives of individuals with ASD themselves on this topic. The purpose of this study was to use qualitative methods to examine the preferences and motivations for video game play among adults with ASD. Individual interviews were conducted with 58 adults with ASD, and responses were coded through an iterative and collaborative process. Several themes were identified, including perceived benefits of video game use (e.g., social connection, stress reduction) as well as perceived negative effects (e.g., time use, addictive potential). Participants also noted both positive and negative aspects of game design that affect their overall enjoyment. The most frequent all-time favorite video game genres were Role-Playing (31%) and Action-Adventure (19%). These qualitative findings enhance our understanding of video game use from the direct perspectives of individuals with ASD, and suggest a need for incorporating these perspectives in future quantitative studies on positive and negative aspects of game use in this population.

Making inferences: Comprehension of physical causality, intentionality, and emotions in discourse by high-functioning older children, adolescents, and adults with autism

Studies investigating inferential reasoning in autism spectrum disorder (ASD) have focused on the ability to make socially-related inferences or inferences more generally. Important variables for intervention planning such as whether inferences depend on physical experiences or the nature of social information have received less consideration. A measure of bridging inferences of physical causation, mental states, and emotional states was administered to older children, adolescents, and adults with and without ASD. The ASD group had more difficulty making inferences, particularly related to emotional understanding. Results suggest that individuals with ASD may not have the stored experiential knowledge that specific inferences depend upon or have difficulties accessing relevant experiences due to linguistic limitations. Further research is needed to tease these elements apart.

Bedtime Electronic Media Use and Sleep in Children with Autism Spectrum Disorder.

Objectives: The purpose of this study was to better understand the use of screen-based media at bedtime among children with autism spectrum disorder (ASD). The study specifically examined whether the presence of media devices in the childs bedroom, the use of media as part of the bedtime routine, and exposure to media with violent content just before bedtime were associated with sleep difficulties. Methods: Parents of 101 children with ASD completed questionnaires assessing their childrens sleep habits, bedroom media access (including television, video game devices, and computers), and patterns of nighttime media use (including timing of media exposure and violent media content). Results: Children with ASD who used media as part of the bedtime routine showed significantly greater sleep onset latency than those who did not (39.8 vs 16.0 minutes). Similarly, children who were exposed to media with violent content within the 30-minute period before bedtime experienced significantly greater sleep onset delays and shorter overall sleep duration. In contrast, the mere presence of bedroom media was not associated with either sleep onset latency or sleep duration. Conclusion: Overall, these findings indicate that incorporating television and video games into the bedtime routine is associated with sleep onset difficulties among children with ASD. Exposure to violent media before bed is also associated with poor sleep. Families of children with ASD should be encouraged to regulate and monitor the timing and content of television and video game use, whether or not such devices are physically present in the childs bedroom.

How much evidence is p > .05? Stimulus pre-testing and null primary outcomes in violent video games research.

Research on the effects of violent video games frequently relies on arguments for the null hypothesis. Proponents of the effects argue that there are no meaningful differences save violent content between the violent and nonviolent games played, while critics of the effects argue that their nonsignificant study results constitute evidence for the null hypothesis of no difference. However, neither argument can be supported through the use of traditional null-hypothesis significance testing, as such tests can only ever reject or retain the null, never rejecting the alternative hypothesis in favor of the null. Therefore, to evaluate these claims, we apply a more appropriate Bayesian analysis to measure evidence for or against the null hypothesis relative to reasonable alternative hypotheses. We conclude that current methodological standards cannot rule out substantial confounds between violent and nonviolent video games. Furthermore, we find that studies that claim to find an absence of violent video game effects vary substantially in the strength of evidence, with some strongly supporting the null, others weakly supporting the null, and some others finding evidence of differences between conditions. We recommend the use of Bayesian analyses, larger sample sizes, and the creation of custom-designed games for experimental research.