Abstract
This study presents the findings of a systematic review of empirical research on the use of augmented reality (AR), virtual reality (VR), mixed reality (MR), and extended reality (XR) to present social skill instruction to school-age students with autism spectrum disorder (ASD). Forty-one articles met the inclusion criteria. Studies targeted relationship skills, emotion recognition, social awareness, cooperation, and executive functioning. The intervention caused statistical improvement in 15 of the 41 studies (37%). Practitioners, parents, and researchers reported significant improvement of social skills in 32 studies (83%). We suggest modifications to the technology and interventions within the technology which may increase statistical gains for students. We conclude with recommendations for researchers and practitioners implementing AR and VR delivered social skill interventions.
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References
*Adjorlu, A., Hoeg, E. R., Mangano, L., & Serafin, S. (2017). Daily living skills training in virtual reality to help children with autism spectrum disorder in a real shopping scenario. Paper presented at the 2017 IEEE International Symposium on Mixed and Augmented Reality (ISMAR-Adjunct). https://doi.org/10.1109/ISMAR-Adjunct.2017.93
*Alcorn, A., Pain, H., Rajendran, G., Smith, T., Lemon, O., Porayska-Pomsta, K., . . . Bernardini, S. (2011). Social communication between virtual characters and children with autism (Vol. 6738). https://doi.org/10.1007/978-3-642-21869-9_4
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub. https://doi.org/10.1176/appi.books.9780890425596.
*Bekele, 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. https://doi.org/10.1007/s10803-014-2035-8
Bellani, M., Fornasari, L., Chittaro, L., & Brambilla, P. (2011). Virtual reality in autism: State of the art. Epidemiology and Psychiatric Sciences, 20(3), 235–238. https://doi.org/10.1017/S2045796011000448.
*Bernardini, S., Porayska-Pomsta, K., & Smith, T. J. (2014). ECHOES: An intelligent serious game for fostering social communication in children with autism. Information Sciences, 264, 41-60. https://doi.org/10.1016/j.ins.2013.10.027
Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and Personality Psychology Compass, 8(2), 58–72. https://doi.org/10.1111/spc3.12087.
*Cai, Y., Chia, N. K., Thalmann, D., Kee, N. K., 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. https://doi.org/10.1109/TNSRE.2013.2240700
Campbell, D. T., & Stanley, J. C. (2015). Experimental and quasi-experimental designs for research. Ravenio Books.
Carreon, A., Smith, S. J., Mosher, M. A., Rao, K., & Rowland, A. (2020). A review of virtual reality intervention research for students with disabilities in K–12 settings. Journal of Special Education Technology, 0162643420962011.
Charlop-Christy, M. H., & Daneshvar, S. (2003). Using video modeling to teach perspective taking to children with autism. Journal of Positive Behavior Interventions, 5(1), 12–21. https://doi.org/10.1177/10983007030050010101.
*Chen, I. & Lin, L. Y. (2016). Augmented reality-based video-modeling storybook of nonverbal facial cues for children with ASD to improve their perceptions and judgments of facial expressions & emotions. Computers in Human Behavior, 55, 477-485. https://doi.org/10.1016/j.chb.2015.09.033
*Chen, J. L., Leader, G., Sung, C., & Leahy, M. (2015). Trends in employment for individuals with autism spectrum disorder: A review of the research literature. Review Journal of Autism and Developmental Disorders, 2(2), 115-127. https://doi.org/10.1007/s40489-014-0041-6
*Cheng, Y., & Ye, J. (2009). Exploring the social competence of students with autism spectrum conditions in a collaborative virtual learning environment–the pilot study. Computers & Education, 54(4), 1068-1077. https://doi.org/10.1016/j.compedu.2009.10.011
*Cheng, Y., Chiang, H. C., Ye, J., & Cheng, L. H. (2010). Enhancing empathy instruction using a collaborative virtual learning environment for children with autistic spectrum conditions. Computers & Education, 55(4), 1449-1458. https://doi.org/10.1016/j.compedu.2010.06.008
*Cheng, 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 ASD. Focus on Autism and Other Developmental Disabilities, 30(4), 222-236. https://doi.org/10.1177/1088357615583473
*Didehbani, 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. https://doi.org/10.1016/j.chb.2016.04.033
Garzón, J., & Acevedo, J. (2019). Meta-analysis of the impact of augmented reality on students’ learning gains. Educational Research Review, 27, 244–260. https://doi.org/10.1016/j.edurev.2019.04.001.
