Reducing Specific Phobia/Fear in Young People with Autism Spectrum Disorders (ASDs) through a Virtual Reality Environment Intervention A Randomised Controlled Trial of an Information Communication Technology Delivered Intervention for Children with Autism Spectrum Disorder Living in Regional Australia Avatar Assistant: Improving Social Skills in Students with an ASD Through a Computer-Based Intervention Anatomical differences in the mirror neuron system and social cognition network in autism. Improvement in Social Competence Using a Randomized Trial of a Theatre Intervention for Children with Autism Spectrum Disorder A systematic review of peer-mediated interventions for children with autism spectrum disorder. Use of Social Stories to Improve Self-Regulation in Children with Autism Spectrum Disorders Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study. Developmental Profiles of Infants and Toddlers with Autism Spectrum Disorders Identified Prospectively in a Community-Based Setting A Virtual Week study of prospective memory function in autism spectrum disorders. An Evaluation of a Mobile Application Designed to Teach Receptive Language Skills to Children with Autism Spectrum Disorder Early identification and intervention in autism spectrum disorders: Some progress but not as much as we hoped Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome. Neurofibromatosis Type 1 and Autism Spectrum Disorder Challenges in Evaluating Psychosocial Interventions for Autistic Spectrum Disorders
Anxiety is common in children with autism spectrum disorders ( ASD ) , with specific fears and phobias one of the most frequent subtypes . Specific fears and phobias can have a serious impact on young people with ASD and their families . In this study we developed and evaluated a unique treatment combining cognitive behaviour therapy ( CBT ) with graduated exposure in a virtual reality environment ( VRE ) .  Nine verbally fluent boys with an ASD diagnosis and no reported learning disability , aged 7 to 13 years old , were recruited . Each had anxiety around a specific situation ( e.g. crowded buses ) or stimulus ( e.g. pigeons ) . An individualised scene was recreated in our ‘ wrap-around ’ VRE . In the VRE participants were coached by a psychologist in cognitive and behavioural techniques ( e.g. relaxation and breathing exercises ) while the exposure to the phobia/fear stimulus was gradually increased as the child felt ready . Each child received four 20–30 minute sessions . After participating in the study , eight of the nine children were able to tackle their phobia situation . Four of the participants completely overcame their phobia . Treatment effects were maintained at 12 months . These results provide evidence that CBT with VRE can be a highly effective treatment for specific phobia/fear for some young people with ASD . Trial Registration Controlled-Trials.com IS RCT N58483069 This exploratory r and omised controlled trial tested the effectiveness of a tablet-based information communication technology early intervention application to augment existing therapy with the aim of improving visual motor , imitation , language and social skills in young children with ASD who reside in regional areas . Fifty-nine participants were recruited and r and omised to either a therapy-as-usual group or intervention group . With the exception of the expressive language subscale on the Mullen Scales of Early Learning , no significant between-group differences were recorded for visual motor , imitation , receptive language and social skills of participants between baseline and post-intervention . When all participants were pooled and measured over time , improvements were shown in receptive and pragmatic language and social skills ; these gains were maintained , thus suggesting skill acquisition This study assessed the efficacy of FaceSay , a computer-based social skills training program for children with Autism Spectrum Disorders ( ASD ) . This r and omized controlled study ( N = 49 ) indicates that providing children with low-functioning autism ( LFA ) and high functioning autism ( HFA ) opportunities to practice attending to eye gaze , discriminating facial expressions and recognizing faces and emotions in FaceSay ’s structured environment with interactive , realistic avatar assistants improved their social skills abilities . The children with LFA demonstrated improvements in two areas of the intervention : emotion recognition and social interactions . The children with HFA demonstrated improvements in all three areas : facial recognition , emotion recognition , and social interactions . These findings , particularly the measured improvements to social interactions in a natural environment , are encouraging Autism spectrum disorder ( ASD ) is a neurodevelopmental disorder associated with impaired social and emotional skills , the anatomical substrate of which is still unknown . In this study , we compared a group of 14 high-functioning ASD adults with a group of controls matched for sex , age , intelligence quotient , and h and edness . We used an automated technique of analysis that accurately measures the thickness of the cerebral cortex and generates cross-subject statistics in a coordinate system based on cortical anatomy . We found local decreases of gray matter in the ASD group in areas belonging to the mirror neuron system ( MNS ) , argued to be the basis of empathic behavior . Cortical thinning of the MNS was correlated with ASD symptom severity . Cortical thinning was also observed in areas involved in emotion recognition and social cognition . These findings suggest that the social and emotional deficits