Targeting Technology for Autistic Spectrum Disorder

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Targeting Technology for Autistic Spectrum
Disorder Patrice L. (Tamar) Weiss, Ph.D,
OTDept. of Occupational TherapyFaculty of
Social Welfare Health SciencesUniversity of
Haifatamar_at_research.haifa.ac.il
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Virtual Reality
Applying interactive simulations created with
computer hardware and software to present users
with opportunities to engage in environments that
appear and feel similar to real world objects and
events
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Virtual Reality Continuum
Cost
Complexity
Presence
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User Location Plane
Examples StreetCrossing for ASD Virtual
Classroom for ADHD IREX Meal-Maker for CP
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Functional Virtual Environments Desktop System
Street crossing

• 6 children, 9-16 years, low functioning ASD used
  desktop VR street crossing intervention program
  (ten 30 min sessions) 6 children with ASD as
  controls.
• All children in VR group improved in task while
  operating the VE.
• all succeeded in advancing from initial baseline
  performance to their final baseline significantly
• number of accidents decreased significantly
• transfer of skills 3/6 children achieved greater
  proficiency in the protected real street
  environment occurred

Josman, N., Milika Ben-Chaim, H., Friedrich, S.
and Weiss, P.L. Effectiveness of virtual reality
for teaching street-crossing skills to children
and adolescents with autism. International
Journal of Disability and Human Development. 7
49-56, 2008. Bart, O., Katz, N., Weiss P.L.,
Josman, N. Street crossing by typically developed
children in real and virtual environments. OTJR
Occupation, Participation and Health, 28 89-97,
2008.
New VE
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Functional Virtual Environments Video Capture
Systems IREX vs EyeToy
Virtual Meal Maker IREX
clip
7 years, mainstream school in the first grade,
has mild right hemiparesis
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Functional Virtual Environments Video Capture
Systems IREX vs EyeToy
Using EyeToy with and without adaptation
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Functional Virtual Environments Virtual
Classroom using a Head Mounted Display
Virtual classroom
Heads
Rizzo et al., University of Southern California
Pollak, Y. Weiss, P. L., Rizzo, A.A., Gross-Tsur,
V., Shalev, R. The utility of a continuous
performance test embedded in virtual reality in
measuring ADHD-related deficits. Journal of
Developmental and Behavioral Pediatrics, in press.
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School of Occupational Therapy, Hebrew University
2. Chaim Sheba Medical Center 3. Dept. of
Occupational Therapy, University of Haifa
Virtual Reality
Assets for Rehabilitation and Special Education
Ecological validity
Grade cognitive motor demands
Convenient times locations
Performance can be documented
Easy to test change
Safe for user
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User Location Plane
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User Location Plane
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DiamondTouch Interactive Table

• Mitsubishi Electronic Research Lab (MERL)
• Large horizontal interactive surface
• Table-top interaction modality
• Operated through PC using Flash programming
• Images are top projected

Gal, E., Bauminger, N., Goren-Bar, D., Pianesi,
F., Stock,O., Zancanaro, M. and Weiss, P.L.
Enhancing social communication of children with
high functioning autism through a co-located
interface. Artificial Intelligence Society,
247584, 2009. Kupersmitt, J., Yifat, R., Gal,
E., Bauminger, N., Stock, O., Zancanaro, M.,
Pianesi, F. and Weiss, P.L. Joint construction
of stories by high functioning children with
autism Using a technological setting. Int J
Child Adolesc Health 3 00-00, 2010.
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(No Transcript)
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Story Table

• Interface to support pairs of children in the
  activity of collaborative storytelling
• Implements Enforced Collaboration paradigm

Story characters
Lady bugs to hold audio snippets
Alternate story backgrounds
Voice recording
Story sequence
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Story Table
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Story Table Initial Study

• SAMPLE
• 3 pairs of boy with high functioning ASD, 8-11
  years
• OUTCOME MEASURES
• Behavioral Checklist
  (based on Bauminger, Aviezer Rogers, 2004)
• positive social interactions
  (e.g., look at peer with positive affect)
• negative social interactions
  (e.g., ignoring action of peer)
• autistic behaviors (e.g., perseveration)
• Analysis of language usage in the interactions
  and in the narrations

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Story Table Initial Study
Pre- and Post-tests
MarbleWorks Free structure play construction game
Link to ST intervention video clip
Low-Tech ST scenarios with cardboard figures
Link to 1 min video clip
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Story Table Initial Study

• Comparison of Pre and Post outcomes
• increase in key positive social interactions
• decrease in negative interactions
• increase in narrative and play ability

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Collaborative Puzzle Game Options for non
verbal children
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PlayCubes Individual or Collaboration - DCD
Real-time Interaction
Real-time 3D Modeling
Bi-directional Interface
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PlayCubes Individual or Collaboration - DCD
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PlayCubes Individual or Collaboration - DCD
Quantitative tracking of the similarity scores
during the construction process
Similarity versus time during the construction of
the airplane and slide apparatus
Airplane
Slide
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PlayCubes Individual or Collaboration - DCD
TSU.MI.KI
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User Location Plane
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From Avatars to Virtual Humans (Tele-Health)
Autism tele-consult
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From Avatars to Virtual Humans
Autism Justine Cassels virtual peers
Eye tracking Autism virtual mall
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User Location Plane
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• Second Life an Internet-based virtual world
  launched in 2003 by Lindens Lab
  http//lindenlab.com).
• Residents inhabit virtual worlds and interact
  via avatars
• Users participate in individual and group
  activities, and to create and trade items and
  services using Linden dollars
• By the end of March 2008, 13 million registered
  accounts. About 38,000 residents are
  logged on to Second Life at
  any particular moment.
• number of medical health educational
  projects
• Nutrition Game
• Occupational Therapy at the Virtual Neurological
  Education Centre
• Brigadoon designed for people with Aspergers
  syndrome. Brigadoon - a controlled environment
  where users are encouraged to feel comfortable
  and learn socialization skills at their own pace.
  

Link
http//www.youtube.com/watch?vpmTXGQ2BhUAfeature
PlayListpE048D6F190577DEDindex0playnext1
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Balancing Collaboration Technologies Assets and
Limitations for ASD

• Bottom Line
• effectiveness?
• transfer?

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Studies using Virtual Reality and Shared Active
Surfaces for Autism Table of Evidence - AACPDM
Level Strength of Evidence for Intervention Type of study design VR studies (N18) SAS studies (N19)
I Good Meta-analysis of randomized controlled trials (RCT)
II Good Large-sample RCT
III Good to fair Small-sample RCT
IV Good to fair Nonrandomized controlled prospective trials 3
V Good to fair Nonrandomized controlled retrospective trials
VI Fair Cohort studies 7
VII Fair Case-control studies 2 3
VIII Poor Non-controlled clinical series descriptive studies 8 4
IX Poor Anecdotes or case reports 5 5
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Acknowledgements Laboratory for Innovations in
Rehabilitation Technology University of Haifa,
Haifa, Israel
Caesarea-Rothschild Institute Fondation Ida et
Avrohom Baruch Israeli Ministry of Health Israeli
Ministry of Defense Yad Hanadiv-Keren
Rothschild Israeli Foundation for Spinal Cord
Injured due to Gunshot Israel Science
Foundation Keren Shalem Koniver Foundation Rayne
Foundation Autism Speaks European Union FP7 ICT