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Not perfect but good enough: a primer for creating spherical video-based virtual reality for autistic users
Abstract
Purpose
Previous research provides promising insights to the role of spherical video-based virtual reality (SVVR) applied with and for autistic users. Work already conducted in this area suggests that SVVR delivered via a range of head-mounted displays (HMDs) are useable, acceptable, can enable skill acquisition, can be relevant for delivering training, can help to reduce discomfort and promote skills generalization. However, to date very little research articulates methods or approaches to the design and development of SVVR. Here, the authors share the experiences of working in this space and designing SVVR content with and for autistic groups.
Design/methodology/approach
The authors draw upon two case studies/projects that were previous worked on with the intention to extrapolate key parts of the production process of SVVR development. The authors also outline key theoretical contexts as related to SVVR development in this field.
Findings
The goal of this primer on SVVR is to provide researchers and practitioners with an overview of using this technology. The authors provide a set of recommendations that should inform others in creating their own content and developing SVVR for/with/by autistic people.
Originality/value
This work combines and outlines theoretical, conceptual and practical considerations for practitioners and stakeholders seeking to build and deploy SVVR content; aspects not reported in previous research.
... To date this remains a limitation, and researchers' understanding of SVVR's learning affordances lag behind the more well-known advantages of IVR (e.g., Glaser & Schmidt, 2018;Schmidt et al., in-press). A need exists to explore technologies such as SVVR that can be more readily designed and deployed (Newbutt et al., 2022). A need also exists to explore possible adverse effects (i.e., cybersickness, eye strain, feeling dizzy) of working with an emerging technology and ethical challenges of working with autistic groups to decide on the most appropriate ways to use this form of technology . ...
Research suggests that virtual reality (VR) technologies can promote learning opportunities for individuals with autism in safe and controllable training scenarios. However, substantial challenges exist concerning the development and deployment of fully immersive VR systems in real-world settings. Video-based virtual reality is an emerging technology that maintains many of the same potential learning benefits to traditional VR systems while being easier to develop and deploy. This emerging technology report explores the use and potential of video-based virtual reality to support autistic users within naturalistic settings. Current trends in the field are reported, along with a focus on the application of evidence-based practices that align with this learner population. Finally, challenges with adoption and implementation are considered in addition to implications for future research.
In recent years, the application of virtual reality (VR) for therapeutic purposes has escalated dramatically. Favorable properties of VR for engaging patients with autism, in particular, have motivated an enormous body of investigations targeting autism-related disabilities with this technology. This study aims to provide a comprehensive meta-analysis for evaluating the effectiveness of VR on the rehabilitation and training of individuals diagnosed with an autism spectrum disorder. Accordingly, we conducted a systematic search of related databases and, after screening for inclusion criteria, reviewed 33 studies for more detailed analysis. Results revealed that individuals undergoing VR training have remarkable improvements with a relatively large effect size with Hedges g of 0.74. Furthermore, the results of the analysis of different skills indicated diverse effectiveness. The strongest effect was observed for daily living skills ( g = 1.15). This effect was moderate for other skills: g = 0.45 for cognitive skills, g = 0.46 for emotion regulation and recognition skills, and g = 0.69 for social and communication skills. Moreover, five studies that had used augmented reality also showed promising efficacy ( g = 0.92) that calls for more research on this tool. In conclusion, the application of VR-based settings in clinical practice is highly encouraged, although their standardization and customization need more research.
Research on the use of virtual reality (VR) for individuals with autism lacks design precedent and theoretical guidance. Further, research in this area often fails to include participants in the design of interventions. This paper seeks to address these gaps. A proof-of-concept adaptive skills intervention for adults on the autism spectrum was developed to promote safe and appropriate utilization of public transportation. Grounded in theories of complexity and generalization, technological and pedagogical scaffolds were designed in a staged manner and gradually faded to promote acquisition and generalization of target skills. A constellation of technologies was employed, including 360-degree video and headset-based VR. A multi-phase usage study was conducted to evaluate the efficiency and appeal of the prototype intervention so as to reveal design flaws and uncover opportunities to improve the overall learner experience. Findings are presented from the perspectives of expert testers (n = 4) and participant testers with autism (n = 5). Results suggest a largely positive learner experience and that the intervention is feasible and relevant to the unique needs of the target population. Implications are presented from the perspective of Roger's adoption characteristics.
