2 47 REVIEW OF APPLIED & CASUAL GAMES FOR MENTAL HEALTH an active condition to (a) casual game(s) were both nonsignificant (–0.29 and 0.56, respectively). Benzing and Schmidt (2019) showed a nonsignificant effect size of 0.12 when comparing a casual game to a passive condition. Autism and Social Skill Challenges Seventeen papers included participants with (high functioning) ASD, ASD and face processing deficits/difficulty in maintaining eye contact/deficient eye gaze processing, ASD and attending autism-specific classes, and participants with social skill deficits or social communication impairments. Participants’ mean age ranged from 6 to 13 years, and the proportion of male participants varied from 59.6% to 95.0%. Thirteen papers used a regular RCT design, two papers used cluster randomisation (Beaumont et al., 2015; Murphy et al., 2021), one paper used a crossover design (Beaumont & Sofronoff, 2008), and one paper used both cluster randomisation and a crossover design (Einfeld et al., 2018). See Table A.3 (Appendix) for the characteristics and findings of these studies. Most papers measured social skills as an outcome variable. Effect sizes for social skills were calculated on data from eight papers. These papers measured social skills through parent-report, with the exception of Sanchez et al. (2017) who included a self-report scale and Murphy et al. (2021) which included a teacher-report scale. The remaining nine papers were not included in the plot because they did not measure social skills as outcome variable (Alvares et al., 2019; De Vries et al., 2015; Dickinson & Place, 2014; Fridenson-Hayo et al., 2017; Kirst et al., 2022; Milajerdi et al., 2021; Sanchez et al., 2014; Sosnowski et al., 2022; Tanaka et al., 2010). The papers included in the plot all employed two intervention arms, comparing the applied game to an active condition (Beaumont et al., 2015; Beaumont et al., 2021; Einfeld et al., 2018; Griffin et al., 2021; Murphy et al., 2021) or to a passive condition (Beaumont & Sofronoff, 2008; Faja et al., 2021; Sanchez et al., 2017). Although both intervention arms in Beaumont et al. (2015) included the applied game, the structured version was categorised as an applied game and the unstructured version as the active condition for the purpose of this review, because Beaumont et al. (2015) originally hypothesised that both conditions would show improvements in social skills with the structured version showing greater gains. Figure A.6 (Appendix) shows that the five effect sizes comparing an applied game to an active condition ranged from –0.60 to 1.00. Only the study of Beaumont et al. (2021) reported a significant effect favouring the applied game. The three effect sizes comparing the applied game to a passive condition ranged from 0.19 to 1.41, with Beaumont and Sofronoff (2008) and Sanchez et al. (2017) showing significant effects in favour of the applied game.
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