characteristic of autism may reflect abnormal thinning of the MNS and the broader network of cortical areas subserving social cognition The efficacy of a peer-mediated , theatre-based intervention on social competence  in participants with autism spectrum disorder ( ASD ) was tested . Thirty 8-to-14 year-olds with ASD were r and omly assigned to the treatment ( n = 17 ) or a wait-list control ( n = 13 ) group . Immediately after treatment , group effects were seen on social ability , ( d = .77 ) , communication symptoms ( d = −.86 ) , group play with toys in the company of peers ( d = .77 ) , immediate memory of faces as measured by neuropsychological ( d = .75 ) and ERP methods ( d = .93 ) , delayed memory for faces ( d = .98 ) , and theory of mind ( d = .99 ) . At the 2 month follow-up period , group effects were detected on communication symptoms ( d = .82 ) . The results of this pilot clinical trial provide initial support for the efficacy of the theatre-based intervention BACKGROUND Peer mediated intervention ( PMI ) is a promising practice used to increase social skills in children with autism spectrum disorder ( ASD ) .  PMIs engage typically developing peers as social models to improve social initiations , responses , and interactions . METHOD The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group design s. Five studies met the pre-specified review inclusion criteria : four r and omized controlled trials and one pre- and post-test design . RESULTS Four of the studies were conducted in school setting s , whereas one study was conducted in a camp setting . The studies all reported that participants improved in social skills ( e.g. , social initiations , social responses , social communication ) post intervention . Additionally , sustainment , generalization , and fidelity of implementation were examined . CONCLUSION PMI is a promising approach to address social skills in children with ASD , and this approach can be conducted in meaningful real-word context s , such as schools . Limitations of the studies as well as future directions are discussed ABSTRACT A multiple baseline across participants design was used to evaluate the effects of Social Stories to help preschool-aged children with characteristics of Autism Spectrum Disorders ( ASD ) increase their engagement in functional behaviors and use sensory integrative-based strategies to promote self-regulation . Three children , 3–5 years old , from a self-contained preschool classroom were selected to participate in the study . The intervention package included reading individualized Social Stories that discussed desired behaviors and self-regulation strategies . The research ers measured the percentage of intervals in which participants engaged in desired behaviors . The frequency of desired behaviors increased for all participants . The use of self-regulation strategies varied across participants . These findings suggest that the intervention was successful in increasing desired behaviors of the three children . Further research is recommended on the effectiveness of embedding sensory integrative strategies into Social Stories . Practitioners may consider the use of Social Stories as a tool to increase independence and encourage self-regulated behaviors in children with characteristics of ASD Youth with autism spectrum disorders frequently experience significant symptoms of anxiety .  Empirically supported psychosocial interventions exist , yet access is limited , especially for families in rural areas .  Telehealth ( i.e. videoconferencing ) has potential to reduce barriers to access to care ; however , little is known about the feasibility or efficacy of directly intervening with youth with autism spectrum disorders through this modality . This study details the pilot testing of a telehealth version of an empirically supported intervention targeting anxiety in youth with autism spectrum disorders . The primary focus of this study is on feasibility , with evaluation of outcomes as a starting point for future r and omized trials . In all , 33 families of youth with autism spectrum disorders and significant anxiety symptoms participated in this study ( Telehealth Facing Your Fears ( FYF ) Intervention : n = 17 ; Wait-list control : n = 16 ) . Youth of all functioning levels were included .  Acceptability was strong ; however , the usability of the technology was problematic for some families and impeded some sessions significantly . Fidelity of the telehealth version to the critical elements of the original , in vivo version was excellent . More work is needed to improve delivery of exposure practice s and parent coaching . Preliminary efficacy analyses are promising , with improvements observed in youth anxiety over time ( relative to a comparison group waiting for live intervention ) and parent sense of competence ( within group ) . Clearly , stronger design s are necessary to evaluate efficacy sufficiently ; however , this study does provide support for further investigation of clinic-to-home videoconferencing as a direct intervention tool for youth with autism spectrum disorders and their parents This study evaluated a manualized intervention for sensory difficulties for children with autism , ages 4–8 years , using a r and omized trial design . Diagnosis of autism was confirmed using gold st and ard measures . Results show that the children in the treatment group ( n = 17 ) who received 30 sessions of the occupational therapy intervention scored significantly higher ( p = 0.003 , d = 1.2 ) on Goal Attainment Scales ( primary outcome ) , and also scored significantly better on measures of caregiver assistance in