Autistic children spent more time playing video games

Children with autism spectrum disorders spent significantly more time than their typically developing siblings playing video games, and playing certain types of video games was associated with behavioral issues, according to two studies published in Research in Autism Spectrum Disorders and in the Journal of Autism and Development Disorders.

But children with autism spectrum disorders (ASD) spent significantly less time than their typically developing (TD) siblings on social media and socially interactive games, as well as on all nonscreen activities in general, such as homework, socializing, or sports.

©adamfilip/iStockphoto.com

Meanwhile, boys with ASD who played video games showed addictive behaviors in their gaming if they played them for more hours or if they played shooter or role-playing games, and problem behaviors were positively associated with inattention and oppositional defiant symptoms, the researchers found.

The findings on video game behaviors among boys with ASD were reported on Feb. 13 by Micah O. Mazurek, Ph.D., and Christopher R. Engelhardt of the University of Missouri, Columbia (Res. Autism Spectr. Disord. 2013;7:316-24). Dr. Mazurek and her colleague Colleen Wenstrup reported the screen behavior findings in ASD children and their siblings in 2012 (J. Autism Dev. Disord. 2012 Sept. 22 [doi: 10.1007/s10803-012-1659-9]).

The researchers recruited the parents of 202 children and teens with ASD and their 179 TD siblings through the Interactive Autism Network Project at the Kennedy Krieger Institute in Baltimore. The project is sponsored by the Autism Speaks Foundation. The predominantly white children were aged 8-18 years; the mean age of the children in the ASD group was 12.1 years, and the mean age for the sibling group was 12.5 years.

Among the 202 ASD children, 53.5% had autistic disorder, 27.2% had Asperger’s disorder, and 17.3% had pervasive developmental disorder, not otherwise specified (PDD NOS). A subgroup of the ASD children, comprised of 169 boys who played video games, was evaluated for the study on video game playing and problem behaviors.

Parents were surveyed via the Web for information on their children’s video game usage. In addition to information on age, race, parent marital status, household income, number of siblings, the autistic child’s estimated IQ (if known), and diagnostic information, the parents estimated how much time their children spent in hours each weekday and each weekend day on the following activities:

• Reading for pleasure.

• Doing homework/studying.

• Spending time with friends.

• Playing sports/other physical activity.

• Watching TV.

• Playing video or computer games.

• Using e-mail, Facebook, or texting.

Parents whose children played video games also were asked whether the children played the games with other children in the same place and whether they play multiplayer networked games. Parents also answered questions for the Problem Video Game Playing Test (PVGT) to assess problematic aspects of the children’s video gaming.

ASD children spent 62% more time on screen-based activities (mean, 4.5 hours daily) than on all nonscreen activities combined (mean, 2.8 hours daily), and a substantial portion of this additional screen time included video games, where ASD children outplayed their TD siblings. ASD children spent an average of 2 hours each weekday and 3.1 hours a day on weekends playing video games, compared with 1.2 daily weekday hours and 1.7 weekend daily hours spent by the TD children.

Dr. Mazurek, a clinical child psychologist at the Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, said there are several possibilities she and colleagues are exploring related to why ASD children play more video games. "One theory is that children with autism have really strong visual spatial skill and are really drawn to visual stimuli," she said in an interview. "These games also are designed to provide really frequent reinforcement: They’re engaging, but they have a lot of structure, and that can be reinforcing for kids with ASD." She added that video games don’t require a lot of face-to-face interaction like other social games might require.

ASD boys spent an average of only 0.2 hours daily on social media, compared with 0.8 hours daily among TD boys, and ASD girls spent 0.3 hours daily on social media, compared with 1.2 hours daily among TD girls. Time spent with friends showed similar patterns: ASD boys spent 0.4 hours daily and ASD girls spent 0.2 hours daily socializing with friends, while TD boys spent 1.8 hours daily and TD girls spent 1.7 hours daily.

The ASD children were not getting additional social interaction from their video game play: 48% of the ASD boys and 61% of the ASD girls had never played video games with other people, and 76% of boys and 90% of girls had never played online multiplayer games. Only 15% of boys and 6.5% of girls played video games once a week with others.

