Investigating alterations of social interaction in psychiatric disorders with dual interactive eye tracking and virtual faces

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Attention-Based Applications in Extended Reality to Support Autistic Users: A Systematic Review

With the rising prevalence of autism diagnoses, it is essential for research to understand how to leverage technology to support the diverse nature of autistic traits. While traditional interventions focused on technology for medical cure and rehabilitation, recent research aims to understand how technology can accommodate each unique situation in an efficient and engaging way. Extended reality (XR) technology has been shown to be effective in improving attention in autistic users given that it is more engaging and motivating than other traditional mediums. Here, we conducted a systematic review of 59 research articles that explored the role of attention in XR interventions for autistic users. We systematically analyzed demographics, study design and findings, including autism screening and attention measurement methods. Furthermore, given methodological inconsistencies in the literature, we systematically synthesize methods and protocols including screening tools, physiological and behavioral cues of autism and XR tasks. While there is substantial evidence for the effectiveness of using XR in attention-based interventions for autism to support autistic traits, we have identified three principal research gaps that provide promising research directions to examine how autistic populations interact with XR. First, our findings highlight the disproportionate geographic locations of autism studies and underrepresentation of autistic adults, evidence of gender disparity, and presence of individuals diagnosed with co-occurring conditions across studies. Second, many studies used an assortment of standardized and novel tasks and self-report assessments with limited tested reliability. Lastly, the research lacks evidence of performance maintenance and transferability.Comment: [Accepted version] K. Wang, S. J. Julier and Y. Cho, "Attention-Based Applications in Extended Reality to Support Autistic Users: A Systematic Review," in IEEE Access, vol. 10, pp. 15574-15593, 2022, doi: 10.1109/ACCESS.2022.314772

Assessment of postural, locomotor, and physical fitness status in individuals with intellectual and developmental disabilities

Introduction: Postural control and locomotion deficits can be observed during the early years of childhood development and throughout life. For those with disabilities, these deficits can advance past the development years and into adolescence and adulthood while affecting the quality of life and daily activity. Finding interactive rehabilitative activities to delay or limit these deficits is essential for people with disabilities to improve their quality of life, inclusion, and overall movement. Adapted physical activity/sports like badminton and virtual reality could promote improvements in postural and locomotor status for young adults with intellectual and developmental disabilities like cerebral palsy (CP), intellectual disability (ID), and autism spectrum disorder (ASD). Purpose: These studies aim to assess the postural and locator status of young adults with intellectual and developmental disabilities after participating in a 12-week badminton and intensive virtual reality programs. Methods: Study A will follow a multiple baseline approach to access postural control, locomotion, and areas of physical fitness in young adults with IDD utilizing the immersive virtual reality game Fruit Ninja™ while study B will follow and repeated measures design accessing static postural control for students in a comprehensive transition program for intellectual disabilities at a southeastern university

Factors Influencing the Adoption of Immersive Virtual Reality for Individuals with Autism Spectrum Disorder: Parents Perceptions

The purpose of this qualitative study was to identify factors that affect the adoption of a spherical video virtual reality (SVVR) mobile application among parents of adults with Autism Spectrum Disorder (ASD). The study used the diffusion of innovation theory by Rogers (2003) as a framework to explore parents’ perceptions of an SVVR transportation model designed to improve the quality of life of adults with ASD. In addition, the study sought to learn what might increase adoption of VR technology among other parents of individuals with ASD and what life skills that might be addressed using VR technology in the future. The study employed interviews, focus groups, and observation to collect data. The factors that negatively affected the perception of VR technology among parents were categorized into themes: awareness of VR learning applications, availability, disadvantages of SVVR, and technical issues related to the SVVR transportation model. Factors that positively affected the parents’ decision to adopt VR were immersion, realism, ease-of-use, enjoyment and motivation. To increase the adoption of VR by other parents of individuals with ASD, parents suggested that understanding of VR learning applications needs to increase, more teachers should be trained to use VR, the SVVR model should be improved, and there should be greater exposure to VR in schools and at home. Potential future life skills that need to be addressed through the VR technology were also identified. The findings of this study may help eliminate concerns about using VR technology as a therapy for ASD individuals and encourage more parents, teachers, and other stakeholders to adopt it

Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review

[EN] Autism Spectrum Disorder (ASD) is a neurodevelopmental disease that is specially characterized by impairments in social communication and social skills. ASD has a high prevalence in children, affecting 1 in 160 subjects. Virtual reality (VR) has emerged as an effective tool for intervention in the health field. Different recent papers have reviewed the VR-based treatments in ASD, but they have an important limitation because they only use clinical databases and do not include important technical indexes such as the Web of Science index or the Scimago Journal & Country Rank. To our knowledge, this is the first contribution that has carried out an evidence-based systematic review including both clinical and technical databases about the effectiveness of VR-based intervention in ASD. The initial search identified a total of 450 records. After the exclusion of the papers that are not studies, duplicated articles, and the screening of the abstract and full text, 31 articles met the PICO (Population, Intervention, Comparison and Outcomes) criteria and were selected for analysis. The studies examined suggest moderate evidence about the effectiveness of VR-based treatments in ASD. VR can add many advantages to the treatment of ASD symptomatology, but it is necessary to develop consistent validations in future studies to state that VR can effectively complement the traditional treatments.Mesa Gresa, P.; Gil Gómez, H.; Lozano Quilis, JA.; Gil-Gómez, J. (2018). Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review. Sensors. 18(8):1-15. https://doi.org/10.3390/s18082486S115188World Health Organizationhttp://www.who.int/en/news-room/fact-sheets/detail/autism-spectrum-disordersColombi, C., & Ghaziuddin, M. (2017). Neuropsychological Characteristics of Children with Mixed Autism and ADHD. Autism Research and Treatment, 2017, 1-5. doi:10.1155/2017/5781781Merriam-Websterhttps://www.merriam-webster.com/dictionary/virtual%20realityBird, M.-L., Cannell, J., Jovic, E., Rathjen, A., Lane, K., Tyson, A., … Smith, S. (2017). A Randomized Controlled Trial Investigating the Efficacy of Virtual Reality in Inpatient Stroke Rehabilitation. Archives of Physical Medicine and Rehabilitation, 98(10), e27. doi:10.1016/j.apmr.2017.08.084Albiol-Pérez, S., Gil-Gómez, J.-A., Muñoz-Tomás, M.-T., Gil-Gómez, H., Vial-Escolano, R., & Lozano-Quilis, J.-A. (2017). The Effect of Balance Training on Postural Control in Patients with Parkinson’s Disease Using a Virtual Rehabilitation System. Methods of Information in Medicine, 56(02), 138-144. doi:10.3414/me16-02-0004Garcia-Palacios, A., Herrero, R., Vizcaíno, Y., Belmonte, M. A., Castilla, D., Molinari, G., … Botella, C. (2015). Integrating Virtual Reality With Activity Management for the Treatment of Fibromyalgia. The Clinical Journal of Pain, 31(6), 564-572. doi:10.1097/ajp.0000000000000196Bekelis, K., Calnan, D., Simmons, N., MacKenzie, T. A., & Kakoulides, G. (2017). Effect of an Immersive Preoperative Virtual Reality Experience on Patient Reported Outcomes. Annals of Surgery, 265(6), 1068-1073. doi:10.1097/sla.0000000000002094Orlosky, J., Itoh, Y., Ranchet, M., Kiyokawa, K., Morgan, J., & Devos, H. (2017). Emulation of Physician Tasks