Virtual Reality-based Safety Skills Training for Individuals in the Autism Spectrum

By Dr Silpaja Chandrasekar, PhDReviewed by Susha Cheriyedath, M.Sc.Jan 26 2024

In a paper published in the journal Behavioral Sciences, researchers examined the extensive use of virtual reality (VR) technology in safety skills interventions for individuals with autism spectrum disorder (ASD). The review, comprising 20 pertinent articles, highlighted the effectiveness of VR training for skills such as street-crossing, driving, bus riding, and air travel in ASD individuals.

The study emphasized assessing older, high-functioning individuals' suitability for more complex skills training using scales or questionnaires. While acknowledging VR's efficacy in safety skill training, the review identified a lack of conclusive evidence regarding the relationship between VR immersion levels and intervention outcomes. The paper also advocated for realistic VR settings and proposed future research avenues, particularly exploring adaptive models for personalized training in VR environments for individuals with ASD.

Related Work

Past research has extensively addressed ASD, a developmental condition with lifelong implications characterized by communication challenges, social impairments, and behavioral patterns. The Centers for Disease Control and Prevention (CDC) reported a prevalence increase to 2.8% in 2023, emphasizing the vulnerability of children with ASD to unintentional injuries. Safety skills training is crucial for this population, considering the heightened risk. Traditional methods face challenges in natural environments, prompting the exploration of VR as an alternative. VR interventions, though promising, present challenges such as the need for real-world application, potential discomfort, and limited personalized resources.

Criteria, Search, Screening, Coding

The materials and methods employed in this review included specific inclusion and exclusion criteria. The review focused on actively considering peer-reviewed articles published within the past ten years, precisely honing in on studies that actively diagnosed ASD using standardized tools and actively implemented VR interventions for individuals with ASD. They conducted an initial screening based on the title and abstract, excluding papers unrelated to VR and ASD, leaving 58 articles for comprehensive review. Researchers conducted an initial screening based on the title and abstract, excluding papers unrelated to VR and ASD. This process left 58 articles for comprehensive review. 

The second round of screening, based on detailed inclusion and exclusion criteria, resulted in 20 articles. The coding process involved topics, subject information, VR device details, immersion levels, intervention goals, skill maintenance, and intervention characteristics. The two authors resolved disagreements during the screening process through consultation and sought expert opinions.

VR Enhances Safety

The review results provide valuable insights into the application of VR for improving safety skills in individuals with ASD. The study examined four categories of safety skills—street-crossing, driving, air travel, and bus riding—emphasizing their significance in fostering independence and safety among individuals with ASD. Street-crossing skills, a crucial aspect of daily life, were addressed by 30% of the studies, employing VR interventions such as urban virtual environments and immersive scenarios to train individuals with ASD effectively. Additionally, 45% of the studies focused on driving skills, utilizing adaptive models within VR driving simulators and personalizing tasks to enhance training effects. Researchers also targeted air travel and public transportation skills in 10% and 15% of the studies.

The intervention subjects in the studies demonstrated a broad range, with inclusionary and exclusionary criteria ensuring the suitability of individuals with ASD for specific safety skill training. The age range of participants varied, spanning from younger age groups (4–12 years old) to older individuals (19–44 years old), reflecting the diverse needs within the ASD population. The majority of studies included subjects with high-functioning autism, with considerations such as language proficiency, attention maintenance, and absence of severe impairments.

The studies on VR applications for safety skills training in individuals with ASD revealed diverse immersion levels, ranging from immersive (head-mounted displays, VR cave automatic virtual environment (VR CAVE)) to semi-immersive (Microsoft Kinect) and non-immersive (desktop displays) environments. Researchers tailored the choice of VR devices to intervention goals and ASD characteristics. Immersive VR offered interaction advantages but raised concerns about sensory issues, while semi-immersive VR, like Microsoft Kinect, balanced interactivity and sensory considerations.

Using standard devices, non-immersive VR proved effective and user-friendly in specific scenarios—research methods involved comparative and single-subject designs, focusing on positive effects. Despite acknowledging the critical importance of skill generalization, it still needs to be explored, possibly due to safety concerns and varied evaluation approaches. Future research is encouraged to adopt rigorous experimental designs for a comprehensive understanding of VR intervention effectiveness, addressing the crucial aspect of skill generalization.

VR Training for ASD Safety

The review evaluated VR technology's effectiveness in training safety skills for individuals with ASD based on 20 research papers from 2013 to 2023. It highlighted the suitability of older, high-functioning individuals for complex skills training, especially in driving.

Researchers noted the positive impact of VR interventions on ASD safety skills, emphasizing the potential of immersive VR for older individuals. The discussion stressed the need for personalized interventions incorporating adaptive models based on physiological responses. While acknowledging VR's promise, the review suggested cautious use in younger ASD patients and recommended further research into tailored interventions and adaptive models.

Conclusion

To sum up, the review highlights the effectiveness of VR in safety skills training for individuals with ASD. The study emphasizes the importance of assessing participants' suitability for training based on age, functionality, and sensory considerations. VR interventions improved street-crossing, driving, air travel, and bus-riding skills.

The review suggests choosing high-functioning ASD individuals for specific training, considering age-appropriate VR devices, and focusing on personalized interventions. While noting positive outcomes, the evaluation identifies limitations in measurement methods, generalization assessments, and sample sizes. Future research should address safety skills training for low-functioning ASD individuals and explore diverse VR intervention models.