Improved Socio-Emotional and Behavioral Functioning in Students with Autism Following School-Based Smartglasses Intervention: Multi-Stage Feasibility and Controlled Efficacy Study

Abstract

Background: Students with Autism Spectrum Disorder (ASD) commonly demonstrate prominent social communication deficits, symptoms of attention-deficit/hyperactivity disorder, and chronic irritability. These challenges hinder academic progress and frequently persist despite educational, behavioral, and medical interventions. An assistive smartglasses technology may aid these individuals, especially if the technology is efficacious in ecologically-valid school settings. This study explored the feasibility and efficacy of Empowered Brain, a computerized smartglasses intervention designed as a socio-emotional behavioral aid for students with ASD. Methods: This two-part six-week study involved four school children with ASD from a public elementary school. The study incorporated an initial three-week feasibility stage followed by a three-week controlled longitudinal efficacy stage. Both stages involved the use of a twice-daily socio-emotional intervention with the smartglasses. Educators completed pre-intervention and post-intervention Aberrant Behavioral Checklist (ABC) ratings at the start of the feasibility stage, and weekly during the efficacy stage. Primary outcome measures were improvements in the ABC subscales of irritability, hyperactivity, and social withdrawal. Results: Students in both feasibility and efficacy stages demonstrated improvements (decreases) in irritability, hyperactivity, and social withdrawal compared to a baseline period and control periods, respectively. Participants in the controlled efficacy stage demonstrated decreased ABC subscale scores of 90% for irritability, 41.6% for hyperactivity, and 45.6% for social withdrawal. An intervention exposure-response improvement in irritability and hyperactivity was found during the efficacy stage. Educators rated the technology as superior or vastly superior compared to other assistive technologies. Conclusion: A substantial number of school children with ASD demonstrate chronic and impairing cognitive and behavioral challenges. This study provides evidence that Empowered Brain, a smartglasses-based socio-emotional aid for autism, is both feasible and efficacious in improving symptoms of social withdrawal, irritability, and hyperactivity in students with autism. The improvement is demonstrated as part of a longitudinal school-based intervention. Further studies involving larger samples and incorporation of randomized controlled trial methodology are underway to further elucidate the impact of this technology.

Exploring the Impact of Augmented Reality in Children and Adolescents with Autism Spectrum Disorder: A Systematic Review

“…This review analyzed and selected twenty studies [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. Thirteen were single subject designs [ 24 , 26 , 27 , 28 , 30 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 41 ]. Five of them were multiple baseline design [ 24 , 26 , 27 , 31 , 32 ], and seven were group design studies [ 25 , 29 , 33 , 34 , 35 , 42 , 43 ].…”

“…Regarding the gender of the sample, the total percentage of males was 65.8%. Furthermore, fifteen studies reported a clinical sample with an IQ > 70 [ 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 42 , 43 ], three studies reported a clinical sample with a low IQ (<70) [ 28 , 33 , 34 ], and two studies did not specify the IQ of the ASD participants [ 35 , 41 ]. All studies analyzed included augmented reality in their intervention process.…”

“…Regarding the technology used in the different interventions, three studies were carried out with a smartphone [ 28 , 34 , 42 ], six studies used smartglasses [ 30 , 36 , 38 , 39 , 41 , 43 ], and eleven studies used multiple devices (augmented reality device with screens and helmet, computer games, or computer tablets). In the study by Cihak et al [ 24 ], augmented reality application was downloaded onto an iPod and it allowed users to create an augmented reality experience by matching a user-created visual marker to trigger user-created digital content.…”

“…The main focus of most of the studies was on social interaction abilities ( n = 11, 55%), including social communication, social interaction tasks, motivation, or social engagement, with promising outcomes [ 30 , 31 , 32 , 34 , 35 , 36 , 38 , 39 , 40 , 41 , 42 ]. A total of three studies (15%) aimed to improve attention skills (selective and sustained attention, and reaction time) [ 28 , 29 , 37 ].…”

Can Academic Achievement in Primary School Students Be Improved Through Teacher Training on Emotional Intelligence as a Key Academic Competency?

“…In recent decades, there has been growing evidence of the importance of EI competency in primary school (Karavasilis et al, 2010;O'Rourke et al, 2010;Kopecki and Katavic, 2011;O'Connor, 2012;Pangiras et al, 2012;Baumeister et al, 2014;Barmpouti et al, 2015;Ferres et al, 2018). The new competencies needed for academic achievement in primary school are no longer exclusively academic (Aslam, 2018;Howard and Cogswell, 2018;Vahabzadeh et al, 2018;Vasilieva, 2018). Other types of skills such as EI and everything that EI implies (e.g., selfesteem, self-realization, emotional self-consciousness, positive relationships, empathy, and social responsibility) are also factors in academic achievement.…”