in Eye-Tracked Virtual Reality for Remote Diagnosis of Neurodegenerative Disease. IEEE Transactions on Visualization and Computer Graphics, 23(4), 1302-1311. doi:10.1109/tvcg.2017.2657018Areces, D., Rodríguez, C., García, T., Cueli, M., & González-Castro, P. (2016). Efficacy of a Continuous Performance Test Based on Virtual Reality in the Diagnosis of ADHD and Its Clinical Presentations. Journal of Attention Disorders, 22(11), 1081-1091. doi:10.1177/1087054716629711Phé, V., Cattarino, S., Parra, J., Bitker, M.-O., Ambrogi, V., Vaessen, C., & Rouprêt, M. (2016). Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery. The International Journal of Medical Robotics and Computer Assisted Surgery, 13(2), e1740. doi:10.1002/rcs.1740Pulijala, Y., Ma, M., Pears, M., Peebles, D., & Ayoub, A. (2018). Effectiveness of Immersive Virtual Reality in Surgical Training—A Randomized Control Trial. Journal of Oral and Maxillofacial Surgery, 76(5), 1065-1072. doi:10.1016/j.joms.2017.10.002Jarrold, W., Mundy, P., Gwaltney, M., Bailenson, J., Hatt, N., McIntyre, N., … Swain, L. (2013). Social Attention in a Virtual Public Speaking Task in Higher Functioning Children With Autism. Autism Research, 6(5), 393-410. doi:10.1002/aur.1302Mishkind, M. C., Norr, A. M., Katz, A. C., & Reger, G. M. (2017). Review of Virtual Reality Treatment in Psychiatry: Evidence Versus Current Diffusion and Use. Current Psychiatry Reports, 19(11). doi:10.1007/s11920-017-0836-0Liu, X., Wu, Q., Zhao, W., & Luo, X. (2017). Technology-Facilitated Diagnosis and Treatment of Individuals with Autism Spectrum Disorder: An Engineering Perspective. Applied Sciences, 7(10), 1051. doi:10.3390/app7101051Van Bennekom, M. J., de Koning, P. P., & Denys, D. (2017). Virtual Reality Objectifies the Diagnosis of Psychiatric Disorders: A Literature Review. Frontiers in Psychiatry, 8. doi:10.3389/fpsyt.2017.00163Provoost, S., Lau, H. M., Ruwaard, J., & Riper, H. (2017). Embodied Conversational Agents in Clinical Psychology: A Scoping Review. Journal of Medical Internet Research, 19(5), e151. doi:10.2196/jmir.6553Lau, H. M., Smit, J. H., Fleming, T. M., & Riper, H. (2017). Serious Games for Mental Health: Are They Accessible, Feasible, and Effective? A Systematic Review and Meta-analysis. Frontiers in Psychiatry, 7. doi:10.3389/fpsyt.2016.00209Parsons, S. (2016). Authenticity in Virtual Reality for assessment and intervention in autism: A conceptual review. Educational Research Review, 19, 138-157. doi:10.1016/j.edurev.2016.08.001Den Brok, W. L. J. E., & Sterkenburg, P. S. (2014). Self-controlled technologies to support skill attainment in persons with an autism spectrum disorder and/or an intellectual disability: a systematic literature review. Disability and Rehabilitation: Assistive Technology, 10(1), 1-10. doi:10.3109/17483107.2014.921248Ip, H. H. S., Wong, S. W. L., Chan, D. F. Y., Byrne, J., Li, C., Yuan, V. S. N., … Wong, J. Y. W. (2018). Enhance emotional and social adaptation skills for children with autism spectrum disorder: A virtual reality enabled approach. Computers & Education, 117, 1-15. doi:10.1016/j.compedu.2017.09.010Chen, C.-H., Lee, I.-J., & Lin, L.