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Empirical studies reviewed on VR applications in ASD assessment and intervention.
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The worldwide rising trend of autism spectrum disorder (ASD) calls for innovative and efficacious techniques for assessment and treatment. Virtual reality (VR) technology gains support from rehabilitation and pedagogical theories and offers a variety of capabilities in educational and interventional contexts with affordable products. VR is attracti...
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Context 1
... section illustrates recent evidence-based applications of VR technologies to ASD research and treatment, with a primary focus on the social aspects, including social functioning, emotion recognition, and speech and language. The key information of these studies is outlined in Table 2. ...Citations
... 8 The use of VR in patient care offers many potential advantages, including creating environments that meet specific patient needs, facilitating real-time feedback, providing an entertaining tool that may increase patient motivation, providing experiences that are fully controlled and may be better suited for repeated practice, and creating experiences which may be impossible in the real world. 3,9,10 There are also potential challenges to the use of extended reality technologies for health care applications, including costs (e.g., hardware, software development), technical issues (e.g., computational limitations, tracking issues, battery consumption), privacy and security concerns (e.g., hacking, data collection), and safety (e.g., side effects, addiction). 4 An additional challenge to be considered is the ability of health care providers and patients to use these technologies effectively. ...
... 50 Some VR and AR interventions may involve the recording of a range of personal information including facial expressions, eye movement patterns, and body responses and reflexes. 10,49 There may be privacy concerns related to the collection of this data and therefore, patients should be made aware of and consent to any data collection related to VR and AR interventions. 10 If VR or AR interventions require patients to have access to their own devices (e.g., computer, smartphone, tablet) or internet connection this could pose a barrier to patients without access to these technologies. Additionally, many extended reality technologies are currently commercially available however, they may need to be reclassified as medical devices to ensure coverage under health insurance plans. ...
This Horizon Scan summarizes the available information regarding virtual reality (VR) and augmented reality (AR) interventions for various clinical applications. While the technologies are not new, the use of VR and AR as clinical interventions in health care is still emerging in Canadian health care systems. VR interventions have been studied in various clinical applications, including acute and chronic pain, stroke, traumatic brain injury, cerebral palsy, Parkinson disease, autism spectrum disorder, anxiety and depression, mental health in older adults, and attention-deficit/hyperactivity disorder (ADHD). Limited information on AR interventions was identified in this Horizon Scan. There is a wide range of VR and AR hardware and software available that varies in cost and complexity. Much of this hardware and software is commercially available; however, some have been developed specifically for clinical use. There are several VR interventions for various clinical indications cleared by the FDA and available in the US. Many factors should be taken into account when considering implementing a VR or AR intervention, including those related to safety, privacy, and access. It will be essential to ensure equitable access to VR and AR interventions so that their introduction does not exacerbate health inequities.
... Virtual reality (VR) is a simulated three-dimensional immersive environment in which the user can act according to prearranged scenarios [20]. In recent years, various VR applications have found increasingly wide application in medical practice, including programs for both specialists (training of specific skills, simulation of medical processes, etc.) and patients (relaxation and stress management, overcoming anxiety, neurorehabilitation, etc.) [21][22][23]. ...
Introduction. Patients with somatic disorders often have sings of concomitant mental distress such as depressive mood, anxiety, apathy, asthenia, which can have a negative impact on the course of the underlying disease and recovery processes. One of the non-medicinal approaches that have been increasingly introduced into medical practice in recent years is the use of techniques based on virtual reality.The paper presents the results of an open comparative study of the effectiveness of a new scenario of virtual reality platform named Flow. Flow was developed as an innovative tool to reduce the severity of negative psychological states.The aim of the study. To evaluate the effectiveness of the virtual reality application Flow in relation to symptoms of anxiety and asthenia in somatic inpatients.Material and methods. 60 hospitalized patients with different diagnoses and comorbid complaints of mental disadaptation were included. 40 patients underwent a course of five daily relaxation sessions in virtual reality in addition to their basic treatment. 20 patients of the control group were treated in accordance with the hospital routine practice. Psychometric scales and questionnaires were used to assess patients condition; indicators of blood pressure and pulse were also measured.Results. The addition of Flow to the course of standard treatment was associated with a significant advantage in reducing affective complaints in patients, both after one session and as a result of the course, and a few days after its completion. Patients of the experimental group also demonstrated a significant decrease in blood pressure after the sessions, and it was most pronounced in individuals with initially high blood pressure. Conclusion. The course of relaxation in virtual reality Flow is an effective and promising method of non-pharmacological care for patients of a somatic hospital in relation to symptoms of anxiety and depressive mood, as well as of hypertension.
... In the last few years several commissions and committees have proposed to apply AR/VR to induce new ways of interpersonal skills and abilities in autism (Lord et al., 2022). Zhang et al. (2022) asserted that by offering a more realistic and welcoming atmosphere, VR can be turned into the ideal tool for intervention and rehabilitation. People with specific medical or mental disorders may struggle to take care of themselves or manage their conduct, and they may also feel uncomfortable around other people in social situations. ...
