A Gaming Approach to Behavioral Rehabilitation ...

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A Gaming Approach to Behavioral Rehabilitation: Concept Exploration

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A Gaming Approach to Behavioral Rehabilitation: Concept Exploration M. Fraiwan*, L. Barqawi, G. Haddad, D. Tawalbeh, M. Al-Zamil Department of Computer Engineering, Jordan University of Science and Technology, P.O. Box 3030 Irbid 22110 Jordan E-mail: [email protected] (M.Fraiwan), [email protected] (L. Barqawi), ghadeer [email protected] (G. Haddad), deema [email protected] (D. Tawalbeh), [email protected] (M. Al-Zamil) *Corresponding author Abstract: The awareness of behavioral disabilities has increased dramatically in the past few years, revealing staggering numbers of affected individuals, mainly children. Such disabilities can be caused by a wide range of disorders, like Autism, ADHD (Attention Deficit Hyper Activity Disorder) and Acquired Brain Injury (ABI). The pervasiveness of mobile Technology and Computer Games along with the wide acceptance of such gadgets presents an excellent opportunity to reach out and educate children with behavioral difficulties. Mobile Devices offer a flexible, customizable (e.g., sound levels and color), and entertaining platform. In this paper, Gaming Technology was used in an innovative manner to present real-life scenarios to children in order to teach them how to interact and react under those scenarios and circumstances. The Developed application is comprised of many games that take place in the child’s home, school, and playground. The various scenes unconsciously train the child to act in the right manner, which aids the patient’s logic, behavior, and self-confidence. The synergy of advanced fun 2D gaming and animation, attractive graphics, and professional therapy guidance provides an effective and strong learning experience. The paper is meant as a concept exploration to shed more light into the problem and possible solution platforms. It opens avenues and breaths fresh air into educational and rehabilitation methods for challenged children. More useful interdisciplinary work and evaluation is achievable in this arena. Keywords: Computer Games; Behavioral Disability; Autism; ABI; ADHD; ADD; Android. Reference to this paper should be made as follows: Fraiwan, M., et al. (2014) ‘A Gaming Approach to Behavioral Rehabilitation: Concept Exploration’, Int. Journal of Computer Applications in Technology, Vol. y, Nos. x/y, pp.xx–yy. Biographical notes: Mohammad Fraiwan received his B.S. (with honors) degree in Computer Engineering from Jordan University of Science and Technology (JUST), Jordan, and Ph.D. degree from Iowa State University (ISU), USA, in 2003 and 2009 respectively. He is currently an assistant professor in the Computer Engineering Department at JUST. His main research interests include network monitoring, biomedical applications, data mining, and computer systems and applications. He worked at Akamai Technologies, Boston, in summer of 2008, and as a visiting scientist at ISU during the summers of 2009 and 2010. Lama Barqawi, Ghadeer Haddad, Deema Tawalbeh, and Malak Al-Zami received their computer engineering degrees from Jordan University of Science and Technoogy, Jordan (2013). The work in this paper was part of their senior design project.

1 Introduction Recent years have witnessed an increased awareness of mental disorders and disabilities. Many behavioral difficulties have been tied together in what now appears to be specific mental deficiencies (e.g., Autism). For example, studies in

the U.S. have shown that Autism currently affects about 1 in 88 children with about 1 out of 54 boys suffering from Autism. Nearly 11% of children in USA have ADHD (Attention Deficit Hyperactivity Disorder), and over 500, 000 Australians have an ABI (Acquired Brain Injury) (Autism Speaks, 2013; NY Times, 2013; Australia Brain Injury,

