A new computerized remediation programme for children with developmental delay has been launched internationally. Vis-à-vis – ‘face to face’ – was developed by the research unit of the Office Médico-Pédagogique at the University of Geneva School of Medicine and is available in French, English and Italian.
“It would be wonderful for the instrument to be available to most of Europe through translation, because these cognitive skills really should be learned in a child’s native language”, says Bronwyn Glaser, research psychologist and creator of the programme.
Vis-à-Vis works on key socio-emotional skills with children and adolescents with developmental delay. The program targets three main skills, or domains, that are important for improving socio-emotional performance and reasoning abilities: focusing on the eyes of the face, emotion recognition and understanding, and working memory. Vis-à-vis should be done at the computer, in tandem with an adult. The interaction and stimulation of receiving undivided attention from the adult helps the child to approach the material. A demonstration video and a free trial are available on the Vis-à-vis website.
Bronwyn Glaser: “When we developed Vis-à-Vis, we targeted school-age children with developmental delay, between the ages of seven and sixteen, who are missing skills that rely on prefrontal networks, such as working memory and executive functions. We intend to improve their ability to plan, their ability to organize themselves and keep more information in their minds at one time. Apart from academic tasks this will also help the children with their social interactions, because children with developmental delays have a really hard time with keeping so much information in their minds while they are thinking of something else.”
In addition to three games targeting working memory, the program includes six games that target face and emotion processing skills. The games go from simple to complex. Some of them are learning where to focus on a face; other games work on perspective-taking or understanding how a situation can change for the different people involved in the situation. “This helps children to build an emotional vocabulary, so to speak. The stories help them to understand mental states, that disappointment is related to sadness.”
Although independent research is not available yet, Glaser and her team were pleasantly surprised by the results of their own research, that has shown the effect of the training on three groups, children with autism, developmental delay, and 22q11.2 deletion syndrome (paper in press). “All kids enjoyed participating and they improved their social skills and cognitive skills supporting academic learning. The groups benefitted in different ways, but they all benefitted. There are a very few evidence-based treatments for kids with developmental disorders such as autism, and very little educational material that has been validated for these kids. There are excellent therapeutic programmes for very young children – but we need more programs for older children. Once they are in elementary school, educators and parents need cognitive-based programs that are adapted for a child’s age group and individual profile of needs.”
Working on empathy
Bronwyn Glaser and the team at the University of Geneva would like to add to the materials offered on the website. “There are a couple more games that I would like to add to the website. The three modules that we have now work on some cognitive building blocks underpinning social skills – and now I am working on games that help with the generalization of those skills, working on their empathy. So that will be about making emotional judgements, before and after they understand the context of a situation. And another game that I have in mind is one that works on social anxiety. To try and bring those arousal levels down so they can work are their cognitive maximum.”
Vis-à-Vis is unusual in that it comes from a fully scientific environment, the University of Geneva, and is designed to forge a direct link between research and clinical practice. Glaser: “We would have liked this to be an open and operational platform where we could regularly add outcomes from our research. Also we want it to uphold its integrity and stay non-commercial. Unfortunately, we came across so many difficult logistics, such as finding funding, figuring out marketing, ensuring a future for the site. The project has been an uphill battle. All that said, we are very happy with the resulting site and project. It is magical that the games are a pure product of what works, they adhere completely to research findings. Moreover, the interface is simple and was designed for educational utility, to make sure that the children are not distracted while playing the games. It is satisfying to make something available to the children and families that we know is effective.”
The Vis-à-vis programme consists of nine games, three for each of the main domains. In addition, itincludes a teaching module that provides examples and descriptions of the facial emotions. The teaching module focuses on the emotions that are used each week in the games.
The games and teaching module are done together in 48 unique sessions to be completed over the course of twelve weeks (four sessions per week). Previous studies testing educational intervention programs have shown that it is advisable to practice skills multiple times per week for longer than two months in order to see effects.
It takes approximately 20 to 25 minutes for a child to complete each of the four weekly practice sessions. While the exercises maintain the same structure throughout the program, each session is unique and designed to maintain the users’ interest.