How virtual reality computer programs can help three year old children with ASD communicate
Individuals with ASD often experience difficulties with communication which can lead to anxiety. Ultimately, this anxiety hinders children’s ability to fulfill their potential. Many virtual reality programs have been developed the help improve communication skills for children with ASD. However, despite the fact that early intervention is the best way to promote a successful future, there has yet to be a virtual reality program designed specifically for children three years old. Therefore, I propose the creation of a new interactive virtual reality program to improve the socialization and communication skills for children around the age of three with ASD. The program will be tested using the results of a one way ANOVA, which measures the child’s engagement, enjoyment and learning.
Keywords: virtual reality, ASD, Communication, children.
Virtual Reality Improving Communication For Children with ASD
Autism spectrum disorder (ASD) is defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a complex neurological disorder that affects, inter-alia, communication and socialization. Although, the causes of language development difficulties in autistic children is still largely undetermined, many experts believe that the problems result from a variety of conditions occurring prior to birth. Some studies have shown that autism is positively correlated to the age of the father (Tsuchiya, K. J, et. al., 2008). Other researchers have linked autism to the child’s genetic disposition (Ziats, M. N., et. a., 2016l). The number of children who are being diagnosed with autism spectrum disorder continues to increase. In fact, according to the Center for Disease Control and Prevention, autism affects one out of every 68 births in the United States (Christensen DL., et. al., 2012). ASD is defined as a spectrum because autism includes a broad range of varying symptoms and degrees of severity, from high to low functioning. Therefore, the communication and language difficulties experienced by children with ASD vary greatly. For example, some children with “low functioning” autism may be unable to speak. Other children on the spectrum may be able to speak but have trouble understanding the meanings and rhythms of words and sentences. Furthermore, some high functioning children, with fewer verbal impairments may still have trouble understanding social cues, such as where to look while talking to others (Mayes, S. D., et. al., 2009 ).
The acquisition of communication and language skills for autistic children can be dramatically different than those experienced by children who meet typical development expectations. The first indicators of normal language development generally occur in the first few days of life. Usually a newborn quickly learns that crying will result in receiving food or attention. Between the first six to eight weeks of life, babies begin to make eye contact and by 18 months of age most children can say 8 to 10 words (Hurley, A., 2006). At ages three, four, and five, a child’s vocabulary rapidly increases, and they begin to master the rules of language including; phonology (speech sounds), syntax (sentence formation), semantics (word and sentence meaning), and pragmatics (effective use of language) (Fromkin, V., Rodman, R., & Hyams, N., 2010). Some indicators of autism in child development include: a child’s failure to babble or coo by 12 months, gesture by 12 months, say single words by 16 months, and say two-word phrases by 24 months (Thurm, A., et. al., 2007). While these delays in language development may not always indicate that a child has autism, they are frequently the first indicators of ASD. As the child grows older, the symptoms, particularly those including eye contact, and verbal responses, often become more pronounced and lead to other difficulties with socialization.
Having a limited capacity to communicate with others can result in severe emotional distress. An individual’s unsuccessful attempt to communicate verbally and/or physically may lead to an increase in their internal frustration and anger. Research has shown that 40% of children with autism also have anxiety disorder (Van Steensel &Vogels 2011). Furthermore, another study reported that rates of anxiety are higher in those children who have language disorders (Gillott et al, 2001). This is significant in that anxiety can negatively affect an individual with ASD’s ability to fulfill their potential. Anxieties has the ability to impair an individual’s success in education, friendships and social participation, and places an immense strain on other members of the family (Reaven, 2011). As exemplified in the video below see appendix A, non verbal autistic individuals, such as Carly, are often very smart. Thus, not being able to express oneself creates an enormous amount of frustration. This repeated feeling of frustration and failure to be able to express emotions can result in anxiety (Ozsivadjian, A., e.al., 2012).