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2013). Patients and families are riven by these disorders. They impede personal communication and social relationships, and drastically reduce and restrict and individual’s interests and activities. Specialized schooling in closely monitored environments is required to deal with such disorders. The educational material that aims to improve the behavior of the young patients is based on paper-based curriculum. Simple storytelling material and child games are used to emphasize good behavior. Several studies have been conducted on the impact and positive effects of computer games on children, especially on their behavioral activities (Raise Smart Kid, 2013). Carefully tailored games can sharpen various skills including; problem solving and logic, instruction following, quick thinking, making fast analysis and decisions, accuracy, memory, concentration, simulation and real world skills. The number of children, who play video games, is significant. For example, 91% of American children, aged between 2 and 17 years, play various types of video games. This accounts for about 64 million children (Tech Crunch, 2013). Of course, not all of these games are educational nor they enforce positive behavior (Autism Speaks, 2013), but the appeal of video games to children is a non-disputed fact. Thus, we aimed at using the appeal of video games in behavioral education of challenged-children. The process is non-trivial, as their disabilities may make this sensitive to various levels of lighting, sound volume, etc. In this paper, we have implemented an Androidbased mobile gaming application that target children with behavioral disabilities. The game seeks to aid these patients deal with the various social situations they may find themselves in. Carefully tailored scenarios will introduce many situations to the patient and guide her/him to the appropriate action in a fun interactive manner. The rest of this paper is organized as follows: In section 2 we give a background into behavioral and development disorders, and mobile game development. Section 3 discusses the various game sections including the behavior game plot, the connection with behavioral difficulties, and the various scenes. Software design along with the highly technical implementation details are explained thoroughly in section 4. The conclusion and future work are presented in section 5.

2 Background 2.1 Behavioral Disorders A number of behavioral disorders have been identified in the medical community. Most of these disorders share common symptoms and behavioral difficulties. Autism, ADHD (Attention Deficit Hyperactivity Disorder), and ABI (Acquired Brain Injury) are among a few of these disorders. Common symptoms of these disorders include a number of behavioral and educational difficulties. These include; problems with social interaction with others, repetitive behavioral patterns, attention difficulties, task/event sequencing, planning and organization problems,

impulsiveness, overreaction or lack of, dysfunctional family relationships, and start and stop certain behaviors (ADD Help Guide, 2012)(Spring and Swan, 2000)(LDA, 2012). All of these aforementioned symptoms affect the livelihood of the patients and their interaction with their environment in a counterproductive manner and often resulting in therapy relapses. Obviously, training children to the proper behavior is thus expected to improve their living, social behavior and interaction, and eventually their therapy process.

2.2 Mobile Game Development The proliferation of mobile devices and their ubiquity into daily life has caused a revolution in mobile application development. For example, Apple just recently reported close to 50 Billion App downloads (Forbes, 2013). The light weight, ease of mobility, and strong processing power of these devices fuels the dependence on their applications. Game development is an integral part of mobile applications. Roughly 17% of active applications in Apple’s App Store are gaming applications (Apple App Store, 2013), with that same percentage of the newly added apps every day. A plethora of mobile game development tools and engines are presented in (DZone, 2013). GameSalad (Game Salad, 2013) is the chosen development kit for this paper. GameSalad is a game creation based on drag and drop manipulation with little source coding involved. It can be used to develop games for Android, iOS, Windows Phone, among others.

3 Methodology Our application is specialized in the behavioral rehabilitation and training of challenged children suffering from common behavioral difficulties. These difficulties can be causeed by a range of disorders, such as the ones mentioned in section 2.1. Children typically tend to be more of visual learners (i.e., they learn faster and the knowledge persists for a longer period of time) when they watch a short scenario that faces them almost every day. Then, they can judge the situation better and conclude the right way to respond if (s)he is put in the same situation again. We opined that the best and effective way to achieve this rehabilitation is through computer games. The game plot and scenarios will emphasize and introduce favorable behavioral patterns. Communication skills and event sequencing are emphasized through a short stories section. In this section, the child is narrated stories and is later told to retell the stories again and sequence the sentences or events. Events of each story will be listed as an un-ordered set of pictures along with appropriate captions. It also includes two other games, the puzzle game (i.e., reconstructing shapes) and the matching game (matching of various hidden shapes) that improve their memory and many other mental functions. In summary, the application consists of four mains sections: • The behavior game, section 3.1.

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• Short stories for event narration and sequencing, section 3.2. • Puzzle and matching games, section 3.3. • Emotions, section 3.4. All scenarios and stories are carefully designed by our team members based on the latest studies, researches and books (Baker, 2013)(Lovaas et al., 1973) that target behavioral difficulties. So we created all of the scenes by ourselves extracted from real-life scenarios that may face any child on daily basis.