... First developed in the 1960s, VR is increasingly used in education and training worldwide from teaching mathematical concepts (e.g. [28,29]), to learning about thermodynamics [30], to enhancing writing skills of pupils with English as an Additional Language (EAL) [31], as an intervention tool for pupils with autism [32], as an assessment tool for pupils with ADHD [20] and as an effective tool for demonstrating vocational skills [33]. ...
This small-scale study explores the attitudes of fifty initial teacher education (ITE) subject methods tutors towards the use of virtual reality (VR) in education and considers whether VR could be a catalyst for reviewing the partnership model within ITE programmes. In addition, this study offers a novel solution to ITE tutors’ challenges when managing their own technological and pedagogical development alongside preparing student teachers for technology-enhanced learning (TEL). Building on previous research on ITE tutors’ use of TEL across the island of Ireland, this paper discusses the synergy between the cognitive apprenticeship model and reverse mentoring that upends the classic co-operating teacher/student teacher hierarchy and positions all partners in ITE programmes as learning leaders at key points in the partnership process. An online survey comprising 51 items was administered to a purposive sample of 50 ITE tutors from four ITE providers, two in Ireland and two in Northern Ireland (NI), who were selected due to their developing interest in the use of virtual reality in teacher education. Data analysis using SPSS combined with thematic analysis of open-ended responses revealed that although the majority of ITE subject methods tutors conveyed open-minded and willing attitudes to embrace VR in the future, they identified a number of systemic issues that need to be addressed first. These include the disconnect between innovative pedagogical practices presented in university-based modules and the stark reality of technological deficits in some classrooms; the pedagogical and resource-based ‘readiness’ of ITE tutors to embed VR in their subject-specific teaching; and the need for curriculum-focused, VR resources for school-based use. As a result of this study, an incremental, cyclical approach to growing the body of knowledge around VR pedagogy is proposed in conjunction with new forms of collaboration between the partners in ITE.
... With the recent addition of eye trackers in the IVR headsets, unique research is being pursued. There is rising interest and research being undertaken to explore IVR as an interventional tool in children and adults with ASD [6][7][8]. ...
... In recent years, several applications and platforms have been developed to promote social skills training, emotion recognition, and language development for people with autism [6]. In general, the findings of these interventions have been positive, showing the transfer of gains made in the virtual environment to real-world interactions and scenarios [6,9]. ...
... In recent years, several applications and platforms have been developed to promote social skills training, emotion recognition, and language development for people with autism [6]. In general, the findings of these interventions have been positive, showing the transfer of gains made in the virtual environment to real-world interactions and scenarios [6,9]. Within the research on VR as an intervention for social and communication development in children with ASD, we have found no studies that describe visual behaviors of participants during the VR intervention. ...
Children and youth with Autism Spectrum Disorder (ASD) display difficulties recognizing and interacting with behavioral expressions of emotion, a deficit that makes social interaction problematic. Social skills training is foundational to the treatment of ASD, yet this intervention is costly, time-consuming, lacks objectivity, and is difficult to deliver in real-world settings. This pilot project investigated the use of an immersive virtual reality (IVR) headset to simulate real-world social interactions for children/youth with ASD. The primary objective was to describe gaze fixation and visual search behaviors during the simulated activity. Ten participants were enrolled and completed one social-skills training session in the IVR. The results demonstrate differential patterns between participants with mild, moderate, and severe ASD in the location and duration of gaze fixation as well as the patterns of visual searching. Although the results are preliminary, these differences may shed light on phenotypes within the continuum of ASD. Additionally, there may be value in quantifying gaze and visual search behaviors as an objective metric of interventional effectiveness for social-skills training therapy.
... Authentic immersive design is centered on the idea that a simulation must capture the basic truth of what it represents and evoke a sense of realism that can enable individuals to share space, experiences, thoughts, and emotion (Jerald, 2015;Parsons, 2016;Jacobson et al., 2017;Scavarelli et al., 2020). Researchers have recently considered the quality and utilization of LIVR to reach individuals with autism spectrum disorders (ASD) and found moderate evidence for its effectiveness using a traditional laboratory-based delivery model to train skills such as emotion recognition, social communication, and cognition (Grinberg, 2018;Mesa-Gresa et al., 2018;Karami et al., 2021;Farashi et al., 2022;Zhang et al., 2022). Furthermore, VR applications for pediatric populations not diagnosed with ASD, but struggling with engagement have also shown positive effects on social behavior (Grinberg et al., 2014;Ip et al., 2018;Rus-Calafell et al., 2018;Tan et al., 2018;Nijman et al., 2019). ...