-Y. (2016). Augmented reality-based video-modeling storybook of nonverbal facial cues for children with autism spectrum disorder to improve their perceptions and judgments of facial expressions and emotions. Computers in Human Behavior, 55, 477-485. doi:10.1016/j.chb.2015.09.033Didehbani, N., Allen, T., Kandalaft, M., Krawczyk, D., & Chapman, S. (2016). Virtual Reality Social Cognition Training for children with high functioning autism. Computers in Human Behavior, 62, 703-711. doi:10.1016/j.chb.2016.04.033Lorenzo, G., Lledó, A., Pomares, J., & Roig, R. (2016). Design and application of an immersive virtual reality system to enhance emotional skills for children with autism spectrum disorders. Computers & Education, 98, 192-205. doi:10.1016/j.compedu.2016.03.018Wade, J., Zhang, L., Bian, D., Fan, J., Swanson, A., Weitlauf, A., … Sarkar, N. (2016). A Gaze-Contingent Adaptive Virtual Reality Driving Environment for Intervention in Individuals with Autism Spectrum Disorders. ACM Transactions on Interactive Intelligent Systems, 6(1), 1-23. doi:10.1145/2892636Ke, F., & Lee, S. (2015). Virtual reality based collaborative design by children with high-functioning autism: design-based flexibility, identity, and norm construction. Interactive Learning Environments, 24(7), 1511-1533. doi:10.1080/10494820.2015.1040421Chen, C.-H., Lee, I.-J., & Lin, L.-Y. (2015). Augmented reality-based self-facial modeling to promote the emotional expression and social skills of adolescents with autism spectrum disorders. Research in Developmental Disabilities, 36, 396-403. doi:10.1016/j.ridd.2014.10.015Cheng, Y., Huang, C.-L., & Yang, C.-S. (2015). Using a 3D Immersive Virtual Environment System to Enhance Social Understanding and Social Skills for Children With Autism Spectrum Disorders. Focus on Autism and Other Developmental Disabilities, 30(4), 222-236. doi:10.1177/1088357615583473Kim, K., Rosenthal, M. Z., Gwaltney, M., Jarrold, W., Hatt, N., McIntyre, N., … Mundy, P. (2014). A Virtual Joy-Stick Study of Emotional Responses and Social Motivation in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 45(12), 3891-3899. doi:10.1007/s10803-014-2036-7Parsons, S. (2015). Learning to work together: Designing a multi-user virtual reality game for social collaboration and perspective-taking for children with autism. International Journal of Child-Computer Interaction, 6, 28-38. doi:10.1016/j.ijcci.2015.12.002Bai, Z., Blackwell, A. F., & Coulouris, G. (2015). Using Augmented Reality to Elicit Pretend Play for Children with Autism. IEEE Transactions on Visualization and Computer Graphics, 21(5), 598-610. doi:10.1109/tvcg.2014.2385092Bekele, E., Crittendon, J., Zheng, Z., Swanson, A., Weitlauf, A., Warren, Z., & Sarkar, N. (2014). Assessing the Utility of a Virtual Environment for Enhancing Facial Affect Recognition in Adolescents with Autism. Journal of Autism and Developmental Disorders, 44(7), 1641-1650. doi:10.1007/s10803-014-2035-8Escobedo, L., Tentori, M., Quintana, E., Favela, J., & Garcia-Rosas, D. (2014). Using Augmented Reality to Help Children with Autism Stay Focused. IEEE Pervasive Computing, 13(1), 38-46. doi:10.1109/mprv.2014.19Finkelstein, S., Barnes, T., Wartell, Z., & Suma, E. A. (2013). Evaluation of the exertion and motivation factors of a virtual reality exercise game for children with autism. 