3.1 The Behavior Game We next go through the main section of the application, which is the behavior game.

(a) Sami

(b) Sami’s sister Salma

(c) Sami’s mom

(d) Sami’s dad

3.1.1 Game Plot The game plot revolves around a five-year old boy called Sami that lives an ordinary life with his parents and his sister Salma. The game starts when Sami wakes up in the morning and prepares himself to go to school. Throughout his day, Sami is confronted with a number of situations, problems, and events. These scenes take place in his home, school, school bus, and playground. The goal of the game is to help Sami collect as many toys as possible to fill in the new closet that his father brought for him. By deciding what to do appropriately under the various circumstances, Sami can win a number of gifts.

3.1.2 Characters The characters involved in the application are: (a) Sami: the main character emulating our patient, (b) Salma: his sister, (c) The father, and (d) The mother. Sami has two friends Emma and Abi. There are also the teacher and other children in school. Sami along with his Family are shown in Fig. 1.

Figure 1: Sami’s Family.

3.1.3 Locations The game takes places in a typical child’s environment. The implemented locations include; (a) Sami’s house consisting of his bedroom, bathroom, the kitchen, and the living room. Fig. 2 shows the kitchen along with the dinning area. (b) The school bus, see Fig. 3. (c) The school, which includes the school yard, the play room, and playground.

3.1.4 Scenes and Their Goals We go through the details of each scene. Not all scenes are mentioned, and many more scenes can be added to further emphasize or introduce new proper behaviors. • Scene #1: Sami appears for the first time in the game, introducing himself and his family. After that, Sami talks about the game and what the user is expected to do to reach his goal. - Location: N/A - Goal: Presenting the main characters, and clarifying the goal of the game.

 Figure 2: The kitchen dinning area.

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M. Fraiwan et al. - Goal: Teaching Sami not to interrupt others, ask for things politely, and to say thank you. It is important to repeat scenarios more than once to emphasize key points. • Scene #8: Salma tells Sami that he should hurry up to catch the school bus, but he is not looking at her while she speaks (i.e., no eye contact). - Location: living room at Sami’s house. - Goal: Emphasize eye contact. It also teaches him to say Goodbye. • Scene #9: The school bus is a scene for many situations facing Sami like changing seats, saying proper greetings, etc. Figure 3: The school bus. • Scene #2: Sami appears sleeping while his mother tries to wake him up to go to school. Moreover, the scene shows -in a fun way- the morning activities that must be done by any child. - Location: Sami’s bed room - Goal: Clarifying the main activities that must be done by any child in the morning. • Scene #3: The scene introduces Sami’s family for the first time. After waking up, Sami heads toward the kitchen, where his family is gathering. Two options will appear as bubbles, and the narrator will then pose the question of “what should you say now?”. - Location: Kitchen. - Goal: Teaching Sami to say proper greetings. • Scenes #4 and #5: Sami starts having breakfast with his family and he wants to eat cheese so Sami should ask his sister to pass on the cheese. - Location: Kitchen. - Goal: This scene teaches him how to ask for anything he wants politely, and to show gratitude. • Scene #6: The father is talking to the mother, but Salma interrupts him while he is speaking; she wants to go to the amusement park. Her father points out that she should wait for him till he finishes talking. - Location: Kitchen. - Goal: Indirectly teaching Sami not to interrupt others while they are speaking. • Scene #7: The father and the mother are having a conversation while Sami wants milk. The game will ask Sami “What should you do now?” Afterwards, two possible answer bubbles will be shown; the first one shows “I have to wait until they finish”, while the second bubble indicates “I should interrupt them and order milk”. - Location: Kitchen.

- Location: School bus. - Goal: Teaching Sami how to interact properly with his peers (e.g., saying good morning, facing competition from peers). • Scene #10: The teacher tells everyone that, we reached the school, then the game will ask Sami “what is the correct way to leave the bus?” indicating they should leave some space between each other. - Location: School bus. - Goal: To teach Sami to respect the line, be organized, and to keep proper space between Sami and the others. • Scene #11: Sami enters the school and starts his day, and he needs to arrange his belongings - Location: Sami’s class. - Goal: To teach Sami to properly stow and organize his belongings in the proper place. • Scene #12: Sami wants to take off his jacket but he needs help from his busy-talking teacher, so what should he do? Two option bubbles will appear explaining the choices he has, the first one is “I will wait until they stop talking ”the second one is “grabbing the teacher from her clothes and shout help me right now!”. - Location: Sami’s class. - Goal: To make sure that Sami knows that he must not interrupt others while they are speaking, to ask for help politely, and to say thank you. • Scene #13: Sami is at his class learning shapes and a voice will be shown to teach him each shape. - Location: Sami’s class. - Goal: To make sure that Sami knows and distinguishes the various shapes. • Scene #14: Sami is at the art class and the teacher says “Let’s paint! ”, a voice will ask Sami “What you should do to take the green crayon from your friend Abi? and should you share it with him?” - Location: Sami’s class.