"Anecdotally, I’ve heard people hypothesize that video game play or technology use may be a social outlet for ASD children, but we found that kids with autism are using a lot less of those social media and social video games than their typically developing siblings," Dr. Mazurek said. "It does seem to be more of an isolated experience for them."

Among the 169 boys who were assessed for problem behaviors associated with video game play, 52.7% had autistic disorder, 28.4% had Asperger’s disorder, and 18.9% had PDD NOS. The parents of these boys filled out additional questionnaires about the video game genres their children most often played and the boys’ symptoms of inattention, hyperactivity/impulsivity, and oppositional defiant behaviors as assessed through the Vanderbilt Attention-Deficit/Hyperactivity Disorder Patient Rating Scale (VADPRS).

The three most popular game genres were action (this genre was ranked by 16% of parents as their child’s first preference, and by 31% of parents as one of their child’s top three preferences), platform (14% ranked it first and 25% ranked it in the top three), and shooter (13% ranked it first and 21% ranked it in the top three). The researchers found statistically significant associations only between the children’s VADPRS scores and the role-playing and shooter games. Role playing was ranked first by 9% of the parents as their child’s primary game and was ranked in the top three by 20% of parents.

Hours per day spent playing games was not associated with any of the problem behaviors (inattention, hyperactivity, or oppositional defiant behavior). "Rather, the most reliable predictors of problem behaviors were shown to be video game genre and problematic, or addictive, qualities of play," the investigators wrote. The number of daily hours spent playing video games was positively and significantly associated with PVGT scores, especially among boys playing shooter or role-playing games.

PVGT scores were positively associated with inattention and oppositional defiant behavior, but not hyperactivity/impulsivity – a surprising finding, Dr. Mazurek said, because other studies have found correlations with impulsivity. No association was found for predicting inattention based on age, video game hours, or video game genre. Oppositional defiant behavior was predicted for role-playing genres, but not age, video game hours, or shooter games.

"Given their tendency to engage in restricted and repetitive patterns of activity, children with ASD may be at particular risk for developing problematic, or addictive, game play patterns," the researchers wrote.

However, the attraction of video games could serve therapeutic purposes as well. "I would encourage parents not to let their kids have free rein to play games as much as they want," Dr. Mazurek said. "If we’re going to capitalize on this interest in technology in therapeutic ways, we need to do that alongside face-to-face interactions."

The authors noted that the cross-sectional design of the video game behaviors study precludes conclusions about causality. "It is possible that children with pre-existing behavior problems are more inclined to play video games for longer periods of time and in a more intense manner," they wrote, or video game play patterns could influence problem behavior, or the problems could be bidirectional.

Both studies were internally funded, and the authors had no disclosures.

Children with autism spectrum disorders spent significantly more time than their typically developing siblings playing video games, and playing certain types of video games was associated with behavioral issues, according to two studies published in Research in Autism Spectrum Disorders and in the Journal of Autism and Development Disorders.

But children with autism spectrum disorders (ASD) spent significantly less time than their typically developing (TD) siblings on social media and socially interactive games, as well as on all nonscreen activities in general, such as homework, socializing, or sports.

©adamfilip/iStockphoto.com

Meanwhile, boys with ASD who played video games showed addictive behaviors in their gaming if they played them for more hours or if they played shooter or role-playing games, and problem behaviors were positively associated with inattention and oppositional defiant symptoms, the researchers found.

The findings on video game behaviors among boys with ASD were reported on Feb. 13 by Micah O. Mazurek, Ph.D., and Christopher R. Engelhardt of the University of Missouri, Columbia (Res. Autism Spectr. Disord. 2013;7:316-24). Dr. Mazurek and her colleague Colleen Wenstrup reported the screen behavior findings in ASD children and their siblings in 2012 (J. Autism Dev. Disord. 2012 Sept. 22 [doi: 10.1007/s10803-012-1659-9]).