Fortunately, contemporary technological advances include new ways of improving communication skills for autistic children. These technological innovations range in function, from teaching children to understand the implication of other people’s facial expressions (i.e., frowning it means unhappy) to providing the means for nonverbal autistic individuals, like Carly, to communicate. One of the most interesting innovations helping to improve communication skills for autistic children, is the the development of virtual reality computer programs. Such virtual reality programs, can be very beneficial to children with ASD in that, the program creates a safe space for children with autism to practice social skills without the fear of negative consequences. Research conducted by Nyaz Didehbani, et al., (2016) indicated that “participants who completed the training demonstrated improved social cognition skills and reported better relationships. Neurocognitive testing showed significant gains in emotional recognition, understanding the perspective of others and the ability to solve problems.” Their study consisted of a sample size of 30 individual ranging in age from seven to sixteen, with high functioning autism. The participants, who were paired into groups of two, were required to complete ten, one-hour long sessions of virtual reality training for five weeks. During that time, the participants learned and practiced strategies for handling social situations, such as, meeting a peer for the first time, confronting a bully and inviting someone to a party. The following (see appendix B) video demonstrates one of the numerous virtual reality programs designed to help autistic children communicate.
Another study about virtual reality programs, was conducted by Fabbri et al. (2006). Their study sought to determine how individuals with autism can improve their communication skills by interacting with avatars which show facial expressions conveying emotions (happiness, sadness, anger and fear). The children, in a sample size of 34, with an average age of ten, were asked to choose the emotion the avatar was expressing. The children subsequently viewed the avatar in a social situation and the participant was asked to associate the given scene with an emotion. Lastly, the participant had to choose from a list, the cause of the emotion that the avatar was expressing. Researchers stated that 30 of the participants understand and appropriately identified the emotions of the avatar. The remaining four in the sample, who had a more severe form of of autism, had trouble understand the emotions of the avatar.
As exemplified by the studies discussed above, virtual reality programs can improve communication skills for autistic children. However, virtual reality programs designed specifically for three year old children with ASD have not yet been developed. This is significant because research shows that early intervention is the most effective way to promote a child’s future success. As well known autism advocate Temple Grandin stated in an interview with Autism Live, an interactive webshow, “Kids two, three and four years old need twenty hours of intensive early intervention…push because you’ve got to stretch these kids. You don’t stretch them somewhere they don’t advance.” (2013) Thus, the development of a virtual reality program designed for young children can be critical to improve communication skills.
Therefore, I propose that a new interactive virtual reality program be developed to improve the socialization and communication skills for children around the age of three with ASD. In this new virtual reality program the child will be represented by an avatar of their choice. As the avatar, they will have the option of taking part in a daily adventure such as a virtual visit to the zoo, or participating in an interactive story of their choice. Their choice of activity will be represented by a symbol which they would choose by the use of a gesture. An example of an interactive story in which a child could participate could be a well known fairy tale like Goldilocks and the Three Bears. While listening to the story, the narrator would ask the child to help Goldilocks find simple objects, by asking questions such as “where is the bed.” Another example of a story, could be the creation of a completely new tale involving a group of colorful animated animals that would frequently use the child’s name in songs. While telling a story, the characters would encourage a child to interact. For example, if one of the animals mentions a ball, they would ask the child to gesture to a picture or say the word ball, depending on the severity of their autism. If the child chooses to visit a virtual zoo, they would similarly be required, after a computer prompt, to say the name of a given animal, or point to a symbol of the animal. Throughout the activity, the child would randomly be required to interact with other avatars. The computer program would indicate the emotion of the other avatar (sad, happy, angry, etc.) and the child would indicate which facial expression, from a sample list of simplistic symbols, expresses the given emotion. The goal of this program would be to help a child improve their communication skills.
The study would consist of a minimum sample size of 36 children with ASD around the age of three. Their parent or caregiver would also be available in the same room to ensure the child is calm and provide positive feedback to the child. The researcher would not be in the room because this may be a cause of anxiety for the child.
There would be a computer available in a quiet isolated room with the virtual reality program already installed. There would also be a camera for the researcher to record the child’s progress.
Every day for at least an hour for ten weeks, the child with ASD will play the games and practice interacting with the virtual reality program in the lab with their parent or trusted caregiver.
The results would be measured using a one way ANOVA test. The test would measure enjoyment which would be indicated by how much fun the child seemed to be having while using the virtual reality program. The test would also measure the child’s engagement which would be indicated by how interested they were in the activity. Lastly, the test would measure whether the child is learning from the program, by comparing their communication skills prior and subsequent to the study.