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- Goal: Teach Sami how to share items with his friends and to be sociable. • Scene #15: The teacher says that we have finished the class and Sami leaves the class room and walks down the corridor. His friend Emma is walking toward him, so the game asks Sami “What should you do?” either say hello or keep quite. - Location: Corridor at Sami’s school - Goal: To teach Sami to say proper greetings to people he knows. • Scene #16: Sami is in the play room, the teachers says “Go and find something to play with!”. Sami, sees his friend Abi is sitting alone. The game will ask “Why don’t you play together?”. - Location: playroom. - Goal: Teach Sami to play with his friends and to ask them to play with him. • Scene #17: Sami is still in the playroom, two girls are playing with a toy and Sami wants to play with that toy. - Location: playroom. - Goal: To teach Sami to be polite with his friends at school, not infringe on other children’s toys, and to share with others. • Scene #18: Sami is the schoolyard; the teacher is surrounded by three boys. The teacher asks them if they want to play a specific game. When they agree, she starts explaining the game to them. - Location: School yard. - Goal: Teach Sami how to play in the school yard sharing games with his friends and to learn new games. Also, instruction following is emphasized. • Scene #19: Abi is playing on the swing, while Sami and Emma wants to play on the swing too, so what should Sami do? - Location: School yard. - Goal: To teach Sami that he should wait for his turn to play and to be happy after waiting and playing. • Scene #20: Sami is in the playroom, the teacher says “who wants to tell us a story?” then Sami says “I want to”, but while Sami is telling the story some of the boys and the girls are making some noise. Then a voice will ask Sami “Is this correct?” - Location: Playroom. - Goal: To teach Sami to keep calm and to listen carefully to others while they are talking. Also, emphasize eye contact. • Scene #21: Sami is in the school yard and some boys are playing basketball so he wants to play with them, but he is afraid to try a new game. - Location: School yard.

Figure 4: A scene from the short stories section. - Goal: To make sure that Sami is not afraid of trying new games/things, and how to ask politely and boldly to play with them. Table 1 summarizes the connection between the various scenes in the game and the behavioral difficulties they are targeting.

3.2 Short Stories The purpose of this part along with the puzzles and the matching games is to provide more entertainment, variety, fun, and useful gaming. Popular short stories are narrated, along with proper graphics, and the child is asked questions about the events and their sequence. Consequences of certain behaviors (good or bad) will influence the child’s mentality while listening to those stories. Fig. 4 shows a scene from the short stories part of the application.

3.3 Puzzle and Matching Games The puzzle games will ask the player to reassemble the various scrambled parts into a shown picture. The matching game on the other hand will display multiple squares, under each square is a drawing. The group of squares contain a pair of each type of drawings. The player is asked to find the squares containing matching drawings. Quick memory skills are required here to remember were each drawing was last seen. Fig. 5 shows one of the puzzle games, while Fig. 6 shows the shape matching game.

3.4 Emotions Another small but interesting section was implemented, which deals with expressing emotions. An array of various faces along with appropriate sounds are presented to the child. Touching one of the faces will generate the corresponding sound or emotion type. Fig. 7 shows the feelings faces.

4 Implementation 4.1 Graphics Design To make our game attractive we decided to draw the characters, the scenes and other graphics using Adobe

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Difficulty Inattention

Poorly formed letters, words or messy writing

Acts without thinking

Rarely completes tasks due to boredom

Loses things necessary for tasks or activities Struggles with, dislikes, or avoids tasks that require prolonged and continuous mental effort Often interrupts others Cannot wait for his/her turn, in line, or in games Says the wrong thing at the wrong time

