Psychiatric Live Animotion Intervention (PLAI) - Virtual Training for Preschool Children with Autism Spectrum Disorder

Background: Autism Spectrum Disorders (ASD) are considered incurable. Studies have found that early intervention is crucial for the development and prognosis, and the existing early interventions are often extensive and costly, or in-effective. Therefore, there is an urgent need for the development and application of efficacious and cost-effective interventions. Virtual reality (VR) paradigms can be empowering for children with ASD, because it may overcome some of the barriers experienced in face-to-face interaction with humans. However, the effect of VR is still sparsely explored in children with ASD.

Objectives: The objectives are to explore the feasibility and effect of the newly developed Psychiatric Live Animotion Intervention (PLAI) for preschool children with ASD.

Methods: A therapist puts on a motion-capture suit (Smartsuit Pro©, Rokoko) that registers every movement of his/her body and transfers them to an animated character on a computer. The animated character is streamed through the Internet to the child’s device at home and a live recording of the child is projected back to the therapist (Figure 1). It is hypothesized that the simplified and interesting playful universe may induce a greater level of social behavior and communication in children with ASD. Two boys with ASD, age 4 and 5, received 8 weeks of intervention with sessions twice a week (duration of 12-18 minutes). The treatment manual was developed with inspiration from Applied Behavior Analysis (ABA) and the Early Start Denver Model and consisted of eight activities that attempted to strengthen and encourage the use of both verbal and non-verbal communication, motor skills, social skills, and pretend play. The authors used a case study-design including both qualitative and quantitative data. The study explored the effectiveness of PLAI in improving behavioral, social and communicative outcomes in preschool children with ASD.

Results: The participants showed a significant improvement in therapist rated problem behavior (Test Observation Form, TOF) and vocalization after participating in PLAI (Table 1). Furthermore, the children’s vocabulary increased respectively with 5.5 % and 7.7 %. Significant improvements were seen in subscales on both parent and daycare rated problem behaviors (CBCL 1½-5 and C-TRF). No significant effects were found on ASD symptomatology (Social Responsiveness Scale 2^ndedition, SRS-2). Parents expressed great satisfaction with the intervention and reported improvements in their offspring’s greeting behavior, concentration level and communication skills. One of the parents stated “He has learned a simple thing such as how to wave goodbye. It is such a small thing, but still very important”. The other family emphasized the effect on communication skills “We think he has become much better at answering our requests. Previously we could ask him about the same thing five times and he would not respond. We think that could be a result of this intervention”.

Conclusions: These case studies support the feasibility of PLAI. The families had positive views on the intervention. Likewise, PLAI seems to have a potential impact on several verbal and behavioural measures both in and outside the intervention.