Virtual Conversation Partner for Adults with Autism

Autistic Spectrum Disorder (ASD) is notable for severely impaired reciprocal social interaction skills relative to language and intellectual abilities, presenting a major barrier to social integration and vocational success. Evidence-based interventions to address these needs are lacking. We report on the development of a small, prototype conversation simulation to teach conversational skills to adolescents and adults with ASD and average to superior intellectual abilities. We also report on a test of the feasibility and acceptability of the simulation approach with a sample of the target population. The simulation engages the user in a virtual conversation with an on-screen partner whose reactions provide naturalistic feedback geared to the appropriateness of the learner's response choices. The prototype simulation, which provides for up to 12 potentially unique multi-turn conversations, was used over a period of 2 weeks by 16 adolescents and adults who then rated statements about the system on a linear scale of 1 (disagreement) to 5 (high agreement). The participants highly endorsed the majority of positive statements about the quality and credibility of the interaction and the virtual conversation partner. In contrast, agreement with positive statements about instructional features external to the conversation was moderate. Unexpectedly, most participants strongly agreed that using the simulation had been helpful to them. Further development and testing in the context of a controlled study with randomized assignment to control and experimental groups are needed to determine whether this approach is effective in improving real-world pragmatic language behavior of high-functioning adults with ASD.

[1]  M. Sigman,et al.  Social deficits and interpersonal relationships in autism , 1998 .

[2]  Aubyn C. Stahmer,et al.  Early Intervention Practices for Children With Autism: Descriptions From Community Providers , 2005, Focus on autism and other developmental disabilities.

[3]  S Baron-Cohen,et al.  The development of a theory of mind in autism: deviance and delay? , 1991, The Psychiatric clinics of North America.

[4]  S. Baron-Cohen,et al.  Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia , 2006, Development and Psychopathology.

[5]  E. Keenan Dimensions in Sociolinguistics , 1975, Language in Society.

[6]  E. Grigorenko Pathogenesis of autism: a patchwork of genetic causes. , 2009, Future neurology.

[7]  Gerry Leisman,et al.  Autistic Spectrum Disorders as Functional Disconnection Syndrome , 2009, Reviews in the neurosciences.

[8]  E. Fombonne Epidemiological Surveys of Autism and Other Pervasive Developmental Disorders: An Update , 2003, Journal of autism and developmental disorders.

[9]  Victoria Shea,et al.  Adolescents and Adults with Autism , 2005 .

[10]  M. Sigman,et al.  Continuity and change from early childhood to adolescence in autism. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[11]  N. Minshew,et al.  Neuropsychologic functioning in autism: Profile of a complex information processing disorder , 1997, Journal of the International Neuropsychological Society.

[12]  C. Dissanayake,et al.  Autism Spectrum Disorders in Infancy and Toddlerhood: A Review of the Evidence on Early Signs, Early Identification Tools, and Early Diagnosis , 2009, Journal of developmental and behavioral pediatrics : JDBP.

[13]  S. Baron-Cohen,et al.  Using Assistive Technology to Teach Emotion Recognition to Students With Asperger Syndrome , 2007 .

[14]  S. Baron-Cohen Autism: The Empathizing–Systemizing (E‐S) Theory , 2009, Annals of the New York Academy of Sciences.

[15]  Y. Kawamura,et al.  Reevaluating the incidence of pervasive developmental disorders: Impact of elevated rates of detection through implementation of an integrated system of screening in Toyota, Japan , 2008, Psychiatry and clinical neurosciences.

[16]  Marsha Mailick Seltzer,et al.  Peer Relationships and Social and Recreational Activities Among Adolescents and Adults with Autism , 2004, Journal of autism and developmental disorders.

[17]  Janet E. Lainhart,et al.  Overrepresentation of mood and anxiety disorders in adults with autism and their first‐degree relatives: what does it mean? , 2008, Autism research : official journal of the International Society for Autism Research.

[18]  J. Matson,et al.  Social-Skills Treatments for Children With Autism Spectrum Disorders , 2007, Behavior modification.

[19]  S. Folstein,et al.  Infantile autism: a genetic study of 21 twin pairs. , 1977, Journal of child psychology and psychiatry, and allied disciplines.

[20]  P Howlin,et al.  Autism and developmental receptive language disorder--a follow-up comparison in early adult life. II: Social, behavioural, and psychiatric outcomes. , 2000, Journal of child psychology and psychiatry, and allied disciplines.

[21]  A. Couteur,et al.  Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders , 1994, Journal of autism and developmental disorders.

[22]  A. Avramides Studies in the Way of Words , 1992 .

[23]  S. Rogers,et al.  Evidence-Based Comprehensive Treatments for Early Autism , 2008, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[24]  D. Penn,et al.  Brief Report: Feasibility of Social Cognition and Interaction Training for Adults with High Functioning Autism , 2008, Journal of autism and developmental disorders.

[25]  C. Trepagnier A Possible Origin for the Social and Communicative Deficits of Autism , 1996 .

[26]  Sarah Parsons,et al.  The Use and Understanding of Virtual Environments by Adolescents with Autistic Spectrum Disorders , 2004, Journal of autism and developmental disorders.

[27]  Skye McDonald,et al.  An Exploration of Causes of Non-Literal Language Problems in Individuals with Asperger Syndrome , 2004, Journal of autism and developmental disorders.

[28]  P. Mitchell,et al.  Using Virtual Environments for Teaching Social Understanding to 6 Adolescents with Autistic Spectrum Disorders , 2007, Journal of autism and developmental disorders.

[29]  Michael Halliday,et al.  Explorations in the functions of language , 1973 .

[30]  U. Frith,et al.  The Weak Coherence Account: Detail-focused Cognitive Style in Autism Spectrum Disorders , 2006, Journal of autism and developmental disorders.

[31]  Christopher Gillberg,et al.  Autism in adults: symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. , 2007, Journal of child psychology and psychiatry, and allied disciplines.

[32]  A. Mack,et al.  Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, United States, 2006 , 2011 .

[33]  S. Bryson,et al.  Brief Report: Pragmatic Language in Autism Spectrum Disorder: Relationships to Measures of Ability and Disability , 2009, Journal of autism and developmental disorders.