Is always “on the go,” as if driven by a motor Table 1

Software Feature Throughout the game, pop up quizzes and prizes will restore the patient attention to the application and improve his/her focus. This feature is common across all scenarios. The game does not require writing. Touch-based interface along with colorful pictures and attractive sounds form the basis of communication. Motivate the patient to think. The game trains the user to think by posing questions, pointing correct behaviors and rewarding those behaviors. This feature is common across all scenarios. - Variety; The scenes take places in many different locations from the patient’s environment (e.g., scenes 2, 3, 10, 14, 19, and 20). - A gaming prize-winning context and scenarios should be more entertaining. -Electronic material is typically more appealing than a paper based one. Scene 11, for example, teaches the child how to stow his stuff. As for using the game itself, aside from the mobile device, no tools are required. Moreover, the interface is touch-based that requires no extra tools like a pen or coloring tools. Minimal mental effort is required through the short-scripted story-telling nature of the game. Many scenarios indirectly emphasizing this aspect are incorporated in the game. For example, scenes 6, 7, and 12. Several scenes in the game emphasize patience (e.g. scene 19). Many scenarios will present situations were the wrong thing was said in the wrong manner, at the wrong time, or in the improper wording. Then, proper questions are posed to direct toward the right behavior (e.g., scenes 3, 9, and 15). The mobile aspect of the gaming hardware is easy to carry around, stay with the patient, and embrace his/her mobility.

Connection between behavioral difficulties and game features.

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Illustrator. A single scene is comprised of multiple frames that are used to emulated movements (e.g., eyes blinking, lips moving). See Fig. 8, which shows the frame sequencing, while Fig. 9 shows the questions and options posed to the child being created as bubbles.

4.2 Game Implementation

Figure 5: One of the puzzle games.

We developed the game using GameSalad Creator, which is a visual editor and behavior-based logic system. It provides a graphical user interface and has many components like Scenes, Layers, Actors, Library, and behaviors. Fig. 10 shows the Rules, the functions, and the behaviors to create a scene. Game development under GameSalad Creator is based on the drag and drop principle. It is used to create iOS, Android, and HTML5 applications. The many scenes of the game, each containing one or more actors, are controlled by the gaming engine via a set of behaviors and rules, as follows: • Rules: The first step would be to choose the type of event that needs to take place in order to trigger certain actions. Since our application is targeting a mobile device touch-based interface, “touch” conditions (i.e., when the screen is touched and released within a certain boundary) are employed. The “attribute” condition, which checks a flag value(when attribute has some value), is also used to add more control. After that the behaviors to be executed were chosen if the conditions are met, and what needs to be done if the conditions are not met (i.e., an if...else control sequence).

Figure 6: One of the shape matching games.

• Timers: The sequence of the game events is controlled mainly by timers. The programmer determines when exactly to start a certain behavior, for how many seconds, after and before a certain amount of time. • Groups: when we will use many behaviors in more than one actor we can put them all in a group for ease of use in later development stages. The main behaviors we have used in our game: • Animate: Sequenced images are put together and the frequency of their transition is determined in order to get the animation we are looking for. • Play sound: Choose the sound of the actors and narrator, and volume levels. Changing the software language will only require changing the audio files of the game, in addition to any language-specific graphics (e.g., writings).

Figure 7: The feelings (emotions) faces.

• Play music: We used this behavior to run the game’s background music and during transitions among the various scenes. • Change image: Used to change the actor’s image permanently.

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M. Fraiwan et al. • Change attributes and constrains: We have created a wide range of attributes as flags. Checking the flags will activate the corresponding rules and conditions. • Change size: Change the size of each option by some scale; a positive number indicates a larger size, while a negative number is used to scale down. • Change scene: to go from one scene to another. • Move to: Used to change the position of the actor with a specific speed. The position can have a fixed (x,y) coordinate point, or let the actor follow the player’s finger touch path. • Reset scene: Used when the user wants to replay one of the game levels, all of the attributes and other actors’ initial settings will need to be reset. • Destroy: This deletes the actor.