The researchers recruited the parents of 202 children and teens with ASD and their 179 TD siblings through the Interactive Autism Network Project at the Kennedy Krieger Institute in Baltimore. The project is sponsored by the Autism Speaks Foundation. The predominantly white children were aged 8-18 years; the mean age of the children in the ASD group was 12.1 years, and the mean age for the sibling group was 12.5 years.

Among the 202 ASD children, 53.5% had autistic disorder, 27.2% had Asperger’s disorder, and 17.3% had pervasive developmental disorder, not otherwise specified (PDD NOS). A subgroup of the ASD children, comprised of 169 boys who played video games, was evaluated for the study on video game playing and problem behaviors.

Parents were surveyed via the Web for information on their children’s video game usage. In addition to information on age, race, parent marital status, household income, number of siblings, the autistic child’s estimated IQ (if known), and diagnostic information, the parents estimated how much time their children spent in hours each weekday and each weekend day on the following activities:

• Reading for pleasure.

• Doing homework/studying.

• Spending time with friends.

• Playing sports/other physical activity.

• Watching TV.

• Playing video or computer games.

• Using e-mail, Facebook, or texting.

Parents whose children played video games also were asked whether the children played the games with other children in the same place and whether they play multiplayer networked games. Parents also answered questions for the Problem Video Game Playing Test (PVGT) to assess problematic aspects of the children’s video gaming.

ASD children spent 62% more time on screen-based activities (mean, 4.5 hours daily) than on all nonscreen activities combined (mean, 2.8 hours daily), and a substantial portion of this additional screen time included video games, where ASD children outplayed their TD siblings. ASD children spent an average of 2 hours each weekday and 3.1 hours a day on weekends playing video games, compared with 1.2 daily weekday hours and 1.7 weekend daily hours spent by the TD children.

Dr. Mazurek, a clinical child psychologist at the Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, said there are several possibilities she and colleagues are exploring related to why ASD children play more video games. "One theory is that children with autism have really strong visual spatial skill and are really drawn to visual stimuli," she said in an interview. "These games also are designed to provide really frequent reinforcement: They’re engaging, but they have a lot of structure, and that can be reinforcing for kids with ASD." She added that video games don’t require a lot of face-to-face interaction like other social games might require.

ASD boys spent an average of only 0.2 hours daily on social media, compared with 0.8 hours daily among TD boys, and ASD girls spent 0.3 hours daily on social media, compared with 1.2 hours daily among TD girls. Time spent with friends showed similar patterns: ASD boys spent 0.4 hours daily and ASD girls spent 0.2 hours daily socializing with friends, while TD boys spent 1.8 hours daily and TD girls spent 1.7 hours daily.

The ASD children were not getting additional social interaction from their video game play: 48% of the ASD boys and 61% of the ASD girls had never played video games with other people, and 76% of boys and 90% of girls had never played online multiplayer games. Only 15% of boys and 6.5% of girls played video games once a week with others.

"Anecdotally, I’ve heard people hypothesize that video game play or technology use may be a social outlet for ASD children, but we found that kids with autism are using a lot less of those social media and social video games than their typically developing siblings," Dr. Mazurek said. "It does seem to be more of an isolated experience for them."

Among the 169 boys who were assessed for problem behaviors associated with video game play, 52.7% had autistic disorder, 28.4% had Asperger’s disorder, and 18.9% had PDD NOS. The parents of these boys filled out additional questionnaires about the video game genres their children most often played and the boys’ symptoms of inattention, hyperactivity/impulsivity, and oppositional defiant behaviors as assessed through the Vanderbilt Attention-Deficit/Hyperactivity Disorder Patient Rating Scale (VADPRS).

The three most popular game genres were action (this genre was ranked by 16% of parents as their child’s first preference, and by 31% of parents as one of their child’s top three preferences), platform (14% ranked it first and 25% ranked it in the top three), and shooter (13% ranked it first and 21% ranked it in the top three). The researchers found statistically significant associations only between the children’s VADPRS scores and the role-playing and shooter games. Role playing was ranked first by 9% of the parents as their child’s primary game and was ranked in the top three by 20% of parents.

