Zirkus Empathico 2.0: a multiplayer serious mobile game for children with autism spectrum disorder (ASD), with a focus on enhancing social and emotional development

This study explores the effectiveness of the multiplayer serious mobile game “Zirkus Empathico (ZE) 2.0” in enhancing social-emotional behaviors in children diagnosed with autism spectrum disorder (ASD). It aims to assess how such games can foster emotional recognition, empathy, and prosocial behavior, thereby supporting the holistic development of children with ASD. An eight-week randomized controlled trial (RCT) was conducted between January and April 2021 at autism centers in Islamabad, Pakistan, and Berlin, Ger-many. The study involved 107 children aged 5–11 years, with 60 diagnosed with ASD and 47 typically developing children serving as an Active Control Group (ACG). Participants were engaged in sessions using the bilingual "ZE 2.0" game, incorporating multiplayer and emotional learning modules. The intervention required 120 min of weekly training supplemented by daily sessions. Post-intervention assessments demonstrated significant improvements in the ASD group compared to the control group in areas of empathy and emotional awareness, as evidenced by higher scores on the Griffith Empathy Measure (GEM) and multiplayer module evaluations. Notable was the ability of participants to apply learned social skills in dynamic, real-world contexts, which suggests the game’s effectiveness transcends the controlled settings typically associated with ASD interventions. ZE 2.0 adds to the social and teamwork competencies of children with ASD. Besides encouraging peers to be proactive in communications and cooperation, the multiplayer mode provides an immersion learning atmosphere for facilitating social and emotional development. Such an out-come underlines the perspectives of serious games for use as a framework for the treatment and education of children who have ASD. In this manner, serious games can be utilized as a supplementary or alternative means of treating ASD. Future research may focus on distinguishing the effects of intervention from those of other therapy modalities. In addition, more objective measurements should be introduced to increase the validity of the results in the future.