5 Conclusion and Future Work Technology has the potential to transform the way we conduct many activities into a fun, attractive, and exciting experience. Moreover, technology improves the outreach of previously privileged scientific content, therapy, and information. More importantly, it has been shown that activities masquerading as games can achieve better results than traditional methods. In this paper, behavioral disabilities were targeted as a possible gaming application. Having studied behavioral deficiencies caused by such disorders like Autism, we have set course to design games with features addressing these disabilities. The developed games unconsciously aid patients of young ages in acquiring appropriate behavioral patterns. These patterns should aid them to better cope with society and deal with their surrounding environment. Games are traditionally more appealing to the younger generation than typical textbook material. Moreover, expansion into a wide spectrum of learning disabilities is a great avenue for research and development, while more evaluation and empirical studies are also needed. Many more avenues are worth investigating in this venue. These include, devleopment of adaptive and intelligent learning systems for the rehabilitation curriculum (Hafidi and Bensebaa, 2014), social networks-empowered learning,collaborative learning among patients (BaniSalameh and Jeery, 2014)(Colazos et al., 2004). The awareness of behavioral disorders has increased dramatically in the past few years, revealing more and more of undetected cases. Many families are facing daily struggles to adapt their affected loved ones and provide them with proper care. Thus, the contributed gaming application has great potential medically, socially, and commercially. Acknowledgments. This research was funded in part by Jordan University of Science and Technology Deanship of research funds 20110266 and 20110070. The authors would like to thank Dr. Fidaa Al-Momani from the Allied Medical Sciences Department for her advice and valuable input.

References Autism now affects 1 in 88 children and 1 in 54 boys.[last accessed 3/5/2013] http://www.autismspeaks.org/what-autism/factsabout-autism Nearly 11% of children in USA have ADHD.[last accessed 7/5/2013] http://www.nytimes.com/2013/04/01/health/morediagnoses-of-hyperactivity-causingconcern.html?pagewanted=all& r=0 Over 500,000 Australians have an ABI. [last accessed 7/5/2013] http://www.braininjuryaustralia.org.au/ Positive effects of video games on children. [last accessed 3/5/2013] http://www.raisesmartkid.com/3-to-6-years-old/4-articles/34the-good-and-bad-effects-of-video-games 91% of American children, aged between 2 and 17 years, play video games[last accessed 7/5/2013] http://techcrunch.com/2011/10/11/91-of-kids-aged-2-17playing-video-games-says-report/ Signs and Symptoms of Attention Deficit Disorder in Kids [last accessed 26/12/2012] http://www.helpguide.org/mental/ adhd add signs symptoms.htm Spring, G., Swan, D. (2000), ‘Children with acquired braininjury planning and support guide for schools, preschools and childcare services’, [Adelaide]: Department of Education, Training and Employment, 2000. 43 p., ISBN 0730876446. Attention Deficit Disorder/ Attention Deficit Hyperactivity Disorder (ADD/ADHD) [last accessed 26/12/2012] http://www.ldanatl.org/aboutld/teachers/ understanding/adhd.asp Apple just recently reported close to 50 Billion App downloads [last accessed 8/5/2013] http://www.forbes.com/fdc/welcome mjx.shtml Apple App Store [last accessed 8/5/2013] http://www.mobilemarketingwatch.com/apple-app-storereaches-250000-total-apps-nearly-25k-for-the-ipad-alone9005/ Windows 8 Game Development [last accessed 8/5/2013] http://css.dzone.com/articles/windows-8-game-developmentwin Game Design Engine, Make Games for iPhone & Android [last accessed 13/6/2013] http://gamesalad.com/ Baker, J. (2013), ‘The Social Skills Picture Book’, Future Horizons pub., ISBN: 1885477910, April 2003. Lovaas, O. I., Koegel, R., Simmons, J. Q. and Long, J. S. (1973), ‘Some Generalization and Follow-up Measures on Autistic Children in Behavior’, Therapy. Jnl of Applied Behav Analysis, 6: 131165. doi: 10.1901/jaba.1973.6-131 Hafidi, M., Bensebaa, T. (2014), ‘Development of an adaptive and intelligent tutoring system by expert system’, International Journal of Computer Applications in Technology, (to appear, in press). Bani-Salameh, H., Jeery, C. (2014), ‘ Collaborative and Social Development Environments - a Literature Review’, International Journal of Computer Applications in Technology, (to appear, in press). Collazos, C. A., Guerrero, L. A., Pino, L. A. Ochoa, S. F. (2004), ‘A method for evaluating computer-supported collaborative learning processes’, International Journal of Computer Applications in Technology, 2004 Vol. 19 No. 3/4.

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Figure 8: Graphics development in Adobe illustrator.



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Figure 9: Creating the choices using the bubbles in GameSalad Creator.

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Figure 10: Scene development options in GameSalad Creator.

A Gaming Approach to Behavioral Rehabilitation: Concept Exploration