Hours per day spent playing games was not associated with any of the problem behaviors (inattention, hyperactivity, or oppositional defiant behavior). "Rather, the most reliable predictors of problem behaviors were shown to be video game genre and problematic, or addictive, qualities of play," the investigators wrote. The number of daily hours spent playing video games was positively and significantly associated with PVGT scores, especially among boys playing shooter or role-playing games.

PVGT scores were positively associated with inattention and oppositional defiant behavior, but not hyperactivity/impulsivity – a surprising finding, Dr. Mazurek said, because other studies have found correlations with impulsivity. No association was found for predicting inattention based on age, video game hours, or video game genre. Oppositional defiant behavior was predicted for role-playing genres, but not age, video game hours, or shooter games.

"Given their tendency to engage in restricted and repetitive patterns of activity, children with ASD may be at particular risk for developing problematic, or addictive, game play patterns," the researchers wrote.

However, the attraction of video games could serve therapeutic purposes as well. "I would encourage parents not to let their kids have free rein to play games as much as they want," Dr. Mazurek said. "If we’re going to capitalize on this interest in technology in therapeutic ways, we need to do that alongside face-to-face interactions."

The authors noted that the cross-sectional design of the video game behaviors study precludes conclusions about causality. "It is possible that children with pre-existing behavior problems are more inclined to play video games for longer periods of time and in a more intense manner," they wrote, or video game play patterns could influence problem behavior, or the problems could be bidirectional.

Both studies were internally funded, and the authors had no disclosures.

Children with autism spectrum disorders spent significantly more time than their typically developing siblings playing video games, and playing certain types of video games was associated with behavioral issues, according to two studies published in Research in Autism Spectrum Disorders and in the Journal of Autism and Development Disorders.

But children with autism spectrum disorders (ASD) spent significantly less time than their typically developing (TD) siblings on social media and socially interactive games, as well as on all nonscreen activities in general, such as homework, socializing, or sports.

©adamfilip/iStockphoto.com

Meanwhile, boys with ASD who played video games showed addictive behaviors in their gaming if they played them for more hours or if they played shooter or role-playing games, and problem behaviors were positively associated with inattention and oppositional defiant symptoms, the researchers found.

The findings on video game behaviors among boys with ASD were reported on Feb. 13 by Micah O. Mazurek, Ph.D., and Christopher R. Engelhardt of the University of Missouri, Columbia (Res. Autism Spectr. Disord. 2013;7:316-24). Dr. Mazurek and her colleague Colleen Wenstrup reported the screen behavior findings in ASD children and their siblings in 2012 (J. Autism Dev. Disord. 2012 Sept. 22 [doi: 10.1007/s10803-012-1659-9]).

The researchers recruited the parents of 202 children and teens with ASD and their 179 TD siblings through the Interactive Autism Network Project at the Kennedy Krieger Institute in Baltimore. The project is sponsored by the Autism Speaks Foundation. The predominantly white children were aged 8-18 years; the mean age of the children in the ASD group was 12.1 years, and the mean age for the sibling group was 12.5 years.

Among the 202 ASD children, 53.5% had autistic disorder, 27.2% had Asperger’s disorder, and 17.3% had pervasive developmental disorder, not otherwise specified (PDD NOS). A subgroup of the ASD children, comprised of 169 boys who played video games, was evaluated for the study on video game playing and problem behaviors.

Parents were surveyed via the Web for information on their children’s video game usage. In addition to information on age, race, parent marital status, household income, number of siblings, the autistic child’s estimated IQ (if known), and diagnostic information, the parents estimated how much time their children spent in hours each weekday and each weekend day on the following activities:

• Reading for pleasure.

• Doing homework/studying.

• Spending time with friends.

• Playing sports/other physical activity.

• Watching TV.

• Playing video or computer games.

• Using e-mail, Facebook, or texting.

Parents whose children played video games also were asked whether the children played the games with other children in the same place and whether they play multiplayer networked games. Parents also answered questions for the Problem Video Game Playing Test (PVGT) to assess problematic aspects of the children’s video gaming.

