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Currently submitted to: JMIR Serious Games

Date Submitted: May 1, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

The Development of a Virtual Escape Room to Trigger Social Interaction and Communication between High-Functioning Children with Autism and their Peers: An Iterative Design Approach

  • Gijs Terlouw; 
  • Derek Kuipers; 
  • Job van 't Veer; 
  • Jelle T Prins; 
  • Jean Pierre E N Pierie; 



Children with autism spectrum disorder (ASD) have social deficits that affect social interaction, communication, and relationships with peers. Many interventions focus mainly on improving social skills in a clinical setting. However, developed social skills are not necessarily applied to children's daily life at school, and children with ASD face challenges in forming and maintaining relationships with peers. In addition to the direct-instruction-based programs, more activity-based programs could be of added value, especially to bridge the relational gap between children with ASD and their peers.


This paper describes an iterative design process of the development of a virtual escape room as an activity-based serious game and describes the development of a game as a boundary object. The purpose of the serious game is to facilitate and trigger direct communication between high-functioning children with ASD and their peers. During the design research process, we examined in small steps whether the developed prototypes are feasible and whether they have the potential to achieve the objective of the serious game.


This study is structured around the Design Research Framework to develop the escape room through an iterative-incremental process. Three playful test sessions (n=12; n=21; n=12) with different prototypes were initiated to eventually develop a beta-prototype. The beta-prototype was subsequently tested with children (n=12) and experts (n=12).


By testing various prototypes, including a paper prototype and an augmented reality prototype, different insights were found to get the design right. Insights were gathered to find the right theme, content, practical constraints, and shape of the serious game. Eventually, a multiplayer virtual escape room, AScapeD, was developed. Three children can play the serious game together in the same room on tablet devices. The first tests show that the game triggers social interaction and communication between the children.


This paper presented the iterative design process of AScapeD. AScapeD triggers social interaction and connection in a playful way between children with ASD and their peers. The conceptual structure of an escape room contributes to the natural emergence of communication and cooperation. The iterative design process has been beneficial to finding the right design, getting the design right, and contributed to the design of a serious game as a boundary object which mediates the various objectives of different stakeholders. The developed prototype is feasible and has the potential to achieve the aim of the serious game.


Please cite as:

Terlouw G, Kuipers D, van 't Veer J, Prins JT, Pierie JPEN

The Development of a Virtual Escape Room to Trigger Social Interaction and Communication between High-Functioning Children with Autism and their Peers: An Iterative Design Approach

JMIR Preprints. 01/05/2020:19765

DOI: 10.2196/preprints.19765


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