Introduction:
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in communication, social interaction, and repetitive behaviours, often accompanied by executive functions (EFs) impairments. These difficulties can affect learning, daily activities, and independence. Despite the availability of EFs interventions, there is a need for engaging, technology-based approaches. Moto Tiles, an interactive play tool combining physical movement with cognitive tasks, has shown promise in enhancing cognitive and motor functions in different populations. This study investigates the potential benefits and challenges associated with the use of Moto Tiles in medium and high-functioning ASD children, with a focus on the effects on their EFs. Using a multiple single-case study approach, we assessed the impact of a structured Moto Tiles training program focusing on updating, inhibition, switching, and planning.

Methods:
Three children participated in a seven-session intervention, conducted twice a week over one month. Each session, lasting 30 minutes, alternated between reaction/attention and memory-based games, tailored to individual abilities. Instructions were provided clearly and adjusted as needed, and game settings were progressively modified to increase difficulty. Performance was evaluated through scores recorded by the Moto Tiles system and qualitative observations related to task comprehension, engagement, and motor coordination. A psychologist guided the sessions, offering immediate feedback and verbal support. In addition to individual training, three sessions included a group activity designed to train impulse control through turn-based play. In To measure the effect of the training on EFs, we conducted a pre-post single-case subject-by-subject comparison using a range of standardized tests: the Selective Visual Attention, the Digit Span, and the London Towers, from Batteria di Valutazione Neuropsicologica per l'età evolutiva (BVN 5-11); the Corsi block span from Batteria per la Valutazione della memoria Visiva e Spaziale (BVS); the Inhibition test from Developmental NeuroPsychological Assessment (NEPSY-II); the Ranette test from Batteria Italiana per l’ADHD (BIA).

Results:
The results indicate notable improvements in EFs, particularly in planning abilities, visuospatial working memory, and inhibition of automatic responses, suggesting enhanced cognitive control, strategic thinking, and spatial processing. While certain functions, such as verbal working memory and visual attention, remained stable, all participants showed increased motor coordination and engagement over time, actively participating in tasks with growing enthusiasm and confidence.

Conclusion:
This case study provides preliminary evidence that Moto Tiles can support EF development, motor coordination, and engagement, highlighting the potential of interactive, game-based interventions in neurodevelopmental disorders. Future research should investigate larger cohorts to generalize the results, explore longer-term effects, refine intervention strategies, and optimize cognitive training for children with ASD.

Keywords: Autism Spectrum Disorder, executive functions, game-based learning, technology-based interventions.