2013 1st Workshop on Virtual and Augmented Assistive Technology (VAAT). doi:10.1109/vaat.2013.6786186Maskey, M., Lowry, J., Rodgers, J., McConachie, H., & Parr, J. R. (2014). Reducing Specific Phobia/Fear in Young People with Autism Spectrum Disorders (ASDs) through a Virtual Reality Environment Intervention. PLoS ONE, 9(7), e100374. doi:10.1371/journal.pone.0100374Stichter, J. P., Laffey, J., Galyen, K., & Herzog, M. (2013). iSocial: Delivering the Social Competence Intervention for Adolescents (SCI-A) in a 3D Virtual Learning Environment for Youth with High Functioning Autism. Journal of Autism and Developmental Disorders, 44(2), 417-430. doi:10.1007/s10803-013-1881-0Bekele, E., Zheng, Z., Swanson, A., Crittendon, J., Warren, Z., & Sarkar, N. (2013). Understanding How Adolescents with Autism Respond to Facial Expressions in Virtual Reality Environments. IEEE Transactions on Visualization and Computer Graphics, 19(4), 711-720. doi:10.1109/tvcg.2013.42Cai, Y., Chia, N. K. H., Thalmann, D., Kee, N. K. N., Zheng, J., & Thalmann, N. M. (2013). Design and Development of a Virtual Dolphinarium for Children With Autism. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 21(2), 208-217. doi:10.1109/tnsre.2013.2240700Ke, F., & Im, T. (2013). Virtual-Reality-Based Social Interaction Training for Children with High-Functioning Autism. The Journal of Educational Research, 106(6), 441-461. doi:10.1080/00220671.2013.832999Lorenzo, G., Pomares, J., & Lledó, A. (2013). Inclusion of immersive virtual learning environments and visual control systems to support the learning of students with Asperger syndrome. Computers & Education, 62, 88-101. doi:10.1016/j.compedu.2012.10.028Modugumudi, Y. R., Santhosh, J., & Anand, S. (2013). Efficacy of Collaborative Virtual Environment Intervention Programs in Emotion Expression of Children with Autism. Journal of Medical Imaging and Health Informatics, 3(2), 321-325. doi:10.1166/jmihi.2013.1167Wang, M., & Reid, D. (2013). Using the Virtual Reality-Cognitive Rehabilitation Approach to Improve Contextual Processing in Children with Autism. The Scientific World Journal, 2013, 1-9. doi:10.1155/2013/716890Milne, M., Luerssen, M. H., Lewis, T. W., Leibbrandt, R. E., & Powers, D. M. W. (2010). Development of a virtual agent based social tutor for children with autism spectrum disorders. The 2010 International Joint Conference on Neural Networks (IJCNN). doi:10.1109/ijcnn.2010.5596584Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. doi:10.1016/j.jaac.2017.03.013Mesa-Gresa, P., Lozano, J. A., Llórens, R., Alcañiz, M., Navarro, M. D., & Noé, E. (2011). Clinical Validation of a Virtual Environment Test for Safe Street Crossing in the Assessment of Acquired Brain Injury Patients with and without Neglect. Lecture Notes in Computer Science, 44-51. doi:10.1007/978-3-642-23771-3_4Spreij, L. A., Visser-Meily, J. M. A., van Heugten, C. M., & Nijboer, T. C. W. (2014). Novel insights into the rehabilitation of memory post acquired brain injury: a systematic review. Frontiers in Human Neuroscience, 8. doi:10.3389/fnhum.2014.00993Pietrzak, E., Pullman, S., & McGuire, A. (2014). Using Virtual Reality and Videogames for Traumatic Brain Injury Rehabilitation: A Structured Literature Review. Games for Health Journal, 3(4), 202-214. doi:10.1089/g4h.2014.001

