• Gijs Terlouw, Job Tb van 't Veer, Jelle T Prins, Derek A Kuipers, and PierieJean-Pierre E NJENhttps://orcid.org/0000-0002-2310-5791Medical Faculty Lifelong Learning, Education & Assessment Research Network, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.Surgery Department, Medical Cente.
• Academy of Healthcare, Digital Health Care Research Group, NHL Stenden University of Applied Sciences, Leeuwarden, Netherlands.
• JMIR Ment Health. 2020 Jul 10; 7 (7): e17260.

BackgroundChildren with autism spectrum disorder (ASD) often face difficulties in social situations and are often lagging in terms of social skills. Many interventions designed for children with ASD emphasize improving social skills. Although many interventions demonstrate that targeted social skills can be improved in clinical settings, developed social skills are not necessarily applied in children's daily lives at school, sometimes because classmates continue to show negative bias toward children with ASD. Children with ASD do not blame the difficult social situations they encounter on their lack of social skills; their main goal is to be accepted by peers.ObjectiveThis study aims to design a comic creator-It's me-that would create comics to serve as transformational boundary objects to facilitate and enact a horizontal interaction structure between high-functioning children with ASD and their peers, aiming to increase mutual understanding between children at school.MethodsThis research project and this study are structured around the Design Research Framework in order to develop the comic through an iterative-incremental process. Three test sessions, which included 13, 6, and 47 children, respectively, were initiated where the focus shifted in time from usability during the first two tests to the initial assessment of acceptance and feasibility in the third session. A stakeholder review, which included six experts, took place after the second test session.ResultsA digital comic creator, It's me, was produced within this study. Children can create their own personal comic by filling in a digital questionnaire. Based on concepts of peer support, psychoeducation, and horizontal interaction, It's me has a rigorous base of underlying concepts that have been translated into design. Based on the first test sessions, the comic has shown its potential to initiate personal conversations between children. Teachers are convinced that It's me can be of added value in their classrooms.ConclusionsIt's me aims to initiate more in-depth conversations between peers, which should lead to more mutual understanding and better relationships between children with ASD and their peers. The first test sessions showed that It's me has the potential to enact horizontal interaction and greater understanding among peers. It's me was designed as a boundary object, aiming to connect the objectives of different stakeholders, and to trigger reflection and transformation learning mechanisms. The applied design research approach might be of added value in the acceptance and adoption of the intervention because children, professionals, and teachers see added value in the tool, each from their own perspectives.©Gijs Terlouw, Job TB van 't Veer, Jelle T Prins, Derek A Kuipers, Jean-Pierre E N Pierie. Originally published in JMIR Mental Health (http://mental.jmir.org), 10.07.2020.

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