Toward the Design of Enjoyable Games for Children with Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorder (FASD) is a heterogeneous and complex set of disorders caused by prenatal alcohol exposure, estimated to affect 2-5% of the North American population. Deficits associated with FASD affect social skill development and executive function, including emotional regulation and impulse control. These deficits can increase the difficulty of playing digital games. While considerable research has been performed in understanding how to design games for people with neurodevelopmental disorders in general, there is little data on how to design engaging games for children with FASD. We conducted a ten-week in-school gaming trial with eleven elementary-aged children with diagnosed or suspected FASD. Participants enjoyed playing together and responded well to the in-game reward system, while some game elements caused unexpected frustration. Based on our observations, we advise that games for FASD be designed to have low cost of failure, avoid retracting options, account for taking breaks when needed, show progression in rewards, and enable cooperative play.