Research shows that early intervention is the most effective way to promote a child’s future success. Accordingly, intervening in a child’s development at the age of three, by the use of a virtual reality program may be critical for improved communication. This is important because not being able to express oneself can lead to frustration and anxiety which can further hinder the child’s ability to communicate. As research clinician Dr. Nyaz Didehbani states, “[I]ndividuals with autism may become overwhelmed and anxious in social situations…The virtual reality training platform creates a safe place for participants to practice social situations without the intense fear of consequence,”(Nyaz Didehbani, et al., 2016)).
Each element of the virtual reality program that I purpose has a unique purpose. The use of the colorful animated, animals is intended to keep the child interested in order to encourage their desire to learn. The narrator’s frequent repetition of the child’s name is intended to help the child practice responding to their name. For non verbal ASD children, the use of gestures to respond to questions is meant to demonstrate their capability of communicating to others and themselves. It also encourages the child to practice ways that they could communicate since they cannot speak. For high functioning children with ASD who are verbal, answering the questions is practice with direct communication and speech. Moreover, the requirement to practice using simplistic symbols which express emotions is important to help a child understand which expressions are associated with specific emotions.
There are certain limitations to this study. One of the limitations is that the virtual reality program might only be beneficial to high functioning autistic children. Children with low functioning autism may not be able to be engaged in the activities because they might be too challenging. Furthermore, measuring some of the test results may be subjective. For example, it it may be difficult to measure how much fun a child is having or how engaged they are in the program. However, an experienced researcher should be able to make these determinations.
“ABC World News 0219 – Carly’s Story.” ABC World News, 20 Feb. 2008,
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(DSM-5®). American Psychiatric Pub.
AutismLive. “Temple Grandin: Helping Kids with Autism.” Http://Www.autism-Live.com/, 1
Christensen DL, Baio J, Braun KV, et al. Prevalence and Characteristics of Autism Spectrum
Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveill Summ 2016;65(No. SS-3)(No. SS-3):1–23. DOI: http://dx.doi.org/10.15585/mmwr.ss6503a1.
Fabri, M. (2006). Emotionally expressive avatars for collaborative virtual environments
(Doctoral dissertation, Leeds Metropolitan University).
Fromkin, V., Rodman, R., & Hyams, N. (2010). An introduction to language. Cengage Learning.
Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high-functioning children with autism.
Autism, 5(3), 277-286.
Hurley, A. (2006). Cognitive Development: Overview. Retrieved November, 26, 2006.
Mayes, S. D., Calhoun, S. L., Murray, M. J., Morrow, J. D., Yurich, K. K., Mahr, F., … &
Petersen, C. (2009). Comparison of scores on the Checklist for Autism Spectrum Disorder, Childhood Autism Rating Scale, and Gilliam Asperger’s Disorder Scale for children with low functioning autism, high functioning autism, Asperger’s disorder, ADHD, and typical development. Journal of autism and developmental disorders, 39(12), 1682-1693.
Nyaz Didehbani et al. Virtual Reality Social Cognition Training for children with high
functioning autism, Computers in Human Behavior (2016). DOI: 10.1016/j.chb.2016.04.033
Ozsivadjian, A., Knott, F., & Magiati, I. (2012). Parent and child perspectives on the nature of
anxiety in children and young people with autism spectrum disorders: a focus group study. Autism, 16(2), 107-121.
Petersen, J. L. (2011). Computer interaction system to identify learning patterns and improve
performance in children with Autism Spectrum Disorders. Florida Atlantic University.
Reaven, J. (2011). The treatment of anxiety symptoms in youth with high-functioning autism
spectrum disorders: Developmental considerations for parents. Brain research, 1380, 255-263.
“Temple Grandin: Helping Kids with Autism : Free Download & Streaming.” Internet Archive,
Thurm, A., Lord, C., Lee, L. C., & Newschaffer, C. (2007). Predictors of language acquisition in
preschool children with autism spectrum disorders. Journal of autism and developmental disorders, 37(9), 1721-1734.
Tsuchiya, K. J., Matsumoto, K., Miyachi, T., Tsujii, M., Nakamura, K., Takagai, S., … &
Sugihara, G. (2008). Paternal age at birth and high-functioning autistic-spectrum disorder in offspring. The British Journal of Psychiatry, 193(4), 316-321.
Van Steensel, F. J., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and
adolescents with autistic spectrum disorders: a meta-analysis. Clinical child and family psychology review, 14(3), 302.
Ziats, M. N., & Rennert, O. M. (2016). The evolving diagnostic and genetic landscapes of autism
spectrum disorder. Frontiers in genetics, 7.