SoundFields: A Virtual Reality Home-Based Intervention for Auditory Hypersensitivity Experienced by Autistic Children

Abstract

Previous studies have shown that autistic people often display atypical responses when processing sensory information, with particular prevalence within the auditory domain. Often provoked by common everyday sounds, auditory hypersensitivity can result in self-regulatory fear responses. This can be potentially harmful to autistic individuals and the people around them and is associated with greater occurrence of anxiety, depression, and poorer overall quality of life in the autistic population. Rather than a physiological causation, the literature suggests that hypersensitivity to sound is likely to be caused by how auditory stimuli are processed in the brain. This paper reports a home-based digital intervention aimed to address auditory hypersensitivity in autistic children. Developed as an interactive virtual reality game, the system integrates exposure-based therapy techniques into game mechanics and delivers target auditory stimuli to the player rendered via binaural-based spatial audio. The performance of the platform was evaluated in a 10-week feasibility study, during which children (n = 7) engaged weekly with the game during a 30 min session. Following this period, a comparison of pre- and post-study measurements showed a decrease in sensitivity for five participants, with qualitative feedback highlighting an increase in tolerance towards real-world stimuli and challenging environments. These results provide initial support for SoundFields as a home-based intervention targeting auditory hypersensitivity experienced by autistic children.

Evaluating the Potential of Immersive Virtual Reality-Based Serious Games Interventions for Autism: A Pocket Guide Evaluation Framework

“…A systematic analysis of the literature on the topic [22] accompanied by a study of recent literature on this topic (e.g., [61][62][63][64][65][66][67][68]) revealed the presence of several methodological issues underpinning the evaluation process: it can be like a black hole since it does not produce rigorous scientific studies to show the efficacy of IVR-based SG interventions for ASD and in real-world applications of such intervention; the effectiveness is reduced [35,36]. Among these methodological issues, the need for a multidisciplinary team and the involvement of stakeholders in the evaluation process, although already addressed in the literature related to this field of research, remain unresolved [30,33,61,145].…”

“…Indeed, the following methodological criteria and sub-criteria result from the joining of the outcomes obtained in Peretti et al [22], the most recent referred references on the topic (e.g., [65][66][67][68]), and the most recent research articles describing IVR-based SG interventions for ASD (i.e., four articles: [61][62][63][64]). The deep study of these articles has also highlighted the same methodological issues, ranging from sample size to the lack of ethical committee approval.…”

“…Overall, it emerges that each of the methodological issues obtained by Peretti et al [22] (see Table 5) undermines the possibility of conducting a proper evaluation of IVR-based SG interventions for an ASD individual. This awareness prompted us to make a greater effort by combining such evidence with what is actually known in the literature on this topic (e.g., [61][62][63][64][65][66][67][68]) to transform these methodological issues into criteria that can be addressed systematically, thus enabling controlled evaluation. The result is the identification of six methodological criteria and their sub-criteria, as illustrated in the following section.…”

“…(i) It is the result of a rigorous research method related to planning, conducting, and inferring the results of a systematic review, i.e., Kitchenam's method [70]; (ii) Kitchenam's rigorous method [70] was, in our case, enriched by the study of recent literature on this topic (e.g., [61,[63][64][65][66]) and by the hard work conducted by a balanced multidisciplinary team of two psychologists with expertise in autism and research methodology and two ICT experts, especially in designing and developing IVR-based systems and SG; (iii) The indications or suggestions provided for addressing each of the six methodological criteria and their sub-criteria are supported by established scientific evidence. For example, it is known from the relevant scientific literature [60,113] that the diagnosis of ASD as well as the indication of the level of severity of the disorder should be by the Diagnostic and Statistical Manual of Mental Disorders-5th (DSM-5).…”

“…Nowadays, achieving this goal is not an easy task since there is a lack of evaluation guidelines that allow for avoiding or dealing satisfactorily with methodological issues. A detailed examination of the methodological issues that emerged from a previous systematic review [22] accompanied by a study of recent literature on this topic (e.g., [61][62][63][64][65][66][67][68]) leads us to identify methodological criteria for avoiding these issues in future evaluation processes. The term criterion (plural, criteria) refers to all the elements that allow a methodologically controlled study to be conducted [60,69].…”