self-care ( p = 0.008 d = 0.9 ) and socialization ( p = 0.04 , d = 0.7 ) than the Usual Care control group ( n = 15 ) . The study shows high rigor in its measurement of treatment fidelity and use of a manualized protocol , and provides support for the use of this intervention for children with autism . Findings are discussed in terms of their implication s for practice and future research Early intervention has been reported to improve outcome in children with autism spectrum disorders ( ASDs ) . Several studies in the field have been r and omized controlled trials ( RCTs ) . The aim of this study was to assess ASD outcome in a large naturalistic study . Two hundred and eight children , aged 20 - 54 months , with a clinical diagnosis of ASD were given intervention and monitored prospect ively in a naturalistic fashion over a period of 2 years . The toddlers were considered representative of all but the most severely multiple disabled preschool children with ASD in Stockholm county . They fell into three cognitive subgroups : one with learning disability , one with developmental delay , and one with normal intellectual functioning . Data on intervention type and intensity were gathered prospect ively in a systematic fashion . Intervention was classified into intensive applied behaviour analysis ( ABA ) and non-intensive , targeted interventions , also based on ABA principles . Children were comprehensively assessed by a research team before the onset of intervention , and then , again , 2 years later . Change in Vinel and adaptive behaviour scales composite scores from intake ( T1 ) to leaving the study ( T2 ) was set as the primary outcome variable . The research team remained blind to the type and intensity of interventions provided . One hundred and ninety-eight ( 95 % ) of the original sample s stayed in the study throughout the whole 2-year period and 192 children had a complete Vinel and composite score results both at T1 and T2 . Vinel and composite scores increased over the 2-year period . This increase was accounted for by the subgroup with normal cognitive functioning . There was no significant difference between the intensive and non-intensive groups . Individual variation was considerable , but no child in the study was " problem-free " at follow-up . Our data do not support that children with ASD generally benefit more from the most intensive ABA intervention programs than from less intensive interventions or targeted interventions based on ABA This prospect i ve , longitudinal , study charted the developmental profiles of young children with Autism Spectrum Disorders ( ASD ) identified through routine developmental surveillance . 109 children with Autistic Disorder ( AD ) , ‘ broader ’ ASD , and developmental and /or language delays ( DD/LD ) were assessed using the Mullen Scales of Early Learning ( MSEL ) at 12-months ( n = 10 assessment s ) , 18-months ( n = 45 assessment s ) , and 24-months ( n = 99 assessment s ) . The children with AD performed most poorly , overall , than the ASD and DD/LD groups on the MSEL . Furthermore , the children with AD/ASD displayed an uneven cognitive profile , with poorer performance on verbal ( particularly receptive language ) relative to nonverbal skills . There was also evidence of developmental slowing in verbal skills from 18- to 24-months for children on the spectrum , especially those with AD . Given that the poor receptive , relative to expressive , language profile emerges very early in life for children with AD/ASD , this cognitive profile may serve as an additional red flag to social attention and communication deficits . Receptive language should therefore be stringently monitored in any developmental surveillance program for autism spectrum disorders in the second year of life Prospect i ve memory ( PM ) refers to the implementation of delayed intentions , a cognitive ability that plays a critical role in daily life because of its involvement in goal -directed behavior and consequently the development and maintenance of independence . Emerging evidence indicates that PM may be disrupted in autism spectrum disorders ( ASDs ) , potentially contributing to the functional difficulties that characterize this group . However , the degree , nature , and specificity of ASD-related impairment remains poorly understood . In the current study , children between 8 and 12 years of age who were diagnosed with ASDs ( n=30 ) were compared with typically developing children ( n=30 ) on a child-appropriate version of the Virtual Week board game . This measure provides an opportunity to investigate the different sorts of PM failures that occur . The ASD group showed significant PM impairment on measures of time-based ( but not event-based ) prospect i ve remembering . However , only a subtle difference emerged between regular and irregular PM tasks , and group differences were consistent across these tasks . Because regular and irregular tasks differentially load retrospective memory , these data imply that the PM difficulties seen in ASDs may primarily reflect a monitoring deficit and not an encoding and memory storage deficit . PM performance was poorer under conditions of high ongoing task absorption , but the magnitude of this effect did not vary as a function of group . In both groups , time-based ( but not event-based ) PM difficulties were associated with functional outcomes in daily life , but only an inconsistent association with executive control emerged The current study evaluated the effectiveness of a mobile application , Camp Discovery , design ed to teach receptive language skills to children with autism spectrum disorder based on the