Skeleton-Based Activity Recognition for Children with Autism Using Graph Convolutional Networks

Movement-based and physical activity programs are central tools in autism intervention, so recognizing the activities a child performs during therapy is valuable for objective progress tracking. Manual monitoring of these sessions is time-consuming and subjective, and raw videos raise privacy concerns because it shows identifiable children. We address autism therapeutic activity recognition from privacy-preserving 2D skeletons, and we focus on the practical difficulty of how several therapeutic activities differ only in subtle motion details. As a backbone, we adopt ProtoGCN, a graph convolutional network that represents each action as a combination of learnable motion prototypes. However, this contrastive backbone organizes all classes at once, so it does not enforce a margin between the few pairs that remain entangled after training. We therefore introduce a Refine-Confusable (RC) module, a training-only regularizer that pushes apart the empirically most-confused class pairs using a hinge-margin loss over momentum-updated class centroids. The module changes neither the backbone nor the inference cost. On the MMASD dataset, restricted to the ten-class 2D-skeleton configuration, the RC module improves the base model across random, session-independent, and subject-independent evaluation. The gain is largest on the strictest subject-independent split and a clip-level analysis confirms that this improvement is statistically significant. Under the protocol-matched holdout, the method reaches 96.30% accuracy with 0.959 macro-F1, surpassing recent 2D-skeleton baselines while keeping a lightweight and privacy-preserving modality. The improvements are modest, as expected on a small clinical dataset, and t-SNE and prototype visualizations show that the learned representation is discriminative and interpretable.