Media Equation of the Interaction of Children with Autism Spectrum Disorder: A Proof-of-Concept Approach Using an Equivalence Test in a Within-Subject Design.

Digital technology promises to improve the process of identifying autism spectrum disorder (ASD). Specifically, an automated digital screening tool with avatar-based interaction may be appropriate for children to differentiate between typically developing children and those at risk for ASD. The first challenge is to verify media equation: children with ASD need to interact in a digital environment as they would in a face-to-face situation. Therefore, a warm-up/conversation situation was analyzed within five conditions representing a hierarchy of successive mediation: (a) face-to-face, (b) facetime, (c) avatar real-time, (d) video pre-recorded, (e) avatar pre-recorded. Data from 20 boys with ASD were analyzed in a within-subject design using an equivalence test. Approximate equivalence was found between all five conditions. The median across all conditions is 5 (verbal response related to the conversation). Most importantly, children with ASD behave similarly in the digital environment with an avatar as they do in a real-life situation with a human experimenter. We discussed implications for clinical practice.