Gersten, R., Fuchs, L., Compton, D., & Coyne, M. (2005). Quality indicators for group experimental and quasi-experimental research in special education. Exceptional Children, 71(2), 149–164. https://doi.org/10.1177/001440290507100202.
Gresham, F. M., & Elliott, S. N. (2008). Social skills improvement system: Rating scales manual. NCS Pearson.
*Grynszpan, O., Martin, J.-C., & Nadel, J. (2008). Multimedia interfaces for users with high functioning autism: An empirical investigation. International Journal of Human Computer Studies, 66(8), 628-639. https://doi.org/10.1016/j.ijhcs.2008.04.001
*Halabi, O., Abou El-Seoud, S., Alja’am, J., Alpona, H., Al-Hemadi, M., & Al-Hassan, D. (2017). Design of immersive virtual reality system to improve communication skills in individuals with autism. International Journal of Emerging Technologies in Learning (iJET), 12(05), 50-64. https://doi.org/10.3991/ijet.v12i05.6766
*Herrera, G., Alcantud Marín, F., Jordan, R., Blanquer, A., Labajo, G., & Pablo, C. (2008). Development of symbolic play through the use of virtual reality tools in children with autistic spectrum disorders. Autism : the International Journal of Research and Practice, 12, 143-157. https://doi.org/10.1177/1362361307086657
Hew, K. F., & Cheung, W. S. (2010). Use of three-dimensional (3-d) immersive virtual worlds in k-12 and higher education settings: A review of the research. British Journal of Educational Technology, 41(1), 33–55. https://doi.org/10.1111/j.1467-8535.2008.00900.x.
Higgins, J. P., & Green, S. (2011). Cochrane handbook for systematic reviews of interventions (Vol. 4): John Wiley & Sons.
Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine, 49(4), 559–572. https://doi.org/10.1017/S0033291718002283.
Horner, R., Carr, E., Halle, J., & McGee, G. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71(2), 165–179. https://doi.org/10.1177/001440290507100203.
Howard, M. C., & Gutworth, M. B. (2020). A meta-analysis of virtual reality training programs for social skill development. Computers & Education, 144, 103707. https://doi.org/10.1016/j.compedu.2019.103707.
*Ip, H. H., Wong, S. W., Chan, D. F., Byrne, J., Li, C., Yuan, V. S., ... Wong, J. Y. (2016). Virtual reality enabled training for social adaptation in inclusive education settings for school-aged children with autism spectrum disorder (asd). Paper presented at the International Conference on Blended Learning. https://doi.org/10.1007/978-3-319-41165-1_9
*Ip, 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 ASD: A virtual reality enabled approach. Computers & Education, 117, 1-15. https://doi.org/10.1016/j.compedu.2017.09.010
*Jarrold, 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. https://doi.org/10.1002/aur.1302
*Ke, 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. https://doi.org/10.1080/00220671.2013.832999
*Ke, 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, 1-23. https://doi.org/10.1080/10494820.2015.1040421
*Kim, K., Rosenthal, M. Z., Gwaltney, M., Jarrold, W., Hatt, N., McIntyre, N., ... Mundy, P. (2015). A virtual joy-stick study of emotional responses and social motivation in children with autism spectrum disorder. J of Autism & Dev. Disorders, 45(12), 3891-3899. https://doi.org/10.1007/s10803-014-2036-7
Knapp, M., & Mandell, D. (2012). Inventing in our future: The economic costs of autism. Paper presented at Goldman Sachs in collaboration with the Child Development Centre and Autism Speaks.
Kurilovas, E. (2016). Evaluation of quality and personalisation of vr/ar/mr learning systems. Behaviour & Information Technology, 35(11), 998–1007. https://doi.org/10.1080/0144929X.2016.1212929.
*Lan, Y. J., Hsiao, I. Y., & Shih, M. F. (2018). Effective learning design of game-based 3d virtual language learning environments for special education students. Journal of Educational Technology & Society, 21(3), 213-227.
Ledford, J. R., & Gast, D. L. (Eds.). (2014). Single case research methodology: Applications in special education and behavioral sciences. Routledge.
