Virtual Reality for Autism Special Report: Research and Experiences

One of the wonderful aspects of virtual reality is the ability to experience presence through immersive story telling. In other words, to feel like you are actually there in your virtual environment and very much part of the story that is unfolding around you. This allows for creative imaginations to run wild and dream up some wonderful never before experienced scenarios. But what if we could use this technology to help understand reality more? What if we could help more of us appreciate how some people actually live on a day to day basis? A tool to transport us into how things that we consider to be basic everyday tasks but for others they may be challenging uncomfortable experiences. In a world where compassion and empathy seems to be a rare trait, how can we help ignite caring for other humans in a more profound way? Well, lets take an in-depth look at how virtual reality helps with this by shining a spotlight on VR for Autism.

I don’t have anybody in my immediate family who has been diagnosed with Autism but have many friends who have children who have been. I’m not an expert and actually, I don’t really know too much about it. From what I understand, old school stereotypes are not something that should be relied on. In fact, there seems to be a spectrum but individuals can have more or less of some conditions/symptoms than others. So there is a no one shoe that fits all. But what if you only know the stereotype symptoms? How full on do you know them? Do you really know them if you have never experienced them for yourself? Many symptoms of Autism are subject to perception and unless you are an individual with the condition then how can you possibly fully understand what it looks and feels like from an individual perspective? How can you then take an overview guesstimate of that and then dig beneath the layers to understand how those symptoms can flare up during certain triggers or how they impact going about your day to day responsibilities? The truth is that we can’t, really, not truly understand. We could raise our awareness by watching documentaries, listening to lectures, speaking with our friends and family with the condition but there’s still a gap between knowing the theory and experiencing it.

Autistic children using virtual reality. Source: edweek.org

That’s where virtual reality comes in. In this special edition blog I will take you through virtual reality Autism experiences, Autism VR apps, virtual reality research papers, Autism VR articles and more. I have taken a great deal of time to compile this information for you in the hope that it helps somebody out there in one way or another. Supporting the immersive industry and encouraging more humanitarian projects within the sector is something that I am personally passionate about. I have spend many years working on virtual reality for dementia with my company Pivotal Reality and I know how time consuming research can be. I published an article for the Springer Biomedical Series last year about VR Dementia use cases and the cost to buy that book shocked me. So much so that I wouldn’t even buy a copy for my family. Yes, I am aware that as a founder of a company, society may frown upon that opinion but I am remaining true to myself and my roots. I’m not in the business of ripping people off! I never have and I never will. That’s not me. I am therefore creating this blog so that this information is out there for free. If you have found this to be useful then perhaps you might like to sign up to my monthly newsletter or follow this blog to show your support but there’s no pressure to do that.

Autism VR Simulators

According to the National Autistic Society 99% of people in the UK have heard of Autism but only 16% of autistic people feel the public truly understands it.

Taken from The National Autistic Society

As I’ve already alluded to, the most powerful way to help people understand what Autism is like is through VR apps and experiences that are designed to put the user in the shoes of someone who has the condition. One of my all time favourite real world examples of this is a VR app called iSenseVR developed by Friendly Access, Glasgow School of Art and Crag3D. Their VR app is focused on allowing people who have Autism to prepare for a visit to Aberdeen International Airport in Scotland using gradual scenarios and exposure therapy with a view to reduce anxiety for attending the airport in real life. Its such a beautiful concept and allows the user to build up on the amount of stress & anxiety triggers that they are exposed to such as a hand dryer in the toilets, a broken cup at the cafe, security check process and waiting at the boarding gate. In addition to the virtual reality exposure therapy they then have the opportunity to try it out in the real world! Aberdeen International Airport was recreated exactly as is in real life so users who did have the chance to experience the VR app had the benefit of already knowing the layout of the building. They tested their work with a small group and published their findings here. In summary, they saw an enthusiasm amongst the participants who were actively engaged with the experience. However, there is further research to be carried out. This I imagine is due to the rigid location of users because they would need to test both the virtual experience as well as attend Aberdeen International Airport too so that the results can be conclusive. Plus you need to have a large group of participants, all of which would ideally have been diagnosed with Autism too. Not an easy task and something to consider yourself if you plan to design and implement a VR experience that is reliant on a real world location too. It’s very niche but I love it. I think it’s extremely heartwarming that Glynn Morris CEO of Family Access went ahead and created this app with the support of Dr Matt Poyade from Glasgow School of Art and Crag3D. How meaningful will it be for families within the area or those needing to travel to Aberdeen International Airport to have this amazing accessibility tool at the ready for them?!

