Virtual Reality (VR) has shown to be a preferable tool for autistic individuals and is now to be used for training social skills in children and adolescents who want to improve such skills. Doctoral Research Fellow Anders Dechsling from Østfold University College collaborates with autistic individuals and researchers worldwide in developing and testing social skills interventions using VR Head-Mounted Displays.
By Anders Dechsling, Doctoral Research Fellow / PhD candidate, Østfold University College
Research group: DeveLeP
Supervisor and principal investigator: Professor Anders Nordahl-Hansen
Individuals with autism spectrum disorders (ASD) often experience challenges in social contexts, which in turn cause unwanted consequences in their everyday life. Research shows that adolescents with ASD report having fewer friends. A higher rate of school refusal behavior is also common for adolescents with ASD. When experiencing feelings of not mastering social interaction, the individual often ends up avoiding social situations. This, in turn can quickly become a behavioral pattern resulting in more isolating behaviors.
Parts of these problems can and should be solved through public enlightenment on the diversity amongst people on the autism spectrum. However, autistic individuals should also be given the opportunity to enhance their social skills, which gives them the tools to understand and participate in a broader range of social situations.
We are now collaborating with researchers from Yale University, University of Tromsø, and University of Washington in testing a Virtual Reality social skills intervention aimed at helping children and adolescents with ASD. In cooperation with Visu Learning/-Media, we are developing interventions and VR-programs aimed to be scientifically robust, applicable and available for the clinical field.
Ensuring acceptability of VR
We decided that it was necessary to investigate whether VR- and computer-based interventions, including Head-Mounted Displays (HMD), were accepted amongst individuals with ASD. It could be that sensory oversensitivity would affect the ability for individuals to use HMDs. Even though we always take into consideration individual differences, we wanted to check out the reported findings in the current research literature. Therefore, we conducted a systematic literature search and found that the vast majority of reported acceptability from autistic individuals are positive towards such interventions, and wearing HMD. Many individuals with ASD report that VR provides less stressful environments, and thus recommend it to others. These findings encouraged us to move forward with doing research on VR and ASD.
From the very start of our research project our colleague Stian Orm, who is diagnosed with ASD, has contributed both as a researcher and user consultant. He has first-hand experience with receiving social skills interventions as an adolescent, and combined with his experience of having difficulties with social interactions he provides the project with valuable insights regarding design, content, and ethical aspects of the interventions. Stian is also a popular speaker giving talks on his life from a special education pupil to recently submitting his psychology master thesis. Stian is most of all a talented researcher contributing to our project.
VR and Social Skills
VR has shown feasibility in a wide range of research, such as assessments, training daily living skills, driving simulations, as support while receiving injections, or social skills to name a few. The research on VR social skills training is relatively new but the results seem promising and the reports are positive. To provide an overview of the research applying VR-interventions on ASD and social skills, we conducted another systematic review of the research literature. This study revealed the novelty and diversity in this research field, and thus the inconsistencies and lack of rigorous research. Various studies have utilized social stories or learning facial expression recognition. It remains to study the effects of automating and generalizing these skills. Hence, these are important steps in future research in order to help children and adolescents with ASD.
Because, in accordance with all other types of skills, good social skills depend on sufficient training and practice. Humans are daily exposed to natural training episodes, which is where most children acquire their skills in understanding and interpreting social situations. However, children with ASD might miss out on the learning provided by these situations. Many with ASD use a lot of energy to cope with social situations, which feels exhausting.
Various interventions have been developed to enhance social skills and thereby reduce the negative consequences for individuals with ASD. The effective interventions contain sequential and systematic training, which in turn demands a lot of resources in terms of personnel, time, locations, and facilities. Even though we know based on research that the society will profit by providing enough resources into early interventions we see that this does not happen sufficiently. As a result, children with ASD go through education without systematic training and education with sufficient resources. The intervention given through VR has the opportunity to be managed by dedicated clinicians but administered by the children themselves, caregivers or teachers at home, in school, or elsewhere. The VR-training is not limited by location or specific personnel and can thereby solve some of the challenges related to logistics and resources, without replacing them.
VR further provides the opportunity to rehearse more often in various social settings without being dependent on other persons being present. Virtual scenarios have the possibilities of safely simulating the real world. For example, simulating social situations without the unpleasant consequences from the real world such as scolding, laughter, eyes rolling or others – of which can be avoided during training. The complexity and details of the situations can be changed if there is a need to overshadow disruptive stimuli in the beginning before gradually increasing their presence in order to resemble the actual social situation.
Children with autism are as much interested in technology as others, and even more in some cases, which in turn can be motivating for training as the training is fun in its own right. The flexibility of the VR-technology makes it possible to tailor the content to match each individuals’ skill level and interests, which is highly important when working with individuals with ASD. The tailoring can for example take form in filming the child’s daily environment giving a possibility to practice in a familiar but virtual context. It is also possible to film the child’s future arenas (e.g., change of school) in order to give the child a possibility to prepare for the new arena, or broaden the scope of places in which it might find preferable activities (e.g., amusement parks etc.). In fact, this has already been done by our partners VisuMedia.
The possibilities are infinite, and in common is the experience of training in safe environments. There are many reasons to continue developing VR-interventions. The motivational aspects and access to a range of interesting training possibilities will give children and adolescents with ASD better skill sets. Skills that increase the probability of mastering more social interactions might make society a bit more available and less uncomfortable.
Anders Dechsling is currently working as a Doctoral Resarch Fellow at Østfold University College. His occupational background has been within the special education domain as both a therapist and adviser. Anders’ research focuses mainly on autism spectrum disorders and virtual reality, and developmental disabilities.