*Lee, I. J., Chen, C.H., Wang, C. P., & Chung, C. H. (2018). Augmented reality plus concept map technique to teach children with asd to use social cues when meeting and greeting. The Asia-Pacific Education Researcher, 27(3), 227-243. https://doi.org/10.1007/s40299-018-0382-5
*Lorenzo, 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. https://doi.org/10.1016/j.compedu.2012.10.028
*Lorenzo, 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. https://doi.org/10.1016/j.compedu.2016.03.018
*Lorenzo, G., Gómez-Puerta, M., Arráez-Vera, G., & Lorenzo-Lledó, A. (2019). Preliminary study of augmented reality as an instrument for improvement of social skills in children with autism spectrum disorder. Education and Information Technologies, 24(1), 181-204. https://doi.org/10.1007/s10639-018-9768-5
Maggin, D. M., Talbott, E., Van Acker, E. Y., & Kumm, S. (2017). Quality indicators for systematic reviews in behavioral disorders. Behavioral Disorders, 42(2), 52–64. https://doi.org/10.1177/0198742916688653.
*Mantziou, O., Vrellis, I., & Mikropoulos, T. A. (2015). Do children in the spectrum of autism interact with real-time emotionally expressive human controlled avatars? Procedia Computer Science, 67, 241-251. https://doi.org/10.1016/j.procs.2015.09.268
Martin, J. (2019). Building relationships and increasing engagement in the virtual classroom: Practical tools for the online instructor. Journal of Educators Online, 16, 1–8. https://doi.org/10.9743/jeo.2019.16.1.9.
Merchant, Z., Goetz, E. T., Cifuentes, L., Keeney-Kennicutt, W., & Davis, T. J. (2014). Effectiveness of virtual reality-based instruction on students’ learning outcomes in k-12 and higher education: A meta-analysis. Computers & Education, 70, 29–40. https://doi.org/10.1016/j.compedu.2013.07.033.
Mikropoulos, T. A., & Natsis, A. (2011). Educational virtual environments: A ten-year review of empirical research (1999–2009). Computers & Education, 56(3), 769–780. https://doi.org/10.1016/j.compedu.2010.10.020.
Miller, H., & Bugnariu, N. L. (2016). Level of immersion in virtual environments impacts the ability to assess and teach social skills in autism spectrum disorder. Cyberpsychology & Behavior, 19(4), 246–256. https://doi.org/10.1089/cyber.2014.0682.
*Mitchell, P., Parsons, S., & Leonard, A. (2007). Using virtual environments for teaching social understanding to 6 adolescents with autistic spectrum disorders. Journal of Autism and Developmental Disorders, 37(3), 589-600. https://doi.org/10.1007/s10803-006-0189-8
*Modugumudi, 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. https://doi.org/10.1166/jmihi.2013.1167
*Moore, D., Yufang, C., McGrath, P., & Powell, N. J. (2005). Collaborative virtual environment technology for people with autism. Focus on Autism and Other Developmental Disabilities, 20(4), 231-243. https://doi.org/10.1177/10883576050200040501
*Parsons, 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. https://doi.org/10.1016/j.ijcci.2015.12.002
*Parsons, S., Mitchell, P., & Leonard, A. (2004). The use and understanding of virtual environments by adolescents with autistic spectrum disorders. Journal of Autism and Developmental Disorders, 34(4), 449-466. https://doi.org/10.1023/B:JADD.0000037421.98517.8d
*Parsons, S., Leonard, A., & Mitchell, P. (2006). Virtual environments for social skills training: Comments from two adolescents with autistic spectrum disorder. Computers & Education, 47(2), 186-206. https://doi.org/10.1016/j.compedu.2004.10.003
Plavnick, J. B., & Hume, K. A. (2014). Observational learning by individuals with autism: A review of teaching strategies. Autism, 18(4), 458–466. https://doi.org/10.1177/1362361312474373.
Radu, I. (2014). Augmented reality in education: A meta-review and cross-media analysis. Personal and Ubiquitous Computing, 18(6), 1533–1543. https://doi.org/10.1007/s00779-013-0747-y.
Rajendran, G. (2013). Virtual environments and autism: A developmental psychopathological approach. Journal of Computer Assisted Learning, 29(4), 334–347. https://doi.org/10.1111/jcal.12006.
Reed, F. D. D., Hyman, S. R., & Hirst, J. M. (2011). Applications of technology to teach social skills to children with autism. Research in Autism Spectrum Disorders, 5(3), 1003–1010. https://doi.org/10.1016/j.rasd.2011.01.022.