principles of applied behavior analysis . Participants ( N = 28 ) were r and omly assigned to an immediate-treatment or a delayed-treatment control group . The treatment group made significant gains , p < .001 , M = 58.1 , SE = 7.54 , following 4 weeks of interaction with the application as compared to the control group , M = 8.4 , SE = 2.13 . Secondary analyses revealed significant gains in the control group after using the application and maintenance of acquired skills in the treatment group after application usage was discontinued . Findings suggest that the application effectively teaches the targeted skills Abstract Camarata 's ( 2014 ) review summarizes the progress that has been made in the field of early identification and early intervention in autism spectrum disorders ( ASD ) over the past few decades , but also provides a salutary reminder that much still needs to be done . Whilst it is possible to prospect ively identify cases of ASD using screening instruments ; it is critical that those using such screens in clinical practice underst and how to interpret data from published studies and consider how screening information is communicated to parents . After several decades when few r and omized controlled trials of early intervention in ASD were conducted , the last decade has seen an explosion of new studies . Despite initial optimism , as more trials are published they have highlighted the limits of , and challenges to , early intervention in ASD . Given the complex nature of ASD these sobering lessons are perhaps not surprising . Rather than promote despondency , they need to inspire and inform the next decade of clinical research to move the field forward to the benefit of young children with ASD and those who care for them This quasi-experimental study compared the effect of st and ard occupational therapy ( SOT ) and virtual reality using Wii gaming technology ( VRWii ) on children with Down syndrome ( DS ) . Children ( n = 105 ) were r and omly assigned to intervention with either SOT or VRWii , while another 50 served as controls . All children were assessed with measures of sensorimotor functions . At post-intervention , the treatment groups significantly outperformed the control group on all measures . Participants in the VRWii group had a greater pre-post change on motor proficiency , visual-integrative abilities , and sensory integrative functioning . Virtual reality using Wii gaming technology demonstrated benefit in improving sensorimotor functions among children with DS . It could be used as adjuvant therapy to other proven successful rehabilitative interventions in treating children with DS OBJECTIVE : To determine the prevalence of autism spectrum disorder ( ASD ) in Neurofibromatosis Type 1 ( NF1 ) . METHODS : Second-phase population -based epidemiologic study using an allcase NF1 registry in a defined UK 4.1 million population area . A total of 109 ( 52.7 % ) of 207 responders from the initial screening phase were grouped by using the parent-rated Social Responsiveness Scale ( SRS ) as significant ASD ( SRS≥76 ; n = 32 ) , moderate ASD ( SRS ≥ 60<76 ; n = 29 ) , or non-ASD ( SRS < 60 , n = 48 ) . Twenty-three cases from the significant ASD group , 16 from moderate ASD , and 8 from non-ASD ( total n = 47 ) , invited proportionately by r and om selection , were seen for detailed confirmatory ascertainment . Assessment s on Autism Diagnostic Interview-Revised , Autism Diagnostic Observation Scale-Generic , and verbal IQ were combined by using st and ard Collaborative Program for Excellence in Autism criteria into an ASD categorization for each case ( ASD , broad ASD with partial features , non-ASD ) . A preplanned weighted analysis was used to derive prevalence estimates for the whole population . RESULTS : Fourteen ( 29.5 % ) of 47 showed ASD , 13 ( 27.7 % ) broad ASD , and 20 ( 42.5 % ) non-ASD . The ASD/broad ASD group showed male predominance ( 1.7:1.0 ) , but did not differ significantly from the non-ASD group on IQ , age , socioeconomic status , inheritance , physical severity , or education . The population prevalence estimate is 24.9 % ASD ( 95 % confidence interval 13.1%–42.1 % ) and 20.8 % broad ASD ( 95 % confidence interval 10.0%–38.1 % ) ; a total of 45.7 % showing some ASD spectrum phenotype . CONCLUSIONS : Findings indicate high prevalence of ASD in NF1 , with implication s for clinical practice and further research into NF1 as a single-gene model for autism In 2002 , the National Institutes of Health sponsored a meeting concerning method ological challenges of research in psychosocial interventions in Autism Spectrum Disorders . This paper provides a summary of the presentations and the discussion s that occurred during this meeting . Recommendations to federal and private agencies included the need for r and omized clinical trials of comprehensive interventions for autism as the highest , but not the sole priority . Ongoing working groups were proposed to address psychosocial interventions with a focus on relevant statistics , st and ardized documentation and methods of diagnosis , development of outcome measures , establishment of st and ards in research ; and the need for innovative treatment design s , including application of design s from other research areas to the study of interventions in ASD
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
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 review ed the VR-based treatments in ASD , but they have an important limitation because they only use clinical data bases 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 data bases about the effectiveness of VR-based intervention in ASD .