Gameplay as Reward in Pediatric Autism Care
Pediatric Psychiatry Ward
The Challenge
In pediatric autism care, structured reward systems are a core therapeutic tool.
Children are often asked to:
- Complete specific tasks
- Practice targeted behaviors
- Regulate emotions or transitions
- Engage in social or daily-life activities
When they succeed, they are rewarded, traditionally with treats, toys, stickers, or extra free time.
These rewards work, but they come with limitations:
- They're static and lose novelty
- They don't always scale well across patients
- They're disconnected from the child's interests over time
- They don't easily adapt to different sensory or cognitive needs
The team at Sheba is interested in a new approach: Using gameplay itself as the reward.
The Big Idea
What if completing a therapeutic task unlocked:
- Game time
- In-game items
- New characters, abilities, or spaces
- Progress in a persistent game world
Instead of external rewards, progress in therapy fuels progress in play.
Games already excel at:
- Motivation through anticipation
- Clear goals and feedback
- Scalable reward systems
- Personalization
- Safe repetition
This challenge asks game developers to apply those strengths to autism care, in close collaboration with clinicians.
What the Ward Is Looking For
The goal is not to turn therapy into a game, or to distract from care.
The goal is to:
- Reinforce desired behaviors
- Support consistency and structure
- Increase engagement without overstimulation
- Align rewards with each child's interests and sensitivities
Games should support the therapeutic plan, not override it.
Core Design Direction: Gameplay as a Reward Layer
Design a game (or game system) that:
- Is not always available
- Is unlocked through real-world therapeutic actions
- Can be paused, resumed, or limited by staff
- Feels genuinely rewarding to the child
Examples
- Completing a task unlocks 5 minutes of play
- Reaching a behavior milestone unlocks a new in-game item
- Consistent engagement unlocks new areas or characters
- Calm transitions unlock cosmetic rewards or customization
Design Considerations for Autism Care
Important constraints and opportunities:
- Predictability: Clear rules, clear cause-and-effect
- Low frustration: No punishing randomness
- Sensory control: Adjustable sound, color, motion
- Clear structure: Simple goals, consistent feedback
- Choice without overload: Limited, meaningful options
- Non-competitive: No pressure to "win"
Games may be very simple, highly repetitive, or calm rather than exciting.
That's a feature, not a bug.
Possible Game Directions
These are starting points, not requirements.
- Collection-based games (earn items, creatures, parts)
- Customization-focused play (decorate, build, arrange)
- Calm exploration spaces
- Simple progression loops with visible growth
- Games that emphasize order, pattern, or routine
Some teams may design:
- One standalone game
- A modular reward "hub" that could host many mini-games
Both approaches are welcome.
Therapist & Caregiver Control
A key requirement is control.
Strong designs will allow therapists or staff to:
- Gate access to gameplay
- Control duration and frequency
- Adjust rewards per child
- Align in-game rewards with therapeutic goals
This is a collaboration tool, not an unsupervised entertainment system.
Jam Scope & Expectations
- Simple beats complex
- Mock data and placeholder flows are fine
- Focus on one clear therapeutic use case
- Therapist feedback matters more than polish
- Ethical, child-centered design is essential
What This Is Not
- Not a diagnostic tool
- Not replacing therapy
- Not overstimulating "dopamine machines"
- Not competitive or social-pressure-driven
The game is a supportive incentive, not the treatment itself.
Extra Points For...
- Thoughtful alignment with behavioral therapy principles
- Designs that therapists can easily control and adapt
- Calm, respectful experiences suited to diverse sensory needs
- Reward systems that scale across different ages and abilities
Why This Matters
For many children with autism, motivation and consistency are the hardest parts of care.
This challenge asks:
What if progress in therapy unlocked progress in a world a child genuinely cares about?
It's an opportunity to apply game design where empathy, restraint, and clarity matter more than spectacle, and where the right design can make daily care feel more achievable for everyone involved.