Importance
The global prevalence of autism spectrum disorder (ASD) has been reported to be between 1% and 2% of the population, with little research in Black, Asian, and other racial/ethnic minority groups. Accurate estimates of ASD prevalence are vital to planning diagnostic, educational, health, and social care services and may detect possible access barriers to diagnostic pathways and services and inequalities based on social determinants of health.
Objective
To evaluate whether socioeconomic disadvantage is associated with ASD prevalence and the likelihood of accessing ASD services in racial/ethnic minority and disadvantaged groups in England.
Design, Setting, and Participants
This case-control prevalence cohort study used the Spring School Census 2017 from the Pupil Level Annual Schools Census of the National Pupil Database, which is a total population sample that includes all English children, adolescents, and young adults aged 2 to 21 years in state-funded education. Data were collected on January 17, 2017, and analyzed from August 2, 2018, to January 28, 2020.
Exposures
Age and sex were treated as a priori confounders while assessing correlates of ASD status according to (1) race/ethnicity, (2) social disadvantage, (3) first language spoken, (4) Education, Health and Care Plan or ASD Special Educational Needs and Disability support status, and (5) mediation analysis to assess how social disadvantage and language might affect ASD status.
Main Outcomes and Measures
Sex- and age-standardized ASD prevalence by race/ethnicity and 326 English local authority districts in pupils aged 5 to 19 years.
Results
The final population sample consisted of 7 047 238 pupils (50.99% male; mean [SD] age, 10.18 [3.47] years) and included 119 821 pupils with ASD, of whom 21 660 also had learning difficulties (18.08%). The standardized prevalence of ASD was 1.76% (95% CI, 1.75%-1.77%), with male pupils showing a prevalence of 2.81% (95% CI, 2.79%-2.83%) and female pupils a prevalence of 0.65% (95% CI, 0.64%-0.66%), for a male-to-female ratio (MFR) of 4.32:1. Standardized prevalence was highest in Black pupils (2.11% [95% CI, 2.06%-2.16%]; MFR, 4.68:1) and lowest in Roma/Irish Travelers (0.85% [95% CI, 0.67%-1.03%]; MFR, 2.84:1). Pupils with ASD were more likely to face social disadvantage (adjusted prevalence ratio, 1.61; 95% CI, 1.59-1.63) and to speak English as an additional language (adjusted prevalence ratio, 0.64; 95% CI, 0.63-0.65). The effect of race/ethnicity on ASD status was mediated mostly through social disadvantage, with Black pupils having the largest effect (standardized mediation coefficient, 0.018; P < .001) and 12.41% of indirect effects through this way.
Conclusions and Relevance
These findings suggest that significant differences in ASD prevalence exist across racial/ethnic groups and geographic areas and local authority districts, indicating possible differential phenotypic prevalence or differences in detection or referral for racial/ethnic minority groups.
Interest in the use of virtual reality technologies for individuals with autism spectrum disorders has been increasing for over two decades. Recently, research interest has been growing in the area of head mounted display-based virtual reality technologies, thanks to increased availability and affordability. Affordances and theorized benefits of headset- based virtual reality for individuals with autism spectrum disorders are quite promising. However, very little attention has been given in the literature to implementation safety and ethics. This is a particular concern in light of documented adverse effects associated with headset-based virtual reality. To approach this gap, this article details how the authors approached the issue of minimizing adverse effects with related and overlapping methods, but from two separate, independent research sites—one in the United States and one in the United Kingdom. A structured within- and across-case analysis of the two independent studies was conducted to identify central implementation processes and procedures. Analysis resulted in development of a model for minimizing potential adverse effects of headset-based virtual reality for this population. We assert that our model could provide clarity in terms of design and implementation of headset-based virtual reality for individuals with autism spectrum disorders, guide implementations of future researchers and practitioners, and contribute to minimizing and controlling for potential adverse effects.
