Enhancing ADL skill acquisition in children with ASD through a personalized, fuzzy logic-based tablet game: a pilot study

Children with autism spectrum disorder (ASD) often experience challenges in performing Activities of Daily Living (ADLs), especially when tasks are complex and require the integration of cognitive, psychological, and motor skills. These difficulties are commonly linked to symptom severity, limited opportunities for practice, and lack of access to adaptive learning tools. To address these needs, we developed a Fuzzy logic-based tablet game that delivers a personalized learning experience tailored to each child's performance. The game simulates a typical daily routine through six real-life contexts: Home, School, Canteen, Playground, Transportation, and Shopping. A Fuzzy expert system dynamically adjusts the learning path, providing a just-right challenge aligned with the learner's ability level. This study was conducted using a one-group pre- and post-test design with 16 ASD children over a 4-week intervention period. Results showed significant improvement in ADL after gameplay (Wilcoxon Signed-Rank Test, [Formula: see text]), with the greatest gains observed in the "canteen" context ([Formula: see text]). Based on in-game performance, participants were classified into fast, moderate, and slow learning groups; all of which demonstrated positive learning trajectories over time, as measured by task accuracy and completion time. Further analysis using Spearman's rank correlation revealed a strong relationship ([Formula: see text]) between in-game reward metrics and teachers' assessments of learning behavior, supporting the game's validity as a learning tool. These findings suggest that the Fuzzy logic-based adaptive game is both effective and feasible for enhancing learning for children with autism. Its ability to personalize learning in real time offers a promising strategy for promoting functional independence.