Neuroaffirmative Approaches to Extended Reality: Empowering Individuals with Autism Spectrum Condition through Immersive Learning Environments

Traditional teaching and working environments often prioritize extroverted qualities, disadvantaging individuals with conditions that impact social engagement, such as autism spectrum condition (ASC). These individuals usually thrive in calmer, low-key learning environments but face challenges in lecture-style classes, and traditional office environments leading to marginalization in academic and professional settings. This study explores the neuroaffirming potential of extended reality (XR) in creating immersive learning and working environments tailored to the unique needs of individuals with ASC. By focusing on four key factors—indirect social engagement, digital communication preferences, sensory sensitivity, and avatar-based communication—XR technologies can provide a supportive and accommodating environment for those with sensory processing disorders (SPD). As the metaverse and virtual reality (VR) technology advances, education and industry can harness social VR to prepare students for a future of work defined by virtual collaboration. This research investigates the transformative role of XR and the metaverse in promoting a more inclusive educational and professional landscape by adapting environments to empower individuals with ASC, enabling them to reach their full potential in a neuroaffirmative manner

Using social robots to study abnormal social development

Social robots recognize and respond to human social cues with appropriate behaviors. Social robots, and the technology used in their construction, can be unique tools in the study of abnormal social development. Autism is a pervasive developmental disorder that is characterized by social and communicative impairments. Based on three years of integration and immersion with a clinical research group which performs more than 130 diagnostic evaluations of children for autism per year, this paper discusses how social robots will make an impact on the ways in which we diagnose, treat, and understand autism

A terapia de integração sensorial como facilitadora do desenvolvimento da inteligência emocional em crianças com perturbação do espectro autista e o papel das TIC

Sensory Integration Therapy (SIT) is a widely known and used intervention by a lot of professionals and practitioners in the field of special education as being an enabler of functionality of the child. Through intervention, the sensory processing components that have been affected are targeted. Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is highly affected by sensory modulation disorder (SMD), a special subcategory of sensory processing disorder (SPD) that is expressed in various ways causing activation of Autonomic Nervous System (ANS) leading to biological and physiological stress. Emotional Intelligence (EI) is a complex set of skills that drive us to higher mental states. According to theorists the basis of these skills is the ability to manage and regulate stimulus. The purpose of this literature review is to investigate the connections between SIT and EI in children with ASD. In the introduction basic definitions and concepts of ASD and SIT are analyzed and in the main part correlations between EI and SMD are made, discussing the effectiveness of SIT in ASD children.La Terapia de Integración Sensorial (SIT, por sus siglas en inglés) es una intervención ampliamente conocida utilizada por muchos profesionales y practicantes en el campo de la educación especial como facilitadora del funcionamiento infantil. A través de la intervención, los componentes del procesamiento sensorial que se han visto afectados son objeto de intervención. El Trastorno del Espectro Autista (TEA) es un trastorno del neurodesarrollo que se ve muy afectado por el Trastorno de Modulación Sensorial (SMD), una subcategoría especial del Trastorno del Procesamiento Sensorial (SPD) que se expresa de varias maneras, desencadenando la activación del Sistema Nervioso Autonómico (SNA) , lo que conduce a estrés biológico y fisiológico. La Inteligencia Emocional (IE) es un conjunto complejo de habilidades que nos llevan a estados mentales superiores. Según los teóricos, la base de estas habilidades es la capacidad de gestionar y regular los estímulos. El objetivo de esta revisión de la literatura es investigar los vínculos entre SIT y EI en niños con TEA. En la introducción se analizan las definiciones y conceptos básicos de TEA y SIT y, en su mayor parte, se realizan correlaciones entre IE y SMD, discutiendo la efectividad de SIT en niños con TEA.A Terapia de Integração Sensorial (SIT) é uma intervenção amplamente conhecida e utilizada por muitos profissionais e praticantes no domínio da educação especial como facilitadora da funcionalidade da criança. Através da intervenção, os componentes do processamento sensorial que foram afetados são alvo de intervenção. A Perturbação do Espectro do Autismo (PEA) é uma perturbação do neurodesenvolvimento muito afetada pela perturbação da modulação sensorial (SMD), uma subcategoria especial da perturbação do processamento sensorial (SPD) que se exprime de várias formas, provocando a ativação do Sistema Nervoso Autónomo (SNA), o que leva a um stress biológico e fisiológico. A Inteligência Emocional (IE) é um conjunto complexo de competências que nos conduzem a estados mentais mais elevados. De acordo com os teóricos, a base destas competências é a capacidade de gerir e regular os estímulos. O objetivo desta revisão da literatura é investigar as ligações entre os SIT e a IE em crianças com PEA. Na introdução, são analisadas as definições e os conceitos básicos de PEA e de SIT e, na parte principal, são feitas correlações entre a IE e o SMD, discutindo-se a eficácia do SIT em crianças com PEA