Treating Autism With Technology

ASD studies explore social skill development using robots and virtual environments

/ Author:  / Reviewed by: Joseph V. Madia, MD

Autism spectrum disorder (ASD) can be a difficult issue to cope with. Problems with communication and social interaction can plague patients at all ranges of the spectrum.

There is a continual demand for new treatment options as the number of autism diagnoses grow.

This fact combined with the continual advancement of technology has led researchers to explore how technology could potentially help children with an ASD strengthen their social skills.

At the 2012 International Meeting for Autism Research (IMFAR) in Toronto in May 2012, several studies on this topic were presented. Though sample sizes were small and further research needed, the studies represent a new trend in the field of autism treatment.

Interacting in a Virtual Environment

One area it is thought that technology might help children with an ASD is in their participation with others. Several studies presented at IMFAR looked at how technology, by providing a virtual character to interact with, might help autistic kids improve social skills and teamwork.

In one study, “Promoting Social Communication in Children on the Autism Spectrum Through a Virtual Learning Environment,” a collaboration by researchers from the University of Birmingham and the University of Edinburgh, a virtual learning environment called “ECHOES” was created and accessed by the child through a large touch-screen.

In the study, 15 children aged five to eight (one group with autism and a control group without) used ECHOES to interact with a virtual character and collaborate and communicate in order to complete activities together.

Analysis is still undergoing for this study, but researchers are examining “initiation and response to joint attention, reciprocal interactions, imitative behaviors and other forms of social communication” between the children and the virtual character and comparing these to interactions between the children and a human partner. The researchers expressed that joint attention seems specifically interesting and shows potential to improve with this kind of computer interaction.

Researchers are also using the ECHOES program in a separate study to examine the potential of virtual characters and virtual environments to improve spontaneous initiation (meaning “sharing interest, affect, and events”) in kids with ASD.

Another study, “Exploring the Use of Cross-Cultural Parameterised Avatars in Virtual Learning Environments for Social Competence of People with Autism Spectrum Conditions” out of Leeds Metropolitan University, explored the use of avatars in a virtual learning environment to improve the emotion recognition ability in people with autism.

The researchers in this study are specifically focusing on cultural diversity, creating avatars with a variety of ethnicities, genders and ages as well as a variety of levels of emotional expression in a “social-context rich collaborative virtual environment.”

The study, which is currently ongoing, is examining eighteen subjects and results are yet to be seen. However, the researchers are curious to see if the cultural diversity and varying levels of expressiveness of the avatars leads to better emotional recognition in the ASD participants.

Computers for Collaboration

In another study, “Collaborative Collocated Technologies to Promote Social Communication in Children with HFASD” the tendency of kids with HFSAD (or High functioning Autism Spectrum Disorders) to be drawn to solitary tasks, like computer games, was used strategically in an attempt to better their communication and social skills.

The researchers developed a computer program titled “No Problem!” with the goal of working on these skills. The program includes a learning section which explores the stages of social conversation (here sectioned into initiating, maintaining, switching topic and closing the conversation) and requires that the children “explore alternative solutions or suggest new ways of managing each phase.”

In the next part, the experience section, a human facilitator engages the children in role-play, records the experience and then reviews it with the child.

The researchers explored No Problem! with nine HFASD children from nine to thirteen years-old and surveyed them on the results. They found the children to be motivated by the program and that it did not cause any anxiety or tension, like one would expect from a similar social interaction with people. More research is necessary to see if the program could significantly improve the social communication skills of the children over time.

Researching Robots

In a study from Yale University and the University of Southern California titled “A Simon-Says Robot Providing Autonomous Imitation Feedback Using Graded Cueing,” researchers explored how a robot that can imitate behavior might affect children with an ASD.

The study is based on “graded cueing,” a therapy structure in which feedback is provided in a range from general to specific before reframing and simplifying the way the problem is viewed.

The study employed an “autonomous socially assistive robot used to recognize correct and incorrect imitation behavior of a child” and provide graded cueing feedback on a game of Simon Says.

Researchers examined the robot at play with two children (with an average age of 11), in which the robot provided in-depth graded cueing feedback in one session and only stated correct or incorrect to the child’s imitation in another session. One child imitated the robot with a high success rate, and was able correct mistakes every time with graded cueing. The other child had more trouble with the imitation, but improved some of the time with graded cueing, and none of the time with only a statement of correct or incorrect.

Such a small sample obviously does not represent a definitive finding, but according to the authors, the subjects’ positive response to the robot and its success in the Simon Says game shows a need for further research into possibilities.

Complicated Costs

While some of the technology explored could definitely represent a high cost of treatment, one study explored how technology could potentially lower cost.

In “Robot-Mediated Adaptive Response System in Joint Attention Task for Children with Autism Spectrum Disorders,” researchers argued that the round-the-clock care that autism often necessitates could actually be mediated through new technology.

In the study, a set-up was created that included a robot, infrared cameras, computer monitors and LEDS to determine the gaze of the child. Twelve children aged three to five (half with an ASD, half without) were given prompts for tasks like pointing or shifting their gaze by either a human or a robot.

According to the authors, “Data indicated preschool children with ASD directed their gaze more frequently toward the humanoid-robot than human administrator and were capable of correctly responding to target.” If further research confirms that the program works, the robots could potentially cost less over time and be of greater effectiveness than that of human workers.

All of these studies require much more research, investigation and critique before their feasibility and effectiveness can be proven. Since the studies have not yet been published in a peer-reviewed journal, other scientists have not had a chance to review the methods and data to ensure it passes their quality standards.

Furthermore, most of the studies observed small sample groups and for some, data is still being analyzed and gathered. However, they do represent a trend in the field of autism research and treatment.

As technology and autism diagnoses both expand, we can expect to see more studies exploring how the two might combine to improve the lives of children with an ASD.

Reviewed by: 
Review Date: 
June 11, 2012