Reichow, B. (2011). Development, procedures, and application of the evaluative method for determining evidence-based practices in autism. In Evidence-based practices and treatments for children with autism (pp. 25-39): Springer. https://doi.org/10.1007/978-1-4419-6975-0_2
*Saadatzi, M. N., Pennington, R. C., Welch, K. C., & Graham, J. H. (2018). Small-group technology-assisted instruction: Virtual teacher and robot peer for individuals with autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(11), 3816-3830. https://doi.org/10.1007/s10803-018-3654-2
Sansosti, F., Doolan, M., Remaklus, B., Krupko, A., & Sansosti, J. (2015). Computer-assisted interventions for students with autism spectrum disorders within school-based contexts: A quantitative meta-analysis of single-subject research. Review Journal of Autism and Developmental Disorders, 2(2), 128–140. https://doi.org/10.1007/s40489-014-0042-5.
*Schmidt, M., Laffey, J., & Stichter, J. (2011). Virtual social competence instruction for individuals with autism spectrum disorders: Beyond the single-user experience.
Scribani, J. (2019). What is extended reality (xr). Visual capitalist, 16, 2019.
*Self, T., Scudder, R. R., Weheba, G., & Crumrine, D. (2007). A virtual approach to teaching safety skills to children with ASD. Topics in Language Disorders, 27(3), 242-253. https://doi.org/10.1097/01.TLD.0000285358.33545.79
Sheik-Ali, S., Edgcombe, H., & Paton, C. (2019). Next-generation virtual and augmented reality in surgical education: A narrative review. Surgical Technology International, 33.
Shih, C. H., Chang, M. L., Wang, S. H., & Tseng, C. L. (2014). Assisting students with autism to actively perform collaborative walking activity with their peers using dance pads combined with preferred environmental stimulation. Research in Autism Spectrum Disorders, 8(11), 1591–1596. https://doi.org/10.1016/j.rasd.2014.08.011.
National Autistic Society. (2016). About the campaign. Retrieved from National Autistic Society website, www.autism.org.uk
*Stichter, J., Laffey, J., Galyen, K., & Herzog, M. (2014). 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. https://doi.org/10.1007/s10803-013-1881-0
*Taryadi, B. R., & Kurniawan, I. (2018). The improvement of autism spectrum disorders on children communication ability with pecs method multimedia augmented reality-based. Journal of Physics: Conference Series, 947, 012009. https://doi.org/10.1088/1742-6596/947/1/012009
Tobin, M. C., Drager, K. D. R., & Richardson, L. F. (2014). A systematic review of social participation for adults with autism spectrum disorders: Support, social functioning, and quality of life. Research in Autism Spectrum Disorders, 8(3), 214–229. https://doi.org/10.1016/j.rasd.2013.12.002.
*Tsiopela, D., & Jimoyiannis, A. (2014). Pre-vocational skills laboratory: Development and investigation of a web-based environment for students with autism. Procedia Computer Science, 27, 207-217. https://doi.org/10.1016/j.procs.2014.02.024
*Wang, C., Hatzigianni, M., Shahaeian, A., Murray, E., & Harrison, L. J. (2016). The combined effects of teacher-child and peer relationships on children’s social-emotional adjustment. Journal of School Psychology, 59, 1-11. https://doi.org/10.1016/j.jsp.2016.09.003
*Wang, X., Xing, W., & Laffey, J. M. (2018). Autistic youth in 3D game-based collaborative virtual learning: Associating avatar interaction patterns with embodied social presence. British Journal of Educational Technology, 49(4), 742-760. https://doi.org/10.1111/bjet.12646
*Yuan, S. N. V., & Ip, H. H. S. (2018). Using virtual reality to train emotional and social skills in children with autism spectrum disorder. London journal of primary care, 10(4), 110-112.
Ziker, C., Truman, B., & Dodds, H. (2021). Cross reality (XR): Challenges and opportunities across the spectrum. Innovative Learning Environments in STEM Higher Education, 55.
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Mosher, M.A., Carreon, A.C., Craig, S.L. et al. Immersive Technology to Teach Social Skills to Students with Autism Spectrum Disorder: a Literature Review. Rev J Autism Dev Disord 9, 334–350 (2022). https://doi.org/10.1007/s40489-021-00259-6
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DOI: https://doi.org/10.1007/s40489-021-00259-6