Another example of a VR app that helps you to understand what it may be like living as someone who has Autism is The Autism Simulator created by Autismity. In this virtual reality experience you are exposed to how visuals and sounds can be distorted for those living with Autism. It appears to be an extreme experience and I’m not confident that I would recommend trying this out to anybody who has epilepsy. Having said that, it looks pretty powerful and definitely an experience that you will not forget in a hurry. I believe once you’ve tried it, you’ll always remember what it felt like to be in those shoes and would hope that understanding and compassion for autism will stay with you for life!

Available from the Oculus Store

Sadly, I struggled to find many more examples of virtual reality applications to share with you. Other than Evenness Sensory Space which is available from Oculus Store, Steam & Viveport but it is geared more towards senses in general. Then there’s also Jam Studio available on Steam & Viveport. Jam Studio is quite expensive but that’s because it includes other medtech experiences too. I’m not sure if you are able to buy the Autistic experience/chapter as a standalone purchase.

Autism 360° Videos (VR Simulators)

Don’t be disheartened as there are a number of 360° videos that you can view in VR. Easily the most accessible method of enjoying an app for purpose like these ones. You can access them via ANY VR headset through the browser or YouTube VR app from the various VR stores. Or you can use a smartphone, VR viewer (e.g. a specific smartphone VR Headset or even cardboard VR Glasses would do the job) and view the 360° from YouTube. You should know that the quality of VR experience using Smartphones is such a basic level of what is available on today’s VR market. You should also be warned that VR sickness using these smartphone options is pretty high.)

Although the ultimate VR experience should be photo-realistic virtual reality graphics to allow for the most ‘believable’ experience, I do think there is still a place for 360° videos in the industry, regardless of their quality. How else are we going to experiment and explore new mediums to help society appreciate all members of our community? Nobody wants to put their foot in it, nobody wants to be rude, nobody wants to say/do anything offensive by mistake and nobody wants that awkwardness of not knowing what to say or do when faced with the unknown. Knowledge is power but experiencing is human. So even if it’s a big challenge to help us experience real world scenarios, I have massive respect for those who push the boundaries forward and at least try new things to help us improve as human beings. So 360° videos has earned their place in this Virtual Reality for Autism Special Report: Research and Experiences!

The National Autistic Society produced a 360° video called Too Much Information to help show what Autism can be like too. Warning: this video contains flashing lights, bright colours and sudden loud sounds. Their website states that they have helped over 56 million people experience “first hand” what Autism can be like. So don’t underestimate the power of 360° video, it would be interesting to see the numbers of those who have tried the virtual reality applications at the start of this report for a comparison. But I think it would be safe to say that 360° video is still the most accessible method to reach a larger audience. When you are working on something that ultimately is helping society as well as giving a voice to those with invisible disabilities then it should not be ignored.

Caution: Flashing lights, bright colours, loud and sudden noises. I would also add that it can be a difficult watch especially if watched via a virtual reality headset.

The Counselling Directory have uploaded a lovely video of some reactions to this experience which I think you may also like to see from a research perspective. In fact, we all would benefit from viewing. It would be lovely to be mindful of accessibility and understanding when we are creating new products or services or even for every day interactions that we may come across.

User reactions to The National Autistic Society’s Too Much Information VR Autism experience. Source: Counselling Directory via YouTube

The BBC made Creating a Positive Environment project (CAPE) to raise awareness of the struggles that people with neurodivergent conditions (Autism, ADHD, Asperger’s etc) have to overcome within a workplace environment. Caution: this video also shows flashing and strobe lighting.

The Guardian created The Party: A Virtual Experience of Autism. A 360° video where you follow the story of 16 year old Layla who has been recently diagnosed with Autism. Layla’s is attending a family birthday party and this film immerses us in what that looks and feels like from her perspective. It’s a lovely story and beautifully made. The Guardian had input from various Autism experts & foundations to ensure their effects were reflected accurately too. You can also access this experience via Oculus Video app from the Oculus Store.

More VR Autism Use Cases

Now that we have taken some time to look at both virtual reality and 360° videos that act as Autism Simulators, let’s move on to see how else VR is being used for Autism in other meaningful ways. Virtual Reality is a compelling medium for training solutions because of its simulation ability, storytelling delivery and emotional connectivity all whilst trainees are directly immersed within that virtual experience without distraction. It’s no surprise that virtual reality users report that they are more likely to remember content from within a virtual reality learning space than they would from more traditional teaching methods.

Training

There was a terrible incident happened in 2016 when a man with Autism had been shot at 3 times by a US Police Officer after mistaking a silver toy truck he was holding as a weapon. The shots missed the Autistic man but his caretaker was wounded. Experts have said that some people with Autism may not know how to react to a police encounter with some looking away or not doing what they have been asked to do. This may be perceived as being defiant or resistant to the demands of the police.