ASD children spent 62% more time on screen-based activities (mean, 4.5 hours daily) than on all nonscreen activities combined (mean, 2.8 hours daily), and a substantial portion of this additional screen time included video games, where ASD children outplayed their TD siblings. ASD children spent an average of 2 hours each weekday and 3.1 hours a day on weekends playing video games, compared with 1.2 daily weekday hours and 1.7 weekend daily hours spent by the TD children.

Dr. Mazurek, a clinical child psychologist at the Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, said there are several possibilities she and colleagues are exploring related to why ASD children play more video games. "One theory is that children with autism have really strong visual spatial skill and are really drawn to visual stimuli," she said in an interview. "These games also are designed to provide really frequent reinforcement: They’re engaging, but they have a lot of structure, and that can be reinforcing for kids with ASD." She added that video games don’t require a lot of face-to-face interaction like other social games might require.

ASD boys spent an average of only 0.2 hours daily on social media, compared with 0.8 hours daily among TD boys, and ASD girls spent 0.3 hours daily on social media, compared with 1.2 hours daily among TD girls. Time spent with friends showed similar patterns: ASD boys spent 0.4 hours daily and ASD girls spent 0.2 hours daily socializing with friends, while TD boys spent 1.8 hours daily and TD girls spent 1.7 hours daily.

The ASD children were not getting additional social interaction from their video game play: 48% of the ASD boys and 61% of the ASD girls had never played video games with other people, and 76% of boys and 90% of girls had never played online multiplayer games. Only 15% of boys and 6.5% of girls played video games once a week with others.

"Anecdotally, I’ve heard people hypothesize that video game play or technology use may be a social outlet for ASD children, but we found that kids with autism are using a lot less of those social media and social video games than their typically developing siblings," Dr. Mazurek said. "It does seem to be more of an isolated experience for them."

Among the 169 boys who were assessed for problem behaviors associated with video game play, 52.7% had autistic disorder, 28.4% had Asperger’s disorder, and 18.9% had PDD NOS. The parents of these boys filled out additional questionnaires about the video game genres their children most often played and the boys’ symptoms of inattention, hyperactivity/impulsivity, and oppositional defiant behaviors as assessed through the Vanderbilt Attention-Deficit/Hyperactivity Disorder Patient Rating Scale (VADPRS).

The three most popular game genres were action (this genre was ranked by 16% of parents as their child’s first preference, and by 31% of parents as one of their child’s top three preferences), platform (14% ranked it first and 25% ranked it in the top three), and shooter (13% ranked it first and 21% ranked it in the top three). The researchers found statistically significant associations only between the children’s VADPRS scores and the role-playing and shooter games. Role playing was ranked first by 9% of the parents as their child’s primary game and was ranked in the top three by 20% of parents.

Hours per day spent playing games was not associated with any of the problem behaviors (inattention, hyperactivity, or oppositional defiant behavior). "Rather, the most reliable predictors of problem behaviors were shown to be video game genre and problematic, or addictive, qualities of play," the investigators wrote. The number of daily hours spent playing video games was positively and significantly associated with PVGT scores, especially among boys playing shooter or role-playing games.

PVGT scores were positively associated with inattention and oppositional defiant behavior, but not hyperactivity/impulsivity – a surprising finding, Dr. Mazurek said, because other studies have found correlations with impulsivity. No association was found for predicting inattention based on age, video game hours, or video game genre. Oppositional defiant behavior was predicted for role-playing genres, but not age, video game hours, or shooter games.

"Given their tendency to engage in restricted and repetitive patterns of activity, children with ASD may be at particular risk for developing problematic, or addictive, game play patterns," the researchers wrote.

However, the attraction of video games could serve therapeutic purposes as well. "I would encourage parents not to let their kids have free rein to play games as much as they want," Dr. Mazurek said. "If we’re going to capitalize on this interest in technology in therapeutic ways, we need to do that alongside face-to-face interactions."

The authors noted that the cross-sectional design of the video game behaviors study precludes conclusions about causality. "It is possible that children with pre-existing behavior problems are more inclined to play video games for longer periods of time and in a more intense manner," they wrote, or video game play patterns could influence problem behavior, or the problems could be bidirectional.

Both studies were internally funded, and the authors had no disclosures.