Research suggests that virtual reality interventions have potential to promote the acquisition and development of social, communicative, and adaptive behavior skills for individuals with autism spectrum disorder. However, creating such an intervention is a task with innate challenges that requires the use of interdisciplinary processes and perspectives from those involved in its design. This challenge is further amplified when trying to design a virtual reality application for individuals with autism who exhibit substantial variability. The purpose of this instrumental case study is to provide insight into the complexities of designing a virtual reality intervention called Virtuoso. The case narrative will address a substantial research-to-practice gap in the field by providing methods that other designers can use in their own development process and will bring to light the interdisciplinary nature of such research.
Purpose
The purpose of this paper is to identify three key areas where autistic people may find themselves impacted through COVID-19, namely, education; employment; and anxiety.
Design/methodology/approach
This paper provides some views based on the extensive experience of using immersive technologies for the utilisation and application with autistic groups during COVID-19.
Findings
This paper offers some examples of immersive technology application that might be helpful for practitioners, services and others to consider in overcoming possible challenges faced by people with autism.
Originality/value
This opinion piece offers expert insights to the role immersive technologies and virtual reality might play during COVID-19 in the lives of autistic groups.
Children with autism spectrum disorder (ASD) are at an increased risk of injury, making safety skills training essential. Whether such training is conducted in the natural environment or in contrived settings is an important consideration for generalization and safety purposes. Immersive virtual reality (VR) environments may offer the advantages of both contrived and natural environment training settings, providing structure to create repeated learning opportunities in a safe and realistic analogue of the natural environment. The current study evaluated the effectiveness of an immersive VR safety skills training environment in teaching 3 children with ASD to identify whether it is safe to cross the street. After modifications to the VR training environment, all 3 participants reached mastery criteria in both VR and natural environment settings. Findings suggest that immersive VR is a promising medium for the delivery of safety skills training to individuals with ASD.
The aims of this systematic literature review were to uncover, analyze, and present design characteristics of virtual reality (VR) systems that have been designed as training tools for individuals with autism. Specifically, this review sought to (1) assess points of convergence and divergence in how researchers define VR, (2) extrapolate individual components of VR systems, and (3) systematically extract how design factors are instantiated in these VR projects. A systematic review was conducted to approach these goals that followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) standards to provide methodological and reporting quality. English language papers published in peer-reviewed academic journals after 1995 were included. Databases searched for this systematic review were Web of Science, PubMed, Scopus, IEEE Xplore, ERIC, and Google Scholar. Searches were conducted in March, 2020. A total of 82 articles was analyzed which were organized by project, resulting in a total of 49 records. Findings from this literature review suggest inconsistencies in how VR is being conceptualized which has implications on how purported benefits of VR technologies may be designed for and greatly impact the possibilities for learner interactions and how benefits can be realized. Open Science Foundation registration:osf.io/5asyg.
This single case design study evaluated the effects of a video modeling (VM) intervention on the customer service skills of five young adults with autism spectrum disorder (ASD). Verbalization of greeting, service, and closing phrases contextualized to community employment settings were the target behaviors. A systematic approach to visual analysis indicated the presence of a functional relation for all participants. Coworkers, job coaches, and supervisors successfully applied the VM intervention during the generalization condition. Maintenance probes conducted at 2 and 4 weeks indicated that most customer service skills were maintained. Results indicated VM was also effective in enhancing the quality of interactions with customers. Implications for research and practice related to the competitive employment of young adults with ASD are discussed.
Background
Needle phobias are common in children and adults worldwide. One effective intervention for this phobia is exposure therapy where a participant is gradually exposed to increasing levels of the fear‐evoking stimulus while differential reinforcement is applied. This intervention, however, may be difficult to implement with some medical procedures as it may be difficult to obtain unfettered access to medical facilities and equipment for the purposes of exposure. Virtual reality may overcome these obstacles.
Methods
In this investigation, the present authors developed a low‐cost virtual reality‐based exposure therapy which was used with an adult male with autism spectrum disorder and a history of extreme needle phobia. The effectiveness of this intervention was evaluated using a changing criterions design with generalization probes.
Results
The intervention quickly increased the participant's compliance in the analogue training setting and the effects were generalized across settings and behaviours, and maintained over time.
Conclusions
The findings indicate combining virtual reality with exposure therapy may produce an effective intervention for medical phobias. The intervention package may remove barriers associate with traditional exposure therapy and was low‐cost which may increase access to the intervention.