After hearing about this, The Children’s Hospitals for Autism Research wanted to help kids and adults with Autism understand what it would be like to have a sudden encounter with the police. By even exposing them to the words that are commonly used or how the presence of the virtual experience would feel would all go towards preparing the user for a real world encounter, should that ever happen. The app was created by a company called Floreo and they have published a whole load of different VR Autism Research papers on their website. Here’s the related related research publication for this particular VR experience. The following clip was taken from a 6abc.com broadcast:

There’s another VR police for Autism experience made by Axon that uses 360° video as a virtual reality Autism police training experience to help people to understand more about people with Autism, how they can behave, interact and with the goal to raise awareness with their police forces whilst keeping innocent citizens safe.

Video from apnews.com

Research

You have to remember that virtual reality for Autism is such a niche area and it can be challenging to move the needle because the medium is relatively new compared to traditional methods. However, despite that, there is a vast amount of research, articles and video evidence of how impactful virtual reality is for people with Autism. Let’s show you some highlights below.

Therapeutic

Watch the WIONews video below to see for yourself the impact using virtual reality experiences has on children with strong to severe Autism. In summary, the observations are that the children are engaged with their virtual experiences. We hear from both parent and professional practitioner perspectives and conclude that this technology is absolutely making a difference to these children.

Lets go back to Floreo for another one of their cracking videos that show you an observers perspective of what VR is capable of doing in terms of engagement, language improvement, calmness, behavioural and so much more. All from a 5 minute or so virtual reality app experience. That’s it. (For quickness, jump to 4 mins 21 secs)

Freethink video of Floreo VR for Autism (Play from 4 mins 21 secs to jump to example of results)

You would be forgiven after reading this Virtual Reality for Autism Special Report to think that in order to strike any meaningful impact you must have a bespoke customised VR application. Not true 🙂 I came across a lovely YouTube video by Justin & Nick that shows you otherwise. We watch as Nolan tries VR for the first time through a variety of consumer applications like Job Simulator, Google Tiltbrush, Space Pirate Trainer etc. Nolan’s reactions are endearing and shows that although a little awkward, the use of controllers is also possible for him so perhaps others with Autism too. I know from my research that elderly people and those living with dementia struggle with the controllers too so I tend to focus on that user pain point more than most people. The conclusion is that consumer virtual reality is also an option here too. And like Nolan says at the end of this video, you should “Try it”.

Source: YouTube Channel, Justin & Nick – My Autistic Brother Nolan Tried HTC Vive

Useful Research Papers

VR Used to Teach Driving Lessons to People with Autism

VR Training for Public Speaking for People with Autism

Autism and Virtual Reality Headsets

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

Did I miss anything?

Thanks for reading this far! If you know about any virtual reality applications or experiences that are geared towards Autism then please get in touch to let me know. If you are working on something within this area then I would love to hear from you and learn more.

I am passionate about the virtual reality industry and want to concentrate my efforts on shining a light on those pioneers who are investing their time to help shape the landscape. Let me help you reach the eyes and ears of those who are hungry to learn about you. Have a virtual reality related product and want to advertise here? Get in touch.

What topic do you want a deep dive on next? I will be working on further blog posts but tell me what you are curious to learn more about and I will add your needs to my list.

Don’t forget to follow this blog to read more interesting use cases of virtual reality!

Take care & keep healthy
Suzanne

Suzanne Showcasing VR latest product review video – Kiwi Design 5 in 1 VR Face Cover Set for Oculus Quest

Phenomenal Results When Using Virtual Reality for Dementia

I created this blogging site a few years ago to capture news, relevant immersive growth and my own musings of the industry. As we approach the end of another year I thought I should share my own personal learning with you. I set up Pivotal Reality Ltd 2 years ago and my main aim was to explore using virtual reality with people who are living with dementia. VR is a powerful medium that transports people to another place and potentially another time too. I was curious whether I could do good with this technology that I loved and help others at the same time. If you are a new startup or are curious to hear more about how this all came about then take a moment to read Lenovo StoryHub: Restoring Memories Frontiers of Treating Dementia with VR.