Low immersion virtual reality (LIVR) is a computer-generated, three-dimensional virtual environment that allows for authentic social interactions through a personal avatar, or digital representation of oneself. Lab-based delivery of LIVR social skills intervention has been shown to support social learning through controlled, targeted practice. Recent remote technological advancements allow LIVR-based social skills training to potentially overcome accessibility barriers by delivering to youth in their home. This study investigated the impact of 10-h of Charisma™ Virtual Social Training (CHARISMA-VST), a LIVR-based intervention, on social skill changes in children and adolescents who struggle socially via either in-person or remote training protocols. Specifically, the aims examined both the impact of training location (in-person vs remote access) and diagnosis (parent report of autism spectrum disorder (ASD) diagnosis versus parent report of other non-ASD diagnosis) on objective measures of social skill change following CHARISMA-VST. Researchers delivered the CHARISMA-VST via Charisma 1.0, a customized virtual gaming environment. Sixty-seven participants (49 males, 18 females) between the ages of 9–17, with parent reported social challenges, completed 10, 1-h CHARISMA-VST sessions during which nine social cognitive strategies were taught and then practiced within a LIVR environment with interspersed social coaching. Four social cognitive domains were measured pre-post training: emotion recognition, social inferencing, social attribution, and social self-schemata. Results revealed improvements in emotion recognition, social inferencing, social attribution, and social self-schemata with medium to large effect sizes following the CHARISMA-VST. There was no moderating effect of training location on emotion recognition, social inferencing, and social self-schemata, suggesting comparable gains whether participants accessed the technology in their own homes or from a school or specialty center. There was no moderating effect of ASD versus non-ASD diagnosis on performance measures, suggesting CHARISMA-VST may be effective in improving social skills in individuals beyond its initially designed use focused on individuals with ASD. These encouraging findings from this pilot intervention study provide some of the first evidence of potential new virtual technology tools, as exemplified by CHARISMA-VST, to improve one of the most important aspects of human behavior—social skills and human connectedness in youth with a range of social competency challenges.
... Fourthly, an extensive body of research has investigated the effectiveness of VR for targeting ASD-associated functioning (e.g. see meta-analysis by Karami et al., 2021), and VR interventions in general show promise for autistic individuals (Emmelkamp & Meyerbröker, 2021;Zhang et al., 2022). The strongest effects have been observed for daily living skills followed by cognitive, emotional regulation/recognition, and social communication skills, although note that most of the trials have been uncontrolled pretest-posttest trials rather than RCTs, with small sample sizes (Karami et al., 2021). ...
Autistic individuals are at disproportionately high risk of experiencing mental health issues, and the quality and accessibility of mental health care are reduced in this population. Investigating the impact of using digital technology in mental health research, assessment, treatment, and care for autistic individuals (i.e. digital mental health, DMH) may help to reduce this disparity. This is suggested because of its apparent potential in aiding adaptations that are recommended for autistic individuals to reduce autism-associated complexities in these domains, but equally because it may introduce challenges which are important to identify given the increasing popularity of DMH. The recommended adaptations that digital technology may aid in these domains include the use of individualised and multi-modal approaches.
This thesis thus aims to explore DMH for autistic individuals, specifically directly for autistic individuals themselves, rather than solely for or via parents/supporters. Objectives include identifying its potential feasibility and acceptability, alongside challenges, benefits, facilitators, and other considerations.
... The worldwide rising trend of autism spectrum disorder calls for innovative and efficacious techniques for assessment and treatment. VR technology gains theoretical support from rehabilitation and pedagogical theories and offers a variety of capabilities in educational and interventional contexts with affordable products 16 . It helps kids with Autism Spectrum Disorder learn a wide range of social skills through fun and engaging activities. ...
Resumen
Los trastornos del neurodesarrollo presentan una gran diversidad entre ellos, pudiendo generar dificultades funcionales o alguna discapacidad que requiera de asistencia tecnológica. Hoy, sin embargo, solo 1 de cada 10 personas que la necesitan, acceden a ella. Estas tecnologías de apoyo se definen como cualquier producto, equipo, software, o tecnología adaptada o especialmente diseñada, para mantener o incrementar las capacidades funcionales de niños, niñas y adolescentes en situación de discapacidad, convirtiéndose en un facilitador para la participación en actividades cotidianas en contexto educativo, de juego, y familiar. Lo anterior, permite generar oportunidades en la mejora en las habilidades de procesamiento, de comunicación y de interacción, siendo en la actualidad las tecnologías herramientas fundamentales en los procesos de inclusión. Existen diferentes tipos de tecnologías de apoyo, dependiendo de su naturaleza, nivel tecnológico y lógicas de operación. Este artículo comenta una gama de tecnologías utilizables en la clínica, como lo son las tecnologías de la información, sistemas de comunicación alternativas aumentativas, dispositivos tecnológicos de música, realidad virtual, juegos serios, relojes inteligentes, tableros electrónicos y Kinect, todos con evidencia científica de su efectividad en personas con trastornos del neurodesarrollo.
