Biofeedback-Based, Videogame Balance Training in Autism.

There was no control group or random allocation, so natural growth, practice effects, attention, or other concurrent therapy could have contributed to the improvements. The training combined a custom in-lab biofeedback game with Wii Fit games, and participants’ occupational and physical therapy hours were inventoried because they could affect balance, so the contribution of any single component cannot be separated. The sample was small and selective: 29 verbal youth with ASD, ages 7–17, and none had intellectual disability, so results may not apply to minimally verbal children or younger children. Some postural sway analyses had fewer participants because of protocol changes, computer malfunction, or one extreme outlier. The eyes-open analysis included 28 participants, the eyes-closed analysis included 27, and the visual-feedback analysis included 26. Balance time gains showed ceiling effects, so the reported fold increases may understate true differences for some participants. Only 11 participants and 11 family members completed the post-study questionnaire, so reported enjoyment and perceived benefit come from a subset. Moderator findings were exploratory correlations; after correction for multiple tests, only pre-training balance, ritualistic behaviors, and stereotyped behaviors remained significant, so they should not yet guide selection of candidates.

Most named authors declared no conflict. Anthony Ellertson is a founding partner of Prentice Technologies. The paper does not state who funded the study or whether Prentice Technologies designed, wrote, or paid for it.

Do not conclude that the biofeedback videogame alone improved balance. The training combined the in-lab biofeedback game with Wii Fit games, and participants’ occupational and physical therapy hours were inventoried because they could affect balance. There was no control group, so the contribution of any single component cannot be separated.