I’ve been volunteering in care homes and have so much to share with you but the main headlines are that VR is simply amazing in this setting. Initially I was concerned about whether anybody would want to try the headset or whether they may be put off. My experience is that the majority jump right in, others need a little reassurance by seeing a casting livestream before trying it (something we didn’t even have when I started on this journey but thankfully things are much simpler these days!) and a tiny proportion refused due to medical conditions (eg severe vertigo & eye conditions). Before starting I would advise to adhere to the headset manufacturers health and safety advice and explore compatibility. As a side note, if you are unsure about the VR headset market for elders or people living with dementia then get in touch – although anything that doesn’t require a mobile phone is more than adequate. Mobile phone VR can cause nausea and is extremely outdated in terms of where we are at with the technology today. In all of my sessions I have asked that people remain seated and I avoid swivel chairs and wired headsets for the obvious health and safety concerns. It goes without saying but permanent supervision is a must too. Industry standards is an area that my good friend, David De Jong and I are working together on. David has been focusing on the training side of elder care in care homes with Patyna. Hopefully we will have more to share on this topic soon.

Virtual Reality for dementia

The Research

Believe it or not there is an ever growing catalogue of research papers into this niche area of MedTech. There’s also a lot of research into specific areas that I was interested in – for me my themes are ‘immersive reminiscence’ (VR that promotes improved memory), immersive meditation/mindfulness and combatting loneliness. Meaning that I could study broader areas of virtual reality research papers & use cases to draw parallels for my own work. I would caution that you pay attention to the number of subjects involved in the scenarios and warn that sometimes the conclusions are confusing! As a non-academic myself the lack of plain English and sometimes the actual outcome being unclear was frustrating. I’m thinking about creating a list of all the research papers I’ve found useful and wondered if making these available via email would benefit anyone? I want to be able to help others by saving time so they don’t have to spend the hours that I have to just sift through the vast amounts of research papers to find those most relevant. You can get in touch and let me know if that would be useful at all.

Proud as punch holding my published chapter ‘A Showcase of Medical, Therapeutic and Pastime Uses of Virtual Reality (VR) and How (VR) Is Impacting the Dementia Sector’ in the Biomedical Visualisation Volume 3 from the Springer series.

Part of this incredible story is that I wrote a chapter for a Springer series book that was published. To others that might seem normal but in my world, this is simply unheard of. I’m incredible proud of myself and as cheesy as it sounds I consider it one of my ultimate life achievements, I seriously do. The book is priced out of my own price range so I have one precious copy that is shared around family members to read… ha! Madness but a true story. The chapter itself was detailing all of my market research when scouting the industry for use cases for VR & dementia. There are so many angles to approach how you can use this technology for this problem. There’s also a handful of amazing trailblazers who are building the paths for others to follow. But there is room for you and so many others so do not be put off by other players. We have an Ageing population across the globe thanks to medical advances (hooray!) but we still haven’t found a cure for Dementia. Until we do, I think it’s important to reach as many people living with the disease to help do what we can to help improve their quality of life. Yes, even a 15 minute VR session can make all the difference to someone.

My Findings

The impact of using virtual reality with pretty much anyone is an instant reaction and the same goes with someone who is living with dementia too. It’s transformational and I would argue even more so when you place the headset on an elderly person. Kids get VR, they just get it and its natural for them to look around, walk around and just get on with it. Its not quite a natural for people living in a care home environment. You need to remind most people to look around with their head because most will only look around the place using only their eyes. Especially so when its their 1st time using the technology.

The phenomenal power of VR that I have been part of or observed

The picture above shows the phenomenal drops in the ocean that I have witnessed. There are many others I can share such as an artist sitting enjoying the mesmerising colours within VR environments for an extended period of time. Others being ecstatic about experiencing things they never thought possible. You need to see it to believe it and I urge you to let your nearest & dearest experience it to see the outcomes for yourself! Its one of the most endearing activities I’ve ever done.

What’s next?

For Pivotal Reality, I’m going to be exploring building content. We already have a VR environment but I want to fill it with meaningful content from my design & experiences research. It’s a bit of a long game for me personally as I venture into the world of Unity and coding ideas for the 1st time. I’m also exploring hand tracking more closely because controllers are a barrier presently – especially for those with limited hand functionality & grip. Oculus have released their Hand Tracking update so I plan to explore that as well as play around with the Leap Motion (now Ultra Leap) sensor. There is a lack of tailored content that meets the needs of those living with dementia or indeed for the elderly population which needs addressed too.

Sadly, the value of bringing ‘joy’ and ‘meaning’ or ‘therapeutic outlet’ to people doesn’t quantify a strong ‘return of investment’ or solid business model especially because it can be difficult to ‘scale’ – at least as far as I have discovered. I joined the Transformative Technology Academy to try and learn from others who are innovating with new technologies to help improve humanity. Common sense tells us that it is harder to be one of the 1st when trying to navigate uncharted waters. However, I’m passionate about this technology and will endeavour to continue exploring this area whilst improving my skills in this industry.

Thanks for reading about my work and feel free to get in touch.